Dr. Sunil Aggarwal

Tonsils are the two oval-shaped tissue pads at the back of your throat, which function as a mechanism to protect you from diseases. Any infection of the tonsils is referred to as ‘tonsillitis’.

You can suffer from tonsillitis at any age, but it is more commonly diagnosed in children. Tonsillitis is highly contagious.

There are two types of tonsillitis:

1. Chronic tonsillitis— Longer episodes of acute tonsillitis
2. Recurrent tonsillitis— Recurrent episodes of tonsillitis in a year

Causes

Tonsillitis can cause viral and bacterial infections. The ‘Streptococcus (strep) bacteria’ is a common cause. Some other causes include:

1. Adenoviruses
2. Influenza virus
3. Epstein-Barr virus
4. Parainfluenza virus
5. Enteroviruses
6. Herpes simplex virus

Symptoms

Since tonsillitis has various causes, symptoms too tend to differ. Some symptoms include:

1. An extremely sore throat
2. Painful or difficult swallowing
3. Scratchy-sounding voice
4. Bad breath
5. Fever
6. Chills
7. Earaches
8. Stomach aches
9. Headaches
10. Stiff neck
11. Neck and jaw tenderness due to inflamed lymph nodes
12. Tonsils that become swollen and red in colour
13. Yellow or white spots on the tonsils

In children, symptoms such as excessive drooling, increased irritability or poor appetite are usually noticeable.

Treatment

If the tonsillitis is mild, especially caused by a virus, it usually doesn’t require any treatment. More critical cases of tonsillitis might require treatments such as tonsillectomy (a surgical process used to remove the tonsils) or administration of antibiotics.

Penicillin is the most commonly administered antibiotic. Once commonly performed, tonsillectomy (surgical removal of tonsils) is now reserved for extremely critical cases. If you wish to discuss any specific problem, you can consult an ent-specialist.

An eardrum rupture or perforation is a little gap or tear in your eardrum and the tympanic membrane. The tympanic membrane is a thin tissue that partitions the canal of the middle ear and outer ear. This layer vibrates when sound waves enter your ear. The vibration proceeds through the bones of the center ear. Since this vibration allows you to listen, your hearing can be affected if your eardrum is harmed. A ruptured eardrum is additionally called a perforated eardrum. Permanent hearing loss could be an end result in some cases.

A ruptured eardrum, similar to thunder; can happen all of a sudden. You may feel a sharp pain in your ear, or an ear infection that you've had for some time all of a sudden leaves. In some cases, the person may not feel any signs of the rupture.

Some of the causes for such a perforation are:

1. Infection: Ear infections are a major reason for eardrum rupture, particularly in children. Liquids tend to deposit behind the eardrum in such cases.
2. Exercises: Exercising can bring about pressure changes in the ear and lead to a punctured eardrum. This is known as barotrauma, and takes place when the pressure outside the ear is not the same as the pressure inside the ear. Activities that can bring about barotrauma include scuba diving or flying on plane.
3. Other activities: Wounds can likewise burst your eardrum. Any injury to the ear or side of the head can bring about a crack.

Diagnosis: Your specialist can use a few approaches to find out whether you have a ruptured eardrum:

1. A liquid test in which your specialist tests liquids that might spill from your ear from infection.
2. An otoscope exam in which a specific gadget with a light is used to investigate your ear channel
3. An audiology exam, in which your specialist tests your listening to range and eardrum limit
4. Tympanometry, in which your specialist uses a tympanometer to test the pressure changes in your ear.

Treatment: The treatments are as follows:

• Patching: In the event that your ear does not recuperate by itself, your specialist may fix the eardrum. Fixing includes setting a sedated paper patch over the tear in the film.
• Antibiotics: Anti-toxins can clear up contaminations that may have prompted your eardrum break. They additionally shield you from growing new diseases from the aperture. Your specialist may endorse oral antibiotics or eardrops.
• Surgery: In uncommon cases, surgery might be required to fix the gap in the eardrum. A surgical repair of a punctured eardrum is called tympanoplasty.

A cracked eardrum generally recuperates without any invasive measures. Many patients with cracked eardrums encounter just transitory listening problems. If you wish to discuss about any specific problem, you can consult an ent-specialist.

The ear is made up of three parts that is outer, middle and the inner part. Infections, disorders and ailments in the ear can occur across all age groups and in any part of the ear. Ear ailments are more common in children than in adults as the Eustachian tubes (tubes which drain out ear fluid) are smaller in children.

