Ear Clinic

The Carolina Ear and Hearing Clinic treats adult and pediatric patients and is focused exclusively on the diagnosis and treatment of disorders affecting hearing, balance and the facial nerve. Many of these conditions can be treated medically, whereas others require surgical intervention. A discussion of these disorders and their treatments can be accessed, by clicking the following booklets.

Dr. McElveen was fortunate to have been trained by some of the leading ear specialists including, William F. House, M.D., the father of Neurotology and developer of the cochlear implant as well as approaches to remove acoustic tumors, Jim Sheehy, M.D., a renowned cholesteatoma/chronic ear disease surgeon, Howard House, M.D., a master in the delicate art of stapes surgery and Rodney Perkins M.D., an innovator in laser stapes surgery and hearing devices. 

Dr. McElveen uses minimally invasive microsurgical techniques that allow him to remove the disease or tumor and preserve or reconstruct the normal anatomical structures. This allows many patients to ultimately preserve/regain hearing and resume their normal day-to-day activities without the need for water precautions.

Although Dr. McElveen personally performs the surgical procedures without the involvement of residents or fellows, he is committed to educating resident otolaryngologists in sophisticated otologic surgical procedures. Consequently, in addition to teaching residents at the Carolina Ear Research Institute’s “William F. House Temporal Bone Dissection Lab”, Dr. McElveen has created educational, minimally edited, surgical videos for some of the otologic procedures. The videos can be accessed by clicking on the links below.

Cholesteatoma Surgery: https://youtu.be/FfRopCcipqM

Stapes Surgery: https://youtu.be/-ckrUp3ocqw

Meniere’s Disease Surgery:

  1. Endolymphatic Mastoid Shunt: https://youtu.be/JiO_dyPm50M
  2. Transmastoid Labyrinthectomy: https://youtu.be/hEeeOyQSWp4

Acoustic Tumor Surgery: https://youtu.be/32Us6UoRUn0


Are there treatments to eliminate my vertigo caused by my Meniere’s disease?

Yes, you do not have to go through life worrying when you will have your next episode of vertigo. The remaining 50% may require surgical intervention ranging from transtympanic injections, an endolymphatic shunt or a selective sectioning of the vestibular nerve (balance nerve).There are a variety of non-surgical and surgical treatments that will stop the episodes. 50% of patients respond to some form of medical therapy. 

My family has a history of hearing loss due to fixation of the third hearing bone (stapes). Is there an option other than hearing aids?

This condition is referred to as “otosclerosis”.  Frequently the stapes bone is fixed, causing some or all of the hearing loss.  Often, using a laser or a small microdrill, an opening can be made in the “footplate” of the stapes and a prosthesis can be placed to restore the transmission of sound into the inner ear.  This procedure is successful in approximately 97% of patients. The surgery can be performed under local or intravenous sedation, can be done through the ear canal, takes around 30-45 minutes and is out-patient.

I have been diagnosed with an acoustic neuroma. What are my treatment options?

As you may know, acoustic neuromas are benign tumors that arise from the covering of the vestibular nerves (balance nerves).  They will not spread to other areas of your body, however, they can put pressure on your brain and surrounding nerves if they become quite large. Once diagnosed, there are basically three treatment options: follow with periodic MRIs until they require treatment (60% of the diagnosed tumors may not grow.), surgical removal (translabyrinthine, retrosigmoid or middle fossa approaches.) or treatment with gamma knife or cyber knife radiation therapy.

I experienced a sudden sensorineural hearing loss in my right ear. Is there any treatment?

Although many times a sudden hearing loss can be caused by cerumen blocking the ear canal or fluid behind the ear drum following a cold, in some cases there is sudden disruption of circulation to the hair cells in the inner ear.  This should be considered a medical emergency and steroid therapy should be instituted as quickly as possible.  In addition to the steroid pills, injection of a steroid into the middle ear may be beneficial.  66% of patients with a sudden sensorineural hearing loss will get an improvement in their hearing.  33% experience no improvement.

My hearing a deteriorated to the point that hearing aids are no longer effective. Is there anything I can do?

You do not need to worry about never being able to hear again.  There are several surgical options available.  Sometimes the cause is due to “far advanced” stapes fixation.  In that cases, a procedure that replaces the stapes bone may restore hearing.  In other cases, a cochlear implant that electrically stimulates the nerve endings is very effective.  Both are out-patient surgical procedures

Overnight, I developed a paralysis of the right side of my face. What should I do?

This is an otologic emergency.  Typically, this is a “Bell’s palsy”.  A virus is thought to cause the nerve to swell within its bony channel, resulting in a disruption of nerve function.  High dose oral steroids and antivirals should be taken immediately. This combination will decrease nerve swelling and treat the viral infection.

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