INFORMATION TO KNOW BEFORE PROCEDURE

INDICATIONS RECURENT ADENOTONSILLITIS/ BREATHING DIFFICULTY/ HEARING LOSS

TREATMENT MODALITIES CONVENTIONAL INSTRUMENTS/ MICRODEBRIEDER ASSISTED/ COABLATOR ASSISTED/ LASER ASSISTED

RISKS AND COMPLICATIONS RARE BUT CHILDERN BELOW 10 SHOULD BE KEPT FOR OVERNIGHT OBSERVATION FOR ANY BLEEDING

SOMETIMES BLEEDING CAN OCCUR AFTER A WEEK IN A FEW WHICH IS RELATED TO INFECTION, THIS MAY SOMETIMES NEED A OPERATIVE CONTROL

RECURRENCE OF ADENOIDS

EAR DRUM PERFORATION

BENIFITS BETTER BREATHING AND SWALLOWING, REDUCED THROAT AND CHEST INFECTIONS, IMPROVED HEARING

POSTOPERATIVE CARE

PAIN IS EXPECTED TO REDUCE AFTER 3-10 DAYS

SOFT DIET FOR 3 DAYS

NORMAL DIET CAN BE STARTED AFTER 3 DAYS

OUTDOOR ACTIVITY BE RESTRICTED FOR 2 WEEKS

TINNITUS OR RINGING SENSATION IN EARS AFFECTS A LARGE NUMBER OF POPULATION IN VARYING DEGREE. MANY OF US HAVE EXPERIENCED IT AFTER A LOUD SOUND EXPOSURE. THE CAUSE CAN BE WAX, ABNORMAL MIDDLE EAR PRESSURE OR FLUID, INNER EAR DYSFUNCTION OR NERVE WEAKNESS. THERE MAY BE ASSOCIATED FEATURES LIKE GIDDINESS AND HEADACHE.IT MAY BE TRANSIENT OR CONTINOUS. SOMETIMES IT MAY CAUSE SIGNIFICANT IMPACT ON THE PERSON. IT MAY LEAD TO DISTURBED SLEEP AND DEPRESSION. IF YOU EXPERIENCE MORE THEN A TRANSIENT TINNUITUS, A PROPER ENT EXAMINATION ALONG WITH AUDIOLOGICAL CHECK SHOULD BE DONE. SOMETIMES A MRI OF BRAIN WITH CONTRAST IS DONE TO EXCLUDE ANY TUMOR . LOUD SOUNDS, CONTINOUS EXPOSURE TO MOBILE, HIGH BP AND DM ALL PREDISPOSE TO DEGENRATIVE CHANGES IN INNER EAR AND COULD LEAD TO PREMATURE HEARING LOSS WITH TINNITUS. VARIOUS THERAPIES LIKE TINNITUS RETRAINING, MEDICATIONS, INTRATYMPANIC INJECTIONS ARE AVAILABLE TO TREAT THIS DISORDER.

ACID REFLUX IS COMMON AMONG URBAN POPULATION DUE TO IRREGULAR EATING HABITS AND SEDENTARY LIFESTYLE. THE WALL OF THROAT IS NOT RESISTANT TO ACID EFFECTS SO VARIOUS SYMPTOMS LIKE BURNING SENSATION, RECURRENT ORAL ULCERS, HEAVINESS, DIFFICULTY IN SWALLOWING, HOARSENESS AND SOMETIMES POST NASAL DRIP CAN OCCUR. MOST PEOPLE WITH ACID REFLUX WILL BENEFIT FROM AVOIDING OILY, SPICY, TEA, COFFEE, AERATED DRINKS. REGULAR SMALL DIET WILL ALSO BE HELPFUL IN PREVENTING REFLUX. THERE SHOULD BE A GAP OF ATLEAST 2 HRS BETWEEN DINNER AND LYING DOWN. IN EXTREME CASES HEAD END OF BED CAN BE ELEVATED TO REDUCE ACID REFLUX. THESE PRECAUTIONS AND SOME ANTIACID OR ANTIREFLUX MEDICATIONS WILL BE USEFUL IN COMBATING ACIDITY. OCCASIONALLY ENDOSCOPY AND BIOPSY IS REQUIRED. RARELY SOME STRUCTURAL DISORDERS MAY REQUIRE SURGICAL INTERVENTION.

