Ears provide sensory information for communication and speech development and are a critical part of our daily interactions with each other. When the ears are not feeling well or functioning properly, they need to be properly diagnosed and treated. Dr. Magill is an expert in diagnosing and treating problems with the ears. At Alaska Facial Plastic Surgery & ENT, we see patients of all ages who are having ear pain, hearing problems, ear infections, cholesteotoma, wax build up, tinnitus, and vertigo. Dr. Magill also treats problems with the outer ear, or pinna, and offers skin cancer removal of the ear, otoplasty, ear gauge correction, and ear lobe reconstruction.
Frequently Asked Questions
When does my child need ear tubes?
Ear tubes, or “myringotomy tubes” are indicated when children or adults are having recurrent episodes of ear infections called otitis media. When fluid never goes away from behind the ear drum, it can lead to a chronic middle ear effusion or chronic otitis media. When there have been greater than 4 to 6 episodes of recurrent otitis media in a year, or when fluid behind the ear drum persists for greater than 3 months, ear tubes can help. Dr. Magill will perform an exam and review a child or adult’s history before recommending ear tubes. Sometimes a hearing test or audiogram will be needed in making decisions about ear tube placement.
How are ear tubes placed?
Ear tubes in children are typically placed under a brief general anesthetic with a mask. The surgery is typically short and performed under the care of Dr. Magill and a skilled anesthesiologist. An operating microscope is used to view the ear drum and a small opening is made into the ear drum called a “myringotomy.” Fluid or mucous is suctioned from the middle ear and a small tube is then placed in the opening. Adults may be able to have ear tubes placed in the clinic with a small numbing medicine on the ear drum.
How long do ear tubes last?
Ear tubes typically last 8 to 12 months and should be checked every 6 months. T-tubes are a type of ear tube that are designed to stay in longer and may remain in place for several years. Dr. Magill will work with you to decide if myringtomy tubes are needed.
Do ear tubes hurt?
Typically not. When ear tubes are placed, children or adults may have strange sensations in the ear that can last for two weeks or so as the ear drum hears around the tube. Tubes are typically not painful. Dr. Magill will examine your ear if you have pain or other unusual symptoms after ear tubes are placed.
What is an ear infection like when ear tubes are in place?
If an ear tube is in and open, ear infections will show up as drainage from the ear. These infections can then be treated directly with ear drops that go through the tube into the infected middle ear space. A primary care provider is able to prescribe ear drops for an ear infection with tubes in place. Dr. Magill can also diagnose and treat ear infections that occur while tubes are in place.
Can ear infections cause hearing damage?
Ear infections in the ear canal, behind the ear drum (middle ear), or in the inner ear can cause temporary or permanent hearing loss. Debris in the outer ear or ear canal can block sound from entering and may need treatment. When there is fluid behind the ear drum, sound cannot travel normally to the inner ear and patients can suffer from “conductive hearing loss.” Inner ear infections are usually from a virus and may lead to hearing loss that is senosorineural. To be evaluated for hearing loss and properly diagnosed, patients benefit from an ear exam, with the possibility of an audiogram (hearing test) or imaging study (CT scan or MRI). Dr. Magill will perform a thorough exam and order needed tests if needed to diagnose and treat hearing loss.
Does fluid behind the ear drum always need to be treated with antibiotics?
No. Not all fluid behind the ear drum or “effusions” needs to be treated with antibiotics. Middle ear effusions can be infectious or can be from mucous, clear fluid, or even material that refluxes from the throat. Many children and adults are often over treated with antibiotics when an ear infection may not be present. Not all ear pain is from infection. Dr. Magill can help properly diagnose and treat ear infections.
If my child has an ear infection, should I see an ENT specialist right away?
No. Primary care providers are well equipped to diagnose and treat most ear infections. ENT specialists can clean the outer ear canal, provide treatment for middle ear fluid that recurs or never goes away, and help diagnose and treat inner ear infections. Dr. Magill will work with your pediatrician or primary care provider to treat infections as needed.
My ears stick out and I want to change their appearance. Is there a surgery for that?
Yes. Otoplasty is a surgery that can change the shape and projection of the outer ear. Some children and adults have ears that are large and protrusive and cause self-consciousness or even bullying. Ears that stick out can bother people, especially when the hair is short or worn back. Otoplasty is a surgery that is typically done under a brief anesthetic and provides correction for ears that stick out. Dr. Magill is expertly trained in otoplasty surgery and can work with you to achieve the results you are looking for.
Does insurance pay for otoplasty?
Sometimes. If a child or adult has a genetic syndrome that causes the outer ears to be shaped differently, insurance may cover correction of the problem. Most otoplasty surgery, however, is not covered by insurance. Dr. Magill will consult with you about otoplasty surgery and discuss pricing options.
What is the recovering time after otoplasty surgery?
Dr. Magill performs otoplasty surgery under a brief anesthetic and you can go home that same day. An ear dressing is worn for 24 hours and changed for the first time in the office. You must then wear an ear band to support the healing of the ears for the next week, and then at night for the second week.
What causes ear pain?
Otalgia, or ear pain, is a common symptom that people can suffer from. Debris or infection in the outer ear or ear canal can cause pain, as can infections of the middle ear space. Not all ear pain is actually from the ears, however. Many people with ear pain or otalgia are actually suffering from pain in the temporomandibular joint, which is intimately associated with the outer ear canal. Ear pain can also be from referred pain from the throat or from muscles of mastication, to name a few.
Can you get skin cancer on the ear?
Skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma can all occur on the skin of the ear. Dr. Magill is expertly training to diagnose and remove skin cancers of the ear and provide plastic surgery reconstruction of the affect area. If there is the need for further treatment of lymph nodes, as may be the case with squamous cell carcinoma or sentinel lymph node biopsies with melanoma, Dr. Magill will treat these areas to ensure the best possible outcomes from the skin cancer treatment.
What is cholesteotoma?
Cholesteotoma is an overgrowth of skin cells that occurs in a space in the ear, including behind the ear drum or from the ear drum itself. Cholesteotomas can cause infections and persistent ear drainage and can also grow to damage the bones that help with earing (the ossicles) and the bone around the ear (the mastoid). Dr. Magill can diagnose and evaluate patients with cholesteotomas in order to offer the best possible treatment for the growth. Cholesteotomas are not cancers, but they grow and destroy surrounding structures due to chronic infection or inflammation. They are best treated with surgery that removes the entire cholestoetoma and patients may require a second surgery to help restore hearing.