Dr. Manish Prakash

Just like there are exercises to lose weight, there are simple exercises, which you can do to stop your snoring completely. Snoring is a common condition and it generally takes place more in men than women. It mostly affects individuals who are overweight and the condition gets worsened with age. Though it is not a serious condition, it has to be dealt as it affects the sleep of your sleeping partner. The main cause of snoring is an improper flow of air through the mouth or nose. 

The airflow to the nose is obstructed by factors like:

1. Obesity
2. Pregnancy
3. Genetic factors
4. Sinus Infection
5. Congestion

How to Prevent Snoring:
It is very essential that prior attention is given to this condition before it turns out to be a serious problem. The self help  tips that can be used by individuals to stop snoring include proper exercising, losing weight, quitting smoking and not drinking alcohol as well as setting up an ideal sleeping pattern. There are devices available in the pharmaceutical stores like the mouth guard device which are specially designed to help stop snoring. There are medications also available that help to stop snoring and have good quality  sleep.

Amazing and Simple Exercises to Stop Snoring:

1. Singing: Singing is an excellent exercise that is very good for your vocal passage and that can cure the snoring problem. It is best that you start singing in a warm shower and the moist steam of the warm water would soothe your throat. The benefit of singing is that it tightens the muscles and it is an excellent and natural way that would cure your sleeping problem. You can practice singing at least 20 minutes in a day, and you would surely experience the difference.
2. Yawning: The second simple exercise that can be done to stop snoring is yawning, which involves opening and closing of your mouth. The exercise done in a yawning motion would strengthen both the inner and outer neck muscles. It is very necessary that the mouth is opened widely, and this activity can be done anytime of the day.
3. Chewing: The third exercise that is helpful to get relief from sleep disorders is chewing. You can fix your throat by chewing the tip of a pencil.  You don't have to bite the pencil, and you just need to fix your throat muscles to make certain that your airway is clear. If you wish to discuss about any specific problem, you can consult an Ent Specialist.

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.

Here are symptoms, effects and procedure of cochlear implants.

Hi! I am Dr. Manish Prakash senior ENT consultant at Mayom Hospital, Gurgaon. Today we are going to talk about Cochlear Implants. Cochlear Implants are the boom for the deaf. They are primarily indicated for severe to a profound Sensorineural Hearing loss in children and adults.

Hearing loss is of two types Conductive Hearing loss and Sensorineural hearing loss.

Conductive Hearing Loss primarily means that the sound is not able to reach inside the inner ear into the cochlea and that is why it is called as Conductive Hearing Loss whereas Sensorineural hearing loss means that the sound is reaching into the cochlea but because to the damage in the cochlea hair it does not reach to the auditory nerve and it cannot reach to the brain.

Cochlear implants are mainly indicative for the treatment of Sensorineural hearing loss. Cochlear implants consists of two parts. One is internal component and the external component. Internal component is the surgically implantable electrode which is inserted by a surgery inside the cochlea which happens to reside behind the ear. The external part is a processor which is also having a microphone and a transmitting coil which is a house behind the ear and is supposed to capture all the sound and transmit it to the electrical signals. Thereby the signals enter to the cochlea via the electrode and these signals are transmitted through the auditory nerve to the brain. Cochlear implants is majorly for pre lingual children. Pre lingual mean before the development of the language and children who are born deaf and children under 8 years of age are good candidates for such kind of intervention and procedure and also children who are post lingual deaf which means that after the acquisition of language. Afterwards who become deaf post lingual children and adults are also good candidates for the cochlear implantation program.

To know more you can visit my website www.entgurgaon.com or connect me to lybrate.com.
 

Here are allergic issues of the Nose

Hello, I am Dr. Manish Prakash, senior ENT consultant at Mayom Hospital, Gurgaon. Today we are going to talk about allergic issues of the nose.

More commonly nasal allergies are referred to as Allergic Rhinitis. These allergies can either be seasonal or perennial allergies. Seasonal allergies majorly manifest in terms of seasonal changes whereas perennial allergies would be present throughout the year and they would tend to bother patients all through the year. These allergies are caused by allergens, most of which are aero allergens, sometimes they can be food allergens as well. These aero allergens are present in our environment commonly like pollens, house dust, mites and can lead to a lot of allergic reactions in the nose. A typical allergic reaction manifests itself whenever the body comes in contact with an allergen. There are a lot of problems in the nose in terms of itching and watery discharge from the nose. The eyes sometimes tend to become red and itch. These manifest in a lot of sneezing and sometimes it may also be associated with some wheezing and difficulty in breathing also. This typical allergic reaction may last for few minutes and may go on for few hours as well. It can incapacitate the patient and lead to a lot of problems in the workplace.

Now we are going to discuss how we handle these allergic problems. The easiest and best way to handle these is to avoid the Allergens. So we try to identify based on the history, the experience of the patient and some clinical testing to find out what is the allergen which is causing the problem to the patient. So typically we start with some IGE profiling which is a blood test which can tell us about the allergy status of the patient and that will give us an idea of how much is the allergy level within the patient’s body. Also nowadays we do some Allergy Profiling Test. These tests can tell us as to we are having a specific allergy to which particular allergen and we can do some blood tests which can guide us towards the further treatment of the patient. Also, we have some Skin Allergy Testing which is what we call as Skin Prick Allergy Testing. This test can help us to differentiate between the various types of allergies.

These allergies may sometimes be used as a prick test over the body either typically over the forearm or shoulder and if there is any swelling in the place of the pricking it confirms that there is an allergic reaction of the body towards this particular thing. Once, we are diagnosed of what we are allergic to, we have to start avoiding that particular thing but sometimes we come across things which are very common in our environment and we cannot avoid them like dust mites, pollens to which we can get exposed to whenever we go out. So we have to think about allergy suppression. When we talk about allergy suppression, it would mean that we can either use some anti histaminic which can help us to suppress the allergic symptoms which are present within the body. Typically we can use over the counter available medication like Cetrazin which can help us to decrease the severity of such kind of symptoms.

Patients who have very high allergy levels and continuous symptoms are often advised to use some nasal sprays. These are typically INCS nasal sprays which are intranasal cortical steroid sprays. They help us to decrease the inflammation inside the nose and also decrease the allergic manifestations which lead to improvement in the patient’s overall well-being. Many of these anti allergic medications may need a long term usage and the latest medications which are available are very good and very safe and they can be used for a long period of time. Nowadays we also have newer modalities in terms of immunotherapy in which we can make some vaccines for the allergens which we have diagnosed to these allergy testing and we can serially expose the patient over a period of time and that can help us to decrease the sensitivity to these allergies and over a period of time it will lead to decreased manifestations of allergies and decreased dependence on anti allergic medications.

If you have any such kind of problems in terms of nasal allergy or any other ENT problem you can contact me through Lybrate.com or visit my clinic at Mayom Hospital, South City-1, Gurgaon. 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.

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.