Dr. Manni Hingorani

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!

When the vocal cords suffer from the accumulation of non-cancerous and abnormal growth, these are known as vocal cord lesions. These lesions usually cause a variety of voice and speech related problems. These are also known as singer’s nodules and nodes, which may be caused by pressure, stress and stretching of the vocal cords. Women between the age of 20 to 50 are more prone to this condition. Here is everything you need to know about the types, causes and treatment of these lesions.

Types: There are three kinds of vocal cord lesions, that is nodules, polyps and cysts. A vocal cord polyps may be caused on one side of the vocal cords and may also lead to many disturbances in one’s voice. Another type of vocal cord lesions includes a mass of tissue that may manifest in the sac or membranes around the vocal cord. This cyst can be on the surface of the vocal cord or in the ligaments of the vocal cord. This may require surgical removal as well as voice therapy thereafter. Nodules are the third type of lesion that may form in the vocal folds. These are basically calluses that may disappear once the pressure and overuse of the vocal cords diminish.

Causes: These lesions are usually benign or non-cancerous growths that may be caused due to a variety of reasons. Screaming and overuse of vocal cords are few of the most common reasons for the eruption of such lesions. The heavy use of one’s voice can cause quite a bit of trauma to the vocal cords and may lead to problems including lesions and disturbances in one’s voice. Conditions like reflux and allergic reactions may also cause vocal cord lesions as a side effect.

Symptoms: From hoarseness to pain, there are a number of symptoms caused by this condition. A low pitch and difficulty while speaking are also some of the common symptoms of this condition. Patients suffering from the growth of such lesions will also find themselves making an effort in order to speak normally and to be heard. Constant throat clearing may be required as well.

Treatment: Besides giving your voice a rest and gargling warm saline water with salt, one can also have the condition checked by the doctor so as to ascertain whether or not it is a serious lesion that may require surgical removal and voice therapy. The doctor will usually prescribe medicines in order to deal with any underlying conditions that may have caused the lesions, including allergic reactions, reflux, sinusitis and other such ailments. One will also have to stop smoking so that there is less chemical pressure on the vocal cord. Finally, one will have to go through voice therapy for more serious lesions. If you wish to discuss about any specific problem, you can consult an Ent Specialist.

Your hearing is one of the most important function your body carries out and sometimes you realize that you are losing your sense of hearing, when it is too late to get it back. There are two main reasons for this. One of the reasons is age and the other is when the inner ear's hair cells break down and do not pick up sound well.

Here are 7 ways to safeguard your hearing:

1. Try to avoid loud places: It is not advisable to go to places where you have to shout to be heard, such as in a street, a concert or a construction site.
2. Buy low noise rating equipment: The equipments in your house will make sound that you hear the most. Try to avoid these equipments by buying appliances with a low noise rating.
3. Wear hearing protection at loud places: However, it is true that it is not always possible to avoid loud noises. This is when you need to get hearing protection. Earplugs and earmuffs are two of the best ways to make sure that even when you are in a loud place, your hearing does not get affected. Earplugs and earmuffs generally reduce sound by 15 to 30 decibels, which may be crucial to make sure that later in your life, you do not lose your hearing.
4. Avoid smoke: Smoking raises your chance of hearing loss. Second hand smoke does the same thing. Therefore, try to avoid, both smoking and secondhand smoking. 
5. Remove earwax properly: Earwax cannot be removed properly using a cotton swab. Instead, you should use an irrigation kit. Remember this as otherwise; the earwax could muffle your hearing.
6. Avoid medications which reduce hearing: Certain medications increase hearing loss. Therefore, double check with your doctor to make sure your medicines will not make you lose your hearing.
7. Get your hearing tested: Finally, get your hearing tested as identifying the problem early on can help stop worsen the situation. In case you have a concern or query you can always consult an expert & get answers to your questions!

Ear infection is a disorder which can either be viral or bacterial, affecting one’s middle ear the most. This disorder is painful as fluid accumulates in the ear leading to inflammation. Infections of the ear can either be chronic or acute in nature, the damage is more prominent in case of chronic infections. Acute ear infections can be painful but they usually fade away in a few days’ time.

Symptoms
In case of an ear infection, you will experience pain in the ear. A pressure may develop in the ear accompanied by drainage of pus from the ears. Some severe cases might also lead to loss of hearing, be it temporary or permanent. The symptoms of ear infection may develop and affect both the ears. Fever during ear infections is another common auxiliary condition.

Causes
Ear infections tend to occur when the Eustachian tubes in the ear get blocked as a result of fluid accumulation in the ear. The Eustachian tubes can get blocked due to the following reasons –

1. Being affected by allergies
2. Conditions such as cold can lead to ear infection
3. Problems in the sinuses
4. Excessive smoking
5. Infected adenoid glands

In addition to the causes, there are certain risk factors which can make one prone to ear infections, some of them being:

1. Narrow Eustachian tubes in children increase the risks of ear infections
2. Changes in climate and altitude
3. Second hand exposure to cigarette smoke

Treatment
For mild symptoms, simple home remedies will suffice. A warm compress on the affected area can reduce the pain. Taking pain relieving medications such as ibuprofen can also help in reducing pain. For moderate symptoms, antibiotics may be required to treat the bacterial infection.
If other treatments do not work, then surgery may be required. Usually tubes are inserted in the ear to drain the accumulated fluid. If it involves the adenoid glands, then surgical removal of the adenoid glands may be required. If you wish to discuss about any specific problem, you can consult an ENT specialist.