Dr. Manni Hingorani

Adenoids are tonsils located behind the nose which affect a fair percentage of the population, especially children. Despite a difference in location, adenoids are essentially like tonsils in their characteristic properties which cause a host of issues. These adenoids get reduced in size as a person ages though it is not abnormal for children to have enormous adenoids.

Problems Caused By Adenoids:
The greatest issue concerning adenoids is that the symptoms are often confused with that of allergies or sinusitis which makes it difficult to treat. Since adenoids cause a restriction in airflow in the nasal passage, it may lead to nasal obstruction, congestion, and even nasal sounding speech. A reduction in the normal mucus flow in the throat leads to rhinitis, snotty nose, and allergy-like symptoms. One may also suffer from ear pain and clog of the ear due to the physical blockage of the Eustachian tube in the ears. The location of the adenoids plays a vital role in determining the symptoms that one will be suffering from.

Treating adenoids with endoscopic adenoidectomy:
The issue can be treated efficiently with adenoidectomy, which is a surgical procedure. In endoscopic adenoidectomy, the adenoid tissue is located with the help of a nasal telescope called the endoscope. This offers better control over the situation and performing the surgery with utmost precision. And it is essential to bear in mind that several million adenoidectomies had been performed all across the globe for many years with satisfactory results.

In the recent times, a new tool known as the debrider is available. The combined benefits of the endoscope and the debrider can offer better results and a more comprehensive procedure. This invariably brings about a hike in the cost and those patients who can afford the costing of such an assisted surgery should go for it for better results. Most of the ENT surgeons have easy access to such instruments and can easily operate successful removal of the adenoid tissue.

The effectiveness of endoscopic adenoidectomy:
Nasal endoscopic adenoidectomy helps in easy assessment of the size of the adenoids and enhances the accuracy of the adenoidectomy. This treatment option is particularly useful for treating children who have small oral cavities. And typically, the assessment and the subsequent excision of the adenoids in the affected patients are often tough. With the help of the nasal endoscope, the curette can be precisely inserted at the superior border of the adenoid so that the main bulk of the adenoid tissue can be trans-orally removed.

According to the experts, nasal endoscopic-guided transoral adenoidectomy is a feasible alternative to the conventional adenoidectomy. Moreover, this technique offers the advantage of using commonly available ENT instruments. Hence, it might be recommended for the right candidates, and is known to offer satisfactory results.

Eardrum perforation is a condition that is more common in young children, though it can affect people across all age groups. A rupture or a hole in the thin membrane separating the ear canal from the middle ear results in eardrum perforation.

Here is a brief account that will help you further understand the symptoms so as to seek treatment at the right time before the condition causes any complication.

Signs and symptoms:
A person with a perforated eardrum may have symptoms that include,

1. Sharp pain that subsides quickly
2. Ear fluid release
3. Ringing sound in the ear (tinnitus)
4. Partial or complete hearing loss
5. Occasionally, fever

Causes of Eardrum Perforation:
The causes of eardrum hole may stem from an infection, injury or chronic disorders related to Eustachian tube. A perforated eardrum from trauma may occur when there is a skull fracture or after a sudden explosion or if the ear is struck directly. In patients with chronic problems with Eustachian tube, the eardrum can become weak and open up. Eardrum perforations may also be caused due to rapid pressure changes such as during air travel.

Treating Eardrum Perforations:
A perforated eardrum caused by infections or pressure changes usually cures in weeks without treatment, however, when the condition does not improve for a significant period of time, medical intervention is required.

Before attempting to correct any eardrum perforation, a hearing test is required to be performed. Then the treatment process would be initiated to close the perforation. This is done due to the advantages it provides including preventing water from entering the middle ear while taking a bath or swimming or showering and also improved hearing. It also prevents the development of cholesteatoma which may cause chronic infection as well as the destruction of the internal ear structures.

When the perforation is too small, a patient may be advised to observe the problem and check whether it is healing on its own. The hearing is generally improved with the closure of the eardrum. An ENT specialist may determine whether a paper patch will be able to provide an adequate closure of the hole in the eardrum and in case it doesn't help, surgery may be required to help the condition.

There are many treatment options, but most of them involve placement of the new patch across the perforation for allowing it to heal. This process is medically termed as tympanoplasty, and the surgery is quite useful in repairing the perforation which helps in bringing back the lost sense of hearing.

Eardrum perforation is a serious health condition that needs to be treated without further delay. It is essential to consult with an ENT specialist to get it treated before any complications arise.

