Department of Otorhinolaryngology - Head and Neck Surgery

McGovern Medical School

ORL Progress Notes

ORL Progress Notes, our second on-line departmental newsletter, provides information about developments in the Department. The newsletter’s target audience includes physicians and health care professionals as well as patients and members of the general public.

With a Bone-anchored Hearing Aid, One Good Ear Helps the Other

In early June 2014, Steve Blatt was riding his motorcycle to work along the same route he’d used for nearly 40 years.  It was raining, and when his front tire hit an uneven spot in the road, his bike slid out from under him.  He did two somersaults through the air and lost his helmet.  When he hit the ground, he suffered a transverse fracture through his right temporal bone – the hardest bone in the body – a complex structure that houses the cochlear and vestibular end organs, the facial nerve, the carotid artery and the jugular vein.  Blatt was rushed to the Level I Texas Trauma Institute at Memorial Hermann-Texas Medical Center as a full code with a traumatic brain injury, mandibular fracture and three broken ribs.  After being stabilized by the trauma team, he was admitted to the otorhinolaryngology service under the care of Ibrahim “Trey” Alava III, MD.

“Steve couldn’t hear out of his right ear and reported dizziness with a sensation of spinning,” says Dr. Alava, an assistant professor in the Department of Otorhinolaryngology-Head and Neck Surgery at UTHealth Medical School.  “A portion of the right mandible under the temporal bone had been fractured, and he was bleeding from his right ear.”   Two days later, Blatt, still hospitalized, developed facial nerve paralysis as a result of swelling in the nerve canal. Dr. Alava prescribed steroids to treat the paralysis, which resolved over time.   After a five-day hospitalization, Blatt continued in follow-up with Dr. Alava for head and ear trauma. A few weeks later, the otolaryngologist referred his patient to UTHealth Audiology, where Allison Boggess, Au.D., performed a comprehensive hearing assessment and evaluation using videonystagmography.

“We knew that conventional hearing aids wouldn’t help his deficit,” Dr. Alava says. “Instead, we recommended a bone-anchored hearing aid (BAHA) to route the sound from his non-hearing right ear to his good left ear.”  BAHAs use the skull’s ability to transmit sound to the ear with good hearing.  The surgeon implants the bone-anchored implant, which picks up sounds through an external, magnetically attached microphone/processor that converts the sound into vibrations. The vibrations are transmitted through the skin to the skull as recognizable sounds.

Bone-anchored hearing aids transfer sound from the patient’s poorly functioning ear to the opposite ear with good hearing. The device transforms sound energy to vibrations transmitted through the skull to the normal cochlea in the hearing ear.

Bone-anchored hearing aids transfer sound from the patient’s poorly functioning ear to the opposite ear with good hearing. The device transforms sound energy to vibrations transmitted through the skull to the normal cochlea in the hearing ear.

In an uncomplicated day surgery, Dr. Alava made an incision behind Blatt’s non-hearing ear, drilled two wells to allow the implant to rest flush to the skull and screwed in the magnetized implant before closing the incision. “The microphone has a magnetic base plate that allows it to attach to the implant and be removed,” he says. “Steve wears the microphone on the outside and as it vibrates the skull, he can perceive sounds that come from the right through his left ear,” Dr. Alava says.

To compensate for his spatial hearing loss, Blatt underwent vestibular rehabilitation at TIRR Memorial Hermann Outpatient Rehabilitation at the Kirby Glen Center, where therapists developed a comprehensive plan to reduce his symptoms and improve his balance.  During an intensive, custom-designed four-month program, he regained much of the physical function he had lost, and continues his recovery.   “It takes a while to get used to the magnet and microphone,” Blatt says.  “The microphone looks like a Bluetooth headset attached to the scalp behind my right ear. It has a volume control, and the magnet has five or six different strengths that have to be adjusted regularly.  I go in to see the audiologist, she connects it to a computer and tweaks the programming or installs an upgrade.”

Dr. Alava is still seeing Blatt in follow-up for balance issues.  “Even though a patient may lose his vestibular function on one side, there is a compensation mechanism because of the brain’s plasticity. They learn to compensate for the loss over time,” he says.

Blatt considers himself lucky to be alive. “I’ve always been an advocate for helmets and motorcycle safety,” he says. “The accident itself and losing my helmet was one of those one in a million things. Allie is a great audiologist, and Trey is a great doctor. I see her regularly, and he’s always available by text when I have a question.  The hearing aid has given me something like 10 to 15 percent hearing in my right ear.  That’s a whole lot better than zero.”

