Any source of sound
sends vibrations or sound waves into the
air. This sound is collected by the pinna
(the visible part of the ear) and is funneled
through the ear opening, down the ear, canal,
and strikes the eardrum, causing it to vibrate
which in turn causes a series of three tiny
bones (the hammer, the anvil, and the stirrup)
in the middle ear to vibrate. Here, the
vibrations become nerve impulses and is
transferred to the snail-shaped cochlea
in the inner ear. The cochlea is lined with
sensitive hairs that trigger the generation
of nerve signals that are sent to the brain,
which interprets the impulses as sound (music,
voice, a car horn, etc.).
On average, people can hear sounds in the
frequencies between 20 to 20,000 Hertz.
Common
Diseases in the Ear
Hearing
Loss In Children
In case of children, parents, grandparents,
and other caregivers are often the first to
notice that something may be wrong with a
young child’s hearing. Even if your
child’s hearing was tested as a newborn,
you should continue to watch for signs of
hearing loss including:
Not reacting in any way to unexpected
loud noises,
Not being awakened by loud noises,
Not turning his/her head in the direction
of your voice,
Not being able to follow or understand
directions,
Poor language development, or
Speaking loudly or not using age-appropriate
language skills.
If your child exhibits any of these signs,
report them to your doctor.
Presbyacusis
or Age Related Hearing Loss
Symptoms: With presbycusis,
sounds often seem less clear and lower in
volume. People with this kind of hearing loss
may have a hard time hearing what others are
saying or may be unable to stand loud sounds.
Individuals with presbycusis may experience
several of the following:
The speech of others seems mumbled
or slurred.
High-pitched sounds such as "s"
and "th" are difficult to hear.
Conversations are difficult to understand,
especially when there is background noise.
A man's voice is easier to hear than
the higher pitches of a woman's voice.
Certain sounds seem annoying or overly
loud.
Tinnitus (a ringing, roaring, or hissing
sound in one or both ears) may also occur.
Causes: Presbycusis, an ongoing
loss of hearing linked to changes in the inner
ear is the most common hearing problem in
older people.
Repeated exposure to noise, hereditary factors
as well as aging, various health conditions,
and side effects of some medicines (aspirin
and certain antibiotics), changes in the blood
supply to the ear because of heart disease
or blood pressure can cause sensorineural
hearing loss that occurs owing to a loss of
hair cells (sensory receptors in the inner
ear).
Treatment: In
case of any given symptoms, consult your ENT
doctor immediately to get a medical evaluation.
Hearing aids are available as a mode of treatment
for the patients, which could be given after
considering the hearing level and speech understanding
ability of the individual.
Tinnitus
(Ringing sensation in the ear)
Symptoms: Signs and symptoms
of Tinnitus may vary on an individual basis
for each patient. The list of signs and symptoms
for Tinnitus includes those listed below:
Noises in the ears
Ringing in ears
Clicking in the ears
Buzzing in ears
Whistling in the ears
Hissing in the ears
Pattern of noise may vary with cases:
Continuous ear noise
Intermittent ear noise
Pulsing ear noises
Ear noises in time with heartbeat
Causes: Hearing inappropriate
sounds such as ringing, buzzing, roaring or
similar noises in the ears are quite common
and are called "tinnitus". It may
be temporary or it may be intermittent or
permanent, and tinnitus may be mostly harmless
(i.e. only annoying), or it may be an indication
of a serious underlying medical condition.
Treatment: Only
your doctor can provide adequate diagnosis
of any signs or symptoms and whether they
are indeed Tinnitus symptoms, so in case of
any of the above symptoms, consult your ENT
doctor immediately, who could give a treatment
that includes:
Hearing aids
Maskers - electronic devices to hide
the tinnitus noises.
Listening to sounds - music, radio static
(for sleeping), natural sounds, etc.
Relaxation
Tinnitus retraining therapy - learning
how to not hear the noises as much.
Various medications
Otitis
Media with Effusion (OME) or Middle Ear Infection
Symptoms: Some of
the basic symptoms for Otitis Media or Middle
Ear Infection are:
Ear pain
Earache - see also symptoms of earache
Other symptoms of earache in infants
or young children:
Irritability
Sleeping difficulty
Pulling at the ears - infants will
often rub or pull their ears.
