The Ear Book: A Complete Guide to Ear Disorders and Health

272 Pages·2017·3.25 MB·English

by  Thomas J. Balkany

THE EAR BOOK
A Johns Hopkins Press Health Book
Thomas J. Balkany, MD, FACS, FAAP, is Hotchkiss Professor and Chairman
Emeritus, Department of Otolaryngology, and formerly Professor of
Neurological Surgery and Pediatrics, University of Miami Miller School of
Medicine. Dr. Balkany is board certified by the American Board of
Otolaryngology in Otolaryngology as well as in Neurotology. He has published
four books and over two hundred fifty scientific papers, and he holds fourteen
US and international patents. His research has been supported by the National
Institutes of Health, and he was a panelist of the US Food and Drug
Administration. Dr. Balkany has served on the editorial boards of eleven indexed
peer-reviewed journals and was an associate editor of Audiology and
Neurotology. He has also acted as a senior examiner of the American Board of
Otolaryngology and is currently Director, Institute for Cochlear Implant
Training, where he teaches advanced surgical techniques in cochlear implant
surgery.
Kevin D. Brown, MD, PhD, is Associate Professor of Otolaryngology and
Neurosurgery at the University of North Carolina School of Medicine. He is also
the medical director of the Children’s Cochlear Implant Center at the University
of North Carolina, the largest pediatric implant program in the United States. He
is Board Certified in Otolaryngology and Neurotology. He has been published in
numerous clinical and scientific papers and has written chapters for several
textbooks. He serves as an examiner for the American Board of Otolaryngology
and is on the Editorial Board of the major journal for clinical ear research,
Otology and Neurotology.
THE EAR BOOK
A Complete Guide to Ear Disorders and Health
Thomas J. Balkany, MD, FACS, FAAP
Kevin D. Brown, MD, PhD
Note to the Reader: This book is not meant to substitute for medical care and treatment should not be based
solely on its contents. Instead, treatment must be developed in a dialogue between the individual and his or
her physician. Our book has been written to help with that dialogue.
Drug dosage: The author and publisher have made reasonable efforts to determine that the selection of
drugs discussed in this text conform to the practices of the general medical community. The medications
described do not necessarily have specific approval by the US Food and Drug Administration for use in the
diseases for which they are recommended. In view of ongoing research, changes in governmental
regulation, and the constant flow of information relating to drug therapy and drug reactions, the reader is
urged to check the package insert of each drug for any change in indications and dosage and for warnings
and precautions. This is particularly important when the recommended agent is a new and/or infrequently
used drug.
© 2017 Thomas J. Balkany and Kevin D. Brown
All rights reserved. Published 2017
Printed in the United States of America on acid-free paper
9 8 7 6 5 4 3 2 1
Johns Hopkins University Press
2715 North Charles Street
Baltimore, Maryland 21218-4363
www.press.jhu.edu
Library of Congress Cataloging-in-Publication Data
Names: Balkany, Thomas J. | Brown, Kevin D. (Kevin David)
Title: The ear book: a complete guide to ear disorders and health / Thomas J. Balkany, MD, FACS, FAAP,
and Kevin D. Brown, MD, PhD.
Other titles: Complete guide to ear disorders and health
Description: Baltimore: Johns Hopkins University Press, 2017. | Series: A Johns Hopkins Press health book
| Includes bibliographical references and index.
Identifiers: LCCN 2016040194| ISBN 9781421422848 (hardcover: alk. paper) | ISBN 9781421422862
(pbk.: alk. paper) | ISBN 9781421422862 (electronic) | ISBN 1421422840 (hardcover: alk. paper) | ISBN
1421422859 (pbk.: alk. paper) | ISBN 1421422867 (electronic)
Subjects: LCSH: Otology—Popular works. | Ear—Diseases—Popular works. | Hearing disorders—
Diagnosis—Popular works. | Hearing disorders—Treatment—Popular works.
Classification: LCC RF123 .B245 2017 | DDC 617.8—dc23 LC record available at
https://lccn.loc.gov/2016040194
A catalog record for this book is available from the British Library.
Figures 1.1, 1.2, 1.3, 4.1, 5.1, 8.1, 9.1, 9.2, 10.1, 12.1, 13.1, 13.2, 14.1, 15.1, 18.1, 19.1, 20.1, and 29.1 are
by Jane Whitney.
Special discounts are available for bulk purchases of this book. For more information, please contact
Special Sales at 410-516-6936 or [email protected].
Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper
that is composed of at least 30 percent post-consumer waste, whenever possible.
To my family—Diane, Jordan, and Sarah Balkany
—TJB
To my wife, Nicole, and our three sons, Luke,
