By John W. Watford, MD, LLC
Our inner ears are tiny apparatuses each occupying a very small space within the bone of our skulls that measures about 1.5cm by 2cm on each side. The pair of tiny organs allow us to not only hear a whisper across the room, but also to be able look with both eyes at objects in the world around us. Our ears are also critical to our ability to stand and move our bodies the way we desire. Small disturbances within the organs themselves or to the bone or blood vessels nearby can create major changes in how we hear or move. Those disturbances can be from acquired infections, changes in blood flow or bone growth, or injury.
Many people have experienced an unusual, high-pitched, often transient tone in their ears that can cause some mild hearing loss or dizziness called tinnitus (TIN-ni-tus), or eponymously, Ménière’s Disease. Physicians encounter some patients suffering from this syndrome continuously. It is difficult to fully treat and is a source of significant burden and discomfort. We internists and primary care physicians rely heavily on our ear, nose, and throat colleagues to evaluate our patients with severe cases that persist and do not respond to initial treatment.
Some people experience an audible “swooshing” noise in one or both ears that corresponds to their heartbeat or pulse. Hence, it is called pulsatile tinnitus. Its cause may be very different from more common ringing in the ears and should be carefully evaluated. A healthy athlete who has just run a race or performed another strenuous exercise may experience the normal sensation of hearing their heartbeat or feeling their pulse in their throat or neck. However, a person who can hear blood flowing most or all the time requires careful evaluation. Your doctor will examine your ears and may refer you for a formal hearing test and likely examination by an E.N.T. specialist (otolaryngologist). Depending on the hearing test and your history, he or she may also order a brain MRI to fully visualize the functional components of the ear including the ear drum, the three tiny bones of the ear (hammer, anvil, and stirrup – remember those?) and the main sensory organs: the cochlea and the semicircular canals. Sometimes, detailed pictures of the blood vessels near the ear must be taken to make sure no blockages or detours in blood vessels exist that could lead to more severe problems in the future. Those pictures can be taken by CT scan, specially configured MRI study, or angiogram of the blood vessels performed by a neuroradiologist or neurosurgeon. Normal tests are usually very reassuring that no dangerous abnormalities are present.
If hearing your own heartbeat isn’t nuisance enough, stranger things do exist. Some people have described a sensation of not only hearing their heart beating and blood flowing in their head, but also hearing themselves breathing or hearing their own voice as if it was originating in their head. Similarly, others have described a sensation of “walking on the surface of a drum” and hearing their own footsteps internally. Even hearing one’s own eye movements has been described by individuals with a very curious (and fortunately very rare) problem called Superior Canal Dehiscence Syndrome (SCDS). It can occur if the bone encasing the superior semicircular canal (one of the sensors of our inner ear that allows us to know our orientation in space) experiences an otherwise very minor disruption that alters how vibrations are usually conducted through the organs of the inner ear. Consequently, tiny pressure waves or vibrations that are not usually transmitted to the sensory part of our inner ears become detectable and disruptive. The exact source of the disruption to the layer of bone and its nearby superior semicircular canal is not always known. Injury to the head or sometimes underlying defects that create inconsistencies in bone growth are thought to be causes. Diagnosing SCDS is very difficult, and the cure may require skull surgery.
Our inner ears are incredible organs that allow us to interface with our environment and move within it for the duration of our lives. While it is true that most of us will experience transient trouble with our ears, and many of us will experience some hearing loss over time, keep in mind that sudden, odd changes to your hearing or balance warrant a visit to your doctor. Let us use our ears to help you with yours!
ABOUT DR. WATFORD
My pursuit of a career in medicine began with natural curiosity about “how things work”. My early engineering interests later transformed into an interest in biology as I was inspired by my parents, several wonderful teachers in high school, and a general curiosity about physiology.
I believe curiosity helps us connect with each other. Curiosity drives lifelong learning, makes us better problem solvers, and nurtures our need to take on new challenges. It helps us to listen actively, inspires generosity to collaborate, and expands our empathy.
I grew up largely in Alabama and Florida and completed my undergraduate degree in Biomedical Sciences with Honors at Auburn University. There I founded the first inpatient shadowing program for health sciences students and was a charter member of the Auburn University Honors College. I earned my medical degree at the University of South Alabama in 2003 followed by internships in General Surgery at Carraway Methodist Medical Center, Birmingham, Alabama and then Internal Medicine at Providence St. Vincent Medical Center, Portland, Oregon.
My family and I settled in Naples in 2020 where I became part of the staff of Naples Community Hospital providing inpatient services. I opened my own practice in February of 2022.
Dr. John W. Watford is certified by the American Board of Internal Medicine and has been practicing since 2003. His concierge primary care medicine practice is now open and welcoming new patients. Reach Dr. Watford at 239-544-7440 or info@drwatfordnaples.com
Dr. John W. Watford
239-544-7440
www.drwatfordnaples.com
4085 Tamiami Trail North, Suite B103
Naples, FL 34103