Introduction

A cochlear is one of the best electronic medical devices in the modern world. A cochlear implantation is a surgical implantation done on a person who is deaf. This device provides a sense of hearing. It does not amplify the sound like normal hearing aids. It stimulates the auditory nerve directly.It has many advantages and is currently more useful than your average hearing aid.

How can Cochlear implants help?

One may get to hear speech at a normal level. In adults, the result is immediate while in children the rate at which they improve is very slow. In adults, there is a rapid improvement for about three months after which the improvement is slow. Most people can perceive a wide range of sounds varying from soft, medium to loud like the slamming of a door, the barking of dogs, and the ringing telephone. Makes a person more secure and self-reliant. It is very important for a person to be able to hear in case of critical conditions like the fire alarm. Cochlear implant helps with these. One can actually hear auditory voices, even though they are robotic. A person with cochlear implant does not need to lip read.Children can think about studying in mainstream schools instead of studying in a specialized school for deaf people.

Now we will discuss some details about the drawbacks. And, it is not a foolproof method and doesn't guarantee that hearing a person may lose the residue hearing that they have. There are several drawbacks to a cochlear implant.

Let us discuss some down below:

A surgical process involves a lot of money and it has a lot of ordeals associated with it. Therefore, before getting a cochlear implant done ask your specialist to elaborate if it will be of any help to your condition. The cost of maintenance is also very high. It will be difficult for people who are not inborn deaf to cope up with hearing conditions as the sounds are distorted and background noises interfere with the process of hearing. Irritation of your skin, muscle spasms, and even facial paralysis are some of the side effects of this implant. But these are rare conditions. Sounds are translated by the device first and may sound unnatural. It takes time and proper training before a person can be at ease with this condition. In case you have a concern or query you can always consult an expert & get answers to your questions!

Swimmer's ear is an infection of the ear canal, the passage that carries sounds from the outside of the body to the eardrum. It can be caused by many different types of bacteria or fungi.

Swimmer’s ear is a kind of infection which occurs in the outer ear canal and it results in an infected ear canal, long-term pain and irritation. Swimmer’s ear, as you can understand by the name, is referred in such a way because it is caused by water which is left inside the ear after swimming. The stuck water inside the canal gets damp where bacteria and fungus grows and results in an infection. Now we will discuss what are the causes that can bring such a condition.

Causes of Swimmer’s Ear - There are many reasons because of which people suffer from a swimmer’s ear: The entry of too much water inside the ear canal, leaves a part of it inside the ear which eventually allows bacteria to infest. The overcleaning of the ear canal with cotton buds causes the ear wax to come out which allows water to enter. When cosmetic chemicals like hair spray, enter the ears, it causes a sensitive chemical reaction which can lead to infection. Careless scratching inside the ear can result in small cuts inside the sensitive canal, where bacteria can infest. Swimming in water without covering your ears can also cause this.

So next time when you are swimming or scratching your ear without safety, remember that it can cause a swimmer’s ear. But you may have a question in mind, how will I know if I am suffering from this? We have thus listed the symptoms as well.

Symptoms of Swimmer’s Ear-

Constant itching and irritation inside the ear. The pain or itching increases when you pull your year or chew something. There is an acute sensation of blockage inside the ear which is caused because of this condition and results in reduced levels of hearing. Someone suffering from swimmer's ear will have pus or ear fluids draining out from their ears.

Swimmer’s ear condition can be easily prevented if you follow some simple but very effective steps like blocking your ear with buds while swimming, cleaning the ear softly so that no water remains stuck etc. If you neglect any of the symptoms, they can result in a very chronic disease which can even result in hearing loss. So read through our article and understand what Swimmer’s ear is.

It is a disorder of the inner ear, which is characterized by episodes of vertigo, ringing in the ear (tinnitus), hearing loss, and fullness in the ear.

Epidemiology, Incidence, and Prevalence

The reported prevalence of Meniere disease varies widely, from 15 per 100,000 in the United States to 157 per 100,000 in the United Kingdom.

