Meet Dr. Jacob HunterNeurotologist in Dallas

Neurotologist Jacob Hunter, M.D., is an expert in the anatomical structures of the inner ear and the neurological conditions that can affect them. He uses the latest surgical and medical treatments to address impaired hearing and other neurological conditions of the ear in patients of all ages.

Disorders of the middle and inner ear such as hearing loss and dizziness, while not necessarily dangerous, can be debilitating. Hearing loss, for example, often causes social isolation and depression, seriously affecting overall well-being.

“The procedures we perform can have a truly dramatically positive impact on a person’s life,” Dr. Hunter says.

Endoscopic Ear Surgery

In recent years, microscopy and endoscopy have transformed neurotology by providing clear, real-time imaging of the tiny, delicate structures of the middle and inner ear during surgery.

“We can perform a wide range of procedures through the ear canal with the insertion of an endoscope, eliminating the need for a post-auricular incision in many cases,” Dr. Hunter says.

Endoscopic neurotological procedures now are used to address chronic ear infections, cholesteatoma (an abnormal skin growth behind the eardrum), and otosclerosis.

Otosclerosis, affecting by some estimates as many as one in 50 people, occurs when the stapes, a tiny stirrup-shaped bone in the middle ear, becomes rigid and thus no longer conducts sound vibrations properly. Dr. Hunter notes that surgery is indicated when the hearing loss is severe enough that surgery will provide a noticeable hearing improvement to the patient (around 30 decibels). The typical procedure, known as a stapedectomy, removes the nonfunctioning stapes and replaces it with a prosthesis to restore hearing.

Dr. Hunter also treats patients with ear-based tumors called acoustic neuromas or vestibular schwannomas. Such growths are typically viewed as benign; often, the recommended course of action is simply to monitor them. Should they become large enough to risk compressing the brainstem and compromising speaking or swallowing functions, surgery may be recommended. Dr. Hunter and his neurotology colleagues at UT Southwestern are pioneering endoscopic techniques for the removal of these tumors. They’re also investigating potential medical treatments for the condition.

Collaborative, Leading-Edge Care

Dr. Hunter begins his relationships with new patients by using his own ears – to listen carefully to their concerns.

“For example, people may come into the office with some hearing loss, but a conversation with them reveals that they are actually much more bothered by dizziness,” he says. “So I take the time to find out what my patients’ goals are and help them evaluate the risks and benefits of various approaches so that we can address the issues accordingly.”

Dr. Hunter often collaborates with UT Southwestern neurosurgeons, especially during lateral skull base procedures. “Some cases are very complex, and we complement each other’s efforts both physically and mentally,” he says.

UT Southwestern’s team of audiologists, who diagnose and care for individuals with balance and hearing disorders, are also essential to care.

A significant portion of Dr. Hunter’s practice is devoted to cochlear implant surgery. He believes hearing-impaired patients should be tested more frequently to identify appropriate candidates.

“Among my adult patients who previously could hear and then lost their hearing at a later age,” he says, “I can’t think of anyone who isn’t happy that they received a cochlear implant.”

Not all of Dr. Hunter’s work is surgical. Among his patients are people with Meniere’s disease, a buildup of fluid in the inner ear that causes dizziness, ringing in the ears, and fluctuating hearing loss. While there are no universally accepted permanent surgical solutions for the condition, Meniere’s patients who receive care at UT Southwestern may be eligible to participate in clinical trials exploring emerging treatment options.