At the Yale Hearing & Balance Center, a highly specialized team takes a collaborative approach to high-tech care. Most patients have a diagnosis and treatment plan in their first visit.
Dr. Michaelides adjusts a patient’s new cochlear implant.
(April 2012) Practically everyone who has ever dreamed of being a pilot fantasizes about breaking the sound barrier, but 21-year-old Seth Cohen, who was diagnosed as profoundly hearing-impaired at age 2, has quite literally done so already.
When he was in high school, Cohen was given a cochlear implant—a permanent electronic hearing device surgically implanted behind the ear—and now the Hamden, Connecticut resident and certified pilot is completing a degree at Embry-Riddle Aeronautical University.
“I can listen to air traffic control and weather broadcasts over radios with no problems,” says Cohen. “I’m able to understand my friends even in a loud dining hall, and I enjoy being able to go to the movies without having to ask what a character said.”
Elias Michaelides, MD, director of the Yale Hearing & Balance Center, implanted Cohen’s device and has provided cochlear implants for children as young as 12 months. Requiring only a small incision behind the ear, the outpatient procedure is considered safe and beneficial even for elderly patients. “When people can’t hear, they’re often isolated,” Dr. Michaelides says, noting that the problem may worsen symptoms of dementia in the elderly and present safety concerns if they are unable to hear a fire alarm, a phone or the doorbell.
Of course, cochlear implants are not always the answer to a hearing problem. “There are literally hundreds of ways a person can go deaf at any age, including noise exposure, chemotherapy and genetic susceptibility,” says Dr. Michaelides.
Dr. Michaelides, Jennifer Hopper and Dr. Navaratnam discuss a case.
Providers at the center see patients of all ages with inner ear problems (including viral infections), balance issues and facial paralysis. A first visit may last two hours and include an audiogram to measure the patient’s ability to hear certain pitches and tones. Patients will have appointments with Dr. Michaelides, and those being treated for dizziness will also see the Center's neurologist Dhasakumar S. Navaratnam, MD, PhD.
The doctors discuss each and every patient immediately after the visit, an unusually collaborative approach. “This type of comprehensive care is available in just a very few locations around the country,” says Dr. Navaratnam. In some cases the center also coordinates appointments with Yale specialists in cardiology, geriatrics, head and neck surgery, craniofacial surgery and speech pathology.
Video goggles are used to check for inner ear reflexes.
With appointments scheduled “back to back,” Jennifer Hopper, AuD, an audiologist and manager of the center, says most patients are able to leave after the first visit with a diagnosis, or at the very least, a long list of conditions that have been ruled out.
Treatment varies widely depending on the diagnosis, but may include working with an audiologist or speech therapist, medication, physical therapy and, in rare cases, surgery. The center provides leading-edge technology in digital hearing aids, and offers a competitive price structure and a variety of hearing aid styles.
While the center can and does treat patients with sudden problems relating to hearing or balance, many have already seen other doctors by the time they come in, Hopper says. “Many of our patients have a story by the time they get to us,” she says. “We tend to see patients who’ve struggled for years and years. It’s very rewarding to be part of a medical team that is able to help patients get the quality of their life back.”
Story by Nicole Wise
Photos by Robert Lisak
Yale Physicians Building
800 Howard Avenue, 4th Floor
New Haven, CT 06519
Pediatric Specialty Center
Yale-New Haven Children’s Hospital, 2nd floor
New Haven, CT 06519
Dizziness, a problem that affects between 30 to 40 percent of adults at some point in life, is a common complaint at the Yale Hearing & Balance Center. For some, dizziness is intermittent and feels like spinning, while others experience dizziness that is overwhelming and doesn’t stop, affecting balance and causing lightheadedness.
Unfortunately, few doctors focus on dizziness, says Elias Michaelides, MD. “It is something everybody knows a little bit about, but not always enough to make a comprehensive treatment plan.”
Causes of dizziness range from neurological to inner ear to muscular, Dr. Michaelides says. While benign positional vertigo, the most common cause of dizziness, can often be effectively treated by a primary care physician, more complicated cases are the special purview of the Hearing & Balance Center.
The center uses a variety of diagnostic tools, including electrophysiological nerve testing, to determine whether dizziness is caused by an inner ear infection or neurological problem. The center was the first in Connecticut to provide state-of-the-art equipment known as the Dynamic Postural Stability Platform, used for balance retraining for many balance disorders.
Other solutions vary, and may include medication, physical therapy and surgery. “The majority of our patients don’t need surgery,” Dr. Michaelides says.