Ear, Nose and Throat

Nine out of 10 hearing loss patients experience sensorineural or mixed hearing loss and will benefit from the use of hearing aids. Your audiologist may decide you could benefit from hearing aids as part of your comprehensive treatment plan. 

If so, you’ll want to choose a pair that not only addresses your specific hearing needs, but is also appropriate for your lifestyle (how active/social you are), is cosmetically appealing and is within your budget. There is no one-size-fits-all option when it comes to hearing devices. 

There is a wide range of choices available. Choosing a hearing aid can be an overwhelming task, but your audiologist is happy to help you through the process.  Schedule a consultation to discuss what is right for you. 

Hearing aid pricing

Our hearing aid pricing is a form of “unbundled” pricing in which fees are detailed. This plan provides clear, understandable pricing and transparency in your fitting process. You invest in your hearing aids and initial care, then ongoing services are paid as you receive them. 

In this model, the total cost includes the device(s) and the first month of evidence-based professional services plus initial supplies. After your adjustment period, you will pay for your services and supplies as you go, or you can purchase an optional service plan. 

Price varies depending on whether you use one aid or two, your lifestyle and the features you desire. We offer different levels of technology ranging in price from $1,500 to $3,600. We carry a variety of hearing aid brands to help you find the right fit for you. 

Take the first step in improved hearing. Call 903-747-4098 to learn more or schedule an appointment.

Hearing evaluations are a comprehensive, non-invasive hearing test performed with an audiologist. Our experienced audiologists will begin by inspecting your eardrums with an otoscope. Next, you will put on a pair of earphones in a soundproof test booth, where you will listen and respond to different frequencies at varying levels of intensity of loudness (decibels). At times, you will be given prompts to raise your hand, push a button or repeat what you heard through the earphones. Your hearing thresholds for each pitch and ear are recorded throughout the test on a graph called an audiogram. This test will determine the severity of hearing loss as well as the type of hearing loss.

In addition to this test, your audiologist may recommend further testing to gauge the health of your middle ear and inner ear function.

Hearing loss that occurs gradually as you age (presbycusis) is common. About one-third of people in the United States between the ages of 65 and 75 have some degree of hearing loss. For those older than 75, that number is approximately 1 in 2.

Hearing loss is defined as one of three types:

• Conductive (involves outer or middle ear)
• Sensorineural (involves inner ear)
• Mixed (combination of the two)
• Aging and chronic exposure to loud noises both contribute to hearing loss. Other factors, such as excessive earwax, can temporarily reduce how well your ears conduct sounds.

You can’t reverse most types of hearing loss. However, you and your doctor or a hearing specialist can take steps to improve what you hear.

Below are eight signs you may have hearing loss:

1. You have trouble understanding others. You may be able to hear sounds, but not quite make out the words.

2. You have trouble hearing in noisy environments. Environments with multiple background noises, such as restaurants, can make hearing and understanding conversations difficult if you have a hearing loss.

3. You have difficulty understanding women and children. If you have hearing loss, you may experience difficulty hearing or understanding words or speech patterns of women and children as both speak in higher pitches and softer tones.

4. You frequently swap ears when on the phone. Frequent telephone ear swapping and becoming “ear fatigued” may signal hearing loss.

5. You hear a “ringing” in your ears. If you have hearing loss, you may experience a ringing in the ears called tinnitus.

6. You watch television too loudly for others. If you constantly need to increase the volume, or others ask you to reduce the volume, you may require a hearing test.

7. You are physically or mentally fatigued during conversations. Concentrating to hear friends, family members, TV and music can fatigue those with hearing loss.

8. You are often told you “mumble” or talk too loudly. If you have a hearing loss, your overall perception of sound has changed – even your own speech and pronunciation.

Tympanometry is a medical test that measures the function, movement and air pressure of the eardrum and middle ear. The results of tympanometry are represented on a graph called a tympanogram. The test is usually quick and painless, unless the eardrum or middle ear are inflamed.

How is the middle ear checked?