NOSE IS THE MOST COMMONLY INVOLVED IN FACIAL INJURIES DUE TO ITS PROMINENCE. NASAL BLEEDING, PAIN, DISCHARGE, BLOCKAGE, SWELLING AND DEFORMITY ARE THE MAIN SYMPTOMS. ALL NASAL INJURIES SHOULD BE EXAMINED EARLY BY A ENT SPECIALIST TO EXCLUDE COSMETIC OR FUNCTIONAL DEFORMITY. IF A NASAL DEFORMITY IS PRESENT IT CAN BE EASILY REPLACED BY A SPECIALIST. SOMETIMES BLOOD GETS ACCUMULATED IN THE NASAL SEPTUM, WHICH HAS TO BE DRAINED IMMEDIATLEY.

HEARING IS THE FIRST SENSE TO DEVELOP IN A FOETUS. OUR SPEECH DEVELOPMENT DEPENDS ON NORMAL HEARING. A NEWBORN IS REGULARLY SCREENED BY OAE TEST FOR HEARING LOSS AT BIRTH. ANY LOSS OR DEFICENCY IN HEARING CAN BE FURTHER ASSESED BY ENT EXAMINATION AND BERA TEST. EARLY USE OF HEARING AID IS ADVISED FOR HEARING CONDITIONING AND PREVENTING SPEECH IMPAIRMENT. THE BRAIN OF A CHILD NEEDS TO HEAR PROPERLY FOR NORMAL DEVLOPMENT OF SPEECH. A CT SCAN AND MRI OF EAR IS DONE IF THERE IS BOTH SIDED OR ONE SIDED PROFOUND SENSORINEURAL DEAFNESS. THIS IS DONE TO ASCERTAIN THE PRESENCE OF INNER EAR AND THE HAERING NERVE. IF THE INNER EAR AND NERVE IS PRESENT THEN A COCHLEAR IMPLANT SURGERY CAN BE DONE TO RESTORE THE HEARING. A COCHLEAR IMPANT IS A SURGICALLY IMPALNTED HEARING DEVICE WHICH DIRECTLY STIMULATES THE HEARING NERVE. IF THE IMAGING SHOWS NO INNER EAR OR NERVE DEVELOPMENT THEN A BRAIN STEM IMPANT IS AN OPTION TO RESTORE HEARING. THESE PROCEDURES SHOULD ESSENTIALLY BE DONE AT AN EARLY AGE TO ALLOW NORMAL BRAIN AND SPEECH DEVELOPMENT.

Blindness separates us from things but deafness separates us from people

NO OTHER SENSE PERCEPTION IS SO NEGLECTED, RIDICULED AND STIGMATISED AS THE HEARING. THE FIRST SENSE TO DEVELOP BEFORE WE ARE EVEN BORN IN THIS WORLD CAN BE IMPAIRED AS EARLY AS 3 WEEKS INTO CONCEPTION. STUDIES HAVE SHOWN THAT A FOETUS CAN HEAR AND REACT TO ENVIORMENTAL SOUNDS IN EARLY TO MID PREGNANCY. THE IMPORTANCE OF ANTENATAL HEARING TEST ON DAY OF DISCHARGE FROM HOSPITAL OR ON FIRST VISIT CANNOT BE REEMPHISIZED TO DETECT UNILATERAL OR BILATERAL HEARING DEFICENCY. ANY CHILDHOOD ILLNESS OR DELAY IN SPEECH DEVELOPMENT SHOULD ALERT THE PARENTS OR HEALTHCARE PROVIDER. A BATTERY OF TESTS ARE NOW AVAILABLE FOR THE DIAGNOSIS. ONCE A DIAGNOSIS IS MADE EARLY HEARING TRAINING SHOULD BE INITIATED WITH A HEARING AID. THIS WOULD HELP THE BRAIN TO RECOGNISE THE SOUND AND DEVELOP SPEECH. ANY DELAY IN THIS WOULD LEAD TO DELAYED SPEECH DEVELOPMENT. THOUGH OTHER DELAYED MILESTONES AND AUTISM IF PRESENT SHOULD BE DIAGNOSED EARLY AND TREATMENT OR BEHAVIOR THERAPY INITIATED ACCORDINLY. IF NECESSARY EAR IMAGING IS DONE TO SEE IF CHILD IS A CANDIDATE FOR COCHLEAR IMPLANT SURGERY OR BRAIN STEM IMPANT. THIS WOULD DEPEND ON HEARING ASSESMENT AND IMAGING STUDY RESULTS.

