Vestibular evaluation is a variety of tests used to examine and diagnose the vestibular portion of the inner ear, which is responsible for balance. These tests can determine find the cause of dizziness, and help patients find the most effective treatment. Some vestibular tests include:
- Electronystagmography (ENG) – This is the most common test used to evaluate the vestibular system. Electrodes are taped close to the eyes, and a computer records results as patients follow a moving light with their eyes while they sit and lie in different positions. Eye movements are driven by the balance organs whenever the head is moving and can therefore be used to evaluate the balance system.
- Posturography – The patient stands on a platform that moves back and forth slightly. This measures how well patients can maintain their balance. A safety harness is worn to protect the patient from falling.
- Rotational Chair Test – Electrodes are placed near the patient’s eyes so that eye movements can be recorded. The patient sits on a chair that gently swivels from side to side.
- Fistula Test – This test is used to detect perilymphatic fistula (PF), a small tear in the membrane that separates the middle ear from the inner ear. Air pressure is applied to each ear canal and the patient is monitored for abnormal eye movements or balance changes.
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Mastoid surgery, known as a mastoidectomy, is the surgical removal of an infected portion of the mastoid bone (the prominent bone behind the ear) when medical treatment is not effective. Although this surgery is considered rare today because of the effective use of antibiotics, it is still used in unresponsive or very severe cases.
Mastoidectomy is performed to remove infected air cells within the mastoid bone caused by mastoiditis, ear infections, or cholesteatoma (an inflammatory disease of the middle ear). The air cells are open spaces containing air that are located throughout the mastoid bone. They are connected to a cavity in the upper part of the bone which is connected to the middle ear. Infections in the middle ear can therefore spread through the mastoid bone, making surgery necessary if antibiotics do not work. A mastoidectomy may also be performed to repair paralyzed facial nerves.
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Middle Ear Surgery
The ear is made up of three basic parts: the outer ear, the middle ear, and the inner ear. The middle ear is an air-filled cavity which consists of an eardrum and three tiny, interconnected bones called the hammer, anvil, and stirrup. Middle ear surgery is used to treat a variety of conditions in any of these parts. Most ear surgery is microsurgical, performed using an operating microscope to enable the surgeon to view the very small structures of the ear.
Types of middle ear surgery include stapedectomy to repair hearing loss by replacing a middle ear bone with a prosthesis; tympanoplasty to reconstruct the eardrum after partial or total conductive hearing loss caused by an infection; myringotomy to drain ear fluid, preventing infection and normalizing middle ear pressure; repair of a perforated eardrum; and removal of middle ear tumors.
Minimally invasive laser surgery for middle ear procedures is increasing in popularity. Laser surgery reduces trauma, improves blot clotting, and allows the surgeon to operate more easily on hard to reach places in the middle ear.
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People with sleep apnea stop breathing while they sleep, sometimes hundreds of times per night, and sometimes for a minute or longer. Sleep apnea affects about 18 million people of all ages in the U.S. and takes three forms: obstructive, central and mixed. Obstructive sleep apnea (OSA), the most common form, occurs when the soft tissue at the back of the throat closes, blocking (obstructing) the personís airway. The airway remains open in central sleep apnea, but the brain does not send signals to the muscles involved in breathing. Mixed sleep apnea combines aspects of the obstructive and central types. A common warning sign of sleep apnea is snoring (especially snoring interspersed with gasps or lack of breathing) although it is not always as a result of sleep apnea.
Because sufferers are roused from sleep briefly to resume proper breathing, disrupting and lowering the quality of a personís rest, sleep apnea can cause a number of problems. If left untreated, it can result in high blood pressure, cardiovascular disease, stroke, memory problems, weight gain, impotency, headaches, and daytime fatigue leading to job impairment and motor vehicle crashes.
There are a variety of treatments available for sleep apnea, including oral appliance therapy, mandibular repositioning and tongue-retaining devices, nasal sprays, traditional surgery, laser-assisted uvulopalatopharyngoplasty and nasal surgery. If you think you are suffering from sleep apnea, talk with your dentist. He or she will discuss which treatment is right for you.
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