Dr. Manish Prakash

Acoustic neuromas are tumors that develop on the nerves connecting the ear to the brain. Being non-cancerous in nature, they do not spread to other parts of the body. However, they are characterized by symptoms such as gradual or sudden hearing loss, more pronounced with either of the ears, a ringing sensation in the affected ear, weakness, facial numbness and dizziness.

Causes:

Acoustic neuroma can be of two types: one is sporadic in nature and the other is associated with a condition known as neurofibromatosis type II (NF2). NF2 is basically an inherited disorder identified by benign growth in the nervous system. NF2 being a rare disorder, makes the sporadic type the dominant one. Although the causes behind this type of neuroma are still unknown, long term exposure to radiations, especially around the neck and the head, could be one of the most important triggering factors.

Treatments:

Once the diagnosis is done, treatments for acoustic neuroma depend on the growth and size of the tumor.

1. Diagnosis with the help of monitoring: Small tumors exhibiting no such symptom or slow signs of growth need to be monitored with the use of hearing tests and regular imaging. In case, the MRI scans are able to trace any sort of development on the part of the tumor or if the tumor poses subsequent difficulties, opting for treatment becomes the need of the hour.

2. Stereotactic Radiosurgery: Also known as Gamma Knife, radiosurgery is a treatment method wherein controlled radiations are used to treat tumors, thus doing away with the need of making any incision.

3. Surgical Removal: Surgery performed under general anesthesia is directed towards removing the tumor; that helps to preserve the facial nerve and thus inhibit facial paralysis and hearing loss. The tumor is usually removed either through the ear or through the skull. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

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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.

Hoarseness in the simplest sense means, 'hoarse voice'. It may be defined as an abnormal voice change. It is experienced in the form of strained, rough, thick, harsh and grating voice. Variations can be felt even in the loudness and pitch of the voice.

Hoarseness is a temporary infection associated with the larynx, which is also known as the voice box in animals as well as humans. Vocal cords are present inside the voice box. Depending on the vibration of the vocal cord, different sounds are produced.

What are the general causes of hoarseness?

Hoarseness may be caused by common cold, viral infection, cough, irritation due to screaming, smoking, allergy, thyroid problem, acute laryngitis and benign tumor. In adults, the stomach asset comes up to the throat causing hoarseness. Heartburn can also be one of the causes.

When hoarseness arises due to common cold and cough, it will last for 2 to 3 days and will subside using cough suppressant and home remedies like salt water gargling, drinking hot milk with turmeric and pepper powder. As cough or cold suppress, hoarseness will also reduce.

When to see an Otolaryngologist (ENT specialist)?

Serious infections in ear nose and throat are treated by an otolaryngologist. It is very essential to consult this specialist if hoarseness lasts for more than 2 to 3 weeks; pain in ENT is not due to cold or flu, coughing up blood, lump in the neck.

Evaluation: The medical specialist starts his diagnosis by physically examining the vocal cord. Flexible light weight fiber optic tube scope is also used to visually examine the larynx area. Videotaping, acoustic analysis is also done to study voice irregularities, airflow to guide treatment.

How can hoarseness be treated?

The mode of treatments depends on underlying the cause of the problem. The patient may be advised:

1. In most cases, hoarseness can be treated just by resting your throat or modifying the use of your voice.
2. To avoid smoking or passive smoking
3. Referred to a speech therapist to improve sound of voice.
4. In case of benign tumor the nodule or polyp is removed by surgery.

How can you prevent hoarseness?

We've all heard the phrase, 'prevention is better than cure'. Alas, it is. Preventing hoarse voice and throat is a much better option than treating it. Here are some tips on how to prevent hoarseness:

• Avoid smoking
• Avoid overconsumption of caffeine and alcohol.
• Consume plenty of water
• Avoid eating spicy food.
• Avoid speaking loudly for long intervals of time.

When you travel in an airplane or just come out of the swimming pool, your ears may sometimes block up and even be painful. This is what is known ear barotrauma and is caused by pressure differences inside and outside the ear drum. Severe cases may cause damage to the ear and impede your hearing.

Symptoms of ear barotrauma: Ear barotrauma usually occurs when the Eustachian tube is blocked due to differences in air pressure. The Eustachian tube is a long narrow tube that runs from the middle of your ear to the pharynx or the back of the throat and is thus very important in relevance to the ear, nose and throat. Thus ear barotrauma can also translate to pain in the ear and throat as well.

Some of the symptoms are:

1. Discomfort in the ear, or aggravated pain in extreme cases
2. Dizziness
3. The ears being blocked or full, in severe cases may feel like being underwater
4. Temporary hearing loss
5. Nose bleeding in severe cases
6. Health care providers may see an inward caving or outward bulging in the ear drum. In severe cases, the eardrum may look bruised as well.
7. Some severe cases may even exhibit signs typical of an ear infection along with some of the other symptoms mentioned above.

Precautions and self treatment: There are certain steps you can take to either prevent barotrauma or reduce the symptoms, these are:
yawning or gulping. This is very helpful when air pressure differences are caused in cases of travelling by aircraft.

1. Inhale slowly and then exhale while your mouth is closed and you are holding your nostrils closed by fingers. This will help increase the pressure within the tube to try and open it forcefully.
2. Sucking on candy is another way to prevent barotraumas as you are constantly swallowing and keeping your Eustachian tube from being blocked in the first place.
3. Keep a few chewing gums handy and has similar effects on your ears as it forces the Eustachian tube to remain open despite pressure differences.
4. After diving or swimming, come out of the water slowly.  Scuba divers and deep swimmers need to come up slowly to ensure that the Eustachian tube is given enough time to acclimatize and slowly come back to normal.

Usually, ear barotrauma goes away automatically after sometime and no medications are required. However, if symptoms still persist, it is best to go to a relevant doctor or a health care provider for pain relief and long term solutions.

Tonsillitis is a disorder of the tonsils present on the back of your throat. The tonsils acts as a defensive mechanism in the body as they prevent the body from infections. This is a contagious condition and can occur at any age. It is widely prevalent among school going kids.

Tonsillitis may be classified into two types:

1. Chronic tonsillitis: This type of tonsillitis tends to last for an extended duration with symptoms of bad breath and tenderness in the lymph nodes.
2. Recurrent tonsillitis: This is a form of acute tonsillitis which repeats itself over a year.

Causes: Tonsils prevent various virus and bacteria from entering the body through the mouth by producing antibodies. The tonsils, however, may become vulnerable to these infections. A virus that causes common cold or the bacteria that causes strep throat may result in tonsillitis. The most common cause of this disorder is the strep bacteria. School going children are especially vulnerable to this disorder because they are most prone to various infections.

The various viruses that may cause tonsillitis are:

1. Enterovirus
2. Herpes simplex virus
3. Epstein-Barr virus
4. Influenza virus
5. Adenovirus
6. Parainfluenza virus

Common symptoms: 
The various symptoms of tonsillitis are

1. Swallowing difficulties
2. A sore throat
3. The sore throat may result in bad breath
4. You may experience fever and chills
5. Pain in the head, ear and stomach
6. You may experience stiffness in the neck and the jaw
7. Swollen tonsils with possible redness
8. Changes in voice
9. Symptoms of cold

Treatment: The treatment for tonsillitis is usually antibiotics and in some cases, tonsillectomy. The antibiotics help in getting rid of the bacterial infection. Surgery is only done in cases where tonsillitis is chronic in nature. It is important that you drink fluids and restrict smoking to prevent tonsillitis.