Dr. Rajeev Nangia

The tonsils are soft tissue masses which are located at the back of your throat, usually at the pharynx. The tonsils are masses which are part of the lymphatic system that helps fight infections. However, tonsils can themselves become inflamed and cause a lot of pain. Tonsillectomy is a procedure to remove the tonsils and relieve pain.

Why is tonsillectomy performed?
A few decades back, tonsillectomy was a routine surgery performed to relieve any pain within the tonsils. This method of treatment however has changed over the past few decades as pain medications for inflammation have improved vastly. However, tonsillitis is still performed in many cases wherein it tends to cause acute problems. Some of the cases it is applicable in are:

1. Chronic bad breath problems caused by recurrent inflammation of the tonsils
2. Recurrent sore throats caused by tonsillitis
3. It is also done along with dental surgery for correcting teeth with imperfect positioning
4. Abscess formation in the mouth
5. Upper airway being obstructed due to inflammation, thus causing difficulty with sleeping, snoring, or causing sleep apnea (irregular breathing during sleep)
6. Ear infections being regularly caused by inflammation of the tonsils

Other reasons why it may be recommended
Tonsillectomy may be also be recommended when there are no indications of problems but tonsillitis and other infections keep cropping up too regularly. This affects children and can make them sick or keep them in pain regularly. Some of these other indications are mentioned below:

1. Tonsil infections and inflammations happening too frequently within a year
2. Tonsillitis is caused by bacterial infection wherein the antibiotics aren’t effective
3. Formation of pus in the form of an abscess within or around the tonsils which keep forming even after repeated drainage or administering antibiotics

Possible complications and risks
Like any other form of surgery, tonsillectomy has certain risks associated with it as well. However, these are very rare. Some of these risks and complications are mentioned as follows –

1. Swelling of the mouth: The tongue and the soft palate or the roof of the mouth may swell, resulting in breathing difficulties an few hours after the surgery.
2. Infection: As is the case with any surgery, infections may occur in rare cases, which may require further treatment.
3. Adverse reactions to anesthetics: Many patients exhibit an adverse reaction to anesthetics and may develop symptoms such as a headache, nausea, muscle soreness and frequent vomiting.
4. Bleeding during surgery or healing: Although it is rare, bleeding during and after surgery has been reported after all sorts of procedures and it may occur with tonsillectomy as well.

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

Physical pain can often be overwhelming especially for children. Ear ache can cause terrible discomfort to children and can give sleepless nights to both children and parents. It is important for new mom and dads to know the basic causes and remedies of an ear ache. That way the little kids can get relief faster. We will help you know more about ear pain in children. Infants and toddlers suffer more, as they can’t express their discomfort. It is crucial to watch out for symptoms like high fever, pulling or tugging ear, white or yellowish discharge coming out of the ear, restlessness, loss of sleep and appetite.

Causes:

1. The most common cause for ear pain is Acute Otitis Media (AOM) or middle ear infection. Small children are especially vulnerable to this infection. The infection causes fever and pain in children. Infection occurs when the fluid produced, can’t be drained by the Eustachian tube. It happens mostly after a bout of cold in kids. Because of it, the Eustachian tube gets swollen making it difficult for the fluid to flow out.
2. Tonsillitis or an infection of the tonsils can also lead to an ear ache.
3. Too much ear wax can also cause pain in the ear.

Soothing Remedies:

1. In the case of a mild case of infection, certain home remedies can give immediate relief. So before running to the emergency, try a few of these.
2. A hot or cold compress can give some relief. Get a heating pad or ice bag/ pack for this treatment. Children and even adults benefit from this remedy. However, it is not advisable to use heating pads on babies.
3. If the child is old enough to sleep with a pillow keep his/her head elevated.
4. If the pain is too much to bear, over the counter analgesics like acetaminophen or ibuprofen can be given provided the stipulated dose for children and infants are maintained.
5. If the pain is light, simple distraction method works great among children. They can be engaged with either a storybook, a new toy or some game. Letting them munch on their favourite snack can also help.
6. Some home remedies recommend putting a few drops of olive oil inside the ear. Though this method does not have any scientific base, it might give relief, however, it is necessary to check with your child’s doctor before applying this.
7. The most common way to treat this infection is, however, by giving them antibiotics. If the pain persists, visit your child’s doctor, let them examine his/her ears and then if he feels he will prescribe antibiotics.