Causes

The cause of Meniere’s disease is elevated endolymphatic pressure. Causes of elevated endolymphatic pressure include:

1. Metabolic disturbances
2. Hormonal imbalance
3. Trauma
4. Infections, such as otosyphilis and Cogan’s syndrome (interstitial keratitis)
5. Autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis, may cause an inflammatory response within the labyrinth

Signs and Symptoms

1. Recurrent episodes of vertigo, hearing loss and tinnitus
2. These episodes may be accompanied by a headache and a feeling of fullness in the ears
3. People may also have additional symptoms related to irregular reactions of the autonomic nervous system, such as nausea, vomiting, and sweating, which are typical symptoms of vertigo and not of Meniere disease
4. Sensation of being pushed sharply to the floor from behind
5. Sudden falls without loss of consciousness

Complications of Meniere’s disease may include the following:

• Injury due to falls
• Anxiety regarding symptoms
• Accidents due to vertigo spells
• Disability due to unpredictable vertigo
• Progressive imbalance and deafness
• Intractable tinnitus

Differential Diagnosis

• Anterior circulation stroke
• Basilar artery thrombosis
• HIV-1 associated CNS conditions - meningitis
• Hypothyroidism and myxedema coma
• Inner ear labyrinthitis
• Intracranial hemorrhage
• Ischemic stroke in emergency medicine
• Migraine headache
• Multiple sclerosis
• Neurosyphilis
• Polyarteritis nodosa
• Rheumatoid arthritis
• Syncope
• Viral encephalitis
• Viral meningitis
• Wernicke encephalopathy

Investigations

Laboratory studies - No blood test is specific for Meniere’s disease but to exclude obvious metabolic disturbances, infections, or hormonal imbalances:

• Thyroid-stimulating hormone (TSH), T4, and T3 to rule out hyperthyroidism and hypothyroidism
• Glucose level to rule out diabetes
• Erythrocyte sedimentation rate (ESR) and antinuclear antibody (ANA) test to rule out autoimmune disorders
• Complete blood count (CBC) to rule out anemia and leukemia
• Electrolyte levels to rule out salt/water imbalance
• Venereal Disease Research Laboratory test (VDRL) and fluorescent treponemal antibody (FTA-ABS) to rule out neurosyphilis and Lyme disease
• Allergy testing for allergy-mediated Meniere’s syndrome
• C-reactive protein (CRP)

MRI of the brain - Should be done to rule out abnormal anatomy or mass lesions. Specifically, acoustic neuromas or other cerebellopontine angle lesions, multiple sclerosis, or Arnold-Chiari malformations, also can be ruled out. Note that mass lesions rarely are found but are important to exclude.

CT scan of the brain - They are done to detect possible dehiscence of the semicircular canals, congenital abnormalities, widened cochlear and vestibular aqueducts, and subarachnoid hemorrhage.
Audiometry - It is particularly helpful for documenting present hearing acuity and detecting future change.

Management - 

1. Vestibulosuppressants
2. Diuretics and diuretic-like medications
3. Steroids
4. Aminoglycosides
5. Histamine agonists
6. Endolymphatic sac decompression or shunt
7. Labyrinthectomy

In case you have a concern or query you can always consult an expert & get answers to your questions!

A condition that commonly affects young and middle-aged adults and lasts for at least 12 weeks despite treatment is chronic rhinosinusitis. The condition occurs when the cavities in close vicinity to the nasal passages become inflamed and swollen and can cause a disruption in the drainage that leads to mucus buildup, making the area around the eyes and face swollen.

Causes-
The disease can be caused by an infection, growth in the sinuses, or by a deviated nasal septum among others. The most common causes of the condition include,

1. Deviated nasal septum: When the septum becomes crooked, it may hinder or even block the nasal passages.
2. Nasal polyps: It refers to the growth of tissues in the nasal passage which can block the sinuses or the nasal passages.
3. Respiratory tract infections: Infections in the respiratory tract which is commonly referred to as colds can inflame and thicken the sinus membranes and block the drainage of mucus.
4. Hay fever: Inflammation that occurs alongside allergies may also block the sinuses.
5. Allied medical conditions: If there is a complication of cystic fibrosis or HIV or gastroesophageal reflux disease or any other immune-related ailments, it may cause chronic rhinosinusitis.

Signs and symptoms to watch for-
There are four primary signs and symptoms of chronic rhinosinusitis of which at least two must be present with nasal inflammation for being diagnosed with the disease. These symptoms include,

1. Thick and discolored discharge from the drainage down the back of the throat called postnasal drainage.
2. Nasal obstruction along with difficulty in breathing through the nose.
3. Tenderness, swelling, and pain in the eyes, nose, cheeks, or forehead.
4. Reduced sense of taste or smell in adults and coughing in children.

Other symptoms of the disease can include an ache in the upper jaw, sore throat, earache, bad breath, nausea, and fatigue along with irritability. It is worthy of mention here that both chronic and acute rhinosinusitis have similar signs and symptoms, but acute sinusitis is a temporary infection which is often associated with a cough and cold.

