Trinity Hearing & Balance Center

Dr. Kelly Hansen has been successfully treating dizziness and balance disorders and hearing impaired patients in the Tampa Bay area for over 17 years.

Trinity Hearing & Balance Center provides advanced digital hearing aids and utilizes state of the art equipment to aid in the diagnosis and treatment of many different types of dizziness and balance disorders. People no longer have to "learn to live" with it! Trinity Hearing & Balance Center is committed to providing the latest and most up to date diagnostic testing in a warm, friendly atmosphere from professionals who care. Dr. Hansen is dedicated to providing quality personal service that you can trust for years to come. Make your appointment today!

• Causes of Dizziness

• Diagnostic Testing

• Treatment Options

• Hearing Loss

• Hearing Aids

• Insurance

NEW TECHNOLOGY GIVES MILLIONS WITH DIZZINESS
HOPE FOR EFFECTIVE TREATMENT

Trinity Hearing & Balance Center has added the Epley Omniax System to its arsenal of diagnostic and treatment options for patients suffering from dizziness associated with inner ear disorders.

In addition to diagnosing and treating dizziness/balance disorders, Dr. Kelly Hansen has extensive training in fitting advanced digital hearing aids. She has been treating hearing impaired patients in the Tampa Bay area for 18 years. Dr. Hansen is dedicated to providing quality personal service that you can trust for years to come. Trinity Hearing & Balance Center is dedicated to providing quality patient care in a warm, friendly atmosphere from professionals who care!

Causes of Dizziness

Dizziness is the third most common complaint among patients seen in outpatient clinics. Patients may present to emergency departments, family practitioners, or specialty clinics. Patients with chronic dizziness average four to six physician visits without resolution. For some people, dizziness/vertigo is a feeling of unsteadiness, while others can experience the whole room spinning around them. Many times patients can't quite explain what they are feeling, but they know there is something different. Dizziness/vertigo can affect an individual's independence, ability to work, and their quality of life. Often, people report that they feel dizzy, but what they are really feeling is unsteadiness on their feet. Generally, if someone has feelings of nausea, wooziness, and a sensation of spinning, this is usually referred to as vertigo.

There are many different causes of dizziness. Below is a list of some of the more common causes of dizziness.

BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) IS one of the most commonly encountered causes of vertigo. Fortunately, this is both easy to identify and treat. BPPV does not respond to pharmacologic intervention but is managed using appropriate repositioning techniques which are both noninvasive and basically fast to perform. The typical symptoms of patients with BPPV is vertigo (spinning) with looking up or lying down in bed. The vertigo typically lasts less than a minute.

PRESYNCOPE is the uncomfortable, lightheaded sensation preceding fainting. This feeling typically happens when you stand up too quickly. A common cause of presyncope is orthostatic hypotension which happens when there is a slight drop in blood pressure as one stands after being in a sitting or a supine position. As people age, orthostatic hypotension occurs more frequently.

DYSEQUILIBRIUM is a slight dizziness or imbalance not related to head position or activity.

PSYCHOLOGICAL DYSEQUILIBRIUM are typically temporary sensations which can be seen with increased anxiety or stress. Hyperventilation syndrome accounts for the most common cause of dizziness among younger patients.

MOTION SICKNESS

ATAXIA is clumsy motion and unsteadiness due to lack of coordinated muscle movement. Symptoms are typically present constantly and individuals often report that they feel like "they are drunk while walking."

SOUND-INDUCED VERTIGO-the inner ear is susceptible to loud sounds or rapid changes in pressure due to a lack of normal bony cover of the inner ear. This can be seen in superior canal dehiscence and perilymphatic fistulas.

MENIERE'S DISEASE occurs in just under 1% of the population and is a disorder of the inner ear that affects both hearing and balance. Symptoms are thought to occur due to an abnormal accumulation of the fluids of the inner ear. Classic Meniere's disease is thought to comprise the following: episodic vertigo with nystagmus, fluctuating low frequency hearing loss, unilateral tinnitus and aural fullness.

