ENT Patient Information
Information to Know Before the Procedure
Indications:
Recurrent Adenotonsillitis
Breathing Difficulty
Hearing Loss
Treatment Modalities:
Conventional Instruments
Microdebrider Assisted
Coablator Assisted
Laser-Assisted
Risks and Complications:
Rare but children below 10 should be kept for overnight observation for any bleeding.
Sometimes bleeding can occur after a week in a few cases, related to infection. This may sometimes need operative control.
Recurrence of Adenoids
Ear Drum Perforation
Benefits:
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.
A normal diet can be started after 3 days.
Outdoor activity should be restricted for 2 weeks.
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Tinnitus, or ringing sensation in the ears, affects a large number of the population to varying degrees. Many of us have experienced it after exposure to loud sounds. The cause can be wax buildup, abnormal middle ear pressure or fluid, inner ear dysfunction, or nerve weakness. Sometimes, associated features like dizziness and headaches accompany it. Tinnitus can be transient or continuous. At times, it may significantly impact a person, leading to disturbed sleep and depression. If you experience more than transient tinnitus, it’s recommended to undergo a proper ENT examination along with an audiologic check. Occasionally, an MRI of the brain with contrast is performed to rule out any tumors. Factors such as exposure to loud sounds, continuous mobile device use, high blood pressure, and diabetes predispose individuals to degenerative changes in the inner ear, potentially causing premature hearing loss accompanied by tinnitus. Various therapies, including tinnitus retraining, medications, and intratympanic injections, are available to treat this disorder.
Acid reflux is prevalent among urban populations due to irregular eating habits and a sedentary lifestyle. The throat lining isn’t resistant to the effects of acid, leading to various symptoms like a burning sensation, recurring oral ulcers, heaviness, difficulty in swallowing, hoarseness, and sometimes post-nasal drip. Most individuals with acid reflux can benefit from avoiding oily, spicy food, tea, coffee, and aerated drinks. Maintaining a regular small diet can also help prevent reflux. It’s recommended to wait at least 2 hours between dinner and lying down. In severe cases, elevating the head end of the bed can reduce acid reflux. These precautions, along with some antacid or antireflux medications, can effectively combat acidity. Occasionally, endoscopy and biopsy may be necessary. Rarely, structural disorders might require surgical intervention.
The nose is frequently involved in facial injuries due to its prominence. Symptoms of a nasal injury often include nasal bleeding, pain, discharge, blockage, swelling, and deformity. It’s crucial to have all nasal injuries examined promptly by an ENT specialist to rule out any cosmetic or functional deformities. If a nasal deformity is present, specialists can often replace it easily. Sometimes, blood accumulation in the nasal septum may occur, requiring immediate drainage.
Hearing is the first sense to develop in a fetus, and our speech development relies on normal hearing. Newborns are routinely screened for hearing loss using the OAE test at birth. Any detected hearing loss or deficiency can be further assessed through an ENT examination and the BERA test. Early use of hearing aids is recommended for conditioning hearing and preventing speech impairment. A child’s brain requires proper auditory input for the normal development of speech. A CT scan and MRI of the ear are conducted if there is profound sensorineural deafness, either on one side or both sides. This is to determine the presence of the inner ear and the auditory nerve. If the inner ear and nerve are present, cochlear implant surgery can be performed to restore hearing. A cochlear implant is a surgically implanted device that directly stimulates the auditory nerve. If imaging reveals no inner ear or nerve development, a brainstem implant is an option to restore hearing. These procedures are ideally performed at an early age to facilitate normal brain and speech development.