UT ORL Progress Notes Archives

  1. With a Bone-anchored Hearing Aid, One Good Ear Helps the Other
  2. Department of Otorhinolaryngology Extends Facial Plastic & Reconstructive Surgery Expertise to The Woodlands
  3. Rapid Response and Multidisciplinary Teamwork Save a Young Man’s Life
  4. Transoral Robotic Surgery for Airway Obstruction in Pediatric Patients
  5. Kunal Jain, MD joins the Department’s Head and Neck Surgery Program
  6. Zi Yang Jiang, MD joins UTHealth Pediatric ENT Service
  7. Surgeon-performed Ultrasound Provides X-Marks-the-Spot Accuracy for Parathyroid Adenoma
  8. The Watson Case: An “Impossible” Surgery Makes a Night-and-Day Difference for a Patient with Proteus Syndrome
  9. Christian Conderman, MD joins UTHealth Otorhinolaryngology at its New Woodlands Location
  10. James Owusu, MD joins UTHealth Otorhinolaryngology at its New Woodlands Location
  11. New Clinical Learning Guidelines Transform How Medical Residency Programs Prepare Future Physicians
  12. TORS-L Eliminates the Need for Adjuvant Therapies in an Oropharyngeal Cancer Patient
  13. William Yao, MD joins Texas Sinus Institute and Texas Skull Base Physicians
  14. AAO-HNS President-elect to Speaks at 2015 Otorhinolaryngology Frontiers
  15. Surgical Fire Prevention in Laser Laryngeal Surgery
  16. A Gift of Hearing
  17. Breath of Fresh Air
  18. Current Pediatric Guidelines for Tonsillectomy
  19. Profile in Caring: José Elías, RN, CORLN
  20. Amber Luong, MD, PhD, Awarded CCTS Grant in Support of Continued Chronic Rhinosinusitis Investigations
  21. Two ORL Faculty Members Named to Top Doctor Lists
  22. Sialendoscopy: An Innovative Minimally Invasive Approach to the Treatment of Sialolithiasis
  23. Physicians’ Mission Satisfied
  24. A Second Pair of Ears
  25. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  26. More Than 100 People Participate in UTHealth Otorhinolaryngology’s Annual Free Cancer Screening Clinic
  27. Etan Weinstock, MD, Selected Faculty Member of the Year
  28. Amber Luong, MD, PhD, Named Fellow of American College of Surgeons and Promoted to Associate Professor
  29. Memorial Hermann and UTHealth Welcome New Team Members
  30. Texas Hill Country ENT Symposium Recap
  31. Internationally Renowned Expert in Facial Cosmetic Surgery Speaks at 2014 ORL Frontiers
  32. Congratulations to Graduating Residents and Fellows
  33. Samer Fakhri, MD, Chairs Rhinology Program at Middle East Conference in Dubai, Serves as Invited Faculty in Tehran
  34. TORS-L: Transoral Robotic Surgery with CO2 Laser Offers Greater Precision for Surgeons and De-intensification of Adjuvant Therapies for Patients
  35. Reevaluating Anaplastic Thyroid Cancer: Aggressive Treatment May Extend Life and Improve Its Quality
  36. UTHealth Audiology Offers Widex Zen Therapy for Tinnitus Management
  37. MicroSeismic, Inc. Gives Pediatric Patients the Gift of Hearing
  38. In Memoriam: Robert Jahrsdoerfer, MD
  39. Simultaneous Bilateral Cochlear Implants in an Infant After Meningitis
  40. Laryngotracheal Reconstruction Using Anterior Cricoid Suspension in a Three Year Old
  41. Single-Incision Minimally Invasive Parathyroidectomy
  42. Advanced Technology and a Strong Focus on Convenience Improve the Patient Experience
  43. Multidisciplinary Virtual Pre-surgical Planning Optimizes the Outcome for an Ameloblastoma Patient
  44. Dr. Fakhri Receives Regents’ Outstanding Teaching Award
  45. IL-33-responsive Innate Lymphoid Cells Are an Important Source of IL-13 in Chronic Rhinosinusitis with Nasal Polyps
  46. Randomized, Double-Blind, Controlled Trial of Oral Antifungal for the Treatment of Fungal-sensitive Chronic Rhinosinusitis with Nasal Polyps
  47. Dr. Fakhri Promoted to Professor of Otolaryngology-Head and Neck Surgery
  48. TLR4 Signaling in the Pathophysiology of Allergic Fungal Rhinosinusitis
  49. Two ORL Faculty Members Named to Texas Super Doctors 2013 List
  50. Transoral Robotic Surgery for the Treatment of Obstructive Sleep Apnea
  51. Lone Star Rhinology Course Attracts a National Audience
  52. Internationally Renowned Otolaryngologist Speaks at 2013 ORL Frontiers
  53. ORL Welcomes New Recruits
  54. UTHealth Otorhinolaryngology Holds Free Cancer Screening Clinic
  55. Two ORL Team Members Named Fellows of the American College of Surgeons
  56. Faculty Named Among Texas Super Doctors Rising Stars
  57. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  58. Translational Science Program Working to Identify Therapeutic Targets in Chronic Rhinosinusitis
  59. Preventing Surgical Fires: UTHealth Otolaryngologist Provides Expert Advice for a New FDA Safety Initiative
  60. Improving Survivorship in Head and Neck Cancer: UTHealth Department of Otorhinolaryngology and Institute of Molecular Medicine Partner on CPRIT Research Award
  61. Using Intraoperative Staining to Identify the Parathyroid Adenoma
  62. Otorhinolaryngologists Named to 2012 Best Doctors in America List
