When Hearing Needs A Doctor Part 2: Common Auditory Issues Referred To A Physician

What Are Some Common Auditory Issues That Get Referred To A Physician?

When should an audiologist send you to a physician, and what happens next? We dive into two middle ear conditions that often sit at the crossroads between audiology and surgical care: otosclerosis and cholesteatoma. One tends to move slowly and allows space for thoughtful decisions; the other can quietly erode tissue and demands swift action. By the end, you’ll understand the warning signs, the tests that raise red flags, and the treatment paths that protect your hearing and your health.

We unpack otosclerosis first: how a hereditary change in the stapes bone leads to gradual hearing loss, what patterns audiologists look for on the audiogram, and why surgeons may wait until the benefit-risk balance is right. You’ll hear a clear explanation of stapedectomy, including prosthetic replacement, expected outcomes, recurrence risk, and when hearing aids remain a smart option. It’s a practical, plain‑spoken guide to making a confident decision with the support of an experienced ENT or otologist.

Then we turn to cholesteatoma, an abnormal skin growth that can invade the middle ear and mastoid. We explain why it’s dangerous, how it damages bone and the eardrum, and why prompt surgical removal is essential. We talk through hearing changes after surgery, the importance of long‑term monitoring, and why there’s no proven prevention beyond good ear health and timely care. Throughout the conversation, we show how audiologists and physicians collaborate to safeguard your hearing with accurate diagnosis, timely referral, and realistic expectations.

If you’re in the DFW area and want expert guidance on hearing loss, tinnitus, or middle ear issues, we’re here to help. Subscribe, share this with someone who’s concerned about their hearing, and leave a review to tell us what you want us to explore next.

To learn more about Total Hearing Care visit:
https://www.TotalHearingCare.com

Total Hearing Care
Multiple Locations Across the DFW Metroplex
(469) 809-4487

Transcript

Welcome And Focus Of Series

SPEAKER_00 0:00

Welcome to the Total Hearing Care Difference, where we help you experience life through better hearing. Hosted by the Experts of Total Hearing Care, a leading private audiology practice serving the DFW Metroplex, we are here to provide guidance on hearing loss, tinnitus, and the latest advancements in audiology. Transform your life through better hearing. Let's get started.

SPEAKER_01 0:27

Some auditory issues require more than audiology care. Let's explore where physicians step in and why. Welcome back, everyone. I'm Sophia Yvette, co-host and producer, back in the studio with Dr. Jill Copley. Dr. Copley, how's it going today? Hi, Sophia. It's it's going great. Thank you for having me back. Yes, great to be back with you. Now, Dr. Copley, let's dive into part two of what are some common auditory issues that get referred to a physician. Let's start off with talking about cholesteatoma and otosclerosis.

What Otosclerosis Is And How It Progresses

SPEAKER_02 1:07

Okay, those are great. So with audiology, um, when we do our testing or do our history with someone, sometimes there's some red flags that indicate issues that may not be just, as you said, um, focused for audiology. We need to refer to a physician. Particularly in the cases you're talking about, we'd refer to an ear, nose, and throat physician or what we call an ontologist. An ontologist only focuses on ears. And I'll start with cholesteatoma. Um, cholesteatoma is a type of tumor that can develop in your middle ear, and it can sit at the eardrum, it can be further into the middle ear, it can go into what we call the mastoid, which is kind of an air-filled space around the sinus area. And those tumors can actually be very, very dangerous. Um, on the other hand, odosclerosis is actually a hereditary disease that develops um kind of a hardening and yet brittle type of bone in one of your middle ear bones, and that sticks to the membrane that goes from the middle ear into the inner ear, which sends the sound to your brain. And so if that bone is not working, then um you're not getting all the sound you need. Now, otosclerosis, however, is not usually an emergency kind of situation like a cholesteatoma could be.

SPEAKER_01 2:50

So, how exactly um does otosclerosis start developing?

Surgery Options And Outcomes For Otosclerosis

Cholesteatoma Risks, Surgery, And Follow Up

SPEAKER_02 2:59

So that's a great question. Um, usually otosclerosis is very gradual. Um, the hearing loss that goes into is very gradual as that bone is getting more brittle and not working as well. Um, usually we see it working very slowly, and usually the physician's not going to want to do a surgery until it gets to a certain point because it can reoccur. Okay, so what the surgeon does when we refer and the person, the patient decides, okay, I'd I'd like to have the surgery to correct this. If the physician is good at this, and you can find really good physicians that do this kind of surgery all the time, it's called a stapodectomy, then they can be very successful and they can bring your hearing back. Um, or they can bring it back where it's not as severe and it's easier to treat with um hearing aids and amplification. But that person would go in and the physician actually takes that little bone that's not working and replaces it with a prosthetic, um, usually like a titanium, and it replaces that so that that then that bone will work again, um, except it's a it's a prosthesis. And so that works very well uh for most people, but it can reoccur. And like I said, we can test for that. We can see it in our test results. It is a major red flag when we see it. It's very obvious to know when to refer for that. And so um I think I I certainly when I see patients, I'm like, please go talk to a physician. If they've done it a lot, it will probably be a successful surgery. A cholesteatoma is a kind of tumor. Um, I think of it as kind of like um skin is wrapping around and it creates kind of an onion-like tumor with layers, and those layers can attach to the bones in your middle ear, they can attach to the bones that go into the skull, um, they can attach to your eardrum and ruin the eardrum, um, put a hole in it. They it's kind of like it eats through the bone or the tissue. And so it is something that is uh a more dangerous kind of tumor and it should be removed. So, unlike otosclerosis, which is is more like, okay, well, we can treat you with hearing aids, but if you'd like to have the surgery, we could probably make your hearing better. It's um I I won't say it's necessarily elective, but it isn't something you have to rush into. I certainly with a cholesteatoma would go to see a physician right away. And that cholesteatoma would be removed surgically. When it is removed, however, depending on where it is, you can typically lose your hearing in that area from wherever they may have to be removing it from. Um, and a cholesteatoma can come back, so it certainly has to be monitored, your hearing, and the um to see a physician to visualize the middle ear as much as they can to make sure it doesn't reoccur where they'd have to go do surgery again.

SPEAKER_01 6:23

Are there any preventative measures against cholesteatoma?

SPEAKER_02 6:29

There really aren't. Um this is just something you can have good ear health, that would certainly help. But it is just I I think it's just something that that kind of occurs for people I haven't seen. I I'm I'm sure it's some somewhere they have they have looked at who this occurs to and who it hasn't. But when I read the research, it's occurring to both men and women. You're gonna see it. I think um I see it more in adults than children, but certainly I'm it could happen to anybody. I I would say this. Um, if a physician says you have a cholesteatoma and says you need surgery, you should do it. I had a patient once come back to me and say, you know, should I, I just don't know. The physician said I needed surgery. What do you think? And I said, Oh yes, you need the surgery. Please go back and have the surgery with the physician, or I can refer you to another physician, but really you should have this taken care of.

Closing And How To Get Care

Prevention, Who It Affects, And Strong Advice

SPEAKER_01 7:26

Wow. Well, Dr. Copley, thank you so much for walking us through those very important conditions. We'll see you next time on the Total Hearing Care Difference Podcast.

SPEAKER_00 7:39

Thank you for listening to the Total Hearing Care Difference. If you're in the DFW Metroplex and ready to take the next step toward better hearing, call 469 809 4487 to book an appointment or visit totalhearing care dot com because when you hear better, you live better. See you next time.