First, the provider will do a visual inspection of your ear canal and eardrum using a lighted otoscope placed in the ear. Then, a probe with a flexible rubber tip will be placed in your ear, which is attached to a tympanometer. The tympanometer causes the air pressure in your ear canal to change as you hear a low-pitched tone. The feeling is similar to the pressure changes felt during takeoff and landing when you’re on a plane. While the pressure is changing, measurements of your eardrum’s movement will be taken and recorded. Tympanometry is used to detect or rule out several things: the presence of fluid in the middle ear, a middle ear infection, a hole in the eardrum (perforation) or Eustachian tube dysfunction. This test is especially important for children who have suspected middle ear problems and it is given to adults as part of a routine hearing test to determine if there are any middle ear problems contributing to hearing loss.

Adults and children who are seeking medical clearance for hearing aids will usually receive a tympanometry test. Fluid behind the eardrum is the most common cause of an abnormal tympanogram because it prevents the eardrum from moving and transmitting sound properly. This condition is nearly always temporary and medically treatable.

The OAE test checks part of the inner ear’s response to sound. The test is mostly done on infants and children who may not be able to respond to behavioral hearing tests because of their age.

How is an OAE test done?

Otoacoustic emissions are sounds given off by one small part of the cochlea when it is stimulated by soft clicking sounds. When the sound stimulates the cochlea, the outer hair cells vibrate. The vibration produces a nearly inaudible sound that echoes back into the middle ear. Soft foam or rubber tips are placed in your child’s ear. Your child will hear soft sounds through the soft foam or rubber tips. A computer will record quiet echoes from the ear.

Your child will not feel anything during this test and should only take a few minutes.

The results are either present or absent. Present OAEs are consistent with normal to near normal hearing. Absent OAEs may be a sign of a problem. It could be hearing loss, wax in the ears, fluid or infection in the middle ear or a malformed inner ear. This indicates that more testing is needed to find out why the OAEs were absent and to rule out any possible hearing loss.

In addition to this test, your audiologist may recommend further testing to gauge the health of your child’s ear and inner ear function.

We offer the following speech pathology services for children:

• Alternative and augmentative communication: Provides low- and high-tech devices to help supplement verbal communication.
• Articulation therapy: Addresses mispronunciation of sounds.
• Aural rehabilitation: This type of rehabilitation helps individuals with hearing loss manage its impact on their lives and improve their communication abilities.
• Feeding and swallowing therapy: Available for both infants and older children.
• Fluency therapy: Helps children who stutter.
• Infant hearing screening and intervention: We offer hearing evaluations and screening tests for infants.
• Language therapy: Supports children with language impairments.
• Social communication training: Designed for neurodivergent children.
• Voice therapy: Treats hoarse or strained voices.
  

An ear infection (sometimes called acute otitis media) is an infection of the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.

Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Sometimes, antibiotics are used to clear the infection. Some people are prone to having multiple ear infections. This can cause hearing problems and other serious complications.

Ear plastic surgery can help patients born with underdeveloped, protruding, or drooping ear(s) due to weak or poorly formed cartilage. A partially formed exterior ear is called “microtia,” while a completely undeveloped ear is referred to as “anotia.” Traumatic malformations of the ear also occur due to torn earlobes, automobile or other accidents, animal attacks, and more. Deformity of the ears may cause social anxiety and make children vulnerable to teasing. Regardless of the origin of the ear distortion, many ear conditions can be surgically corrected. These procedures do not alter the patient’s hearing, and may improve appearance and self-confidence.

Abnormally protruding ears can make a person of any age the object of cruel remarks by his or her peers. For any person whose appearance causes concern otoplasty, “ear pinning” should be considered before peer pressure begins to play a significant role in their self-esteem, typically age five or six. When otoplasty is performed at about age 5-7, the development of the ear cartilage is at an optimal state of maturity to accept the modified projection.

Otoplasty is a safe, effective procedure performed to achieve a less noticeable appearance while maintaining function. Because of its potential to foster a person’s self-esteem, otoplasty is a most satisfying facial plastic surgery.

Many ear infections resolve on their own, especially if they are viral, and some bacterial infections require treatment with antibiotics. Sometimes recurrent ear infections and/or persistent fluid in the middle ear may become a chronic problem leading to other issues such as hearing loss, poor school performance, or behavior and speech problems. In these cases, insertion of ear tubes by an ENT (ear, nose, and throat) specialist, or otolaryngologist, may be considered.

