North Florida Center for Otolaryngology
head & neck surgery facial plastic surgery, pa

our services

ear, nose, & throat – head & neck surgery

When looking for quality healthcare, North Florida Center for Otolaryngology is the group you can depend on. Since 1990, we have offered otolaryngology (ear, nose and throat), head and neck surgery services to this growing community. When surgery is required, we use state-of-the-art procedures. We are committed to providing leading edge health care to our patients resulting in excellent service and improve overall patient health.

Dr. Taliaferro, Miller, and Leake are highly trained, board certified otolaryngologists with expertise in nasal and sinus disorders, voice disorders, snoring, sleep apnea, hearing, facial skin care, and facial plastic surgery – cosmetic and reconstructive.

ear
mouth
neck & throat
nose
cancer
man at ent exam checking lymph nodes

offering a wide range of

ent services

Thyroid Problems
Sleep Apnea
Sinus Treatments
Hearing Testing
Balance Testing
Hearing Aids
Skin Cancer
Head and Neck Cancer
Treatment of Throat Problems
Ear Surgery
Endoscopic Sinus Surgery

hearing & balance center

Our goal at North Florida Hearing and Balance is to help gain an improved quality of life, starting with hearing amplification.

Our practice is different from an audiology practice designed to sell hearing aids. While we do offer the widest possible variety of hearing aids and other amplification devices, our medical professionals will never use the high pressure sales pitches utilized by standard hearing aid sales offices. If hearing amplification is not appropriate for you, we will tell you and refer you to one of our physicians for further evaluation. In fact, some hearing loss can be the result of an underlying disease including cancer. This can be detected by the professional audiologic testing offered by our practice.

hearing & balance services

Our Audiology team is here to assist you with all your hearing needs.

When you purchase hearing aids from North Florida Center for Hearing & Balance, you are gaining not only a support team, but you will also receive many complimentary services to help you along the way. Complimentary services include, but are not limited to, device cleanings and supplies -domes, wax guards, and batteries. You will receive hearing aid checks and hearing aid adjustments free of charge.

COMPREHENSIVE DIAGNOSTIC HEARING EVALUATIONS

Our audiologist is trained to perform fully comprehensive evaluations of all parts of your hearing system. A visual inspection of your outer ear will be performed and any wax build-up will be removed. Middle ear testing will ensure that your eardrum and middle ear bones are operating as they should. Finally, audiometric testing will determine your hearing sensitivity and measure any amount of hearing loss that you may have. Spoken words and tones will be used to measure this. Also, your word understanding will be measured to fully determine the amount of damage that may be present.

HEARING AID CONSULTATION

After your hearing evaluation, the results will be shared with you. At this point, the audiologist will begin a discussion of what situations you have the most trouble hearing in as well as what you hope to gain from a hearing aid. The most appropriate hearing aid for your hearing loss, lifestyle and personal preference will be selected. Impressions of your ear canals may be taken for certain types of hearing aids, while other types of aids to not require this.

HEARING AID FITTING

Your new hearing aids will typically be ready for you within two weeks. At the time of your hearing aid fitting, you can expect several things. First, the hearing aids will be placed in your ears and several tests will be done. Real-Ear measurements will be taken to ensure that the hearing aids are set appropriately for your hearing loss. After this measurement, the audiologist can make any other adjustments necessary to make the hearing aids as comfortable as possible. You will be taught how to use the hearing aid, change the battery, insert and remove the hearing aid in your ears, and maintenance and cleaning of the hearing aid. You will be scheduled with a follow-up appointment in one or two weeks at which time you will have a better idea of what adjustments you may like.

REAL EAR MEASUREMENT VERIFICATION

North Florida Center for Hearing and Balance is one of few audiology clinics in North Florida where Real Ear measurements can be made on all makes and models of hearing aids. Using a special piece of equipment, small microphones are placed inside of your ears with your hearing aids. The machine plays a spoken passage and the output of the hearing aids is recorded. The audiologist can then adjust your hearing aids to best match the targets that are prescribed for you based on your hearing loss. There is no other way to properly ensure that hearing aids are playing sounds exactly as they should be in your ears. This is a very important step in any hearing aid fitting.

HEARING AID SERVICES

Hearing aids from any manufacturer can be inspected and repaired if necessary. Some repairs are simple and can be done in our office while you wait. Some repairs require that the hearing aids be sent away for repair, and we can also accommodate this. Also, if you have hearing aids that were purchased elsewhere and you would like the settings on them adjusted, we will be more than happy to work with you.

hearing & balance faq’s

Q: What is an Audiologist?

An audiologist is a University-trained professional, usually a doctorate level, who specializes in the non-medical diagnosis, treatment and management of hearing and balance disorders. Audiologists are allied healthcare professionals. They have intensive training in the anatomy, physiology and pathology of the human hearing and balance systems. Some settings in which you may encounter an audiologist are in an ENT office, in the school system, in a hospital setting, or in a private audiology practice. Not all audiologists sell hearing aids; some work exclusively with children, some specialize in cochlear implants, some work for the Veterans Administration, and others perform only diagnostics.

Our audiologist performs a combination of diagnostic testing and hearing aid fitting. Our office can also provide patients with custom fit hearing protection, bluetooth earpieces, swimming earplugs, MP3 headphones, amplified telephones and television amplification systems.

Q: I only have difficulty in hearing background noise. Isn’t this a normal part of aging?