No other sensory perception is as neglected, ridiculed, or stigmatized as hearing. The sense of hearing begins developing before birth and can be impaired as early as three weeks into conception. Studies indicate that a fetus can hear and respond to environmental sounds in early to mid-pregnancy. Antenatal hearing tests upon discharge from the hospital or during the first visit are crucial to detect unilateral or bilateral hearing deficiencies. Any childhood illness or delay in speech development should alert parents or healthcare providers. Various tests are available for diagnosis. Upon early diagnosis, hearing training should start promptly with the use of a hearing aid. This helps the brain recognize sounds and develop speech. Delay in this process may lead to delayed speech development. Other delayed milestones and the presence of autism, if identified, should also be diagnosed early for appropriate treatment or behavioral therapy. If necessary, ear imaging is conducted to determine whether the child is a candidate for cochlear implant surgery or brainstem implant, based on hearing assessment and imaging study results. In adults and the elderly, untreated hearing loss can result in permanent impairment. The brain adapts to silence, causing shrinkage of the auditory cortex, making rehabilitation more challenging over time. A proper ENT examination coupled with audiological assessment is essential. This can lead to appropriate management, whether it involves conservative measures, surgical intervention, hearing aids, or implantable hearing devices. Hearing and speech are closely interrelated and often mutually affected. Proper care and management can bring sounds back into silence.
Constant irritation in the ears affects many individuals. It’s often a result of allergies, excessive cleaning leading to wax irritation, or a fungal infection. This irritation can range from mild to severe, sometimes causing swelling of the ear canal and outer ear (pinna) and, occasionally, resulting in discharge. In most cases, this discomfort can be easily prevented by keeping the ears dry during a head wash, using earplugs or cotton soaked in Vaseline. At times, using earbuds can lead to infections that cause excruciating pain in the ear canal. This necessitates careful cleaning by an ENT specialist and antibiotic therapy. Importantly, it’s advisable to avoid using over-the-counter ear drops or oil in the ear canal.
Tonsils, located at the junction of the mouth and throat, play a crucial role in the immune system’s function. They’re most active in providing immunity from birth to around 8-12 years old, after which they gradually diminish. Alongside tonsils, there are other tissues like adenoids and various small lymphoid tissues contributing to immunity. Tonsillitis can result in throat pain, difficulty swallowing, speaking, and occasionally, breathing issues. Most individuals experience fewer than three episodes a year, which can typically be managed conservatively. However, recurrent infections can lead to complications and the spread of infection to distant organs like the heart, kidneys, and lungs. In some cases, tonsils can become repeatedly infected, causing breathing difficulties or asymmetric enlargement. An ENT specialist performs a thorough evaluation to determine potential solutions, whether through an extended antibiotic course or surgical treatment. Tonsillectomy, a safe and brief procedure to remove the tonsils, proves effective in reducing throat infections and improving breathing. Children who experience recurrent infections or suffer from snoring and stunted growth often benefit from this procedure.
Many parents express concern about delayed speech in children. Typically, children with normal developmental milestones respond to speech at around 6 months, start using monosyllables by 9 months, begin imitation by 12 months, speak three words by 18 months, and achieve understandable speech by 3 years old. Some variations in pronunciation may occur, and milestones might be slightly delayed in boys. Hearing screening at birth is essential, and all newborns should undergo screening with otoacoustic emissions. If there’s any suspicion, a BERA test should be conducted. Any impairment in hearing needs to be addressed promptly as speech development heavily relies on hearing ability. A comprehensive ENT examination is crucial as soon as any suspicion arises regarding delayed or abnormal speech development. Management strategies vary and can include simple procedures like releasing tongue ties, speech therapy, psychological evaluation, and the use of hearing aids or cochlear implant surgery. Early intervention and assessment are key in addressing delayed speech concerns.
Fortunately, most ruptured eardrums heal naturally, albeit sometimes leaving behind a scar from the healing process. The eardrum is a delicate membrane easily ruptured by sudden pressure changes due to incidents like slapping, diving, exposure to loud noises like crackers, or direct trauma from items like earbuds. Typically, a person experiences a feeling of heaviness and blockage in the ear, accompanied by hearing loss and earache. Profuse bleeding or discharge is rare. However, severe hearing loss and dizziness may occur, indicating damage to the ear bones or inner ear—though this is uncommon. The most crucial immediate step is to avoid putting any drops in the ear and to keep the ear dry during a head wash by using an earplug. Immediate consultation with an ENT specialist for audiological evaluation is essential. In many cases, the jaw joint might also be affected due to impact, resulting in difficulty opening and closing the mouth. Management of an ear drum rupture can range from conservative measures to replacing torn edges under a microscope. Rarely, surgery is necessary in cases where there’s damage to the ear bones or when the eardrum doesn’t heal even after a month. Early medical attention is critical in cases of facial assault leading to ear drum rupture.