Ear tubes are tiny cylinders placed through the ear drum (called tympanic membrane) to allow air into the middle ear. They may also be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes.

These tubes can be made of various materials, and come in two basic types: short-term and long-term. Short-term tubes are smaller and typically stay in place for six months to two years before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist may be necessary.

Tinnitus is the perception of noise or ringing in the ears. A common problem, tinnitus affects about 15 to 20 percent of people. Tinnitus isn’t a condition itself — it’s a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder.

Although bothersome, tinnitus usually isn’t a sign of something serious. Although it can worsen with age, for many people, tinnitus can improve with treatment. Treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning. BPPV causes brief episodes of mild to intense dizziness. Benign paroxysmal positional vertigo is usually triggered by specific changes in the position of your head. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although benign paroxysmal positional vertigo can be a bothersome problem, it’s rarely serious except when it increases the chance of falls. You can receive effective treatment for benign paroxysmal positional vertigo during a doctor’s office visit.

Head and Neck cancer is an aggressive form of cancer that may include the tongue, throat and larynx. Historically, it was thought to be a cancer that one gets from smoking, but more cases are appearing in nonsmokers. Skin cancer can also occur on the face and head. Utilizing plastic surgery techniques the cancer can be removed to provide the best cosmetic result possible.

The thyroid is a butterfly-shaped gland located at the base of the front of the neck. It produces thyroid hormone, which controls your metabolism, temperature regulation, and keeps your muscles and organs working properly.

Thyroid and parathyroid conditions include: 

• Goiter: A goiter is an enlarged thyroid gland that develop in one or both sides of the thyroid gland.
• Thyroid cancer: This type of cancer is very common, particularly in women. 
• Thyroid nodules: Thyroid nodules are areas of abnormal growth within the thyroid gland. Some people have a single nodule while others have multiple nodules within the gland.

Hay fever, also called allergic rhinitis, causes cold-like signs and symptoms, such as a runny nose, itchy eyes, congestion, sneezing and sinus pressure. But unlike a cold, hay fever isn’t caused by a virus. Hay fever is caused by an allergic response to outdoor or indoor allergens, such as pollen, dust mites, or tiny flecks of skin and saliva shed by cats, dogs, and other animals with fur or feathers (pet dander).

Besides making you miserable, hay fever can affect your performance at work or school and generally interfere with your life. But you don’t have to put up with annoying symptoms. You can learn to avoid triggers and find the right treatment.

Nasal congestion or “stuffy nose” occurs when nasal and adjacent tissues and blood vessels become swollen with excess fluid, causing a “stuffy” plugged feeling. Nasal congestion may or may not include a nasal discharge or “runny nose.”

Nasal congestion usually is just an annoyance for older children and adults. But nasal congestion can be serious for children whose sleep is disturbed by their nasal congestion, or for infants, who might have a hard time feeding as a result.

A nose injury is an injury to any part of the nose. An injury may cause just a nosebleed or bruising, or it may break the bones in the nose. Nose injuries may also damage the nasal septum, which is the wall that divides the nose into two nasal passages. Nose injuries often occur during play, sports, accidents, fights, and falls. Pain, swelling, and bruising are common, even with minor injuries. Home treatment can usually help relieve your symptoms.

It may be hard to tell if your nose is broken. Swelling can make your nose look crooked even if it is not broken. Sometimes, testing may be needed, such as an X-ray or computed tomography (CT) scan of the head, if other facial injuries or fractures are suspected.

Nasal obstruction can be caused by a deviated nasal septum, enlarged turbinates, nasal polyps, enlarged adenoids, tumors and nasal congestion. Nasal obstruction encompasses anything which hinders the airflow in and out of the nose affecting one or both nasal passages. Nasal obstruction is usually caused by either swelling of the nasal tissue or an anatomical blockage which results in a narrowing of the nasal cavity and the feeling of the passages being congested. Nasal obstruction and can lead to sleeping disorders, snoring and obstructive sleep apnea (OSA). 