MIGRAINE HEADACHES

VESTIBULAR NEURONITIS often presents after a recent cold or upper respiratory infection and the etiology is thought to be related to a viral infection of the vestibular nerve. Vertigo typically lasts between 1 and 3 days.

LABYRINTHITIS is an infection of the entire inner ear which is similar to vestibular neuronitis with the addition of hearing loss and tinnitus.

HEAD TRAUMA

CEREBROVASCULAR DISEASE

MEDICATIONS

METABOLIC DISORDERS such as uncontrolled diabetes, renal failure, hepatic failure, and altered ion homeostasis can induce a constant feeling of dizziness.

NEUROLOGICAL SYMPTOMS Multiple cranial nerve deficits may be seen in patients suffering from strokes, tumors, vertebrobasilar insufficiency, and TIA's. Patients with seizures and multiple sclerosis are also at increased risk for developing vertigo due to interactions with neural pathways.

OTOTOXIC MEDICATIONS

NEUROLOGIC MEDICATIONS

ANTIHYPERTENSIVE MEDICINES include diuretics, beta-blockers, calcium channel blockers, and ACE inhibitors and can lead to orthostatic hypotension in patients.

ACOUSTIC NEUROMA is a noncancerous (benign) growth on the acoustic nerve, which connects the inner ear to the brain.

Diagnostic Testing

Trinity Hearing and Balance Center has advanced diagnostic testing equipment to assist in diagnosing and treating dizziness and balance disorders. Dr. Kelly Hansen is highly experienced in providing the most thorough diagnostic evaluation available today for dizziness and balance impaired patients. Because there are so many possible causes of dizziness and balance disorders, one or all of the following diagnostic tests may be performed:

Videonystagmography (VNG) tests inner ear function by measuring the movements of the eyes directly through infrared cameras . VNG testing is used to determine if a vestibular (inner ear) disease may be causing a balance or dizziness problem, and is one of the only tests available today that can distinguish between a unilateral (one ear) and bilateral (both ears) vestibular loss. VNG testing is non-invasive and very little discomfort is felt by the patient during the testing.

Audiometric (hearing) testing is also a key component of a thorough diagnostic evaluation. Some dizziness and balance disorders develop hearing problems as a result of the condition. It is important to have a comprehensive hearing assessment as part of the diagnostic process to more accurately diagnose and differentiate the source of the problem. All of our hearing tests are performed in sound booths to ensure the most accurate results as possible.

Brainstem auditory evoked response (BAER) tests both the inner ear system and the VIIIth nerve pathway up to the brainstem. This test measures the timing of different electrical waves in response to small clicks of noise in the ear. These tones are delivered through ear phones placed into the ear canal and are then recorded through electrodes typically placed on the forehead and behind the earlobes. The BAER test will allow you to see if there has been a "block" along the VIIIth nerve pathway that lead to the brainstem. Common "blocks" include tumors, infections, and degeneration to the nerve itself.

Vestibular Evoked Myogenic Potential (VEMP) testing has become a well-established test to determine the integrity of the saccule in the inner ear. The purpose of this test is to determine if the saccule, a part of the inner ear organ called the otolith, and the VIIIth nerve are intact and functioning normally. The VEMP is currently the only proven test available that can detect Meniere's disease even when a patient is non-symptomatic.

The VEMP testing procedure consists of placing an electrode on the forehead and on the middle third of the anterior (front) neck muscles (sternocleidomastoids). With the patient in a supine position, the patient is instructed to hold their head up with no support surface using their anterior neck muscles. Tone bursts or loud clicks are then repetitively presented to each ear. Patients are instructed to tense their neck muscles during acoustic stimulation, and relax between bursts.

DYNAMIC VISUAL ACUITY TESTING evaluates the presence of oscillopsia with horizontal and vertical volitional head movement. The test may be used for diagnostic evaluation and pre and post Vestibular Rehabilitation Therapy outcome measures.

SENSORY ORGANIZATION PERFORMANCE TESTING is a simple clinical tool which provides clinicians with an effective method of balance function assessment sensitive to vestibular deficits.