Crying and screaming (infant)
Fever & Ear fluid draining
Relief of earache when fluid leaks from
the ear
Hearing loss - almost always temporary.
Tinnitus
Diarrhea & Vomiting
Any of the above symptoms need immediate attention
and you need to seek medical advice.
Causes: OME is caused
when the Eustachian tube, a narrow channel
that connects the inside of the ear to the
back of the throat, becomes blocked.
Treatment: The line
of treatment in OME includes some medications
or ear tube placement (grommets) might be
appropriate in severe cases. However, laser
myringotomy is a newer alternative to ear
tube surgery.
The
Nose
Structure
of the Nose
The Nose - Side View
Functioning
of the Nose
The nose has two holes
called nostrils.
A wall called the septum separates the nostrils
and the nasal passages. Deep inside your
nose, close to your skull, your septum is
made of very thin pieces of bone.
Closer to the tip of your nose, the septum
is made of cartilage
which is flexible material that's firmer
than skin or muscle. It's not as hard as
bone, and if you push on the tip of your
nose, you can feel how wiggly it is.
Behind your nose, in the middle of your
face, is a space called the nasal
cavity. It connects with the
back of the throat. The nasal cavity is
separated from the inside of your mouth
by the palate (roof of your mouth).
The nose not only helps in breathing, but
also warms, moistens, and filters the air
before it goes to the lungs.
Up on the roof of the nasal cavity i.e.
the space behind the nose, lies the olfactory
epithelium containing special
receptors that are sensitive to odor molecules
that travel through the air.
Common Diseases
in the Nose
Sinusitis
Symptoms: The classic
symptoms of acute sinusitis usually follow
a cold that does not improve, or one that
worsens after 5 - 7 days of symptoms.
They include:
Nasal congestion and discharge
Sore throat and postnasal drip (fluid
dripping down the back of your throat,
especially at night or when you lie down)
Headache -- pressure-like pain, pain
behind the eyes, toothache, or facial
tenderness
Cough, often worse at night & fever
(may be present)
Bad breath or loss of smell
Fatigue and generally not feeling well
Symptoms of chronic sinusitis are the same
as acute sinusitis, but tend to be milder
and last longer than 8 weeks.
Causes: Sinusitis can occur
from one of these conditions:
The small openings (ostia) from the
sinuses to the nose become blocked
Small hairs (cilia) in the sinuses,
which help move mucus out, are not working
properly
Too much mucus is produced
When the sinus openings become blocked and
mucus accumulates, bacterias start breeding
followed by respiratory infections, such as
colds, or an allergic reaction.
Treatment: In case of sinusitis,
doctors prescribe medications, antibiotics,
further testing, decongestants or steroids.
However, surgery to clean and drain the sinuses
may also be done in patients with recurrent
episodes of inflammation despite medical treatment.
An ENT specialist, also known as an otolaryngologist,
can perform this surgery.
Allergy
or Nasal Polyps
Symptoms:
Nasal obstruction
Mouth breathing
Voice (sounds as if person is congested)
Having any of the following conditions indicate
a susceptibility to nasal polyps:
Asthma
Hay fever
Sinus infections
Cystic fibrosis
Causes:
Nasal polyps appear in a number of conditions.
The polyps originate near the ethmoid sinuses
(located at the top of the inside of the nose)
and grow into the open areas. Large polyps
may obstruct the airway.
Children with nasal polyps sound congested
and often breathe through their mouths because
of chronic nasal obstruction. A runny nose
or infected nose is common
Treatment:
Treatment may include medication, such as
steroids (topical or systemic)or antibiotics.
Surgery, such as Functional Endoscopic Sinus
Surgery (FESS), may be necessary in some cases.
If not treated in time extensive polyposis
can lead to serious complications like blindness
by compressing the optic nerve and spread
into the ear.
