- Primary CareIn accordance with federal guidelines, any patients who are experiencing cough and/or fever, or any symptoms of respiratory illness should call their primary care provider for further instructions. If you [...]
- Ear InfectionsCholesteatoma is a type of skin cyst or sac located in the middle ear. Typically, cholesteatoma is a complication of repeated ear infections and eustachian tube dysfunction. Infection weakens an area of the eardrum membrane. If the eustachian tube fails to pass air up into the middle ear, a vacuum develops and pulls the weakened area of the eardrum membrane into the middle ear. The inward progression of the weakened area becomes a sac, lined with skin, which is, by definition, a cholesteatoma. As shedding old skin accumulates in the sac, it enlarges.
- Diarrhea
- Neurology
- Mental HealthPHI consists of all individually identifiable information which is created or received by SPA and which relates to your past, present or future physical or mental health condition, the provision of health care to you, or the past, present or future payment for health care provided to you.
- Psychiatry
- MRIAn audiogram (basic hearing test) finds hearing loss, normally in the higher frequencies. Ability to understand speech is also impaired. The most sensitive home test is to compare ability to understand on the telephone. If one ear has perceptibly poorer speech understanding on the phone, acoustic neuroma should be considered unless an obvious other explanation exists. Thus, any one-sided hearing loss should prompt further investigation. When a hearing test raises a mild suspicion of acoustic neuroma, other screening tests may be done. When suspicion is significant, a Magnetic Resonance Imaging scan is definitive way to discover the tumor.
- RadiologyOther specialty disciplines with which Dr. Bartels, Dr. Danner, and Dr. Allen work include neurosurgery, critical care medicine, interventional radiology, radiotherapy, oncology, cardiology, and others. For patients coming from some distance, coordinated appointments with other specialists can be arranged by the Tampa Bay Hearing and Balance Center staff. First and foremost, Dr. Bartels, Dr. Danner, and Dr. Allen review the patient’s history, performing a pertinent physical examination, and spending up to an hour or more reviewing diagnostic information, alternatives in management, risks of each, perioperative care, and social issues. Not all skull base tumors need surgery and which option is best for one patient might not fit for another.
- Computed TomographyGather and send us a COPY (not originals) of your medical records, and a COPY (not originals) of your MRI/CT Scan on CD/DVD or Film.
- Interventional Radiology
- Wound Care
- Neurosurgery
- OtolaryngologyThis information is provided by Tampa Bay Hearing and Balance Center, the American Academy of Otolaryngology-Head and Neck Surgery, Inc., (AAO-HNS) and the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. (AAO-HNSF) for educational purposes only. Any information provided in this Web site should not be considered medical advice or a substitute for a consultation with an otolaryngologist-head and neck surgeon or other physician.
- LesionsAcute vertigo sometimes has associated symptoms. More chronic vestibular disturbance or recognizable patterns of recurring vertigo must be considered at the outset. With those ruled out, findings infrequently associated with vestibular neuritis include ear fullness or tinnitus or tightness in the neck. Panic is commonly associated with vertigo though long experience suggests that panic from vertigo is much more likely than vertigo from panic though hyperventilation can induce various vestibular symptoms. With acute viral vestibular neuritis, there should be no swallowing problems, no diminished sensation in the face, hands, or feet, no true double vision, no disconjugate eye movement, no acute visual loss, and no specific limb clumsiness. Benign paroxysmal positioning vertigo can have a sudden onset independent of vestibular neuritis but it may also be a sequela of vestibular neuritis, often starting within days. It is differentiable by the Dix-Hallpike test and its classic pattern of response. Vestibular and basilar migraine can cause acute onset vertigo, sometimes with nausea and vomiting but should not last days and typically does not have the physical abnormalities found in vestibular neuritis: the vestibular ocular reflex, headshake testing, and gaze testing should be normal or very nearly normal. Differentiating brainstem dysfunction from peripheral vestibular dysfunction is based on several assessments. Warm versus cool distinction in the hands and feet should be intact unless other neurologic conditions co-exist. Ability to touch the finger to the examiner’s finger should be accurate and ability to rub one’s heel up and down the shin should be normal. While acute brainstem disorders can also cause vertigo, such as vestibular pseudoneuritis due to acute pontomedullary brainstem lesions or cerebellar nodular infarctions, vestibular migraine, and other acute brainstem disorders, these should be differentiable with a high degree of accuracy. Cerebellar nodular infarctions can present with isolated vertigo as a symptom, like vestibular neuritis. Unlike acute vestibular neuritis, nodular cerebellar infarction patients typically have distinctive findings such as complete absence of nystagmus or direction changing nystagmus. [13] Most commonly, cerebellar nodular infarctions are readily called as a cerebellar disorder in terms of normal ear responses to warm and cool stimulation and quite abnormal eye movement assessment whereas vestibular neuritis patients have a high incidence of poor caloric responses on one side and quite suggestive nystagmus and head thrust test response patterns. [14] Notable, though, head thrust abnormalities are present acutely in many vestibular neuritis cases but they may resolve rapidly and may not be present later such that the prevalence rate may be below 50% in the non-acute condition. Quite uncommon in acute vestibular neuritis but common in brainstem origin vertigo, is skew deviation as explained above. Skew d
- Physical TherapyRecovery from vestibular neuritis is spontaneous but can be helped by use of steroids. Peripheral labyrinthine function recovers to some degree in about 60% within 12 months. Adaptation is a part of recovery consisting of proprioception (muscle and joint sensors), visual substitution, and other central compensation. Physical therapy focusing on vestibular exercises can be helpful, as well. [6] Associated positional and positioning nystagmus disappeared in about 60% within 3 months. About half of the cases had long term persisting loss of ability of the affected ear to be stimulated and these patients were more likely to have prolonged symptoms. [10]