HEARING LOSS IN ADULTS AND ELDERLY IF NOT TREATED EARLY CAN LEAD TO PERMANENT IMPAIRMENT. THE BRAIN GETS USED TO SILENCE WITH SHRINKAGE OF AUDITORY CORTEX AND REHABLITATION GETS HARDER WITH TIME. A PROPER ENT EXAMINATION WITH AUDIOLOGICAL ASSESMENT SHOULD BE DONE. THIS WOULD LEAD TO PROPER MANAGEMENT EITHER CONSERVATIVE, SURGICAL ,HEARING AIDS OR IMPLANTABLE HEARING DEVICES.

HEARING AND SPEECH ARE CLOSELY RELATED AND OFTEN CLOSELY AFFECTED. PROPER CARE AND MANAGEMENT CAN FILL SOUNDS IN SILENCE.

CONSTANT IRRITATION IN EARS AFFECTS QUITE A FEW OF US. THIS IS A COMMONLY A RESULT OF ALLERGIES, EXCESS CLEANING OF WAX, FUNGAL INFECTION. IT MAY BE MILD TO SEVERE IN SOME CASES LEADING TO SWELLING OF CANAL AND PINNA AND OCCASIONALLY LEAD TO DISCHARGE. THIS CAN BE EASILY AVOIDED IN MOST PEOPLE BY KEEPING EAR DRY DURING HEADWASH BY USING A EAR PLUG OR VASELINE SOAKED COTTON. SOMETIMES FOLLOWING THE USE OF EAR BUDS THE EAR CANAL GETS INFECTED AND EXCRUCIATINLY PAINFUL. THIS REQUIRES METICULOUS CLEANING BY A ENT SPECIALIST AND A ANTIBIOTIC THERAPY. IMPORTANTLY TRY TO AVOID INSTLLING OVER THE COUNTER EAR DROPS OR OIL IN THE CANAL.

TONSILS ARE LOCATED AT THE JUNCTION OF MOUTH AND THROAT AND ACT AS A GENERATOR OF IMMUNITY. THESE ARE A PART OF IMMUNE SYSTEM AND ARE MOST ACTIVE FROM BIRTH TILL 8-12 YEARS AND THEN GRADUALLY REGRESS. APART FROM TONSILS THERE ARE OTHER TISSUES LIKE ADENOIDS AND MANY OTHER SMALL GROUPS OF LYMPHOID TISSUES WHICH CONTRIBUTE TO IMMUNITY. TONSILLITIS CAN CAUSE THROAT PAIN, PAINFUL SWALLOWING, SPEAKING AND SOMETIMES DIFFICULTY IN BREATHING AS WELL. MOST PEOPLE HAVE FEWER THAN 3 EPISODES A YEAR WHICH CAN BE MANAGED CONSERVATIVELY. RECURRENT INFECTIONS PREDISPOSE TO COMPLICATIONS AND SPREAD OF INFECTION TO DISTANT ORGANS LIKE HEART , KIDNEY AND LUNGS. IN SOME THEY CAN GET RECURRENTLY INFECTED, CAUSE DIFFICULTY IN BREATHING OR ASYMMETRICALLY ENLARGED. A PROPER EVALUATION BY A ENT SPECIALIST IS DONE TO ASCERTAIN A POSSIBLE CURE WHETHER THROUGH PROLONGED ANTIBIOTIC COURSE OR A SURGICAL TREATMENT. TONSILLECTOMY IS A SAFE AND SHORT PROCEDURE TO REMOVE THE TONSILS. IT IS EFFECTIVE IN NEARLY ALL PATIENTS IN REDUCING THE THROAT INFECTIONS AS WELL AS IMPROVING BREATHING. CHILDERN WHO ARE RECURRENTLY INFECTED OR SUFFER FROM SNORING AND STUNTED GROWTH BENEFIT FROM THIS PROCEDURE.

