Dr. Rajeev Nangia

If you hear a constant ringing in your ears without any external stimulus, it is called tinnitus. The sound can also manifest as incessant roaring, hissing, buzzing or clicking. The sound can be loud or soft, low or high pitched. Tinnitus can occur in one ear, or both the ears.

Tinnitus is primarily of two types:

1. Subjective tinnitus: This type of tinnitus is very common. In this type, only you are able to hear the ringing, or buzzing. The main cause of subjective tinnitus is ear problems, especially in the inner, middle and outer ear. Problems in the auditory nerves (hearing) or auditory pathways (the part in your brain that changes nerve signals into sound) can also cause subjective tinnitus.
2. Objective tinnitus: In this type of tinnitus, the doctor can also hear the sound when he/she performs an examination. This type of tinnitus is rare. Muscles contractions, problems in the blood vessels or conditions in the middle ear bone can cause objective tinnitus.

Causes:
Tinnitus is not a condition; it is more of a symptom of some other underlying medical condition. Tinnitus can be caused by any of the following complications-

1. Hearing loss (This happens mostly among older people)
2. Loud noises
3. Sinus and ear infections
4. Blood vessel or heart problems
5. Meniere's disease (The inner ear is affected by unknown causes which lead to deafness)
6. Brain tumours
7. Hormonal changes (This happens mostly to women)
8. Thyroid problem
9. Certain medications (antibiotics, cancer medicines, diuretics, quinine medication, some types of antidepressants, aspirin)

Symptoms:
The symptoms of tinnitus include

1. You hear noises that no one else will be able to hear
2. The sound can be depicted as chirping, whistling, screeching, clicking, static, hissing, buzzing, roaring, pulsing, musical or whooshing.
3. The sounds can vary greatly in volume and it is most prominent at night or when your surroundings are quiet
4. Loss of hearing commonly follows tinnitus.

Treating Your Tinnitus
Depending on the results of your hearing evaluation, you may get a recommendation for one of the following types of tinnitus treatment. 

1. Tinnitus Retraining Therapy (TRT) uses cognitive behavioral therapy in combination with a masking device to help you learn to ignore the background ringing noise in your ears. 
2. Tinnitus masking or noise suppression devices are common treatment options for tinnitus sufferers. This type of device is worn in the ear like a hearing aid and produces either a constant signal or tonal beats to compete with the sounds you're hearing. The hearing care professional will use the pitch matching and loudness matching tests to set the signal at a level and pitch similar to the tinnitus you are perceiving.
3. You can also use a free-standing white noise generating machine. Tinnitus generally gets worse when you're in a quiet space, so being able to bathe a room in background sound might be all you need to help you ignore the ringing in your ears.
    

Are you suffering from a sore throat that is prolonged in nature? Although, a sore throat is not very severe, being prolonged in nature indicates that it is chronic. You should not ignore a sore throat that does not heal over a long period of time. This might be an indication of a serious problem, and you will require proper diagnosis.

When is a sore throat termed as chronic?

1. A sore throat may take various forms. It can be itchy, burning, scratchy in nature, and can also cause difficulty in swallowing food.
2. It is likely for a sore throat to be accompanied by a form of pesky cough that leads to further irritation of the throat.
3. Sore throats can also occur from common colds and several viruses. These usually resolve on their own.
4. However, when your sore throat is persistent and you cannot find relief, it is referred to as a chronic sore throat. The primary cause of sore throat includes strep throat, allergies, tonsillitis or the infection of your tonsils, inhaling air pollutants, influenza, cigarette smoking, and inhaling via the mouth.
5. Among these conditions, strep throat and tonsillitis may turn into severe problems, if not treated properly.
6. Smoking is a major cause of chronic sore throat. You should control your smoking to eliminate these sore throat symptoms.
7. Snoring is also a major cause for sore throat.

Relief from chronic sore throat
No matter what is the cause of your chronic throat pain, or sore throat is, you should follow some steps and undertake simple home remedies for soothing your scratchy, itchy and painful throat. Some of them include the following:

1. Do hot water steam inhalation daily, which will help
2. You must stay well hydrated and should moisten your throat by drinking lots of fluids throughout the day. You should add honey to warm drinks and hot tea.
3. You may take over the counter pain relievers.
4. You should install a humidifier in your home for preventing dry air that causes irritation to your throat.
5. You may try gargling regularly with warm water and salt, at least twice a day.