Unilateral watering from
the eye (Chronic Dacryocystitis)0
Symptoms: It is a
condition in which there is watering or pus
discharge from one eye or in rare cases from
both the eyes. The symptoms can be as follows:
Pain and redness in the eye
Tearing
Swelling at the inner corner of the
eye by the nose
Discharge of pus or mucus through the
punctum on applying pressure on the area.
Causes:
The watering occurs due to the blockage of
the nasolacrimal duct, a tube that connects
the tear sac (lacrimal sac), with the nose.
In an normal individual the tear sac opens
into the nose and that is the reason our nose
starts watering when we cry. In chronic infection
of the lacrimal sac the duct gets blocked
and accumulated secretions get infected leading
to pus formation. In newborn infants, the
nasolacrimal duct may fail to form an opening.
The cause of Dacryocystitis in adults is usually
associated with inflammation and infection
in the nasal region.
Treatment:
Treatment of dacryocystitis with antibiotics
is usually successful in clearing the infection
that is present. If there is a permanent blockage
that prevents drainage, infection may recur
and surgery may be required to open the duct.
If left untreated, the infected sac can rupture,
forming an open, draining sore. Conventional
surgery involves a cut over the skin below
the eye. However, it can nowadays be done
endoscopically through the nose.
The surgery is called as Endoscopic Dacryocystorhinostomy
(DCR). The advantage is no scar, less morbidity.
In elderly patients going in for cataract
surgery it is mandatory to have a patent tear
sac system, otherwise cataract surgery with
the blocked duct can lead to endophthalmitis
(fatal infection of the eye). Thus patients
prefer endoscopic DCR. After endoscopic DCR
the cataract surgery can be accomplished within
a week’s time while in external DCR
one has to wait longer.
Epistaxis
or Nose Bleeding
Symptoms:
Bleeding from one or both nostrils.
Frequent swallowing.
Sensation of fluid in the back of the
nose and throat.
Causes:
Sudden trauma to the nose, very cold
or very dry air, fragile blood vessels,
nasal sprays, strenuous exercise, or picking
the nose cause most nosebleeds.
Nose conditions like allergies, cold,
sinus tumors etc.
Certain Medications
High blood pressure
Bleeding disorders
Treatment:
Call your doctor for an appointment if you
or your child has repeated nosebleeds, particularly
if they are becoming more frequent and if
they are not associated with a cold or other
minor irritation.
Persistent nosebleeds may require urgent medical
care such as packing, embolization, or surgery.
Deviated
Septum (deviated nasal bone)
Symptoms:
Blockage of one or both nostrils
Nasal congestion, sometimes one-sided
Frequent nosebleeds
Frequent sinus infections
At times, facial pain, headaches, postnasal
drip
Noisy breathing during sleep (in infants
and young children)
Causes:
A "deviated septum" occurs when
the septum is severely shifted away from the
midline. In some cases the crooked septum
can interfere with the drainage of the sinuses,
resulting in repeated sinus infections.
Treatment:
Septoplasty is the preferred surgical treatment
to correct a deviated septum. This procedure
is not generally performed on minors, because
the cartilaginous septum grows until around
age 18. Septal deviations commonly occur due
to nasal trauma.
Snoring
Symptoms:
Breathing through mouth resulting in
loud sounds
Difficulty waking up in the morning
or a feeling of insufficient sleep
Stopping breathing or gasping while
asleep
Causes:
Snoring occurs when soft and droopy tissue
in the airway relaxes during sleep and vibrates.
Most snoring is caused by an enlarged soft
palate (the muscular part of the roof of the
mouth) and uvula at the back of the mouth,
although the tongue, tonsils, adenoids and
congested nasal passages can also contribute
to the sound. The level of snoring can be
aggravated by excess weight, alcohol intake
and smoking.
Treatment:
Available treatments require consultation
with an ENT expert who can offer some snoring
remedies or aids like nasal strips etc and
medications to help you reduce snoring.