A LOT OF PARENTS ARE WORRIED ABOUT DELAYED SPEECH IN CHILDERN. MOST CHILDERN WITH NORMAL MILESTONES RESPOND TO SPEECH AS EARLY AS 6 MONTHS, MONOSYLLABLES BY 9 MONTHS, IMMITATES BY 12 MONTHS, SAYS THREE WORDS BY 18 MONTHS, UNDERSTANDABLE SPEECH BY 3 YEARS. SOME VARIATIONS WITH PRONOUNCIATION MAY OCCUR AND MILESTONES ARE SLIGHTLY DELAYED IN BOYS. HEARING SCREENING AT BIRTH IS A MUST AND ALL NEWBORNS MUST BE SCREENED WITH OTOACOUSTIC EMMISIONS. IF ANY SUSPICION IS PRESENT A BERA TEST NEEDS TO BE DONE. ANY IMPAIRMENT OF HEARING NEEDS TO BE ADDRESED AS SPEECH DEVELOPMENT IS DEPENDENT ON HEARING ABILITY. A COMPLETE ENT EXAMINATION IS A MUST AS SOON AS POSSIBLE IN ANY SUSPICION OF DELAYED OR ABNORMAL SPEECH DEVELOPMENT. MANAGEMENT INCLUDES FROM A SIMPLE TONGUE TIE RELEASE, SPEECH THERAPY, PSYCHOLOGICAL EVALUATION, HEARING AIDS AND COCHLEAR IMPLANT SURGERY.

“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.”

LUCKILY MOST OF THE EAR DRUM RUPTURES HEAL NATURALLY ALBIET SOMETIMES LEAVING A SCAR OF HEALING. EAR DRUM IS A THIN MEMBRANE WHICH CAN BE EASILY RUPTURED BY A SUDDEN PRESSURE CHANGE DUE TO SLAP, DIVING, CRACKERS OR SOMETIMES WITH DIRECT TRAUMA DUE TO AN EAR BUD. USUALLY THE PERSON FEELS HEAVINESS AND BLOCKING SENSATION IN THE EAR. THERE IS A HEARING LOSS AND EARCAHE. BLEEDING OR DISCHARGE IS USUALLY NOT PROFUSE. RARELY THERE MAY BE SEVERE HEARING LOSS AND GIDDINESS WHICH INDICATES A DAMAGE TO EAR BONES AND SOMETIMES THE INNER EAR. THE MOST IMPORTANT MEASURE ONE CAN TAKE IS NOT TO INSTILL ANY DROPS IN EAR MOREOVER KEEPING THE EAR DRY DURING HEADWASH WITH A EAR PLUG. IMMEDIATE ENT CONSULTATION WITH AUDIOLOGICAL EVALUATION SHOULD BE DONE. IN MOST OF THE CASES THE JAW JOINT IS ALSO TRAUMATISED DUE TO IMPACT AND THERE MAY BE DIFFICULTY IN OPENING AND CLOSING MOUTH. THE MANAGEMENT OF EAR DRUM RUPTURE CAN RANGE FROM CONSERVATIVE, REPLACEMENT OF TORN EDGES UNDER MICROSCOPE TO RARELY SURGERY IN CASES WITH DAMAGED EAR BONES OR NON HEALING OF EAR DRUM( 1 MONTH).

HOARSNESS IS ANY CHANGE IN VOICE. MOSTLY HAPPENS IN PROFESSIONALS WHO HAVE TO USE VOICE A LOT. THESE INCLUDE TEACHERS, SINGERS, LAWYERS, HAWKERS AND ESPECIALLY MOTHERS OF TWO OR MORE KIDS. SOMETIMES IT CAN OCCUR IN CHRONIC SMOKERS, ALCOHOLICS, PEOPLE WITH ACID REFLEX OR HYPOTHYROIDISM. IT CAN ALSO BE A SIGN OF BRAIN STROKE ESPECIALLY IF ASSOCIATED WITH COUGH ON SWALLOWING MORE FOR LIQUIDS. EARLY DIAGNOSIS CAN PREVENT IRREVERSILE CHANGES WHICH MIGHT NEED ENOSCOPIC SURGICAL PROCEDURE. NEARLY ALL DISEASES CAUSING HOARSENESS CAN E DIAGNOSED BY A SIMPLE ENDOSCOPIC PROCEDURE IN THE OPD CLINIC. IN MOST CASES THE HOARSENESS IS CAUSED BY VOCAL CORD SWELLING WHICH IS EASILY TREATED BY FOLLOWING VOCAL HYGIENE AND FEW MEDICATIONS. PERSISTENT HOARSENESS NEEDS TO BE EVALUATED BY LARYNGOSCOPY TO EXCLUDE NODULES, POLYPS, CYSTS, WEAKNESS, CANCEROUS GROWTH OVER THE VOCAL CORD.

