DRF CENTURIONS — AT THE FOREFRONT OF OUR CAUSE
In 1963, the nation’s leading ear, nose and throat specialists came together with a simple but important goal: to advance the research crucial to their fields, knowing that their practices and patients
would directly benefit from this work. This innovative group became The Centurions – champions and supporters of Deafness Research Foundation (DRF).
The Centurions now enjoy the support of more than 1,800 physicians, researchers and other professionals in fields related to hearing and balance sciences. Under the leadership of President David S. Haynes, M.D., and Secretary/Treasurer John L. Dornhoffer, M.D., The Centurions play an essential role in promoting DRF.
To learn more about The Centurions, how to become a member or identify Centurions members in your area, please contact DRF at 866.454.3924, 888.435.6104 (TTY), visit our Web site at www.drf.org or e-mail centurions@drf.org .
In each issue, a member of The Centurions fields questions about hearing health and related issues. In this issue, questions were addressed by Centurion Lawrence R. Lustig, M.D., director, Division of Otology, Neurotology and Skull Base Surgery; medical director, Department of Otolaryngology – Head and Neck Surgery; and a professor at the University of California, San Francisco.
Last March, I had surgery for chronic mastoiditis but my ear is still odorous. It is bothering me and is inconveniencing me socially. What do you recommend to address the odor?
-Christopher C. via www.drf.org
Depending on what type of mastoid surgery you had, there are many reasons why an ear would continue to drain. In “canal wall up” surgery, the ear canal remains intact but the mastoid air cells behind the ear are opened up to clear out the infection. This operation is often combined with a tympanoplasty to reconstruct the eardrum. In this operation, it is possible the graft did not take and the infection has returned. It is also possible your ear canal or eardrum is inflamed, causing drainage.
In a “canal wall down” operation, the ear canal wall is removed to make one large cavity, combining the ear canal and mastoid air cells. In this operation, ongoing drainage occurs because of ongoing infection or leaving the opening to the canal too small, leading to skin and wax buildup, among other things. Mastoid cavity cleaning can help, including daily flushing with a diluted solution of rubbing alcohol and vinegar. For grossly infected drainage, a culture can be taken to see what bacteria may be causative. Lastly, anything that would make an infection more severe, including diabetes or immune-suppression, would warrant a more aggressive approach. All these treatments should be done under the supervision of a physician. I advise you to consult the surgeon if the ear continues to drain. If he cannot stop the drainage, you may want to seek the opinion of an otologist.
I have a 68-year-old, mentally retarded sister with Usher syndrome. She lost her sight and hearing at age 43. She has profound hearing loss and uses behind- the-ear aids. I am wondering if her cognitive abilities would support a cochlear implant (CI).
- Esprit64 via www.drf.org
There are three types of Usher syndrome: In type 1, children are born deaf. In type 2, children are born with moderate hearing loss and in type 3, children are born with normal hearing that worsens over their lifetime at varying rates. Your sister likely has type 2 or 3. Her other medical conditions should not have a major impact on her ability to hear or the progression of her hearing loss as a result of Usher syndrome.
At present, treatment for hearing loss in Usher syndrome is limited, generally consisting of providing
hearing aids to treat the hearing loss, with close monitoring of changes in hearing. In cases where hearing loss is too severe to be treated with a hearing aid, which sounds like the case with your sister, it is good to consider a CI.
There are many factors involved in selecting a good candidate for a CI: degree of hearing loss; cause of deafness (people with Usher syndrome can do very well with CIs); length of time a person has been deaf (the shorter, the better); and personal and family expectations of how well someone can do with an implant. All of these factors can be adequately determined by having your sister evaluated at a CI program.
Got a question you would like one of the nation’s leading ear, nose and throat doctors to answer? E-mail it to info@drf.org.
The Centurions help ensure that clinical research continues in the field of hearing and balance science. To learn more about The Centurions or how to contribute to the Centurion Clinical Research Award, please visit www.drf.org/Centurions or e-mail centurions@drf.org .
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