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Child has hearing loss, CAT scan normal, floppy eardrums. Advised hearing aids. Is there a laser surgery to tighten the eardrum?

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ENT Specialist
Practicing since : 1991
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My son, 18 years old, has seen an ENT and a Ortolaygologist specialist for hearing loss. It has gotten worse in the last four years. The "speaking range" frequencies and 1,000 hz have a 6 db drop. Had a CAT scan - all normal, but his only fix is to pop his ears, creating pressure....then for about 5 seconds, he regains his normal hearing. DR was going to do surgery by pealing back the eardrum and take a look at the Stipes (sp?) bone and then just as a last test, he did a tympanic test and my son's results were off the chart. The DR said he had "floppy eardums" and there was no surgery to fix it and hearing aids would be his best answer. Please help with some info and advice. Is there a lazer surgery to "tighten" the eardrum to make it a normal tension?
Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 4 hours later

Thank you for your query.

1. The Tympanogram should have been done early in the diagnostic workup. It would be of help if you could share the Audiograms, Pure Tone (PTA) and Impedance (Tympanogram) along with the CT images (Not the report).

2. Eustachian Tube Dysfunction often leads to serous otitis media and glue ear which may cause the floppy or hyper-compliant ear drum. Does he have nasal symptoms? In many people, a thinned out eardrum (old healed perforations) or ossicular chain discontinuity may also be present. Do you have detailed ear drum appearance notes? Is it possible for you to organize and share an endoscopic image of his eardrums?

3. If his middle ear pressures are normal, an attempt at laser tightening may help. You may approach the Michigan Ear Institute which as recently published a paper on CO2 laser assisted Myringoplasty for ear drum atelectasis. However it is not a commonly used procedure. Ear drum replacement or scaffolding is an option. However if the underlying cause persists, the new ear drum will suffer the same fate.

4. If the middle ear pressures are abnormal a Myringotomy with Grommet insertion may help the eardrum recover and tighten over six months to a year.

5. No treatment or no surgery is always an option due to the risks of further hearing damage. He would then require hearing aids or bone anchored hearing aids such a Baha, Ponto Pro or Sophono which bypass the middle ear. These bone anchored ears will also compensate for any additional conductive loss in the future.

6. Intervention is advised if there is any progressive sensori-neural hearing loss.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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