1 ) Allergy Testing and Injections
You are sneezing, wheezing and coughing. Your eyes are itchy and your nose is running. When you visit your doctor, you are told you may have allergies. But to find out exactly what is making you sneeze, you'll need to have allergy testing done.
2 ) Ear infections
Otitis Media is the medical term for inflammation of the middle ear. When the middle ear is infected, the condition is known as Acute Otitis Media. Acute otitis media occurs when a cold, allergy or upper respiratory infection and the presence of bacteria or viruses lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube. This causes earache, swelling and redness.
When fluid forms in the middle ear the condition is known as Otitis Media with Effusion. This is usually associated with a recovering ear infection or one that is about to occur. Fluid can remain in the ear for weeks to many months. When an ear problem persists or repeatedly returns, this is sometimes called chronic middle ear infection, also known as glue ear. If left untreated, ear infections can have potentially serious consequences.
3 ) Ear Tubes - What should I expect?
Before surgery, the doctor performing the procedure will want to know if you or your child has any known allergies or respiratory problems related to anesthesia. While adults may only need local anesthesia, general anesthesia is usually given to children. When having general anesthesia, you or your child should not eat or drink anything for eight to twelve hours before the operation. Oral antibiotics may be prescribed to begin before surgery and continue afterward to guard against any infection. In addition, no other medications should be taken unless specifically recommended by the doctor performing the procedure. Because my ringotomy is such a simple operation, it is usually performed in an out-patient surgery facility with the patient going home the same day. After the surgery, be sure you understand how to take care of yourself or your child at home to speed recovery and prevent any complications from developing. Your doctor's instructions for self care may include: allowing the ears to drain freely by not putting cotton in them unless instructed to do so by the doctor, keeping the outer ear clean and dry, keeping hands washed and clean to prevent spread of new infection from the hands to the ears, and taking precautions to keep water out of the ears while bathing and to avoid swimming.
4 ) How common is sinusitis?
More than 37 million Americans suffer from at least one episode of acute sinusitis each year. The prevalence of sinusitis has soared in the last decade due to increased pollution, urban sprawl, and increased resistance to antibiotics.
5 ) How does a physician determine the best treat ?
To obtain the best treatment option, the physician needs to properly assess the patient’s history and symptoms and then progress through a structured physical examination.
6 ) How Does Primary Snoring Differ from Snoring that Indicates Obstructive Sleep Apnea?
A complaint of snoring by an observer
No evidence of insomnia or excessive sleepiness due to the snoring
Dryness of the mouth upon awakening
A polysomnogram (sleep study) that shows:
Snoring and other sounds often occurring for long episodes during the sleep period
No associated abrupt arousals, arterial oxygen desaturation (lowered amount of oxygen in the blood) or cardiac disturbances
Normal sleep patterns
Normal respiratory patterns during sleep
No signs of other sleep disorders
7 ) How does the doctor decide if I need antibiot ?
The decision to prescribe antibiotics might be based only on your history and physical exam. Antibiotics usually are prescribed only for patients who might have "strep throat," an infection caused by a bacteria called Streptococcus. A patient with strep throat might have a sore throat with fever that starts suddenly, without a cough or cold symptoms. Strep throat is very common in children from 5 to 12 years of age. The exam might show a red throat, with pus on the tonsils and swollen neck glands. If you have these signs, the doctor may do other tests to see if you need an antibiotic.
8 ) How effective are non-prescription nose drops ?
Use of nonprescription drops or sprays might help control symptoms. However, non-prescription drops should not be used beyond their label recommendation.
9 ) How Hearing Works ?
To understand the various types of hearing loss, you must first know how your hearing system works. Sound waves pass through the auditory canal (1) and beat against the eardrum (2), causing vibrations in the chain of three small bones in the middle ear (3). The third bone, called the stapes or stirrup, is the smallest bone in the human body. It fits into an area called the oval window, located between the middle ear and the inner ear (4). When the stapes vibrates with the sound waves passing through, fluid in the inner ear carries the vibrations into the canal of a delicate, spiral structure called the cochlea (5). Thousands of hair cells in one part of the cochlea are connected to fibers that make up the auditory nerve. Each hair cell has many microscopic hairs at one end. Movements of the fluid, with the aid of an overlying membrane, bend the tiny hairs. Movement of the hairs stimulates the hair cells to generate electrical impulses, which are carried up the auditory nerve to the brain.
10 ) How is acute sinusitis treated?
Acute sinusitis is generally treated with 10 to 14 days of antibiotic care. With treatment, the symptoms disappear and antibiotics are no longer required for that episode. Oral and ical decongestants also may be prescribed to alleviate the symptoms.
11 ) How is head and neck cancer diagnosed?