MAJORITY OF HOARSENESS CAN BE REVERSED BY FOLLOWING SIMPLE PRECAUTIONS AS FOLLOWS

1) VOCAL HYGIENE

2) AVOIDING TEA/ COFFEE/ AREATED DRINKS

3) AVOIDING GARGLING

4) DOING STEAM

5) HYDRATION

6) AVOIDING OILY/ SPICY/ SMOKING/ ALCOHAL

IN ANY CASE PERSISTENT HOARSNESS SHOULD NOT BE NEGLECTED AND ENT CONSULT SHOULD BE TAKEN.

NASAL POLYPS ARE FLUID FILLED MUCOSA OF NASAL PASSAGE CAUSED BY ALLEGRY AND SOMETIMES INFECTION. IT IS ESSENTIALLY A MEDICALLY TREATABLE DISORDER OF NASAL LINING. THE NASAL LINING BECOMES UNSTABLE DUE TO VARIOUS RESONS AND POLYPS ARE FORMED. THESE POLYPS BLOCK THE NASAL PASSAGE AND SINUS OPENINGS. THIS LEADS TO NASAL BLOCKAGE, LOSS OF SMELL AND FACIAL HEAVINESS AND PAIN. SOMETIMES FUNGAL INFECTION CAN OCCUR IN BLOCKED SINUSES. LONG STANDING INFECTIONS OF SINUS CAN SPREAD TO EYES AND BRAIN. EARLY MANAGEMENT INCLUDES NASAL ENDOSCOPY, ALLERGY TESTING AND MEDICATIONS TO REDUCE THE POLYPS. IF THESE ARE RECURRENT OR PERSISTANT THEN A CT PNS WITH BIOSPY ARE SOMETIMES ADVISED. SURGERY FOR NASAL POLYPS IS INDICATED IF THEY ARE NOT RESPONDING TO MEDICINES OR IF THERE ARE IMPENDING COMPLICATIONS. FUNCTIONAL ENDOSCOPIC SINUS SURGERY IS DONE TO CLEAR THE SINUSES OF DISEASE AND WIDEN THE OPENINGS TO FACILITAE NASAL CLEANING AND EXAMINATION. THIS ALSO REDUCES THE NEED OF ORAL STEROIDS. ALLERGY TESTING AND IMMUNOTHERAPY ALSO DECRESES THE RECURRANCE OF POLYPS

EAR WAX OR CERUMEN IS A COMBINATION OF EAR SECRETIONS, SHED SKIN AND DIRT. THE WAX HAS AN IMPORTANT FUNCTION OF LUBRICATION, ANTIBACTERIAL AND ANTIFUNGAL APART FROM BEING ANTI INSECT AS WELL. REGULAR EAR CLEANING IS NOT ADVISED OR RECOMMENED. EAR IS ONLY CLEANED IF THE WAX IS BLOCKING AND CAUSING HEARING LOSS. SOMETIMES IS CLEANED IF IT IS INFECTED OR IF EAR DRUM NEEDS TO BE EXAMINED. EAR BUDS SHOULD ONLY BE USED TO APPLY MEDICATIONS NOT TO CLEAN THE EARS. EAR BUD CAN INTRODUCE INFECTION AND CAN TRAUMATISE EAR.

MOST OF KIDS UNDER 10 YEARS HAVE ADENOIDS OF VARYING SIZES. IN SOME THEY MAY OCCLUDE THE NASAL PASSAGE LEADING TO MOUTH BREATHING AND SNORING. THIS ALSO LEADS TO ABNORMAL FACIAL DEVELOPMENT AND PROTRUDING TEETH. DISTURBED SLEEP ALSO LEADS TO IRRITABLITY AND STUNTED GROWTH. TONSILLAR ENLARGEMENT IS ALSO NOTICED IN SOME CHILDERN WITH ADENOID PROBLEMS. THERE MAY ALSO BE A CONTRIBUTARY DEVIATION OF NASAL SEPTUM OR ALLERGIC NASAL CONGESTION ADDING TO THE BREATHING ISSUE. THIS PROBLEM SHOULD BE EVALUATED BY A ENT SPECIALIST AND IF NEED BE A XRAY OR NASAL ENDOSCOPY IS DONE TO PROPERLY DIAGNOSE. THE MANAGEMENT DEPENDS ON SEVERITY AND PERSISTANCE OF SYMPTOMS. MANGEMENT INCLUDES NASAL WASH, NASAL SPRAYS SOMETIMES A ENDOSCOPIC SHAVING OF ADENOIDS IS NEEDED IF SYMPTOMS ARE SEVERE, PERSISTANT OR AFFECTING THE EARS. IF EAR IS ALSO INVOLVED WITH FLUID A SMALL TEFLON OR TITANIUM TUBE IS INSERTED IN THE EAR DRUM TO VENTILATE AND AID DRAINAGE. THESE TUBES SPONTANEOUSLY EVACUATE FROM EAR AS EAR DRUM GROWS WITH RARELY ANY COMPLICATIONS.

