Ear Tubes

What are ear tubes? Ear tubes, also known as PE tubes or Pressure Equalization tubes, are small cylindrical silicone or plastic tubes that are surgically placed into the ear drum. When are ear tubes necessary? Ear tubes are typically placed for 4 reasons: Recurrent Otitis Media. This is the most common reason for ear tube placement for children between the ages of 1 and 6 years old. Tubes are generally considered for patients who are having 5 or more ear infections per year. Persistent Acute Otitis Media. Antibiotic resistant bacteria are becoming more prevalent and we are seeing more and more ear infections that will not clear with oral antibiotics. If an acute infection is not clearing with 2-3 courses of broad spectrum antibiotics, ear tubes are frequently recommended. Otitis Media with Effusion. Middle ear fluid is common for several weeks following an ear infection. If however, fluid persists for 3 or more months, ear tubes are frequently recommended. Eustachian tube dysfunction. Whi ...

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Summer ENT Care

With the arrival of summer this week, summer activities are in full swing, including regular swimming, diving and more active water sports such as water skiing, wakeboarding and tubing. While much attention is directed to safety in and on the water, we see water related ear problems every year, most of which are entirely unavoidable and random. It can be confusing as a patient trying to decide whether an ear needs to be seen and how quickly that is necessary. Otitis externa (“swimmer’s ear”), is easily the most frequently seen ENT problem related to water activities. It accounts for numerous office visits in a specialty ENT practice, as well as in primary care offices and urgent care centers. Pain in the ear (often quite severe) with blockage and often drainage are hallmarks of this problem. The ear is often exquisitely sensitive to pressure or pulling on the visible outside portion of the ear. While this condition often responds well to antibiotic eardrops, especially when discovered early ...

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CT Scan

At Raleigh ENT we strive to provide excellent care. We also know that our patients are busy and appreciate convenience. We are pleased to be able to offer in office CT (CAT) scans for evaluation of the sinuses. What is a CT scan? CT scanning, sometimes called CAT scanning, is a noninvasive medical test that helps physicians diagnose and treat medical conditions. CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. X-rays are not needed for all patients, and your doctor will suggest what is appropriate when you are in for your visit. However, if a CT scan is needed, it can often be done during your visit. When is a CT scan needed? For example, sometimes a patient has been suffering with sinusitis for months. The primary care physician has provided appropriate treatment, yet nothing seems to work. After talking to her and examining her, her physician at Raleigh ENT decides more information is needed. A CT scan can ...

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Sudden Sensorineural Hearing Loss

This month’s blog will cover Sudden Sensorineural Hearing Loss (SSNHL), which is defined as sensorineural hearing loss of at least 30 dB in 3 sequential frequencies that occurs over 3 days or less. The incidence of SSNHL is 5-30 cases per 100,000 per year. Tinnitus is an associated symptom approximately 80% of the time. Hearing loss can cause significant limitations on activities of daily living and communication. Any significant hearing loss should be evaluated by a physician. Your primary care physician can evaluate for cerumen, otitis media, and middle ear fluid. If no clear cause of the hearing loss is identified, prompt referral to an otolaryngologist is the next step in the evaluation to confirm or exclude a diagnosis of SSNHL. A thorough history and neuro-otologic exam is then performed. In SSNHL, typically the outer ear and middle ear exam are normal and the diagnosis is confirmed with comprehensive audiogram. The list of possible causes of SSNHL is fairly long and broad. The more common etiol ...

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Sublingual Immunotherapy

As spring has arrived in the Triangle, we thought that sublingual immunotherapy (SLIT) would be a timely topic for our second blog post. As opposed to allergy shots, SLIT consists of allergy drops placed under the tongue. SLIT has been popular in Europe for years and is becoming increasingly popular in the United States. SLIT has an excellent safety profile so patients can do the treatment at home. The advantage for needle phobic patients is obvious. While SLIT is an attractive option for some patients, there are also some disadvantages. SLIT is not yet FDA approved in the United States and most insurance companies consider SLIT an alternative treatment for allergies and asthma. Patients are responsible for the cost of the serum. Optimal dosing in SLIT is an area of controversy. At Raleigh ENT, we follow dosing protocols advocated by the American Academy of Otolargngic Allergy. Finally, while many studies show that SLIT is an effective treatment, there is still some question whether SLIT is equall ...

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First Blog Post

Welcome to Raleigh ENT’s first blog post. We want to use this space to provide updates about our practice. Mostly I anticipate this will be in the form of clinical information. We are excited about the new additions to our website and want to be able to connect to our patients through a variety of ways. The first topic is balloon sinuplasty. This is a relatively new tool we have to deal with chronic sinus infections. Through the years there have been important advances in the surgical treatment of sinus infections. In the 1980’s endoscopic surgery provided an enhanced view of the sinus passages and improved the accuracy of the procedure. In the 1990’s image guided techniques provided an intraoperative road map of the sinuses. This gives us anatomical detail on the order of several millimeters during a procedure and helps us to safely dissect within the sinus passages. Balloon sinuplasty is another important advancement. The goal of sinus surgery is to improve the natural drainage pathways. ...

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