However, various surgical techniques like
Somnoplasty, Laser or Cautery Assisted Uvuloplasty
(LAUP or CAUP) can be useful in reducing the
severity of snoring
The
Throat
Structure
of the Throat
Functioning
of the Throat
The throat, also known
as pharynx is
a ring-like muscular tube that acts as the
passageway for air, food, and liquid. The
throat also helps in forming speech. The
throat or the pharynx,
is divided into three sections:
The naso-pharynx
– the part of the throat that lies
behind the nose
The oro-pharynx
– the only part of the throat that
you can see just by looking down the mouth,
lying at the back of the mouth, going
from the tonsils backwards.
The laryngo- pharynx
– the upper part of the airways
lying in front of the oesophagus. The
vocal cords are part of the larynx.
However, pharynx has some other important
organs.
- The tonsils
and the adenoids
are masses of lymphoid tissue in the pharynx.
They are part of the defense system that
the body uses to fight off infections. The
tonsils can be found on each side of the
entrance to the oro-pharynx. The adenoids
are situated in the naso-pharynx. They protect
against infection, but generally have little
purpose beyond childhood.
- The Eustachian tubes,
which come from the middle ear, open into
the pharynx very close to the adenoids.
Larynx, also
known as the voice box, is a cylindrical
grouping of cartilage, muscles, and soft
tissue that contains the vocal cords. The
vocal cords are the upper opening into the
windpipe (trachea), the passageway to the
lungs.
The epiglottis
is a flap of cartilage, just above the vocal
chords. The epiglottis folds down over the
vocal cords to prevent food and irritants
from entering the lungs.
The throat contains various blood vessels,
various pharyngeal muscles, the trachea
(windpipe) and the esophagus. The hyoid
bone is the only bone located in the throat
of mammals.
Common Diseases
in the Throat
Sore
Throat
Symptoms:
The following signs and symptoms should alert
you to see your physician:
Flu, cold, sneezing and general aches
or pains
Severe and prolonged sore throat
Difficulty breathing
Difficulty opening the mouth and swallowing
Earache
Fever (over 101°)
Blood in saliva or phlegm
Lump in neck or rashes
Hoarseness lasting over two weeks
Causes:
Sore throat is a symptom of many medical disorders.
Infections cause the majority of sore throats
and are contagious. Infections are caused
either by viruses such as the flu, the common
cold, mononucleosis, or by bacterias.
Treatment:
In any of the above symptoms, consult an ENT
doctor who may prescribe medications and in
case of severity, can go for the surgical
process – tonsillectomy.
Tonsillitis
Symptoms:
Sore throat
Difficulty swallowing
Headache, fever, chills
Tenderness of the jaw and throat
Voice changes, loss of voice
Redder than normal tonsils
A white or yellow coating on the tonsils
Sore throat
Swollen lymph nodes (glands) in the
neck
Causes:
The tonsils are lymph nodes in the back of
the mouth and top of the throat. They normally
help to filter out bacteria and other microorganisms
to prevent infection in the body and may at
times become so overwhelmed by bacterial or
viral infection that they swell and become
inflamed, causing tonsillitis.
Treatment:
Your ENT expert might prescribe you some antibiotics
to get you rid of bacteria. In case of severity,
you might need a surgical process to remove
your tonsils called Tonsillectomy
GERD
Symptoms:
Gastroesophageal Reflux Disease can have
the main signs and symptoms as:
Persistent heartburn - twice a week
or more; most common GERD symptom, though
surprisingly you can have GERD without
heartburn
Acid regurgitation
Some people have GERD without heartburn. Instead,
they experience
Pain in the chest
Hoarseness in the morning
Trouble swallowing
Other symptoms include:
Choking feeling
Dry cough
Bad breath
Burning in the mouth and feeling that
food is stuck in your throat
There are other symptoms of GERD in children:
Vomiting
Coughing
Respiratory problems
Causes:
The factors that contribute to causing GERD
are the lower esophageal sphincter (a reflux
preventing muscle), hiatal hernias, esophageal
contractions (pushes food, saliva, and whatever
else is in the esophagus into the stomach)
and emptying of the stomach.
Treatment:
Your doctor will prescribe you with certain
medications and may ask you to adopt certain
changes in your lifestyle. Surgery is an option
when medicine and lifestyle changes do not
work. Surgery may also be a reasonable alternative
to a lifetime of drugs and discomfort.
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