MOST OF THE PEOPLE HAVE EXPERIENCED EAR INFECTIONS SOME TIME, MANY ARE SIMPLE LIKE INFECTION OF EXTERNAL OR MIDDLE EAR. SOMETIMES THERE CAN BE A INGROWTH OF EXTERNAL CANAL SKIN INTO THE MIDDLE EAR AND THE BONE BEHIND THE EAR. THE EAR IS CLOSLEY RELATED TO BRAIN AND FACIAL NERVE. THESE TYPE OF INFECTIONS CAN ERODE INTO THE BRAIN OR THE FACIAL NERVE CAUSING PUS IN BRAIN OR FACIAL WEAKNESS RESPECTIVELY. THE INNER EAR IF ERODED CAN LEAD TO DIZZINESS AND SENSORINEURAL HEARING LOSS. IT IS IMPORTANT TO BE AWARE OF SUCH DISEASE SO THAT PROPER TREATMENT CAN BE INITIATED BEFORE THE COMPLICATIONS OCCUR. ANY EAR DISCHARGE WHICH IS CONTINOUS, SCANTY, FOUL SMELLING OR BLOOD STAINED SHOULD NOT BE IGNORED AND PROPER ENT CONSULT AND TREATMENT SHOULD BE STARTED.

NOSE IS AN IMPORTANT ASTHETIC AND AIR CONDITIONING ORGAN. NASAL BLOCKAGE IS COMMON IN URBAN AREAS DUE TO MORE DUST AND POLLUTION. NASAL BLOCKAGE LEADS TO DIFFICULTY IN BREATHING, SPEAKING AND ALSO SMELL OR FLAVOUR. NASAL BLOCKAGE CAN OCCUR DUE TO A STRUCTURAL DEFECT OR MASS IN OR BEHIND THE NOSE. THESE CAN BE EASILY DIAGNOSED IN ENT OPD BY CLINICAL EXAMINATION AND SOMETIMES A NASAL ENDOSCOPY. IT IS IMPORTANT THAT NASAL DECONGESTANTS DROPS SHOULD NOT BE USED FOR PROLONGED PERIODS AS THEY CAN BE ADDICTIVE AND CAN CAUSE PERMANENT DAMAGE TO NASAL TISSUE. PERSISTANT NASAL BLOCKAGE CAN OFTEN BE TREATED WITH MEDICATIONS TO DECREASE CONGESTION IN NOSE BUT SOMETIMES A ENDOSCOPIC SURGERY CAN BE DONE TO PERMANENTLY RELIEVE THE OBSTRUCTION.

THE EAR IS RESPONSIBLE FOR HEARING AND BALANCE. SPECIALISED SENSORS ARE PRESENT IN INNER EAR WHICH CONTRIBUTE TO BALANCE. INNER EAR CAN BE AFFECTED DIRECTLY OR VIA MIDDLE EAR DISEASE. MOST COMMON DISORDER OF INNER EAR CAUSING VERTIGO IS BPPV. THIS IS A BENIGN DISORDER OF SEMICIRCULAR CANALS IN WHICH THERE ARE SUSPENDED PARTICLES CAUSING ABNORMAL STIMULATION OF SENSORS. OTHER DISORDERS LIKE MENIERS, NEURONITIS, TRAUMA, INFECTIONS, TUMORS CAN ALSO CAUSE VERTIGO DUE TO INNER EAR DYSFUNCTION. ASSOCIATED SYMTOMS LIKE RINGING SENSATION, FULLNESS IN EARS, HEARING LOSS, HEADACHE, FACIAL WEAKNESS, EAR DISCHARGE CAN BE PRESENT. A COMPLETE ENT EXAMINATION WITH AUDIOLOGICAL TESTS SOMETIMES AN MRI BRAIN IS DONE. TREATMENT RANGES FROM BED REST, SPECIAL MANUVERS, MEDICATIONS, INTRATYMPANIC INJECTIONS AND OCCASIONALLY SURGERY.