UT Health ENTs  specialize in all treatments for nasal obstruction, which includes at-home treatments, in-office treatments and surgical treatments.

Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation and are associated with asthma, recurring infection, allergies, drug sensitivity or certain immune disorders. Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell and frequent infections.

Nasal polyps can affect anyone, but they’re more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them.

Rhinoplasty (nose reshaping), nasal cosmetic surgery, is performed to improve the nose aesthetically – making it harmonize better with the other facial features – while maintaining or improving function. Because it is the most defining feature of the face, the size and shape of the nose has a significant impact on a person’s appearance. The goal in rhinoplasty is to minimize the attention that is given to the nose in order to accentuate the beauty of the eyes.

Balloon sinus dilation (also known as Balloon Sinuplasty) is a minimally invasive treatment for chronic or recurrent sinusitis. In a balloon sinus dilation procedure, your physician uses a small balloon to dilate or expand the sinus opening and drainage pathways to restore sinus drainage. This procedure can be performed in an office under local anesthesia.

Chronic sinusitis occurs when the spaces inside your nose and head (sinuses) are swollen and inflamed for three months or longer, despite treatment. This common condition interferes with the way mucus normally drains, and makes your nose stuffy. Breathing through your nose may be difficult, and the area around your eyes might feel swollen or tender. Chronic sinusitis can be brought on by an infection, by growths in the sinuses (nasal polyps) or swelling of the lining of your sinuses.

Treatments include:

• Endoscopic sinus surgery is done entirely through the nose with no need for incisions. Endoscopes (tiny cameras) and special instruments are used to remove tissue that is obstructing the nasal sinuses. This surgery is done to treat conditions like chronic sinusitis and polyps.
• Endoscopic balloon sinus dilation (balloon sinuplasty) is a very minimally invasive procedure that can be performed in clinic to dilate the natural sinus openings. Balloon dilation of the sinuses can be performed to treat chronic sinusitis and recurrent sinusitis.

Your sinuses are air-filled spaces inside your forehead, cheekbones, and behind the bridge of your nose. When they get inflamed — usually because of an allergic reaction or an infection — they swell, make more mucus, and the channels that drain them can get blocked.

The build-up of pressure in your sinuses causes pain that feels like a headache.

You’ll feel a deep and constant pain in your cheekbones, forehead, or the bridge of your nose. The pain usually gets stronger when you move your head suddenly or strain. At the same time, you might have other sinus symptoms, such as:

• A runny nose
• Feeling of fullness in your ears
• Fever
• Swelling in your face

Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation and are associated with asthma, recurring infection, allergies, drug sensitivity or certain immune disorders. Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell and frequent infections.

Nasal polyps can affect anyone, but they’re more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Endoscopic sinus surgery is done entirely through the nose with no need for incisions. Endoscopes (tiny cameras) and special instruments are used to remove tissue that is obstructing the nasal sinuses. This surgery is done to treat conditions like chronic sinusitis and polyps.

A sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow. The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. A sore throat caused by a virus resolves on its own.

Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires treatment with antibiotics to prevent complications. Other less common causes of sore throat might require more complex treatment.

Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side. Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck. Most cases of tonsillitis are caused by infection with a common virus, but bacterial infections also may cause tonsillitis.

Because appropriate treatment for tonsillitis depends on the cause, it’s important to get a prompt and accurate diagnosis. Surgery to remove tonsils, once a common procedure to treat tonsillitis, is usually performed only when bacterial tonsillitis occurs frequently, doesn’t respond to other treatments or causes serious complications.

Snoring and Obstructive sleep apnea (OSA) are caused by the development of resistance to airflow in the upper airways during sleep. As the resistance to airflow increases breathing is disrupted and obstructive sleep apnea develops. The disruption in sleep can lead to being tired during the day but more importantly contribute to the development of high blood pressure, heart attack and heart failure.

Snoring can be treated in the office with laser assisted uvuloplasty (LAUP), injection snoreplasty, or radiofrequency palatoplasty. Inspire Sleep Apnea Innovation is another treatment option that works inside your body to treat the root cause of sleep apnea with the click of a button.

