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Cysts Removal Procedure
Treatment of Tonsils (Tonsillitis)
Hearing Aid Fitting
Treatment of Throat and Voice Problems
Earlobe Repair Procedure
Treatment of Sleep Disturbance
Nose Reshaping Procedure
Hearing Testing Techniques
Nasal And Sinus Allergy Care
Cochlear Implant Procedure
Ear Micro Surgery
Treatment Of Hearing Deficiency
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I have pain in my throat since three months and I am a thyroid patient what is the cause of this pain.
Hi sir, I have dust allergy while early morning waking is not possible for me because of that cold air, if I breath means no problem I get immediately cold and my nose sweats like water in this allergy my eyes also burns and irritates me pls give me a good solution for my problems For that allergy I have taking levoact m tablet is that OK or I should something else to cure it.
I am having pain in my left ear and in the left side of my head. The pain is more when I feel some vibration. Why?
I am a boy of 19 years old. I'm suffering from nose bleeding on every seasonal change. How will I stop it? Please advice.
As she is getting cough and sneezing. ON/OFF from past 8 months As per doctor advise we took x- Ray for sinus and chest. These are the reports below X-Ray of sinus- bilateral maxillary sinus on both sides X-Ray of chest - hyperinflation bronchi pulmonary markings Please advice is it serious.
Hi, iam 28 years old man suffering from heavy phlegm in chest and throat which interns causing throat irritation. When I was in india, doctors said, it is due to dust allergy. But now iam in europe here pollution is some what less still same issues. Please help me and i am not travelling more on roads also.
I have nasal congestion problem dit it add to my snoring problem as I start snoring harder and harder day by day.
My chest and throat is very sensitive to cold, A/c and for certain foods due to which I feel lot of reflex in throat and breathlessness due to sputum stuck. Can you help me with suggestion.
I am always suffering from throat pain from two years I checkup with so many doctor but its not going so pls can you suggests me something.
I am 25 year old male and I have reddish ulcers in my throat. I chew tobacco. Please tell me what to do ?
I am 21 years old, I feel very sick from last 1 month, Always some pain in body, after sitting 3/4 hours continuously and when get up fell some vertigo. Please give me suggestion to healthy.
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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
I have a problem of nose congestion. I have diagnosed and found that I have deviated nasal septum. So now I have ear fullness in left ear and it feels like water is trapped inside. Please give some solution.
Sinusitis: Management and Prevention
Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows:
● acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms
● subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms
● recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which
Recur at intervals of at least 10 days apart
● chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms
● acute bacterial sinusitis superimposed on chronic sinusitis:
New symptoms that occur in patients with residual symptoms from prior infection (s). With treatment, the new symptoms resolve but the residual ones do not.
Physical findings and clinical presentation
● patients often give a history of a recent upper respiratory illness with some improvement, then a relapse.
● mucopurulent secretions in the nasal passage
● purulent nasal and postnasal discharge lasting more than 7 to 10 days
● facial tightness, pressure, or pain
● nasal obstruction
● decreased sense of smell
● purulent pharyngeal secretions, brought up with cough, often worse at night
● erythema, swelling, and tenderness over the infected sinus in a small proportion of patients
● diagnosis cannot be excluded by the absence of such findings.
● these fi ndings are not common, and do not correlate with number of positive sinus aspirates.
● intermittent low-grade fever in about one half of adults with acute bacterial sinusitis
● toothache is a common complaint when the maxillary sinus is involved.
● periorbital cellulitis and excessive tearing with ethmoid sinusitis
● orbital extension of infection: chemosis, proptosis, impaired extraocular movements.
Characteristics of acute sinusitis in children with upper respiratory tract infections:
● persistence of symptoms
● bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● facial pain or pressure
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.
● each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum).
● acute viral infection
● infection with the common cold or infl uenza
● mucosal edema and sinus infl ammation
● decreased drainage of thick secretions, obstruction of the sinus ostia
● subsequent entrapment of bacteria
A. Multiplication of bacteria
B. Secondary bacterial infection
Other predisposing factors
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● parainfluenza virus
● respiratory syncytial virus
● the principal bacterial pathogens in sinusitis are streptococcus pneumoniae, nontypeable haemophilus influenzae, and moraxella catarrhalis.
● in the remainder of cases, fi ndings include streptococcus pyogenes, staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (peptostreptococcus, fusobacterium, bacteroides, prevotella).
Infection is polymicrobial in about one third of cases.
● anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children.
● fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon
Pathogens in the paranasal sinuses. Fungal pathogens include aspergillus, pseudallescheria, sporothrix, phaeohyphomycoses, zygomycetes.
● nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised.
● s. Aureus
● pseudomonas aeruginosa
● klebsiella pneumoniae
● enterobacter spp.
● proteus mirabilis
Organisms typically isolated in chronic sinusitis:
● s. Aureus
● s. Pneumoniae
● h. Infl uenzae
● p. Aeruginosa
● migraine headache
● cluster headache
● dental infection
● trigeminal neuralgia
● water’s projection: sinus radiograph
● ct scan
● much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses
● recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to
● used for diagnosis of frontal and maxillary sinusitis
● place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses.
● absence of light transmission indicates that sinus is filled with fluid.
● dullness (decreased light transmission) is less helpful in diagnosing infection.
● used to visualize secretions coming from the ostia of infected sinuses
● culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture
● sinus puncture
● gold standard for collecting sinus cultures
● generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis.
Treatment Nonpharmacologic therapy
● sinus drainage
● nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5%
● topical decongestants should not be used for more than a few days because of the risk of rebound congestion.
● systemic decongestants
● nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone
● nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow)
● use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting,
Which blocks the ostia, thus interfering with sinus drainage.
● analgesics, antipyretics.
● most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics.
● current treatment recommendations favor symptomatic treatment for those with mild symptoms.
● antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of
● antibiotic therapy is usually empirical, targeting the common pathogens.
● first-line antibiotics include amoxicillin, tmp-smz.
● second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin.
● for patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the
Costlier second-line agents.
● surgical drainage indicated
● if intracranial or orbital complications suspected
● for many cases of frontal and sphenoid sinusitis
● for chronic sinusitis recalcitrant to medical therapy
● surgical débridement imperative for treatment of fungal sinusitis