REPEATED SNEEZING, WATERY NASAL DISCHARGE, ITCHING, NASAL BLOCKAGE ARE SYMPTOMS OF ALLERGIC RHINITIS WHICH AFFECT NEARLY 13 PERCENT OF THE POPULATION. THESE MAY VARY FROM MILD TO SEVERE FORMS, ALSO MAY BE SEASONAL OR PERINNIAL.

AN IMPORTANT POINT IS TO DIFFERENTIATE FROM PURELY TEMPRATURE SENSTIVITY WHICH IS THE CAUSE OF NON ALLERGIC RHINITIS( VASOMOTOR RHINITIS)

THE TRIGGER OR THE ALLERGEN CAN BE IDENTIFIED BY A SKIN PRICK ALLERGY TEST( GOLD STANDARD)AND ACCORDINGLY THE ALLERGEN MAY BE ELIMINATED FROM THE ENVIORNMENT OF THE PERSON. THE ALLERGENS WHICH CANNOT BE REMOVED FROM THE ENVIORNMENT REQUIRE A GRADUATED BUILDING ADAPTABILITY BY IMMUNOTHERAPY. IMMUNOTHERAPY IS A NOVEL METHOD TO CURE A PERSON OF ALLERGY BY MAKING THE IMMUNE SYSTEM OF PERSON ADAPTED.

EXCERCISE, DIET MODIFICATION, YOGA ALL HELP TO CONTROL THE ALLERGIC SYMPTOMS

PROPER ENT CONSULTATION AND MANAGEMENT IS NEEDED IN MODERATE TO SEVERE CASES TO IMPROVE QUALITY OF LIFE.

NOSE IS THE MOST PROMINENT STRUCTURE OF THE FACE. ANY DEVIATION OR DEFORMITY IS EASILY NOTICED. VARIOUS CAUSES OF DEFORMITY CAN BE TRAUMA, BY BIRTH, AFTER SURGERY OR INFECTION. THERE ARE DIFFERENT METHODS TO IMPROVE A DEFORMED NOSE. THE LEAST INVASIVE IS INJECTING FILLERS WHERE THERE IS A DEPRESSION. THERE ARE IMLANTS WHICH CAN BE INSERTED TO MAKE A ASTHETICALLY PLEASING NOSE. A FORMAL RHINOPLASY CAN BE DONE EITHER BY A OPEN OR CLOSED APPROACH TO IMPROVE THE APPEARANCE OF THE NOSE. A PLASTER IS APPLIED FOR AT LEAST 10 DAYS FOLLOWING THE SURGERY. THE NOSE TAKES 3-6 MONTHS POST SURGERY FOR THE FINAL OUTCOME.

“Before I could utter a word, my listeners had left me long ago.”

A CHANGE IN MIND IS IMPORTANT BEFORE THE SPEECH. A PERSON WITH A STAMMER HAS A MISCONCEPTION REGARDING THE SPEECH THAT IT IS PERFECT WITHOUT ANY HESITATION, PROLONGATION OR PAUSES. A STAMMERER PREFORMS THE SOUND AND TONGUE POSITION. THIS IS THE BASIC DEFECT AS WE CAN PREFORM THOUGHT BUT NOT SOUND. USUALLY STARTS BETWEEN 3-7 YEARS, SPEECH BREAKS DUE TO EXTERNAL PRESSURE TO SPEAK PERFECT. THIS IS TO BE TAKEN IN LIGHT SPIRIT BUT A CHILD INGRAINS IT VERY SERIOUSLY. EXCERCISES, BOTOX, BEHAVIOUR THERAPY ARE ALL USED WITH VARYING SUCCESS.

“Snoring keeps the monsters away.”

SNORING IS AS MUCH AS A RIDICULE AS IT IS A HEALTH HAZARD. SNORING IMPLIES THAT THERE IS A BREATHING OBSTRUCTION. OSA REFERS TO CESSATION OF BREATHING DURING SLEEP. THIS LEADS TO CHRONIC STRAIN OVER HEART AND BRAIN WITH RESULTANT HYPERTENSION AND INCREASED CHANCES OF HEART ATTACK AND STROKE. THE MAIN FACTORS THAT INCREASE SNORING ARE OBESITY, LACK OF EXCERCISE, EXCESSIVE ALCOHAL AND STRUCTURAL DEFECTS IN NOSE/ PALATE/ TONGUE BASE OR EPIGLOTTIS.

