Ear, Nose & Throat Care
Comprehensive treatment and management of diseases and disorders of the ear, nose and throat for both children and adults
Compassionate solutions, experience you can trust.
You-Centered Care
Our multidisciplinary teams partner to coordinate expertise across the spectrum of ear, nose, throat and head and neck conditions to deliver the care you need.
Learning through Discovery
We work hard to improve quality of life through research, and our Ear, Nose & Throat Care patients can tap into these innovative treatment options through clinical trials.
Meet the provider: Carly Gauche, Au.D.
Carly Gauche, Au.D., is a clinical audiologist who specializes in hearing and balance disorders. She counts good listening among her most important tools in improving her patients' hearing. View full bio.
Some of our common services:
Bone-anchored hearing aids: Osseointegrated, or bone-anchored, hearing devices are recommended for patients with specific types of hearing loss for which a traditional hearing aid may not be beneficial. A titanium implant called an abutment is surgically placed in the mastoid bone behind the ear. An external device called a sound processor attaches to the abutment. Microphones on the processor pick up sound and the processor changes that sound into vibrations which are transmitted to the ear via the abutment.
Cochlear implants: A cochlear implant is a surgically implanted hearing device that is recommended for patients with hearing loss so severe that they do not benefit from traditional hearing aids.
The implanted portion consists of a receiver and an electrode array. The electrode array is inserted into the cochlea, the organ of hearing in the inner ear. The receiver is placed behind the ear on the mastoid bone just under the skin. The external portion, called a speech processor, is held in place over the receiver by a magnet. The processor is either a behind-the-ear device similar to a hearing aid, or a body-worn device.
Microphones on the processor pick up sound and the processor changes that acoustic energy into electrical energy. These signals are sent from the external processor to the receiver under the skin, which in turn sends signals to the electrode array. The electrodes in the inner ear stimulate the hearing nerve and send signals to the brain. In this way, the cochlear implant bypasses severe damage in the inner ear to enable patients to hear.
We offer the best standard of care available for cancer and other disorders of the head and neck. Our specialists use advanced surgical techniques along with the latest radiation and chemotherapy to treat head and neck cancers, and our oncologic and reconstructive surgeons work alongside each other to successfully perform complex reconstructions.
Our Head and Neck Cancer Program, part of Fred Hutchinson Cancer Center, is the Northwest's leader in head and neck cancer care. Our expert surgeons and other specialists offer innovative treatments for all types of head and neck cancers, including tongue, laryngeal, nasopharyngeal, oral, sinus, salivary gland, and thyroid, with outstanding results. Our multidisciplinary teams work closely with patients to help them recover quickly.
Sometimes malignant and benign tumors can occur near the skull base, the thin bone that separates the brain from the nose. We offer the latest skull base surgery techniques, in which otolaryngologists and neurosurgeons work together to remove tumors through the nostrils rather than through the skull. This results in shorter hospital stays, fewer complications and better outcomes for patients.
The thyroid and parathyroid glands help regulate your metabolism and calcium levels. Sometimes benign or malignant growths can occur on the thyroid gland, which is located at the base of the neck, or parathyroid glands can malfunction. We offer comprehensive screening and diagnosis along with safe, effective treatment for thyroid and parathyroid disorders.
Transoral robotic surgery (TORS) is a new, minimally invasive surgical technique used to treat tumors at the back of the tongue and throat. It allows patients to return home within a few days and without experiencing long-term effects on swallowing and voice. Our surgeons are national leaders in robotic surgery, and we were the first center in the region to offer this procedure.
Hearing aids can assist with hearing loss. To assess if you would benefit from a hearing aid, our audiologists will administer a hearing test and review the results with you. Our audiologist will make a specific professional recommendation for the most appropriate hearing aids for you, taking into consideration your hearing loss, your listening needs, and your personal preferences regarding style/aesthetics, cost and features.
At your fitting appointment, your hearing aids will be programmed to fit your hearing loss and configuration. You will have at least one follow-up appointment scheduled approximately two weeks after your initial fitting. This appointment allows your audiologist to meet with you, discuss your experiences, and make any further adjustments to fine-tune the hearing aid programming as needed.
Additional appointments can be scheduled during the trial period as needed. There are no additional fees during the trial period or while the hearing aids are in warranty.
Our team understands the significant impact facial nerve dysfunction can have on your daily life. Facial paralysis is a complex medical problem with a range of symptoms, causes, and treatment opportunities.