Treatment Options

VESTIBULAR REHABILITATION

The accurate diagnosis and assessment of a patient is critical for a successful individualized rehabilitation program. The diagnosis and assessment include quantifying the degree of damage to peripheral vestibular structures and central vestibular pathways and evaluating the level of physiologic and neurolgic compensation that may have already occurred. Trinity Hearing & Balance Center offers vestibular rehabilitation therapy for patients that have been diagnosed with a vestibular deficit. Vestibular rehabilitation is typically designed as a therapist-directed patient-motivated home-based exercise protocol. Vestibular rehabilitation exercises typically begin at the minimal skill level that the patient is capable of performing and the complexity is increased as compensation and habituation occur. Generally, home vestibular therapy is performed at home for approximately one month. When home vestibular therapy is not indicated, patients will be referred out to physical therapy. Trinity Hearing & Balance Center works closely with several physical therapists in the area who have special training and certification in treating vestibular disorders and vestibular rehabilitation.

BPPV TREATMENT PROTOCOL consists of repositioning otoconia utilizing Videonystagmography technologies. This increases the accuracy of the repositioning, and allows Dr. Hansen to see residual otoconia for patients that have a multi-canal involvement which may have gone unnoticed using only the naked eye. Once BPPV is diagnosed, an appointment is scheduled for the repositioning of the otoconia. A follow up appointment is then scheduled in one week to reposition any additional residual otoconia. or for multiple canal patients.

Hearing Loss

The first step in determining your level of hearing begins with a comprehensive hearing evaluation. All patients receive a thorough examination before treatment options are discussed. If cerumen (ear wax) is found during otoscopy, Dr. Hansen will remove it prior to the hearing evaluation. Testing is performed in a certified sound booth for accurate results.

DID YOU KNOW..................

31 million Americans have a significant hearing loss.

One of every 4 households in the U.S. have a member who is hearing impaired.

Hearing loss has been cited as the third most common health related problem in America today.

Half of all hearing impaired individuals are over 65.

95% of people with hearing loss can be helped with today's advanced hearing aids.

According to the National Council on Aging...

• 71% of people who wear hearing aids report an improvement in life overall

• 74% of hearing aid wearers report an improvement in relationships at home

• 67% of hearing aid wearers report an improvement in self-esteem.

CAUSES OF HEARING LOSS

Conductive hearing loss is caused by anything that interferes with the transmission of sound from the outer to the inner ear. Below are some possible causes of conductive hearing loss.

• Middle ear infections (otitis media)

• Collection of fluid in the middle ear

• Blockage of the outer ear, typically wax

• Otosclerosis (ossicles of the middle ear harden and become less mobile

• Damage to the ossicles, for example by serious infection or head injury

• Perforated (hole) eardrum, which can be caused by an untreated ear infection, head injury or a blow to the ear, or from poking something in your ear

SENSORINEURAL HEARING LOSS is due to damage to the pathway that sound impulses take from the hair cells of the inner ear to the auditory nerve and the brain. Below are some possible causes.

• Age related hearing loss (presbyacusis)

• Acoustic trauma (injury caused by loud noise) can damage hair cells

• Certain viral or bacterial infections such as mumps or meningitis

• Meniere's disease, which causes dizziness, tinnitus and hearing loss certain drugs, such as powerful antibiotics, can cause permanent hearing loss.

• Acoustic neuroma (benign non-cancerous tumor affecting the auditory nerve)

• Other neurological conditions such as multiple sclerosis or stroke

MIXED HEARING LOSS is a combination of conductive and sensorineural hearing loss.

DIAGNOSING HEARING LOSS

In adults, hearing loss may be very gradual, as in age-related hearing loss. If you, your friends or family think that your hearing is deteriorating, you should have your hearing evaluated.

Pure tone audiometry-An audiometer produces sounds of different volumes and pitch (frequencies). During the test, you are asked to indicate, usually by pushing a button, when you hear a sound in the earphones.

