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Ears and hearing loss

The ears are part of our sensory system, providing us with hearing and contributing to our balance. Many conditions exist that can affect our ability to hear and many of these are either correctable or preventable. When the vestibular system in our ear is affected it can cause imbalance or vertigo, which can be very distressing. The ENTRUST specialists are able to offer management options for these conditions, including:

Glue Ear:

Commonly seen in children, this condition sees the accumulation of fluid behind the ear drum that results in hearing loss. This may affect a child’s speech and language development. Whilst often self-resolving, the insertion of grommets (ventilation tubes) is a simple operative procedure that corrects the problem. This is one of the most common reasons a child has a general anaesthetic in this country.

Ear drum perforations:

Holes in the ear drum can be problematic, in allowing for recurrent ear infections and discharge from the ear. They can prevent the individual from swimming and participating in water sports and are not uncommonly associated with hearing loss. Repair of the ear drum is by an operation called a myringoplasty, which can usually be done in a minimally invasive technique, avoiding external scars, using an endoscope.


This is a challenging condition where the patient typically has a discharging ear and hearing loss caused by a type of skin cyst behind the ear drum. Left untreated it can be of serious concern, as more life-threatening problems can arise. It is therefore usually treated with an operation (combined approach tympanoplasty, mastoidectomy, atticotomy), where cutting-edge technology such as the use of lasers and now endoscopic ear surgery techniques, are used to eradicate the disease.

Hearing loss:

Depending upon the cause, there are a range of treatments that may help an individual hear better if a loss is detected. We will arrange hearing tests when required. After careful assessment, management may include the provision of hearing aids, surgery to repair the bones of hearing (ossiculoplasty), the insertion of grommets (for glue ear) or the insertion of bone anchored hearing aids (BAHA).


Imbalance or dizziness due to problems within the inner ear, are often very distressing. However, there are a number of treatments that can usually help the patient control their symptoms. The majority of the problems fall under 3 main conditions.

  • Benign paroxysmal positional vertigo (BPPV):
    This typically causes brief episodes of vertigo on head movements. Simple outpatient treatments are available that are usually curative (the Epley manoeuvre).
  • Ménière’s disease:
    This condition, associated with tinnitus (ringing in the ears) and hearing loss can be very disabling. There are a wide range of treatment options, from medications to surgical procedures, including the use of Gentamicin ablation therapy.
  • Labyrinthitis:
    Probably due to a viral infection of the inner ear, this condition may be disabling for several days, but usually resolves with time. We will help to exclude other causes of the symptoms and then work closely with our physiotherapy colleagues who specialise in exercises that help to promote recovery (vestibular rehabilitation).


Tinnitus, or ringing in the ears, is a common condition that thankfully is usually self-limiting. As part of the assessment, it is important to rule out certain treatable causes. Understanding tinnitus is of key importance to preventing it from becoming intrusive in a patient’s life, and our specialists can offer this help. There are various management options, including hearing aid provision and tinnitus retraining therapy provided by hearing therapists, with whom we work closely.

Visit our Specialist Tinnitus Clinic – providing treatments to people living in Gloucestershire and the surrounding area.



Eustachian tube dysfunction:

Eustachian tube dysfunction is a frustrating condition where despite a normal ear examination and normal hearing tests, the patient suffers from symptoms including blocked sensation in the ear, muffled hearing, discomfort, inability to make the ears pop and imbalance. It can be a particular issue for those that take regular flights. The Eustachian tube connects the nose to the space behind the ear drum (the middle ear). As such, conventional treatments involve the use of nasal sprays and medication, but are often limited in their effect. Balloon Eustachian Tuboplasty is a new procedure (by Mr Clark), performed under a brief general anaesthetic, that studies indicate can help alleviate these symptoms in at least 70% of cases. It involves a balloon device being inserted into the tube, via the nose, to help open it up. Assessment to decide upon appropriate candidates includes the use of the Eustachian Tube Dysfunction patient questionnaire (ETDQ-7).