No matter what the age, some people are better able to function in background noise than others. Part of this is a trait called Acceptable Noise Level (ANL), and cannot be changed. The other component to this is that you may likely have some loss of high-frequency hearing. High-frequency hearing loss causes you to miss the consonant sounds of speech such as S, T, K, Th, and F. Missing these sounds can make speech sound muffled or mumbled. In a quiet room, your brain can work fast enough to fill in the blanks that your ears are missing. However, when background noise is introduced, your brain is busy filtering out the noise and cannot keep up with the missed consonants, causing you to have a more difficult time understanding what people are saying. You hear the words, but they are not clear.

Q: My neighbor bought $8,000 hearing aids and never wears them. I don’t want to spend that much money for something I don’t use. Will my situation be the same?

Top-of-the-line hearing aids would cost about $6000, however very few people require that level of technology. Most people end up spending much less on a pair of hearing aids. Also, it is important that once you receive your hearing aids you are proactive about getting them adjusted. During your 30-day trial, we will have weekly appointments to make adjustments to the settings. We want your hearing aid use to be a comfortable experience. If you are not comfortable with the hearing aids, there are always adjustments that can be made. If you determine during your trial period that you no longer wish to pursue hearing aids, you may return them.

Q: Is there an adjustment period when I get new hearing aids?

There is absolutely an adjustment period with new hearing aids. The first thing that you will notice is that your own voice seems to echo. This will go away after a few days of full-time use of the instruments. When you are first fit with hearing aids, we start at a very conservative setting. Your hearing has been lost of the course of many years and you cannot expect to have it all back at one time and be comfortable. It will take some time for your brain to re-adjust to hearing a balance of all the sounds again. If you suffer from a high-frequency hearing loss, things will seem tinny at first because we are essentially turning up the treble. It is important during this adjustment period to not be discouraged and try to wear the aids faithfully.

Q: Do I need two hearing aids or can I get away with one?

When we recommend hearing aids, we look at your ears independently. If you have two ears with hearing loss, we recommend two hearing aids. Your brain is wired to hear with input from both sides. The ability to determine where sounds are coming from is dependent upon having equal hearing from both ears. Also, the ability to hear speech sounds over background noise is best accomplished with two ears. There is another phenomenon called auditory deprivation which is thought to cause deterioration of speech understanding when an ear with hearing loss goes un-aided.

Q: Will loud sounds from hearing aids damage my hearing further?

Hearing aids have a set limit to the volume that can be played into your ear. No sound that comes through a hearing aid will do further damage to your hearing. That being said, hearing aids do not prevent your hearing loss from worsening over the years. Often times hearing loss has a genetic component which will cause your hearing to slowly worsen as you age. This is why we recommend having annual hearing evaluations to determine if the hearing aids are set most appropriately for your hearing loss and to monitor any unusual or unexpected changes to your hearing.

Q: My hearing loss is noise-induced. How can I protect my ears from further damage?

The best way to protect your hearing in noisy environments is to wear hearing protection anytime you suspect the sound levels will be very high. The human ear has a Daily Noise Dose that it can tolerate before permanent damage is done. A person can be in an 85dB environment for 8 hours before permanent damage is done. For every 5dB increase in sound, that time is cut in half. For instance, if you are in a factory where the noise level is 100dB, you only have one hour to be in that environment without hearing protection before you can cause permanent damage to your hearing. If you suspect that the noise level will be high, take your hearing aids out if you have them and use earplugs. You can purchase foam earplugs at any drug store. Custom earplugs can also be made by our audiologist if you frequent noisy environments. Common times that earplugs should be used are at concerts, while mowing the lawn or on farm equipment, at a shooting range, or while woodworking, just to name a few.

woman smiling at beach on sunny day

mohs micrographic surgery

Mohs, or Mohs Micrographic Surgery, is a highly effective technique for removing certain types of skin cancer, or skin cancers that are located in cosmetically or functionally high risk areas of the body.  The surgeon removes the lesion, then immediately looks at it under a microscope to make sure it has been completely removed.  If any of the cancer remains, the process is repeated until the lesion is totally removed.  Each time the surgeon removes tissue is called a ‘stage’.  This technique was created by surgeon Frederic Mohs in 1938, and is widely considered to be the most effective way to remove certain skin cancers.  The Mohs process preserves as much of the healthy tissue as possible, while ensuring complete removal of the lesion.

Dr. Taliaferro is a board-certified Otolaryngologist who specializes in Mohs surgery.  He is trained to perform Mohs procedures independently, which means he will complete the excision, the pathological examination of the lesion, and the reconstruction himself.  He also works as a team with Dr. Leake for Mohs procedures.  In those cases, Dr. Taliaferro will perform the excision and the pathological examination of the tissue, and Dr. Leake will complete the closure, or skin cancer reconstruction.  Dr. Leake is double board certified in both Otolaryngology and Facial Plastic Surgery.  The entire procedure will be completed at one location; you will not have to go to two separate offices for the procedure, then the reconstruction.

It is important that you stop taking any over-the-counter medications or dietary supplements that act as a blood thinner, such as NSAIDs, aspirin, flaxseed oil, fish oil and vitamin E, approximately one week to 10 days prior to your procedure.  Speak with your physician before making any changes to your medications.  If you are prescribed a blood thinner by your physician, you must call their office to ask if and when you can stop taking it.  Do not stop taking your prescription medications unless directed to do so by your physician.

Mohs procedures can be lengthy in some cases, so you may want to bring a light snack and a good book.  It can be chilly in the procedure room, so you may want to dress in layers or bring a light sweater.  We want you to be comfortable during your procedure and we will make every effort to meet or exceed your expectations.

Mohs procedures are performed at our North Florida Center for Otolaryngology location across from Flager Hospital at

3 San Bartola Dr.,
St. Augustine, FL 32086