Prevention Is Better Than Cure:
Says all seasoned parents. Hence know when to be careful to avoid further ear infections. Some point to ponder.

1. Since ear infections typically start with a common cold, get your child a flu vaccine every year. This will prevent him from catching cold often.
2. If your child is going to the daycare or school, make sure they do not encourage the sick child to come to school.
3. Do not let your infant lie down with a bottle before sleeping.

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

What is a Sinusitis Surgery?

The traditional sinus surgery involves the removal of the diseased sinus tissue with improvements in the drainage channels by creating a definite pathway so as to drain out the infection from the cavities.

Usually, endoscopic techniques allow for better access and visualization as compared to making external incisions. This furthers the recovery process from this sort of a surgery.

Unlike other surgeries, a sinusitis surgery aims at re-routing the infected sinus pathways in addition to clearing the damage pathways. Post-operative care is as important as the surgery itself. In fact, insufficient follow-up and poor post-op care are two of the most important reasons behind the failure of this surgery.

Few essential things you need to know before such a surgery:

1. Balloon Sinuplasty is a comparatively newer method to treat and expand the natural drainage mechanisms of one’s sinus passages.
2. The patient should refrain from eating or drinking any beverage at least eight hours prior to the surgery.
3. Once the surgery is carried out, the patient can go home and rest with his/her head elevated for faster recovery. Also, applying a towel wrapped in ice can also help stop the bleeding that might so commonly occur.
4. Recovery from the surgery can take about 5 days and the patient should not carry out any strenuous activity until cleared by the surgeon.
5. Post-operative care is of the essence in this sort of a surgery.
6. Follow up with the doctor if you happen to have fever that refuses to subside even with medications, headaches that do not respond to medications or bleeding that doesn’t stop.
7. Any swelling in and around the nose or fluid draining from the nose should not be left ignored and untreated.
8. Identify and stay away from allergens, moisturize your nose frequently with the help of nose moisturizers and avoid the common cold and flu.

Surgery choices

Endoscopic surgery is preferred over traditional surgery for most cases of chronic sinusitis that require surgery. It is less invasive, less expensive, and has a lower rate of complications.

1. Endoscopic surgery may be done to remove small amounts of bone or other material blocking the sinus openings or to remove growths (polyps). Normally, a thin, lighted tool called an endoscope is inserted through the nose so the doctor can see and remove whatever is blocking the sinuses.
2. Sinus surgery may be done when complications of sinusitis, such as the development of pus in a sinus, infection of the facial bones, or brain abscess have occurred. In this type of surgery, the doctor makes an opening into the sinus from inside the mouth or through the skin of the face.

What are the complications and risks?

• Recurrence of polyps or other nasal problems.
• Excessive bleeding post-surgery.
• Chronic drainage from the nasal cavities, crusting of one’s nose and excessive dryness.
• Further aggressive surgery might be required.
• Damage to one’s eyes.
• Damage to one’s skull, including drainage of spinal fluid.
• Facial or upper teeth numbness.
• Polyps which result in nasal obstruction.

Here are some suggestions for taking care of your nose and sinuses after surgery:

1. Keep your head elevated to help reduce bleeding and swelling after your operation. The first night after surgery, elevate your head with extra pillows or sleep in a recliner.
2. If you have packing material and splints in your nose, make sure they stay in place. If the packing gets clogged, breathe through your mouth. Do not remove the packing or splints.
3. Some bleeding is normal for 2 to 3 days after your operation. If you think you are bleeding a lot, be sure to call your doctor.
4. Don’t blow your nose for at least a week after surgery. Don’t do any heavy lifting, straining, or strenuous exercise. This increases the likelihood of bleeding in your nose.
5. If you have to sneeze, try doing it with your mouth open.
6. Don’t take aspirin. It slows clotting and increases bleeding.

   If you wish to discuss about any specific problem, you can consult an ENT specialist.

Neck cancer refers to the formation of cancer cells in the throat or neck region of your body. Neck cancer is commonly seen in people above sixty years of age .But people above forty can also have the chances of getting neck cancer. Though the symptoms of neck cancer can vary from one person to the other, 

Some of the common symptoms are stated as follows:

1. Neck cancer affects the voice box, so a change in your voice can be noticed.
2. Weight loss is also a symptom for neck cancer.
3. A person suffering from neck cancer can also suffer from dysphagia or difficulty in swallowing.
4. Sore throat in some cases can be considered as a symptom of neck cancer
5. Bleeding from mouth or through your nose is also a common symptom for neck cancer.
6. Ear pain in some cases is a symptom of neck cancer.
7. Coughing persistently is also regarded as a symptom of neck cancer.
8. Sometimes a lump in the neck is also noticed and it is usually painless.
9. Some people also encounter breathing problem.
10. In some cases a swelling of the neck, jaw or eyes can also be noticed.