Treating chronic sinusitis-
The most effective treatments for chronic sinusitis include saline nasal irrigation, nasal corticosteroids, oral or injected corticosteroids and aspirin desensitization treatment. Sometimes, antibiotics and immunotherapy are also opted for treating the condition. One must consult with an ENT specialist to treat the condition effectively.

Prevention-
It is important to avoid infections in the upper respiratory tract and manage your allergies well in order to prevent frequent attacks of chronic sinusitis. One should also avoid staying for long hours in polluted air and smoking and use a humidifier to add moisture to the air which can prevent sinusitis.

Though treatable, chronic sinusitis tends to stay for several weeks with symptoms causing discomfort. Hence, it is crucial to seek medical care when diagnosed, and it is also important to follow your doctor’s instructions so as to avoid recurring episodes.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Head and neck cancers usually start in the squamous cells and are also referred to as squamous cell carcinomas of the head and neck. It occurs in the nose, throat, mouth and salivary glands. Head and Neck cancers are further classified into various categories on the basis of the area of the neck and head where they occur. Although head and neck cancers are different, they both occur inside the mouth, sinuses, nose, salivary glands and throat, which are considered as a group.

Salivary gland cancers are generally very infrequent. An assortment of cancer causing cells is present in salivary glands, so various types of salivary gland cancers have been found to occur.

Causes

If you are habituated to consuming tobacco and alcohol, then you are at the highest risk of suffering from head and neck cancer; however, it can also be caused in people who suffer from infections caused by human Papilloma virus. Other factors may include:

1. Oral health- Untreated gum diseases and oral cavity can be the reasons behind the development of the disease.
2. Sex- Women are less prone to head and neck cancers than men.
3. Lack of Nutrition- If your body is lacking in certain nutrients; you are more likely to catch the disease.
4. Age- People above 40 years of age are more susceptible to head and neck cancer.

Symptoms-

1. Difficulty in swallowing- Inflammation and pain in throat, leading to a problem in swallowing.
2. Hoarse Voice- Hoarseness or change in the voice.

Apart from this, there are some symptoms which show up in a specific area of your head and neck, such as:

1. Oral Cavity- A red or white patch on the tongue, the gums or the lining of the mouth.
2. Pharynx- Trouble in breathing and swallowing followed by a frequent headache.

Treatment

1. Surgery- Surgery is usually to remove the primary tumour in toto or as much as feasible. Also, clearence of the lymph nodes that are involved is done during surgery at the same time.
2. Radiation Therapy- Radiation therapy is considered where functions like speech can be conserved.
3. Chemotherapy- Radiotherapy in combination with chemotherapy can help, if you are suffering from a more advanced form of head and neck cancers.

In case you have a concern or query you can always consult an expert & get answers to your questions!

A blocked nose is not only annoying, but is extremely discomforting. Several reasons can be held responsible for it and common cold is certainly not the only one. Some other reasons include:

1. Flu
2. Allergy
3. Sinus

Therefore, the remedial measures for blocked nose vary, depending on the cause that led to it. Some of the ways by which you can redress this problem are:

1. Use a humidifier: Sinusitis is often held responsible for a clogged nose, a condition that is almost always accompanied by severe pain. In such a situation, placing a humidifier in a room proves to be extremely beneficial. This machine treats blocked nose by converting the water to moisture. This fills up the room and significantly increases the humidity of the room. Therefore when you breathe, the humid air soothes the inflamed blood vessels in the nose and helps you to breathe properly.
2. Take a hot shower: When you find it difficult to breathe, a quick hot shower can go a long way in curing the discomfort. The logic that operates is the steam generated from the hot shower thins the mucus and also considerably reduces the inflammation in the nose, allowing you to breathe normally.
3. Drink lots of water: Though the suggestion may seem incredible, drinking water actually helps in un-blocking that blocked nose. When you drink a lot of water, the mucus in the nostrils is thinned, at the same time it pushes back the accumulated fluids, thereby curbing the condition of blocked nose.
4. Using a saline spray: This is one of the most ancient and trusted ways of treating blocked nose. By administering a saline or a nasal spray, the moisture in your nostrils increases and radically diminishes the inflammation.
5. Use warm compresses: Using a warm compress has been the most reliable form of medication in times of high temperature and also at times of blocked nose. The compress that was dipped in hot water, when placed on the nose and forehead helps to unblock the nasal passages. The soothing effect of the warm compresses reduces the inflammation and facilitates the process of breathing.

In case you have a concern or query you can always consult an expert & get answers to your questions!