Hoarseness refers to any change in voice and often affects professionals who extensively use their voice, such as teachers, singers, lawyers, hawkers, and especially mothers with multiple children. It can also occur in chronic smokers, alcoholics, individuals with acid reflux, or hypothyroidism. Sometimes, hoarseness can be a sign of a brain stroke, especially if it’s accompanied by coughing while swallowing, particularly for liquids. Early diagnosis is crucial to prevent irreversible changes that might require endoscopic surgical procedures. Almost all conditions causing hoarseness can be diagnosed through a simple endoscopic procedure in the outpatient clinic. In most cases, hoarseness results from swelling of the vocal cords, which can be easily treated by practicing vocal hygiene and using specific medications. Persistent hoarseness requires evaluation through laryngoscopy to rule out nodules, polyps, cysts, weakness, or potentially cancerous growths on the vocal cords. The majority of hoarseness can be reversed by following simple precautions: Vocal hygiene practices Avoiding tea, coffee, or carbonated drinks Avoiding gargling Steam inhalation Staying hydrated Avoiding oily, spicy food, smoking, and alcohol Persistent hoarseness should never be neglected, and consultation with an ENT specialist is highly recommended.
Nasal polyps are fluid-filled growths on the mucosal lining of the nasal passages, often caused by allergies and sometimes infection. It’s a treatable disorder primarily affecting the nasal lining, where instability in the lining leads to the formation of these polyps. These growths block the nasal passages and sinus openings, resulting in nasal congestion, loss of smell, and facial pressure or pain. In some cases, blocked sinuses might lead to fungal infections. Prolonged sinus infections can potentially spread to the eyes and brain. Early management involves nasal endoscopy, allergy testing, and medications to reduce the size of the polyps. If the polyps persist or recur, a CT scan of the sinuses along with a biopsy might be recommended. Surgery for nasal polyps becomes necessary if they don’t respond to medications or if complications are imminent. Functional endoscopic sinus surgery aims to clear the sinuses of disease and widen the openings to facilitate nasal cleaning and examination. This procedure also reduces the need for oral steroids. Allergy testing and immunotherapy can also decrease the recurrence of nasal polyps.
Earwax, also known as cerumen, is a blend of ear secretions, shed skin, and dirt. It serves important functions such as lubrication, possessing antibacterial, antifungal properties, and acting as an insect repellent. Routine ear cleaning is not advised or recommended. The ears are cleaned only if the wax buildup is causing a blockage and leading to hearing loss. Occasionally, cleaning may be necessary if there’s an infection or if the ear canal needs examination. Earbuds should only be used to apply medications, not to clean the ears. The use of earbuds can introduce infection and potentially cause damage to the ear canal.
Earwax, also known as cerumen, is a blend of ear secretions, shed skin, and dirt. It serves important functions such as lubrication, possessing antibacterial, antifungal properties, and acting as an insect repellent. Routine ear cleaning is not advised or recommended. The ears are cleaned only if the wax buildup is causing a blockage and leading to hearing loss. Occasionally, cleaning may be necessary if there’s an infection or if the ear canal needs examination. Earbuds should only be used to apply medications, not to clean the ears. The use of earbuds can introduce infection and potentially cause damage to the ear canal.