Gabriel, and Ethan
—KDB
Contents
Preface
I | Understanding Your Ears
1 How the Ear Works
2 Ear Symptoms: What Do They Mean?
3 Common Myths about the Ear
II | Common Ear Problems
4 Otitis Media
5 An Overview of Hearing Loss
6 Hearing Loss in Children
7 Age-Related Hearing Loss
8 All about Hearing Aids
9 All about Cochlear Implants
10 Dizziness and Vertigo
11 Tinnitus: Ringing in the Ears
III | Disorders of the Outer Ear
12 Swimmer’s Ear
13 Ear Wax and Foreign Bodies
14 Malformations of the Outer Ear
15 Bony Growths of the Ear Canal
16 Cancer of the Outer Ear
17 Trauma: Cauliflower Ear
IV | Disorders of the Middle Ear
18 Perforated Eardrum and Tympanoplasty
19 Otosclerosis and Stapedotomy
20 Mastoiditis and Cholesteatoma
V | Disorders of the Inner Ear
21 Ménière’s Disease
22 Noise-Induced Hearing Loss
23 Sudden Deafness and Autoimmune Disease
24 Ototoxic Drugs
25 Acoustic Neuroma and Other Tumors
VI | Other Things You Should Know
26 Hearing and Balance Tests
27 The Ear and Scuba Diving
28 Airplane Ear
29 Bell’s Palsy and the Facial Nerve
30 The Future: Gene Therapy and Stem Cell Therapy of the Ear
Appendix 1. Commonly Used Ear Medications and Their Side Effects
Appendix 2. Organizations Offering Information, Support, and Advocacy
Glossary
References
Index
Preface
The importance of any organ system of the human body is related to how often it
must be addressed by health care professionals. The most common illness
requiring a prescription from the pediatrician, the most common operation
performed on children, and the most common disability affecting adults in the
United States all involve the ear. The Ear Book is a comprehensive explanation
of the causes, diagnosis, and treatment of these frequently occurring ear
disorders. It is written in plain language so it can be useful to all those managing
this organ system, including general health care providers and the book’s
primary audience—the lay public.
Symptoms caused by conditions affecting the ear such as hearing loss, ringing
in the ears, and dizziness can be disabling. Explanations of the cause of the
problem and the need and value of testing, as well as treatment options, can be
difficult to follow in the physician’s office. Even common problems like ear
wax, swimmer’s ear, ear infections, and perforations of the eardrum can be
painful and confusing.
Rapid advances in medicine make it difficult to keep up, even for specialists
in the field. Exaggerated claims of miraculous cures found in the media may be
difficult for patients and providers to separate from established treatments
founded in good clinical science. We describe recent innovations in simple terms
and sift fact from fiction to help patients and their caregivers stay abreast of
modern approaches to the ear.
What You Will Find in This Book
The ear is one of the most complex organs of the body, providing the sense of
hearing and balance. Part 1 begins with clear explanations of how the ear works.
After a review of the meaning of different ear symptoms, we dispel some
popular myths about the ear.
In part 2, we review the most prevalent ear disorders—otitis media, hearing
loss, dizziness and vertigo, and tinnitus—focusing on finding the right diagnoses
and getting the best treatment.
Part 3 looks specifically at problems affecting the outer ear—swimmer’s ear,
obstructions, malformations and growths, cancer, and trauma. The middle ear is
the focus of part 4, with a closer look at perforations of the eardrum,
otosclerosis, and mastoiditis. Part 5 looks into the inner ear. Here we discuss
Ménière’s disease and noise-induced hearing loss, two common problems. We
also describe the symptoms of sudden deafness and autoimmune diseases as well
as the consequences of using some life-saving drugs. We close part 5 with a
discussion of tumors.
In the final section we describe different types of hearing and balance tests.
Knowing what to expect in advance will help you get the most out of your visit
to the doctor. In this section we also address the problems of adjusting to
different air pressures (when scuba diving or flying in a plane). Techniques can
be learned to lessen the effects of pressure changes. The last chapter looks to the
future and the progress that has been made with gene therapy and stem cell
research.
At the end of the book you will find a glossary of terms, appendixes
providing a list of ear medications and a roster of resources, references for
further reading, and an alphabetical index to facilitate easy access to specific
topics.
The Ear Book provides up-to-date, reliable information. It follows a
conservative approach to surgery. We hope that it will help you in working
closely with your primary physician or ear specialist.