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Elias M. Michaelides, MD: Finding balance, and healing, in the magic of the inner ear

[February 2007] Dizziness is a common problem, says Elias M. Michaelides, MD, but not one that many physicians devote themselves to treating. “Very few doctors really focus on this,” he says of dizziness, an all-encompassing term that includes vertigo, imbalance, lightheadedness and other symptoms. “It is something everybody knows a little bit about, but not always enough to make a comprehensive treatment plan.”

Since arriving at Yale last August, Michaelides has established the Hearing and Balance Center, which takes a multidisciplinary approach to finding the best treatment for dizziness and hearing disorders. The two are related because the human balance, or vestibular, system resides in the inner ear. The inner ear’s three balance canals contain fluids that stimulate sensory cells, which signal direction to the brain through the vestibular nerve. “The causes of dizziness range from neurologic to inner ear to orthopaedic.”

The center provides hearing testing, hearing aid fitting and dispensing, and balance testing. It also offers electrophysiological nerve testing to determine whether dizziness is caused by an inner ear infection or neurological problem. Treatments may be medical, surgical or rehabilitation. “The majority of our patients don’t need surgery,” Michaelides says.

But that is not all Michaelides does at Yale. “I do comprehensive ear surgery for hearing loss and on tumors of the skull base. I treat facial paralysis. I’m also performing a fair number of cochlear implants,” he says.

- Originally published in the February 2007 issue of Yale Practice.

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Name: Elias M. Michaelides, MD

Title: Assistant professor of surgery.

Area of expertise: Otology, neurotology, skull base surgery, balance control.

Place of birth: Stamford, Conn.

Age: 39.

College: Cornell University.

Med School: State University of New York, Stony Brook.

Training: Medical College of Virginia, Michigan Ear Institute.

Family: Married to Stephanie Michaelides, an audiologist. They are expecting their first child.

What is most challenging to you in academic medicine? “Devising ways of presenting material to residents to make them learn the material in depth and quickly. I think it is important to design your teaching so that there is a solid foundation for residents to build upon.”

What is most rewarding? “Seeing someone start out not knowing a particular subject, teaching them something and then watching them take a step further and understand the material.”

What do you like most about your practice? “The variety of straightforward to very complex cases.”

Personal interests or pastimes? Mountain biking, skiing.

Last book read: The Master and Commander series on the 19th-century exploits of Capt. Jack Aubrey, by Patrick O’Brian.

What would you do to improve our clinical environment if you had a magic wand? “Since I see many patients who have seen many physicians, having a system where I could have access to all my patients’ previous medical records and tests would simplify things, prevent redundancy and clarify a patient’s history. People may come from three different doctors and they show up expecting that you know everything that has been done.”



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