Most children under 10 years old have adenoids of varying sizes. In some cases, these adenoids can block the nasal passage, leading to mouth breathing and snoring. This obstruction can also impact facial development and cause teeth to protrude. Disturbed sleep due to these issues can lead to irritability and stunted growth. Some children with adenoid problems also experience enlarged tonsils. Additionally, there might be other contributing factors such as a deviated nasal septum or allergic nasal congestion, further affecting breathing. Evaluation by an ENT specialist is crucial for proper diagnosis, which may involve X-rays or nasal endoscopy. Management depends on the severity and persistence of symptoms. Treatments can include nasal washes, nasal sprays, and sometimes endoscopic removal of adenoids if symptoms are severe, persistent, or affecting the ears. If the ears are also involved with fluid, a small tube made of materials like Teflon or titanium is inserted into the ear drum to ventilate and aid drainage. These tubes usually fall out spontaneously as the ear drum grows, with rarely any complications. Surgery is not always necessary for adenoid enlargement and depends on the individual case and its impact on the child’s health.
Most people have experienced ear infections at some point, which can often be simple, affecting the external or middle ear. However, certain infections can be more serious. For instance, there might be an ingrowth of skin from the external ear canal into the middle ear and the bone behind the ear. The ear is closely linked to the brain and facial nerve. Infections of this nature can erode into the brain or the facial nerve, leading to pus formation in the brain or facial weakness, respectively. If the inner ear is affected, it can cause dizziness and sensorineural hearing loss. It’s crucial to be aware of such conditions to initiate proper treatment before complications arise. Any ear discharge that is continuous, scanty, foul-smelling, or blood-stained should not be ignored. Seeking prompt consultation with an ENT specialist and initiating appropriate treatment is essential in these cases to prevent potentially serious consequences.
The nose plays a crucial role in aesthetics and air conditioning for the body. Nasal blockage is common in urban areas due to increased exposure to dust and pollution. This blockage can lead to difficulties in breathing, speaking, and even in sensing smell or flavor. Nasal blockage might occur due to structural defects or the presence of masses in or behind the nose. These conditions can be easily diagnosed in an ENT clinic through a clinical examination and, at times, a nasal endoscopy. It’s essential to avoid prolonged use of nasal decongestant drops as they can become addictive and potentially cause permanent damage to nasal tissue. Persistent nasal blockage can often be treated with medications to reduce congestion in the nose. However, in some cases, endoscopic surgery might be recommended to permanently alleviate the obstruction. Seeking medical advice is crucial to identify the cause of nasal blockage and determine the most appropriate treatment.
The ear plays a dual role in both hearing and maintaining balance. Within the inner ear are specialized sensors that contribute to our sense of balance. Disorders affecting the inner ear can result from direct issues within the inner ear itself or problems originating in the middle ear. The most prevalent disorder causing vertigo related to the inner ear is Benign Paroxysmal Positional Vertigo (BPPV). This condition arises from suspended particles in the semicircular canals, leading to abnormal stimulation of these balance sensors. Other disorders such as Meniere’s disease, vestibular neuritis, trauma, infections, or tumors can also cause vertigo due to dysfunction in the inner ear. These inner ear disorders might present associated symptoms like a ringing sensation in the ears, a feeling of fullness in the ears, hearing loss, headaches, facial weakness, or ear discharge. Diagnosis typically involves a comprehensive ENT examination along with audiologic tests, and sometimes an MRI of the brain. Treatment approaches vary and can include bed rest, specialized maneuvers, medications, intratympanic injections, and occasionally surgery. Seeking medical advice is crucial for accurate diagnosis and appropriate treatment of vertigo related to inner ear disorders.
Repeated sneezing, watery nasal discharge, itching, and nasal blockage are common symptoms of allergic rhinitis, affecting nearly 13 percent of the population. These symptoms can range from mild to severe and may occur seasonally or persist throughout the year. It’s essential to differentiate allergic rhinitis from temperature sensitivity, which causes non-allergic rhinitis (vasomotor rhinitis). Identifying the trigger or allergen can be accomplished through a skin prick allergy test, considered the gold standard. Once identified, efforts can be made to eliminate the allergen from the individual’s environment. For allergens that cannot be removed, gradual adaptation through immunotherapy is a potential solution. Immunotherapy is an innovative method that aims to cure allergies by helping the person’s immune system adapt. Exercise, dietary modifications, and practicing yoga can aid in controlling allergic symptoms. In cases of moderate to severe allergic rhinitis, seeking proper ENT consultation and management is crucial to improve the individual’s quality of life. Consulting with an ENT specialist allows for a more comprehensive approach to managing and treating the condition.