Facial paralysis is a term broadly applied to conditions affecting the movement of the face. Symptoms range from slight weakness to the complete inability to move one or both sides of the face. Patients may experience symptoms such as:
- Asymmetry of the face
- Inability to create facial expressions (smiling, frowning, etc)
- Inability to close the eye, dry eye, blurry vision, increased tearing, eye discomfort
- Drooling or decreased saliva, abnormal sense of taste, difficulty eating
- Difficulty breathing through your nose
- Abnormal speech and swallowing
- Tightness and spasm (often of the “unaffected” side of the face)
Facial paralysis is most commonly caused by Bell’s palsy, but other causes include trauma, head and neck tumors, skull base tumors, brain tumors, stroke, surgery in the head and neck area, and presence from birth. Depending on the individual patient situation, further testing may be ordered such as a imaging (CT/MRI), electrodiagnostic studies (EMG/ENOG), hearing test, corneal exam, etc.
Treatment for facial paralysis is aimed at addressing the underlying cause as well as immediate symptoms of paralysis. While facial paralysis can be devastating for the affected patient, a number of medical and surgical procedures can provide significant improvements in the patient’s appearance, function, and quality of life. For complete information we recommend a full consultation with a provider.
Our facial plastic and reconstructive surgery team partners with experts from other specialties to provide the latest treatments available in aesthetic and reconstructive surgery, including advanced reconstruction techniques for head and neck defects and facial injuries. Our patients benefit from our active, NIH-funded research programs that result in new procedures and devices.
Our laryngology team specializes in diagnosing and treating disorders of the throat, including simple and complex voice, airway and swallowing disorders. We offer a multidisciplinary approach and state-of-the-art medical and surgical therapies. Our treatment plans are designed to maintain and recover function.
Your airway consists of your voice box (larynx) and pharynx (throat), and regulates breathing, swallowing and speaking. Damage to your airway as the result of cancer, trauma, smoking or reflux disease can result in voice, swallowing or breathing issues. We offer comprehensive testing and evaluation for airway problems, as well as a variety of surgical and non-surgical treatments.
If the muscle at the bottom of your esophagus (food pipe) doesn't work correctly, gastric acid from your stomach can back up all the way to your throat, voice box or nasal airway. Because many people with LRD don't experience heartburn, it can be hard to diagnose. Our specialists offer advanced, effective methods for diagnosing and treating this condition.
Tonsillitis is a common condition, simply an infection of the tonsils caused by a virus or bacteria. But sometimes these infections become chronic despite appropriate medical treatment. In this case, removing the tonsils (tonsillectomy) can be beneficial. Our otolaryngology surgeons are highly skilled at performing tonsillectomy in children and adults.
The vocal cords are two bands of smooth muscle tissue in the larynx, which vibrate to produce the sound of your voice. Vocal cord disorders are often caused by excessive use of the voice, as well as smoking and inhaling irritants. Our otolaryngologists are experts at diagnosing, treating and preventing vocal cord disorders using a team approach.
This a small pouch that develops in the upper part of the esophagus and causes dysphagia (difficulty in swallowing). Our otolaryngologists and speech language pathologists work together as a team to diagnose and treat this condition using effective techniques like swallowing therapy, minimally invasive surgery and Botox injections.
Our otology and neurotology team specializes in diagnosing and treating disorders of the ear and skull base. Our providers are highly trained in the complex anatomy and physiology of the outer, middle and inner ear along with their central nervous system connections. We work closely with colleagues across related medical fields to provide expert, comprehensive care.
This is an abnormal skin growth in the middle ear behind the eardrum, which can create significant problems with hearing and balance if left untreated. Our specialists are highly skilled at diagnosing this condition and treating it with advanced non-surgical and surgical techniques.
Dizziness and vertigo are common conditions that can have many different causes. Our specialists are highly experienced at evaluating these conditions, and offer comprehensive testing at our Dizziness and Balance Center at UW Medical Center. Depending on your diagnosis, we offer a number of effective, non-invasive and advanced surgical treatments.
This is when your eardrum develops a hole or rupture, which usually occurs as the result of injury, infection or a chronic Eustachian tube disorder. Our specialists are experts in diagnosing, treating and managing eardrum perforations.
Ear infections include middle ear infections and outer ear infections, both of which can cause pain and difficulty hearing. Our otolaryngologists are highly experienced at evaluating all types of ear infections and developing effective treatment plans based on your individual needs.
This disorder of the inner ear is characterized by recurring attacks of vertigo, hearing loss, tinnitus and sometimes a sense of fullness in the ear. Although there's currently no proven cure for Meniere's disease, our specialists use a variety of leading-edge therapies to help you control symptoms and manage the condition effectively.
This common condition occurs when you hear a sound in your ears that isn't coming from the environment. It may come or go and sound like ringing, hissing, roaring, tapping or clicking. Our specialists can evaluate your tinnitus in order to determine the underlying cause and offer a variety of treatments to help.
Our specialists are expert at treating both common and complex pediatric ear nose and throat problems. We offer specialty clinics for sinus problems, voice issues, swallowing and breathing difficulties, thyroid masses and palate (speech) problems.
Patients who have tumors at the base of the skull (commonly in or near the pituitary gland) benefit from our minimally invasive approaches to these tumors through the nose in conjunction with our neurosurgery team to achieve safe and complete removal with rapid recovery and maintenance of quality of life.