It is difficult to diagnose the exact cause of a sore throat, but when it worsens or does not tend to leave, something serious is indicated. You must consult a doctor and undertake a physical examination of your throat in order to detect the cause.

Your hearing is one of the most important functions 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, as 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 sounds 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 chances of hearing loss. Second hand smoke does the same thing. Therefore, try to stop smoking if you are a smoker, and try to stop consuming second hand smoke if you are not a smoker.

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.

Hello!

I am Dr. Rajeev Nangia, senior consultant ENT. Today I will be telling about what is sinusitis, the symptoms, the treatment and the new age advances. Now sinuses are air-filled spaces in the head and the face. There are four sets of sinuses. Now the sinuses are a normal structure and any inflammation or an infection in the sinuses is called sinusitis which is not normal. The symptom of sinusitis if you have a recurrent cough and cold, sneezing, itching, redness, itching around the eyes, loss of concentration, post nasal drip, mild fever. The reason for the sinusitis is- it can be viral. it can be bacterial, it can be infective, it can be due to obstructive causes. Now we come to the treatment. The first one is the symptomatic treatment and that is by medicines. Medicines we prefer like anti-allergic, antibiotic and steroids in some cases. The third part is the surgical part.

First of all, we have to diagnose it with CTL sinuses and diagnostic nasal endoscopy. The surgical way further is FES or Functional Endoscopic Sinus Surgery and that means we create the aeration of the sinuses, remove the polyps, remove any obstruction like any deviated nasal septum. The latest advances in this are Balloon Sinuplasty which is normally done with minimal to moderate sinus problems. If you have any headache or you not able to concentrate or similar things are there then this is the best way. The advantage of balloon sinuplasty which is the latest technique is that there is hardly any bleeding, the post-surgical complications are also minimal. The only problem is it is a little bit expensive though now it bein manufactured in India and it is slightly expensive on the surgical part. But nowadays it is also covered under insurance. That is the best part. I advise balloon sinuplasty as first treatment if it is possible and affordable to the patients. For any other queries or any requirement you want, you can contact me at Lybrate app on my portal.

Thank you!

Any ailment can cause a breakdown of one's overall well-being due to the onslaught of related symptoms, and sinus problem is no different. Sinusitis refers to inflammation or swelling of the tissue that lines the sinus, which are passages filled with air and lie in the nasal tract. 

Sometimes, these passages get blocked with germs, fluid and other elements that can give rise to infections and allergic reactions. Here are the ways in which this condition can affect your health:

• Related ailments: One of the most common outcomes of sinus blockage is common cold, which can happen when the passages do not get proper movement of air. Further, it can also cause allergic rhinitis which is also known as hay fever and comes with its own set of symptoms like a runny nose, blocked nose and ears, watery eyes and other signs. A build-up of nasal polyps can also take place in the blocked path of the sinus, while the nasal cavity can also shift, causing a deviated septum. 
• Pain: We have many sinuses that are located in various parts of our head, including the areas above and below the eyes. As a part of the sinus attack, one may experience pain and fluid fullness in these areas. These regions can ache when there is a sinus infection. This pain can also be caused by the dull pressure exerted by inflammation, and the pain can then travel down to jaws, teeth and even between eyes. 
• Headaches: The constant pressure and persistent pain in the various areas containing the sinus can lead to long term headaches which will be at their worst in the mornings. This is due to the fact that the fluids have been accumulating throughout the night. These headaches can get worse if there is a change in the temperature. 
• Congestion: Congestion is also a common symptom of sinus infection. The swollen sinuses can lead to constrictions in the nasal passage, which can obstruct normal breathing. This will lead to congestion, which can also affect the senses of taste and smell. 
• Cough and discharge: A patient suffering from a sinus infection may end up blowing his or her nose more often than normal. This will usually happen because a yellowing greenish discharge will drain into the nasal passages on a regular basis during the infection. When this discharge bypasses the nasal tract and reaches the throat, it can also cause persistent coughing. It is best to ask for medical intervention and practice steaming to relive the painful symptoms of this condition.

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

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.