Here are a few common ailments which occur in children:

1. Acute otitis media: AOM is the most common ear infection in children. Some parts of the middle ear are infected, resulting in swelling and blockage of fluid behind the eardrum. This condition is characterised by earache in children and in graver conditions, can also cause fever.
2. Otitis media with effusion: This condition usually occurs due to the infestation of an infection when the fluid gets restricted behind the ear drum. This condition doesn’t exhibit too many symptoms except mild earache. You should consult an ENT specialist who can diagnose this condition by checking the concentration of fluid behind the eardrum using special instruments.
3. Chronic otitis media with effusion: This condition occurs in children when the fluid remains trapped behind the eardrum for a long period of time. It can lead to serious infection and can cause hearing problem in children.
4. Barotrauma: Barotrauma occurs due to changes in atmospheric pressure changes. It can cause problems in the Eustachian tube and causes trapping of air in the middle ear. Middle ear problems can become severe if left untreated and result in a burst in the eardrum, causing excessive bleeding.
5. Meniere's disease: This is a disorder, which comes in bouts and is characterised by vertigo and fluctuating hearing loss. This condition usually affects one ear. It can result in tinnitus (ringing in the ear) or permanent loss of hearing if left untreated.
6. Swimmer’s ear: Swimmer’s ear, also known as otitis externa, is a common condition which is caused in the outer area of the ear. This condition is caused due to remnants of chlorine water in the ear or because of inserting swabs too deep inside the canal. This condition is characterised by earache, discomfort and itching of the ear.

Causes, symptoms and preventions for Nasal Allergy

Hello! I am doctor Sunil Agarwal, senior ENT Consultant at Paras Hospital Gurgaon. I did my MBBS in MS from a prestigious college of Delhi that is Maulana Azad Medical College. I was serving in Lok Nayak hospital till 2008, and after 2008 I started my private practice in Gurgaon. Today, I am going to discuss with you about nasal allergies and nasal polyps. Basically, I should explain to you about nose and sinus first. The cheek bones and the forehead bones are hollow bones, they have got air containing cavities which are known as sinuses. Normally there is mucous production in these sinuses which helps in normal humidification of air which we breathe through the nose.
Allergy or sensitivity is basically because of weather change, or can be because of certain food items, dust, pollution, strong smells etc. It can lead on to excess mucous production in the sinuses or sneezing. Nasal allergies can be controlled effectively by medications like antihistamines and intranasal steroids which are very effective and without any serious side effects. But if nasal allergy is uncontrolled or if it is recurrent or prolonged it can lead to swelling of the lining of the sinuses which ultimately can lead on to the formation of polyps.

Polyps are abnormal soft tissue masses in the nose and sinuses. Once the nasal polyps are developed the medical treatment is not that effective, in that case we need to go in for endoscopic surgeries which remove these polyps or soft tissue masses effectively. Nowadays with the advancement in technologies in the endoscopic procedures these things are without any serious complications, there is not too much of pain or bleeding and the recovery time is very fast. Even certain brain or neurosurgical procedures like pituitary glands are done through these intranasal endoscopic procedures.So one should not take these cold and allergies lightly and one should go to his ENT specialist to get these treated so that the production and development of polyps can be prevented and surgeries can be avoided.

In case of any further queries regarding nasal polyps, allergies, or cold, you can contact me through Lybrate or you can consult in my clinic at Gurgaon, sector 15.

It is very common for patients with nasal obstruction to develop clogged ear as well. The back of the nose opens into a tunnel also known as the Eustachian tube. This tube goes up to the ear. In case the ears get clogged the pressure is released by popping of the ears. This is achieved by swallowing, yawning, and trying to blow the nose. When ear pops the tunnel opens and allows the pressure to release from the ear.

Reasons why nasal obstruction causes clogged ears:

1. Mucosal Swelling: When the nose is obstructed, the nasal lining might swell thus making it difficult to breath. This might also lead to swelling in the tunnel of the ear causing it to shut down. Sometimes an ear pop does not happen in this condition and this is called as Eustachian tube dysfunction.
2. Negative Pressure inside the Nose: In nose obstruction when the patient tries to breathe through the nose there is negative pressure. This might build up near the opening of the Eustachian tube or the back of the nose. This pressure gets transmitted to the ear and results in a negative pressure in the ear which leads to the clogging of the ear.
3. Bernoulli's Principle: This principle states that in case of an inviscid flow, increase in speed of the fluid happens side by side with a pressure decrease.

Causes of Nasal Obstruction:

Obstruction or congestion of the nose leads to a stuffy and inflamed nose. In minor illnesses like fever, cold, sinus infection and flu stuffy nose can happen. This congestion might last for a week. In case the congestion is long term then the causes for it are:

1. Allergies and hay fever
2. Chemical and environmental irritants
3. Septum deviation
4. Chronic sinusitis that has lasted for too long
5. Nasal polyps and benign tumors

Symptoms of nasal decongestion are runny or stuffy nose, painful sinus, and swollen nasal tissues along with mucus buildup.