Inspire sleep apnea treatment

Inspire is the only Food and Drug Administration (FDA) approved obstructive sleep apnea treatment that works inside your body to treat the root cause of sleep apnea with the click of a button. Inspire is a small device that is surgically inserted just under the skin during an outpatient procedure. This new treatment option helps sleep apnea patients who cannot use continuous positive airway pressure (CPAP). Inspire allows you to breathe normally, without a CPAP mask, hose or machine.

How does Inspire work?

Inspire delivers gentle stimulation to key airway muscles helping keep the airway open for better breathing during sleep. The Inspire system is controlled by a small handheld sleep remote. The user turns on the device with the sleep remote before going to sleep and turns it off upon awakening.

You may be a candidate for Inspire if:

• You have moderate to severe obstructive sleep apnea.
• You are unable to use or get consistent benefit from CPAP.
• You are not significantly obese.
• You are over the age of 22.

Will Inspire help with snoring?

A significant decrease in snoring has been found as a secondary effect of the Inspire device. Ninety percent of bed partners report no or soft snoring by their partner. If you are suffering from obstructive sleep apnea, ask your health care provider for a referral to UT Health East Texas.

Zenker’s diverticulum is a rare condition that typically affects older adults. It occurs when a pouch of tissue forms where the pharynx meets the esophagus. Mild forms of Zenker’s diverticulum may not require treatment. Treatment for moderate to severe forms of Zenker’s diverticulum typically involves surgery.

Hoarseness, an abnormal change in your voice, is a common condition that’s often experienced in conjunction with a dry or scratchy throat. If your voice is hoarse, you may have a raspy, weak, or airy quality to your voice that prevents you from making smooth vocal sounds. This symptom commonly stems from an issue with the vocal cords and may involve an inflamed larynx (voice box). This is known as laryngitis.

If you have persistent hoarseness lasting for more than 10 days, seek medical attention, as you may have a serious underlying medical condition.

Spasmodic dysphonia is a voice disorder. It causes involuntary spasms in the muscles of the voice box or larynx.  This causes the voice to break, and have a tight, strained, or strangled sound.

Spasmodic dysphonia can cause problems ranging from trouble saying a word or two to being not able to talk at all.

Spasmodic dysphonia is a life-long condition. It most often affects women, particularly between the ages of 30 and 50.

There are 3 types of spasmodic dysphonia:

• Abductor spasmodic dysphonia: This type causes sudden involuntary spasms that trigger the vocal cords to open. Vibration can’t happen when cords are open so making sound is difficult. Also, the open position lets air escape during speech. Speech sounds are weak, quiet, and whispery. Spasms do not happen when laughing or singing.
• Adductor spasmodic dysphonia: This is the most common type. It causes sudden involuntary spasms that trigger the vocal cords to stiffen and slam closed. The spasms interfere with vibration of the vocal cords and with making sound. Stress can make spasms worse. Speech sounds are strained and full of effort. Spasms do not happen when whispering, laughing, singing, speaking at a high pitch, or speaking while breathing in.
• Mixed spasmodic dysphonia: This is a mix of symptoms of both types of dysphonia.

Swallowing is a complex process that changes over time, and swallowing difficulty (dysphagia) can be associated with aging. Changes in the tongue, upper throat (pharynx), vocal cords and voice box (larynx), and lower throat (esophagus) occur with aging.

It has been estimated that more than 20 percent of individuals over the age of 50 experience dysphagia. Since the aging population is increasing, a significant number of individuals will experience changes in swallowing over time. By understanding normal, as well as abnormal, age-related changes, doctors and speech-language pathologists (SLPs) who specialize in swallowing disorders can better counsel patients, and target treatment strategies.

When you have difficulty swallowing, you may be experiencing one or more of the following symptoms:

• Coughing and/or choking with eating and drinking
• Difficulty chewing
• Food getting stuck
• Increased effort or resistance moving food from the upper throat (pharynx) into the lower throat (esophagus)
• Increased effort to move food and liquids from the mouth into the upper throat (pharynx)
• Pills getting stuck
• Recurrent lung infections
• Regurgitation of food (can be right away with swallowing or delayed)
• Weight loss due to food avoidance