THE MANAGEMENT INCLUDES SLEEP STUDY AND ENDOSCOPY. SLEEP STUDY IS DONE DURING NATURAL SLEEP DURING NIGHT AND MEASURES THE SEVERITY OF SNORING AND ITS EFFECTS ON THE BODY. ENDOSCOPY IS DONE TO SEE THE SITE OF OBSTRUCTION. THE TREATMENT DEPENDS ON SEVERITY AND STRUCTURAL DEFECTS OBSERVED. IT RANGES FROM CONSERVATIVE TREATMENT LIKE WEIGHT LOSS, SLEEPING POSTURE TO USING NASAL OR MANDIBULAR DEVICES, CPAP/ BIPAP MACHINES AND LASTLY SURGERIES IF ALL CONSERVATIVE TREATMENT FAILS.

EXTERNNAL EAR INFECTIONS ARE ESPECIALLY COMMON IN RAINY SEASON, SWIMMERS, DIABETIC AND ALLERGIC PERSONS. IT IS IMPORTANT TO AVOID USING EAR BUDS TO CLEAN OR SCRATCH THE EAR. AS A PRECAUTION IT WOULD BE ADVISABLE TO USE VASELINE SMEARED COTTON AS A EAR SEAL DURING HEADWASH. PROPER CONTROL OF BLOOD SUGARS IS IMPORTANT. ANY SKIN DISEASE NEEDS TO BE ADDRESSED AS THIS CAN ALSO AFFECT THE SKIN LINING OF EAR CANAL. APPROPRIATE USE OF EAR PLUGS AND SWIMMING CAPS SHOULD BE DONE TO PREVENT SWIMING RELATED EAR INFECTIONS. DO NOT USE OVER THE COUNTER MEDICATIONS FOR EAR INFECTIONS AS IT MAY BE DETREMENTAL. REFER TO ENT SPECIALIST FOR PROPER CLEANING AND MANGEMENT OF THE PROBLEM.

ORAL ULCERS ARE USUALLY PAINFUL AND MAY RESTRICT EATING, SPEAKING AND SWALLOWING. STRESS, HORMONES, TRAUMA, TOBACCO, DEFICENCIES OF VIT B12, FOLIC ACID, IRON, FOOD ALLERGIES AND SOME DRUGS MAY CAUSE RECURRENT ORAL ULCERS. MOST COMMONLY THEY ARE SMALL BUT SOMETIMES CAN BE LARGE AND MULTIPLE AS WELL. THERE MAY BE MODERATE TO SEVERE PAIN AND MAY LAST FROM A WEEK TO SEVERAL WEEKS. TREATMENT IS TARGETED TO ELIMINATE THE CAUSETIVE FACTOR. AVOIDING ACIDIC, SPICY, HOT, TEA, COFFEE AND AERATED DRINKS. MUTIVITAMINS, LOCAL PAIN RELIVING GELS, SOMETIMES STEROIDS ARE USED AS WELL FOR THE TREATMENT

NASAL BLEEDS CREATE A LOT OF PANIC AND WORRY BUT MOST OF THE BLEEDS ARE NOT RELATED TO A SERIOUS DISORDER. THE FRONT PART OF INNER NASAL WALL IS THE COMMONEST SITE OF NASAL BLEED FOLLOWING TRAUMA OR NASAL PICKING. SOMETIMES DUE TO DEVIATION OF THIS SEPTUM THE INNER LINING OF NOSE BECOMES DRY AND MORE PRONE TO BLEED. NASAL BLEED MAY ALSO FOLLOW INFECTIONS OR ALLERGIES WHICH LEAD TO CONGESTION OF NASAL LINING. A RECURRENT NASAL BLEED ESPECIALLY IF ASSOCIATED WITH NASAL BLOCKAGE, DEFORMITY OR ANY OTHER SYMPTOM NEEDS A ENT EXAMINATION AND DIAGNOSTIC NASAL ENDOSCOPY. RARE CAUSES INCULDE A TUMOR OR CANCEROUS MASS IN THE NASAL PASSAGE. THE MOST IMPORTANT MEASURE TO TAKE DURING A BLEED IS TO PINCH THE NOSE FOR ATLEAST 2 MINUTES. THIS WILL STOP THE BLEEDING. THE NEXT STEP IS TO PREVENT ANY TRAUMA AND TO KEEP THE AREA MOIST BY APPLYING SOME OINTMENT. OCCASIONALLY IF BLEEDING IS CONTINOUS IT NEEDS TO BE EITHER SEALED OR NASAL CAVITIES NEED TO BE PRESSURE PACKED BY AN ENT SPECIALIST.