  63. Four Studies Evaluate the Effectiveness of Optical Rhinometry
  64. A Collaborative Approach Offers Patients a Less Invasive Alternative for Surgical Excision of Pituitary Tumors
  65. Internationally Renowned Otolaryngologist Speaks at 2012 ORL Frontiers
  66. Ron Karni, MD, Selected Faculty Member of the Year by Graduating Residents
  67. Samer Fakhri, M.D., Receives AAO Foundation Honor Award
  68. Two Audiologists Join UTHealth Otorhinolaryngology
  69. 2012 Residency and Fellowship Update
  70. Five UTHealth Medical Students Matched to Top Choice Otorhinolaryngology Residency Programs
  71. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  72. Chair of Otorhinolaryngology Named to Texas Super Doctors 2012 List
  73. Minimally Invasive Surgery for Skull Base Cancer
  74. UTHealth/Memorial Hermann Physician Joins a Medical Mission to Honduras
  75. Online Patient Access Library Offers Medical Information About ENT Diseases & Conditions to Patients
  76. Facial Reanimation Surgery Brightens a Young Boy’s Future
  77. Morphoproteomics: Driving a Shift to Personalized Care for Sinonasal Undifferentiated Carcinoma
  78. Internationally Renowned Otolaryngologist to Speak at 2012 ORL Frontiers
  79. UTHealth Otorhinolaryngology Department Exceeds the National Averages in Quality and Safety
  80. Rhinologist Invited to Serve as Board Examiner in the Middle East
  81. Dr. Citardi Named to the 2011 Texas Super Doctors List
  82. Make Your Voice Count!
  83. Research Update
  84. Advanced Rhinology Concepts CME Attracts a National and International Audience of Otolaryngologists
  85. Outside the Box with Chronic Rhinosinusitis
  86. The Vargas Case: Excision of a Large Benign Goiter
  87. The Reverend Williams Regains His Voice
  88. Nihal Uddin’s Journey to 360-Degree Hearing
  89. Residents Receive Research Grants
  90. Two ORL Faculty Members Receive Dean’s Teaching Excellence Award
  91. Otorhinolaryngologists Named to Best Doctors in America List
  92. Russell Kridel, MD, Reelected to AMA Council Position
  93. From Bench to Bedside: Physician Researcher Amber Luong, MD, PhD Blends Basic Science with Clinical Care
  94. 2011 Advanced Rhinology Concepts Scheduled for November
  95. Internationally Renowned Otolaryngologist Speaks at 2011 ORL Frontiers
  96. Michael Byrd, MD Recruited to UTHealth and Memorial Hermann
  97. UT Physicians Opens Facial Plastic Surgery Clinic in Southwest Houston
  98. UTHealth Audiology Program Expands
  99. 9 UTHealth Medical Students Match in Otorhinolaryngology
  100. Residency and Fellowship Update
  101. Ron Karni, MD Invited to Speak in Panama
  102. Finding the Unknown Primary in Head & Neck Cancer
  103. A Meta-Analysis of Topical Amphotericin B for the Treatment of Chronic Rhinosinusitis
  104. Cytokine Profile Comparison Between Inflamed Sinus Mucosa and Sinonasal Polyps from Chronic Rhinosinusitis
  105. The Distribution of Normal Saline Delivered by Large-Particle Nasal Nebulizer versus Large-Volume/Low-Pressure Squeeze Bottle
  106. Averting the "Limping Larynx" with a Multidisciplinary Approach
  107. Repair of Nasal Obstruction with Functional Septorhinoplasty
  108. Definitive Endoscopic Resection of Inverted Papilloma
  109. Facial Reanimation and Facelift for Facial Paralysis
  110. Mometasone Furoate Gel: A Novel In-Office Treatment of Recalcitrant Postoperative Chronic Rhinosinusitis
  111. Rhinologic Applications of Radiofrequency Coblation
  112. Rhinoplasty for Nasal Obstruction
  113. Producing Quality Outcomes in Thyroid Surgery
  114. Functional Rhinoplasty: Repairing Nasal Valve Obstruction
  115. A Cancer Patient Regains His Voice
  116. Soham Roy, M.D., Named Director of Pediatric Otorhinolaryngology
  117. From Bench to Bedside with New Treatments for Chronic Sinus Disease
  118. Comprehensive Rhinology Program Offers State-of-the-Art Care for Patients with Chronic Rhinosinusitis Refractory to Standard Treatments
  119. Rhinology Update: Advanced Rhinology Concepts CME Scheduled for November
  120. The Comprehensive Voice Program: From Advanced Office-Based Procedures to Community Outreach
  121. Designing the Future: ORL’s New Office Space Features High-Tech Tools
  122. Welcome!

Subscribe to our newsletters

ORL Update UT ORL Update, our first on-line departmental newsletter, summarizes current topics in otorhinolaryngology. The newsletter’s target audience includes both physicians and other healthcare providers, although subscriptions are not limited to members of these groups.

ORL Progress Notes ORL Progress Notes, our second on-line departmental newsletter, provides information about developments in the Department. The newsletter’s target audience includes physicians and healthcare professionals as well as patients and members of the general public.

To subscribe, please fill in your contact information and select the newsletter(s) you would like to receive. Of course, you may opt out of any of the newsletters at any time.