Treatment for Nasal Decongestion:
Once the nasal congestion has been found and the cause behind it has been analyzed, then treatment is must. Treatment usually includes prescription medication or over the counter drugs. Medication of the nasal decongestion involves the following:

1. Oral Antihistamines: These are helpful in treating allergies. Common ones are loratadine (Claritin) and cetirizine (Zyrtec)
2. Nasal Sprays: Nasal sprays which contain antihistamine like azelastine (Astelin, Astepro)
3. Nasal Steroids: Examples of this are mometasone (Asmanex Twisthaler) or fluticasone (Flovent Diskus, Flovent HFA)
4. Antibiotics
5. Over the counter or prescription decongestants

Hearing loss is a common sensory problem that generally develops with increasing age or due to prolonged or persistent exposure to loud noises. It is one of the most typical problems that occurs throughout the world. If you are suffering from partial hearing loss, you may find ways of keeping in touch with your family and friends. If you are not suffering from such the following may help you keep your hearing intact for years to come.

Types of hearing loss:
There are two main types of hearing loss: 
1. Conductive Hearing Loss where the problem lies in the middle ear, eardrum or ossicles. A conductive hearing loss affects the passage of sound between the eardrum and the inner ear. Sound passes down the ear canal to the ear drum and through the middle ear, where the sound is transmitted across the middle ear by the three bones called the ossicles to the inner ear.

Causes of conductive hearing loss:

1. Malformation of outer ear, ear canal, or middle ear structures
2. Fluid in the middle ear from colds
3. Ear infection (otitis media - an infection of the middle ear in which an accumulation of fluid may interfere with the movement of the eardrum and ossicles
4. Allergies
5. Poor Eustachian tube function
6. Perforated eardrum
7. Benign tumors
8. Impacted earwax
9. Infection in the ear canal
10. Foreign body in the ear
11. Otosclerosis

2. Sensorineural Hearing Loss where there is damage in the inner ear, cochlea or hearing nerve. Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, SNHL cannot be medically or surgically corrected. This is the most common type of permanent hearing loss.

Causes of sensorineural hearing loss:

1. Exposure to loud noise
2. Head trauma
3. Virus or disease
4. Autoimmune inner ear disease
5. Hearing loss that runs in the family
6. Aging (presbycusis)
7. Malformation of the inner ear
8. Meniere's Disease
9. Otosclerosis 
10. Tumors

Coping with Hearing Loss:
Antibiotics and eardrops are often prescribed to treat hearing loss and its symptoms. In many cases, people suffering from severe hearing loss use hearing aids. Hearing aids are tiny instruments that people use in their ears to make sounds louder. People who suffer from hearing loss cope with their problems through increased concentration and focus. The usual way involves reading the moving lips of the person while they talk. Prevention is better than cure and is the best solution to avoid long term hearing loss. Avoiding continuous loud noises, to the possible extent helps prevent hearing loss to a great extent.

Hearing loss is experienced by millions of people these days. Ageing is not the only factor that brings hearing impairment. The causes are many. Certain medications, continuous exposure to loud noise, genetic involvement, injury and some medical conditions may cause hearing loss.

There are quite a few myths that people have come to believe about hearing loss over the years. Since it is such a common phenomenon, here we take a look at the common myths surrounding hearing loss.

Myth no. 1: Hearing loss is exclusive to elderly.

Fact: As said before, hearing loss can be an outcome of various causes. Nearly half of the people suffering from the same are below the age of 55 years. No matter what your age is, you must always get your ears checked, especially if you are feeling that are you missing things.

Myth no. 2: Diagnosing hearing loss is easy.

Fact: Most people do not come to know about the condition until it gets worse. Also, your physician never really checks for hearing loss symptoms in a general check-up unless you ask for it specifically.

So, always get a check-up done, like you do for other probable diseases.

Myth no. 3: There's no effective solution for hearing loss.

Fact: Like there have been advancements in the medical field for everything else, there are aids available these days that improve your hearing and have finer adjustments for noise adaptation. Also, there are certain other procedures and surgeries that have proved to improve the condition in many.

So, seek help as soon as possible.

Myth no. 4: The sounds aren't loud enough; my ears are healthy and fine.

Fact: If there is a problem you're experiencing with hearing, you have got to accept that and get it treated. Avoiding a certain condition will only get things worse for you.

Also, hearing aids are no more a stigma. Ear aid devices have designs similar to earphones these days, which are comfortable enough to wear. Ignoring a medical condition or inability to accept the same would only do more harm instead of making things fine.