 Hearing loss and deafness affects almost 30 million people in the U.S. Possible causes of hearing loss are divided into three groups:
- Sensorineural: aging, drugs, tumors, current or past infections, congenital or genetic abnormalities, loud noises, sudden changes in air pressure
- Conductive: ear infection or obstruction, perforated eardrum, cholesteatoma, otosclerosis
- Mixed
Whatever the cause, hearing problems can be frustrating and even harmful, especially for children who are undergoing language acquisition and developing speech habits. Most hearing loss is neither preventable nor curable. Hearing aids or cochlear implants may help patients understand speech better and hear quieter or higher-pitched sounds.
The inner ear, or labyrinth, contains structures that amplify and transmit sound to the brain. It also contains the vestibular system, which controls balance. Ear infections, allergies, nerve tumors, Meniere’s disease, mastoiditis, vestibular neuronitis and trauma can all cause a loss of balance, along with other symptoms such as vertigo, nausea, tinnitus (ringing in the ears), hearing loss and pain.
Many children and adults have repeated ear infections. Fluid can form in the middle ear behind the ear drum and cause hearing loss. If either of these conditions remains after 3 months of good medical therapy, placement of middle ear tubes may be needed. Hearing loss may affect speech and language development along with social and educational skills. Tubes are a very effective way to avoid these problems.
This procedure is usually done in Day Surgery under a general anesthesia for children and in an office setting with local anesthesia for an adult. It is not painful after the tubes are placed. The hearing loss is immediately resolved. The pain from an ear infection is also avoided.
The injury to the ear drum from the placement of a tube is much less damaging than a single ear infection that results in a ruptured and draining ear. Tubes avoid the repeated use of antibiotics. The reduction in the use of antibiotics is a current goal of quality health care.
The experience for a child having tubes placed in their ears can be good. Dr. Lyons takes photos of the patient and family members prior to the surgery. The image is on several monitors in the room and the child enjoys seeing themselves with the family. The placement of tubes is usually painless and the hearing can be improved as soon as they wake up.
Some people have ear disease that disconnects the hearing bones in the middle ear. In this case, Dr. Lyons took a prosthesis, inserted it between the hearing bones and applied a special cement to allow sound to pass. The hearing was dramatically improved.
   
Dr. Lyons was the first surgeon in the region to perform the placement of a Bone Anchored Hearing Device to provide hearing in patients that can not hear from one of their ears. You can now hear the sounds you were missing from one side where conventional hearing aids do not work. A brief and nearly painless surgery implants a titanium attachment for the BAHA device. Dr. Lyons can demonstrate the benefits in his office with a trial unit that you can wear.
The implant is marked behind the affected ear. A flap of skin is created to allow for the removal of tissue down to the covering of the bone. The BAHA implant is placed in the bone.
  
The skin flap is placed over the implant and a dressing is applied. The implant heals over the next 3 months. It becomes solidly mated to the bone. The electronic processor is snapped onto the implant after 3 months and hearing returns.
  
