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This is a centre for the diagnosis and treatment of the young children and adults with speech, languages and hearing challenges. Our vision is to be recognized as one of the leading centre which provides best services to the individual with communication and hearing disorder and which improve their quality of life. Exploratory tympanotomy is used when the diagnosis is in doubt and it is felt that direct microscopic visualization will significantly aid diagnosis and enhance planning of middle ear surgery. To detect conductive hearing loss caused by ossicular fixation, incus discontinuity and otosclerosis is easier with 3D CT imaging. No need of exploratory tympanotomy for diagnostic purpose alone, but can be useful if surgery is considered at the same time. Otosclerosis is a condition that affects the stapes, one of the tiny bony ossicles in the middle ear. 3D CT proved valuable in detecting otosclerosis, foci of demineralization, and changes in bony texture and enables the easy recognition of subtle radiographic findings. 3D CT proved valuable in determining otosclerotic changes of the oval window and otic capsule. Hearing aids can be very helpful and it makes sense to try them before considering surgery. Dr Paulose FRCS, DLO is a Consultant ENT Plastic & Laser Surgeon with over 38 years of world class experience in Ear, Nose, Throat and Laser Surgery treating patients across the world from UK, US, Middle East to Asia. The human ear is fully developed at birth and responds to sounds that are very faint as well as to sounds that are very loud.
TheA outer ear consists of the auricle, ear canal (external auditory canal) and eardrum (tympanic membrane).
The middle ear is a space behind the eardrum that contains three small bones, malleus, incus, stapes, also called ossicles.
The movement of the fluid in the inner ear or cochlea, causes changes in the tiny structures located in the inner ear, called hair cells.
There are four types of hearing loss: conductive, sensorineural, mixed and neural hearing loss.
We carry a wide range of hearing aids to provide relief for all sort of hearing loss issues. High intensity interval training (HIIT) has been growing in popularity in the past few years. The Virginia Hearing Center prides itself on working closely with the physicians to identify patient hearing loss and possible need for hearing aids.


Custom fitting and modern diagnostic testing insures a good match between the hearing-impaired patient and their hearing aid. Our professional staff is comprised of a highly skilled, experienced team of audiologists, who have earned recognition for their outstanding dedication in this field. We are dedicated to providing the highest quality, dignified care for our patients, and to advancing the understanding of hearing loss and implementing the appropriate treatment.
For more information on our services, please call us at 804-288-3277 and ask for the Virginia Hearing Center. In patients who presents with conductive hearing loss due to middle ear abnormalities can be diagnosed by 3DCT imaging. To have normal hearing, the ossicles need to be able to move freely in response to sound waves.
Bone is continually being broken down and remodeled but the remodeling process of the stapes becomes faulty.
The stapes footplate is fixed when the spongiotic focus expands and invades the oval window. However, otosclerosis will continue to progress and hearing aids will not stop you developing profound deafness in the long term.
However, if you suffer from tinnitus, surgery may not relieve this and if your inner ear is also affected, surgery may not improve your hearing either.
This chain of tiny bones is connected to the eardrum at one end and to an opening to the inner ear at the other end. This movement of the hair cells sends electric signals from the inner ear up the auditory nerve (also known as the hearing nerve) to the brain. This computerized hearing test is used to measure the electrical activity of the vestibulocochlear nerve by determining how long it takes nerve impulses traveling along the nerve to reach the brain stem. This hearing test measures the electrical activity of the sensory hair cells in the inner ear in response to sound waves. We take pride in appropriately diagnosing the different forms of hearing loss and when necessary recommending the correct type of hearing aid. When the tympanic membrane is intact, the only way to find out the state of the middle ear structures are by doing an operation called exploratory tympanotomy. Vibrations from the eardrum cause the ossicles to vibrate which, in turn, create movement of the fluid in the inner ear. The first part measures how well you can hear sounds conducted through the air and indicates the condition of your overall hearing.


During the test, a probe that is covered with soundproof material is placed into your outer ear canal, sealing off the entrance to both sound and outside air pressure. During the test, electrodes are placed on your scalp to analyze your brain’s response to sound stimulation produced by an audiometer.
During the test, the eardrum is anesthetized and a very fine needle is passed through the eardrum until it is very near the sensory hair cells. In addition, the treatment of unilateral and conductive hearing loss with the BAHA System is also readily available when indicated.
The test is usually administered in a soundproof room using a machine called an audiometer. The probe then transmits a continuous sound as air is pumped into the ear canal through the probe at various pressure levels (from low to high), and a microphone in the probe measures reflected sound waves.
This test is sometimes used to rule out an acoustic neuroma (a noncancerous tumor in the ear canal).
Sound tones of varying frequency (low to high) and loudness are then transmitted into the ear through headphones, while the needle detects the electrical activity of the sensory hair cells. This abnormal bone reduces the movement of the stapes, which reduces the amount of sound that is transferred to the cochlea.
Through headphones, you listen to a series of sound tones that range from high to low, one tone at a time. This test is used to detect fluid in the middle ear, a perforated eardrum, and disorders of the three tiny sound-conducting bones (the malleus or hammer, the incus or anvil, and the stapes or stirrup) of the middle ear.
The sound level decreases gradually until you are no longer able to hear the tone; this point is your hearing threshold for that frequency. The second part of the test measures how well you can hear sounds conducted through your head and indicates whether your hearing loss is conductive or sensorineural. The procedure is the same as for the first part of the test, but this time you wear special vibrating headphones.
Next you are tested for words to establish the lowest threshold at which you can hear two-syllable words (called your speech-reception threshold) and to determine the percentage of one-syllable words you can repeat back correctly (called speech discrimination).Your hearing thresholds for all parts of the test are recorded on a graph called an audiogram.



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