Hearing loss is measured in decibels hearing level (dBHL). A person who can hear sounds across a range of frequencies at 0 to 20dB is considered to have normal hearing. The thresholds for the different types of hearing loss are as follows:

• Mild 25-39 dBHL

• Moderate 40-69 dBHL

• Severe 70-89 dBHL

• Profound 90dBHL and greater

Tympanometry - essentially measures the mobility of the eardrum. It helps to identify any abnormalities in the auditory system. During this test, a soft probe is placed into the ear canal and a small amount of pressure is applied. The response of the eardrum is recorded which helps to determine if the eardrum is moving normally. This test helps to rule out some outer and middle ear problems such as fluid behind the eardrum.

Otoacoustic emissions-This measures the responses the cochlea makes to sound produced by a probe placed in the outer ear.

THERE IS NO PAIN INVOLVED WITH ANY OF THE ABOVE TESTS

Hearing Aids

Trinity Hearing & Balance Center offers state of the art hearing aid technology. The latest and most up to date advancements in digital technology of hearing aids are available. From affordable entry level products to advanced digital technology, Dr. Kelly Hansen will help you make the best choice for your lifestyle. Most major brands of hearing aids are available. The new advancements in hearing aid technology can make many old problems disappear.

Hearing aid services include:

• selection, fitting, and dispensing of hearing aids as well as assistive listening devices

• in office demonstrations of hearing aid technology

• Extremely competitive hearing aid pricing

• 30 day money back guarantee for your protection

• hearing aid repairs and cleaning

• custom made earmolds including swim molds and hearing protection for musicians and hunters

• hearing aid accessories including batteries, drying units, cleaning tools and wax guards

The most commonly reported problem by hearing impaired individuals is difficulty understanding speech in the presence of noise. Clinical studies have shown even mild amounts of hearing loss can affect one's ability to communicate in background noise. The good news is that hearing aids CAN help you hear better in background noise! Hearing aids utilizing directional microphones have been proven to reduce background noise and are much more effective than traditional microphones. Traditional microphones are used in most conventional hearing aids and pick up sound from all around equally. All sounds are amplified equally, regardless of its origin. On the other hand, with directional microphones, sound is selectively amplified. Sound waves which come from the front are enhanced, while sounds from behind are reduced. The result is conversational speech which is easier to hear and background noise is reduced.

At Trinity Hearing & Balance Center, you can expect Dr. Hansen to evaluate your hearing status and eligibility for amplification. You will learn the cause and degree of your hearing loss. Your specific communication needs will be discussed as well as what technology is most appropriate to fill those needs. If desired, you will receive a personal demonstration of directional microphones and experience how well you CAN hear in background noise.

Hearing Aids Frequently Asked Questions

Are all hearing aids the same?

Today, nearly all hearing aids are digital, but that does NOT mean they are the same. Digital hearing aids can do more with sound than conventional technology. They can make many of the features of a hearing aid automatic. However, digital hearing aids vary by the number and type of features offered.

Is smaller better?

Not necessarily-depending on your specific hearing need, smaller may not be better. The hearing aid that is best for you may depend on many factors including: amount of hearing loss and types of listening situations you are in on a daily basis. Each model has different features, so what is right for one person may not be right for you.

Should I wear one hearing aid or two?

Being able to hear with both ears is as important as being able to see with both eyes. Two hearing aids can be beneficial in attaining a more balanced sense of hearing, provide better understanding in noisy situations, and achieve a better sense of direction for locating the source of a sound.

Why do hearing aids cost so much?

Hearing aids are actually tiny, personalized computers, customized for each individual. Years of research and development are spent to engineer hearing aids with the best sound quality and features. Just like stereos and television sets, more features = greater expense. The miniaturization of computer chips allow for more discreet hearing aids which also means more cost.

Will a hearing aid cure my hearing loss?

No, hearing aids cannot cure hearing loss or restore completely normal hearing. Hearing aids can: significantly aid your ability to understand those around you and help you function more fully in daily communication situations.

Insurance

Trinity Hearing & Balance Center are providers for most insurance companies. Below is a list of the insurance companies and organizations that we are a part of.

Thank you for visiting Trinity Hearing & Balance Center of Trinity Florida.

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