Many ear operations are performed by Dr. Lyons from the placement of middle ear ventilating tubes, to the removal of chronic infection from the ear and mastoid. Ear drums are reconstructed (tympanoplasty) and hearing bones are re-connected (ossicular reconstruction) to improve hearing. The first Zeiss operating microscope with a built in laser for ear surgery in the United States was requested by Dr. Lyons and delivered to Great River Medical Center.
The sinuses are small, hollow chambers inside the nose and head that reduce the weight of the facial bones, give the bones shape and support, assist in mucus drainage from the nose, and help the voice resonate. Healthy sinuses are filled with air. When their mucous membranes swell from allergies, the common cold, infection or another cause, the sinuses become blocked, the pressure inside them drops, and they can fill with fluid, which easily leads to bacterial infection (called sinusitis, or rhinosinusitis if the nasal tissues are also affected). Blocked, inflamed or infected sinuses can be very painful.
There are four groups of sinuses: maxillary, in the cheekbones; ethmoid, along the nose; frontal, above the eyes; and sphenoid, behind the ethmoids. Any or all of these may be involved in an allergy or sinus infection, so accordingly, discomfort may occur in many areas of the face and head, including the cheeks, eyes, forehead and teeth.
Sinusitis may be acute (short-term, as after a cold or flu) or chronic (more than 8-12 weeks). Acute sinusitis symptoms include thick yellow or green discharge from the nose, sharp pain, headache and fever. Symptoms of chronic sinusitis are less obvious and may include nasal blockage or congestion, post-nasal drip, reduced sense of smell, and malaise.
A diagnosis of sinusitis is made after a description of symptoms, a physical examination and potentially one or more imaging tests such as an x-ray, CT scan, or endoscopic examination under local anesthesia. Treatment may include a nasal spray, antibiotic, corticosteroid or antihistamine. In some cases the patient may wish to undergo surgery to clean the sinuses, improve drainage or realign a deviated septum.
We are all designed to breath through our nose. Anyone who has a cold understands how uncomfortable it is when the nose is "stuffed up." A common problem is a twisting deformity of the divider inside the nose called the septum. This can happen from an injury to the nose or it can grow that way with no trauma. Many people have a breathing problem but do not understand where the blockage is. Correction of this problem is a Day Surgery procedure with little pain and mild congestion. Dr. Lyons does not routinely use packing in the nose. This was common years ago and many people remember how uncomfortable they were with both the packing and its removal. Surgery on the inside of the nose, called a septoplasty, allows a rapid return to the patient’s regular activities.
The outside of the nose can also be broken and heal off to one side. This can make the nasal airway even more obstructed. Some people have a nose that is naturally deformed and they want it corrected. Dr. Lyons also operates on the outside of the nose in an operation called a rhinoplasty. This is done for both breathing and cosmetic reasons.
Nasal polyps are non-cancer tumors of the nose that can block both the breathing and the sinuses. These are treated with medications and surgery.
Disorders of the throat, or pharynx, and voice box, or larynx, can take many forms, including:
- Cancers and Tumors
- Epiglottitis – Bacterial infection of the epiglottis.
- Gastroesophageal Reflux (GERD / Heartburn) and Laryngopharyngeal Reflux (LPRD) – Backflow of stomach acid into the esophagus can cause hoarseness, swallowing problems and pain.
- Laryngitis – Inflammation of the voice box from the common cold, bronchitis, overuse of the voice, allergies or irritants.
- Laryngoceles – Air- or mucus-filled, inward or outward bulging of the voice box lining. Most common in wind instrument players.
- Mononucleosis
- Pharyngitis (Sore Throat) & Streptococcal Pharyngitis (Strep Throat)
- Tonsillitis (Swelling of the tonsils), Tonsillar Cellulitis (Bacterial infection of the tonsils) and Tonsillar Abscesses (Pus collection around the tonsils).
- Vocal Cord Paralysis – Loss of movement of the muscles that control one or both vocal cords. Paralysis of one vocal cord leaves the voice breathy or hoarse; paralysis of both weakens the voice and makes breathing difficult when exercising.
- Vocal Cord Nodules and Polyps – Benign (non-cancerous) growths that form from overuse of the voice, smoking, irritants or acid reflux.
- Vocal Cord Contact Ulcers – Sores in the cartilage around the vocal cords caused by straining the voice, frequent talking, smoking, coughing or acid reflux.
Changes in the voice are almost always indicative of a medical problem; patients experiencing hoarseness or other voice changes should see a physician to determine the cause.
 The removal of tonsil and adenoid tissue is performed only when medically necessary. Failure of antibiotic therapy after 3-4 bouts of tonsillitis per year is a common reason. Many children mouth breath, snore and may stop breathing at night (obstructive sleep apnea). This can lead to more serious problems. A tonsillectomy and adenoidectomy (removal of the tissues) can dramatically reduce infections and improve their quality of life. Adenoid tissue can also block the normal function of the ears and lead to ear infections and hearing loss. An adenoidectomy is commonly performed to help resolve ear problems.
Dr. Lyons takes special care with his children for this surgery. He provides carefully placed, long acting local anesthetics to the surgery sites after the child is asleep to greatly reduce the pain felt after surgery. He also uses a special instrument called the Coblator that separates the tonsils and adenoids more gently and reduces pain and recovery time.
To reduce anxiety for the patient and their family, Dr. Lyons personally greets everyone before the operation and takes digital photographs. These are put up on several video screens in the operating room so the child will see their family right in the room with them. Just knowing that makes the parents feel better, too.
This new technique pioneered by Professor Miccoli, of Pisa, Italy, allows removal of the thyroid gland through an incision less than an inch long. There is a much smaller scar and drains are rarely needed. Dr. Lyons trained in this surgery with Dr. Miccoli and was the first to offer it in this area. He also uses the technique for other glands and tumors in the head and neck. Special instrumentation that is used includes the Harmonic Scalpel that can divide blood vessels and tissue with less exposure. Patients appreciate the minimal scars and reduced discomfort.
Dr. Lyons has a keen interest in reconstructing devastating facial injuries with meticulous plastic surgery techniques. This can range from a small cut lip resulting from a fall to a savage mauling of the face from a dog bite. All manner of facial bone fractures are also repaired including the nose, orbit, face and jaw.
Cosmetic surgery of the nose, eyelids, ears and face are offered by Dr. Lyons. These operations include rhinoplasty (nose), blepharoplasty (eyelids), otoplasty (ears), and facial rhytidectomy (face lift).
Blepharoplasty surgery on the eyelids is performed for excessive skin and to correct blocked vision to the sides and upward gaze. The effects can be dramatic and rewarding.
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Dr. Lyons also performs reconstructive plastic surgery of the eyelids on referral from several ophthalmologists and optometrists (eye specialists) in the area. Eyelids that fold out with tearing problems (ectropion) and fold in with eye irritation (entropion) are returned to more normal function. Eyelid tumors are also removed.
He takes pride in seeing patients referred to him from many sources to revise facial scars and repair damaged tissues that would otherwise be a permanent deformity.
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Dr. Lyons 