Neck cancer involves certain risk factors too. Neck cancer can be treated in many ways. The following are few treatments available for neck cancer:

1. Surgery: Your doctor can conduct a surgery for removing the tumors from your neck region. The doctor may decide to do either a microsurgery or laser treatment or endoscopy.
2. Chemotherapy: If the tumor spreads to other regions or is large in size, then your doctor may recommend chemotherapy. 
3. Radiation: It is used to destroy the malignant cells. It is usually conducted after removing the tumor.

These three are the common treatments followed by doctors. Your doctor may also take help of other treatments like administering drugs to control the growth of cancer cells. But, sometimes treatments fail to work if the process of metastasis starts. So you should not ignore it, as soon as you encounter any of the symptoms stated above, visiting an oncologist is highly recommended.

Rhinitis is an irritable medical condition where the mucous lining of a person's nose swells up. The term is more of a category and less of a definitive way to describe something specific. Rhinitis involves a host of other conditions that affect the mucous membranes of your nose. If you were not aware, common cold is also a kind of rhinitis. Rhinitis can cause acute touchiness in the inner lining of the nose leading to continuous discharges from one's nose. It can also lead to clogging of your nose or inflammation of the internal tissues. 

Rhinitis can be divided under two main types; allergic and non- allergic rhinitis. Allergic rhinitis, popularly known as hay fever is caused due to contact with allergens that are usually undamaging. However, in case of non- allergic rhinitis the symptoms take after that of the allergic type but no particular causal factor can be identified.

Factors that can increase your propensity to suffer from rhinitis of any kind are:

• Pollen from flowers
• Inhaling certain substances can be harmful; smell of certain chemicals is bad too.
• Both active as well as passive smoking can be detrimental
• High levels of air pollution contributes to the risk
• Weather conditions affect your health; a windy yet humid weather can aggravate rhinitis.

Common symptoms of rhinitis can be listed as below:

1. A person suffering from this condition might catch a cold all of a sudden.
2. People, usually little children, might even face high fevers.
3. Your nose tends to be runny. After the infection subsides, chances of a thick, sticky discharge are more.
4. Exhaustion is also felt in combination with headaches and teary eyes.
5. The nature of your nasal discharge tells the doctor if you are suffering from an allergy or from a viral infection.

A few preventive measures to aid you against rhinitis:

1. Rhinitis can be communicable and in most cases it is so. Therefore a person should not share his or her utensils and other personal things such as towels or handkerchiefs with any other person.
2. One should not be in close proximity of another infected person.
3. Hands are the most common sources of infection. One must wash his or her unclean hands before touching the face.

Here are some health effects of snoring 

Hi I’m Dr. Rajeev Nangia, senior consultant ENT. Today I’ll be talking on a very important and common topic- Snoring. It is taken to be a very common thing but now it has been proved scientifically that there are a lot of bad effects of snoring too. It is caused by obstructive sleep apnea, whenever there are obstructions in the upper airway then there is a reduction in the oxygen levels to the body which leads to further effects on the body and can cause hypertension, diabetes, and weight gain and even affect your heart and can seldom lead to sudden death.

We should not ignore snoring but rather should always go for a complete ENT examination followed by a nasal endoscopy followed by a sleep test. It is nothing but while you’re sleeping we just attach some instruments and note the apnea and the hypopnea plus we note the oxygen levels and other things. So then we evaluate the severity of the sleep apnea whether it is in the mild, moderate or severe category. If it is mild then we can change our habits or we can reduce weight and other things, we can get over it.

Moderate or severe category can be a serious problem because sometimes people can have a daytime sleeping pattern and have a road accident which can be fatal. So for the moderate we have two things basically: we can either operate which is known as UPPP operation and or we can go for the BiPAPS but for severe category we have to go for the BiPAPS and for any other thing regarding snoring or its problems, you can consult me at this wonderful site called Lybrate or can consult ma directly online.

 

Never take steam or hot things when you have nasal bleeding.