Our rhinology team provides expert, leading-edge care for diseases of the sinuses, nose and anterior skull base. We take a team approach with colleagues in other specialties to provide comprehensive, coordinated treatment plans for the whole patient. Our effective medical and minimally invasive surgical solutions help resolve common and complex disorders and improve quality of life.
This is an inflammation of the lining of the sinuses, often caused by infection or allergies. Symptoms of sinusitis include facial pressure, nasal drainage and congestion, along with fatigue. Our specialists use a team approach to diagnose sinus issues and develop an individualized treatment plan that might include medication or minimally invasive endoscopic surgery.
This is a common condition, especially in children. But when a nosebleed persists for several days or recurs frequently, a thorough evaluation is necessary. Our otolaryngologists are highly skilled at determining the source of the bleeding, and offer various treatment options such as conservative therapies, topical medicines and surgical approaches.
Our sense of smell is important to our quality of life, but it can be lost due to chronic sinusitis, cold viruses, trauma and toxin exposure. Fortunately, recent research has shown that certain treatments can help people regain smell function. Our specialists offer expert diagnosis and leading-edge interventions such as nasal endoscopy.
Our sleep surgery specialists are highly trained in safe, effective, minimally invasive surgical techniques for treating snoring and obstructive sleep apnea. We comprehensively evaluate your breathing passages and use surgery to enlarge and stabilize them. Our procedures make it easier to use other non-surgical treatments like CPAP machines and dental devices if needed.
UW Medicine's vestibular disorders services are designed to evaluate symptoms of dizziness and/or loss of balance due to vestibular (inner ear) conditions. Our team includes licensed physical and occupational therapists, all of whom have advanced training in vestibular rehabilitation.
Vestibular System
The vestibular system is located in the inner ear and is made up of three small semicircular canals, two sensory organs called the utricle and saccule, and the vestibular nerve. The vestibular system detects changes in head movement or body position to help maintain balance.
Symptoms of a vestibular disorder may include:
Dizziness
Episodes of spinning
Periods of lightheadedness
Trouble focusing or reading
Loss of balance
Increased fatigue
Headache or increased neck tension
Common vestibular conditions include:
Benign paroxysmal positional vertigo (BPPV)
A condition where free-floating calcium particles, frequently referred to as “ear rocks,” dislodge in the inner ear, causing a sensation of dizziness or spinning with changes in position.
Vestibular labrynthitis
A virus that affects the inner ear, causing damage to the hair cells. Symptoms may include dizziness, loss of balance and/or difficulty focusing when turning you head.
Meniere’s disease or vestibular hydrops
A fluid imbalance in the inner ear. Symptoms may include a sudden onset of vertigo, ringing in the ear, fluctuating hearing loss and/or loss of balance.
Central vertigo
A condition that can be caused by damage or trauma to the vestibular system from a stroke or head injury. Symptoms can include constant dizziness, headache and/or loss of balance.
Therapy
In most cases, vestibular therapy can help to reduce or stop symptoms of dizziness and improve balance through exercises or various repositioning techniques. We also provide patients with strategies to help manage dizziness during their daily routines while at home, work or out in the community. Depending on the nature of the problem, we also will create an exercise plan designed specifically for each patient.
Licensed speech-language pathologists can help individuals who face vocal challenges with improving their speaking voice, learning good vocal habits, retraining the use of their voice and utilizing strategies to avoid damaging their vocal mechanism.
Everyone experiences occasional problems with their voice, such as hoarseness or times when they cannot produce any sound at all. A voice problem may be related to allergies, an upper respiratory infection or overuse. Continued trauma can damage the vocal folds and cause temporary or permanent damage in vocal function and voice quality, as well as possible loss of voice. Diseases such as cancer, Parkinson’s disease, Lou Gehrig’s disease, multiple sclerosis or stroke may also cause changes to the voice.
Our team of licensed, certified speech-language pathologists includes voice specialists who can evaluate and provide individualized therapy designed to:
Improve vocal economy
Reduce vocal strain
Protect and heal the vocal mechanism
Maximize communication effectiveness
We use a computerized voice-analysis system called SonaSpeech to perform a voice assessment and provide real-time feedback during therapy. Your therapy will include a baseline assessment of your voice, including pitch, volume, voice quality, rate, resonance and inflection patterns.
Based on this assessment, individualized therapy plans may include:
Information about the anatomy and function of the voice system, including how sound is made, the difference between voice and speech and how volume and pitch are controlled
Lee Silverman Voice Treatment®
Lessac-Madsen Resonant Voice Therapy
Casper-Stone Confidential Flow Therapy
Vocal function exercises
Training on breathing and relaxation
Education, training and reference materials on how to change your behavior and keep your voice production system healthy
Techniques to maximize the quality of your voice
Convenient care, in your neighborhood.
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