The nose stands out as the most prominent facial structure, and any deviation or deformity is easily noticeable. Deformities can result from various causes such as trauma, birth conditions, post-surgery complications, or infections. There exist different methods to improve a deformed nose. The least invasive method involves injecting fillers into depressions on the nose. Implants can also be inserted to create a more aesthetically pleasing appearance. A formal rhinoplasty procedure can be performed using either an open or closed approach to enhance the nose’s appearance. Following surgery, a plaster is typically applied for at least 10 days. It takes about 3-6 months post-surgery for the nose to achieve its final outcome. Seeking consultation with a qualified specialist is crucial to determine the most suitable approach for improving the nose’s appearance.
Before I could utter a word, my listeners had left me long ago.” Addressing a stammer involves a significant shift in mindset before speaking. Individuals with a stammer often hold a misconception that speech should be flawless, without any hesitations, prolongations, or pauses. A person who stammers tends to perform the sound and tongue position, which is a fundamental issue as we can perform thoughts but not sounds. Stammering typically begins between 3-7 years of age, often arising due to external pressure to speak perfectly. While it’s essential to approach this condition with a light spirit, children tend to internalize this pressure seriously. Various techniques such as exercises, Botox treatments, and behavior therapy are utilized, each with varying degrees of success in managing stammering. Seeking guidance from professionals can be beneficial in finding effective strategies to manage and improve speech for individuals dealing with a stammer.
Snoring is often regarded both humorously and as a potential health hazard. It indicates a potential breathing obstruction during sleep, and when it’s severe, it can be linked to a condition known as Obstructive Sleep Apnea (OSA). OSA involves pauses in breathing during sleep, leading to chronic strain on the heart and brain. This strain may result in conditions like hypertension, increased risks of heart attacks, and strokes. Several factors contribute to increased snoring, including obesity, lack of exercise, excessive alcohol consumption, and structural issues in the nose, palate, tongue base, or epiglottis.
External ear infections are notably common during rainy seasons and among swimmers, individuals with diabetes, and those prone to allergies. To minimize the risk of infection, it’s important to refrain from using earbuds for cleaning or scratching the ear canal. Instead, consider using cotton smudged with Vaseline as an ear seal while washing your hair. Managing blood sugar levels is crucial, especially for diabetic individuals, as elevated levels can contribute to susceptibility to infections. Any skin conditions should be addressed promptly, as they can affect the skin lining of the ear canal and potentially increase the risk of infection. When swimming, it’s advisable to use earplugs and swimming caps to prevent infections associated with water exposure. Avoid using over-the-counter medications for ear infections without proper guidance, as they might not be suitable and could potentially worsen the situation. For proper cleaning and management of any ear-related problems or concerns, it’s recommended to consult with an ENT specialist. Seeking professional advice ensures appropriate care and reduces the risk of complications associated with external ear infections.
Oral ulcers can be painful and hinder regular activities such as eating, speaking, and swallowing. They can be triggered by various factors including stress, hormonal changes, trauma, tobacco use, deficiencies in vitamins B12, folic acid, iron, food allergies, and certain medications. These ulcers are typically small but can sometimes be large and occur in multiples. They often cause moderate to severe pain and may persist for a week or several weeks. Treatment focuses on addressing the underlying cause. Avoiding acidic, spicy, hot, tea, coffee, and carbonated drinks can help manage and prevent recurrent oral ulcers. Multivitamins, local pain-relieving gels, and occasionally steroids are used in treatment to alleviate symptoms and promote healing.