- In this video, I'm talkin' about the eight FDA red flags
that, if discovered during a hearing evaluation,
should trigger a referral to
an ear, nose and throat physician.
Comin' up!
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Hi, guys, Cliff Olson, doctor of audiology and founder
of Applied Hearing Solutions in Phoenix, Arizona,
and, on this channel, I cover a bunch
of hearing-related information to help
make you a better-informed consumer.
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make sure you hit that Subscribe button,
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While a comprehensive hearing evaluation
with an audiologist or
a board-certified hearing instrument specialist
should be your first thought
if you're having difficulty hearing,
not all ear-related conditions
can be handled by these types of providers.
That's why there are eight red flags
that are indicated by the Food and Drug Administration
that should trigger a referral to a licensed physician,
particularly an otolaryngologist,
otherwise known as an ENT, so they can handle
the medical-related issues that you may be having
in your ears before you actually pursue
hearing treatment with hearing aids.
Conditions like microtia, which result
in a pinna that is smaller or deformed
and aural atresia, which is
the absence of an ear canal.
It can be linked to conditions like Goldenhar syndrome
or Treacher Collins syndrome, both of which
require the attention of a licensed physician.
While individuals with an ear deformity
may still need hearing amplification,
other medical treatments such as reconstructive surgery
may be required first.
The second red flag is a history
of active drainage from the ear in the last 90 days.
Otitis externa, also known as swimmer's ear,
can occur when bacteria or fungus
infect your outer ear canal.
It can be caused by spending a lot of time in water,
hence the name swimmer's ear, but it can also be caused
by inserting foreign objects into your ear canal,
like the things you would use
to remove ear wax from your own ear,
like keys or bobby pins, and even Qtips
which, by the way, you should never stick
inside of your ear canal.
You also have otitis media, otherwise known as
a middle ear infection.
If enough fluid builds up,
it can lead to a rupture of your ear drum,
causing that fluid to leak out of your ear canal.
Both of these conditions require medical intervention
from a licensed physician, which could include antibiotics
or even pressure equalization tubes.
The third red flag is a history of
sudden or rapidly-progressive hearing loss
within the last 90 days.
First of all, if you have a sudden hearing loss,
you should get in to see an ear, nose and throat physician
as soon as humanly possibly because
success in treating a sudden hearing loss
has a lot to do with how quickly you actually get treatment.
Treatment for these types of hearing losses
by your physicians may include oral steroids
or even a transtympanic injection of steroids,
which is an injection using a syringe
through your eardrum.
Now, hopefully, these treatments result
in the restoration of your original hearing ability,
but if they don't, there is a high probability
that you're gonna end up being a candidate for hearing aids
or, in some cases, even a candidate for a cochlear implant.
The fourth red flag is acute or chronic dizziness.
If you are experiencing dizziness and vertigo,
that should trigger a referral to a medical professional
so they can actually get you pointed in the right direction,
which actually is most likely going back
to an audiologist who specializes in diagnostics
for vestibular conditions.
There can also be conditions such as Meniere's disease
or even a tumor growing on your auditory nerve
which is causing these symptoms of dizziness.
So, it's always a good idea to get
those medical conditions taken care of first,
and then going to see your audiologist
or hearing instrument specialist to get hearing treatment.
The fifth red flag is a sudden or recent onset
of unilateral hearing loss within the last 90 days.
Very similar to the third red flag,
a sudden hearing loss in one ear
will also likely result in aural steroids
or a transtympanic injection.
If this medical intervention is unsuccessful
at treating at that unilateral hearing loss,
then you will likely be a candidate
for a variety of different unilateral
hearing loss treatment options
such a CROS, BICROS, AmpCROS
or a bone-anchored hearing device.
The sixth red flag is a audiometric
air-bone gap that is equal to or greater
than 15 decibels at 500 Hertz, 1000 Hertz and 2000 Hertz.
The reason that a audiometric air-bone gap
requires a medical referral is that it indicates
that there is either a conductive or mixed hearing loss.
A conductive hearing loss is when sound
cannot properly pass through the outer ear
and/or the middle ear to the inner ear
where sound is converted into an electrical impulse
and sent to the brain.
Let me show you an example of
an air bone gap on an audiogram.
When identifying an air-bone gap, we are looking for
the difference between the brackets on the graph
and the circles or the x's on the graph.
The brackets represent the hearing sensitivity
of the inner ear alone that is recorded via bone conduction.
The circles and x's represent your hearing sensitivity
when sound has to pass through your ear canal
and your middle ear space before it gets to the inner ear.
If you see a 15 decibel or more difference
at 500 Hertz, 1000 Hertz and 2000 Hertz,
then you have a significant enough of an air-bone gap
that it requires a physician referral.
Conductive and mixed hearing losses
can be caused by a variety of different factors,
including fluid buildup in the middle ear space
or even conditions like otosclerosis, among others.
Now, treatments for these types of conditions
can often include surgery, bone-anchored hearing devices
or good, old-fashioned hearing aids.
The seventh red flag is visible evidence
of significant cerumen accumulation
or a foreign body inside of your ear canal.
In cases, where impacted ear wax or a foreign object
is stuck inside of your ear
and it cannot be safely removed
by your hearing care professional,
it should trigger ar referral to a licensed physician
who can remove those obstructions for you.
Attempting to treat hearing loss using hearing aids
when there's something stuck inside of your ear
is never gonna end up well anyway.
So you need to make sure that you
have a professional remove whatever it is
inside of your ear canal.
And the eighth FDA red flag that should trigger
a referral to a ear, nose and throat physician
is pain or discomfort inside of your ear.
There are a variety of medical conditions
that can cause ear pain, several of which
I've already discussed in this video.
Most of these conditions actually need
to be treated with medications or surgical intervention,
neither of which can be done by an audiologist
or a hearing instrument specialist.
Once you get whatever condition is causing that pain
under control and you still have a hearing loss,
that is the time that you want to
go back and see your hearing care professional.
At the end of the day, if you have your hearing tested,
and you end up having one of these eight red flags,
and you were not referred to a medical professional
like an ear, nose and throat physician,
then I highly recommend that you
get a hold of your primary care physician,
so you can get a referral right away
because the sooner you get these red flags taken care of,
the sooner you can get back to hearing.
That's it for this video.
If you have any questions, leave them
in the comments section below.
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Also, feel free to check out my website, DrCliffAuD.com.
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