Head and neck cancer is diagnosed by a combination of the history and physical examination, various imaging studies (CAT scans, MRI scans), and biopsies of the tumor. The biopsy is often the most important piece of information. It involves cutting a small piece of the tumor and sending this piece to the pathologist for microscopic examination. If the suspicious region is in the mouth, the biopsy can often be done in the office. However, if there are concerns about regions deeper in the throat, the biopsy will probably be done in the operating room under a general anesthetic. Along with biopsies of suspicious lesions, it is also important to examine the entire throat for any sign of other cancers. This is usually done with a general anesthetic in the operating room in a procedure called "endoscopy". Endoscopy consists of a careful examination of the lining of the mouth, throat, esophagus and lungs. In some cases, imaging studies can be done in place of the endoscopy, but this may vary according to each institution's or each physician's preference.
12 ) Should I be concerned about any other symptom ?
Sometimes symptoms change during the course of an illness. Visit your doctor again if you have any of the following problems:
Fever that does not go away in five days
Throat pain that gets so bad you can't swallow
Inability to open your mouth wide
A fainting feeling when you stand up
Any other signs or symptoms that concern you
13 ) Sleep Apnea Defined
The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea s breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.
Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.
Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.
14 ) What are specific types of allergy tests?
Blood (RAST) test: Your practitioner may initially choose to do a blood test, called a RAST (radioallergosorbent) test. Since this test involves drawing blood, the results are not available immediately. Lab results may take several days, but this method is the easiest way to screen for common allergens.
Scratch or puncture test: These tests are done on the surface of the skin. A tiny amount of allergen is scratched across or lightly pricked into the skin. If you have an allergy, the specific allergens that you are allergic to will cause a chain reaction to begin in your body. People with allergies have an allergic antibody called IgE (immunoglobulin E) in their body. This chemical, which is only found in people with allergies, activates special cells called mast cells. These mast cells release chemicals called mediators, such as histamine, the chemical that causes redness and swelling. With testing, this swelling occurs only in the spots where the tiny amount of allergen to which you are allergic has been scratched onto your skin. So, if you are allergic to ragweed pollen but not to cats, the spot where the ragweed allergen scratched your skin will swell and itch a bit, forming a small dime-sized hive. The spot where the cat allergen scratched your skin will remain normal. This reaction happens quickly within your body. Test results are available within 15 minutes of testing, so you don’t have to wait long to find out what is triggering your allergies. And you won’t have any other symptoms besides the slightly swollen, small hives where the test was done; this goes away within 30 minutes. Intradermal test This test is related to the scratch or puncture test, but is slightly more sensitive. It involves injecting a tiny amount of allergen under the skin, usually on the upper arms. Your allergist may do this test when your reaction to the scratch test cannot be clearly determined.
15 ) What are the signs and symptoms of acute sinus ?
For acute sinusitis, symptoms include facial pain/pressure, nasal obstruction, nasal discharge, diminished sense of smell, and cough not due to asthma (in children). Additionally, sufferers of this disorder could incur fever, bad breath, fatigue, dental pain, and cough (in adults). Acute sinusitis can last four weeks or more. This condition may be present when the patient has two or more symptoms and/or the presence of thick, green or yellow nasal discharge. Acute bacterial infection might be present when symptoms worsen after five days, persist after ten days, or the severity of symptoms is out of proportion to those normally associated with a viral infection.
16 ) What are the signs and symptoms of chronic sinusitis ?
Victims of chronic sinusitis may have the following symptoms for 12 weeks or more: facial pain/pressure, facial congestion/fullness, nasal obstruction/ blockage, thick nasal discharge/ discolored post-nasal drainage, pus in the nasal cavity, and at times, fever. They may also have headache, bad breath, and fatigue.
17 ) What can be done about primary snoring?
First of all, it is absolutely necessary to rule out obstructive sleep apnea or other sleep disorders. Be wary of any doctor who says it is not necessary. Behavioral and lifestyle changes may be suggested. Losing weight, sleeping on your side, refraining from alcohol and sedatives are often recommended.
18 ) What causes a sore throat?
Many things can cause a sore throat. These causes include infections with viruses or bacteria, or sinus drainage and allergies, among others. You should see your doctor right away if you have a sore throat with a high fever, if you have problems breathing or swallowing, or if you feel very faint. If you have a sore throat and a fever, but you just feel mildly ill, you should visit your doctor within the next few days if it persists or worsens. If you have a cold with sinus drainage, you may use over-the-counter medicines for short-term relief.. Visit your doctor if the cold lasts for more than two weeks, or if it gets worse.
19 ) What course of treatment will the physician give?
To reduce congestion, the physician may prescribe nasal sprays, nose drops, or oral decongestants. Antibiotics will be prescribed for any bacterial infection found in the sinuses (antibiotics are not effective against a viral infection). Antihistamines may be recommended for the treatment of allergies. Antifungal medicine will be the treatment for any fungal infection.
20 ) What does one hear?
Many sufferers in the online community report that their tinnitus sounds like the high-pitched background squeal emitted by some computer monitors or television sets. Others report noises like hissing steam, rushing water, chirping crickets, bells, breaking glass, or even chainsaws. Some report that their tinnitus temporarily spikes in volume with sudden head motions during aerobic exercise, or with each footfall while jogging. Objective tinnitus sufferers may hear a rhythmic rushing noise caused by their own pulse. This form is known as pulsatile tinnitus.
21 ) What does sinus surgery accomplish?
The surgery should enlarge the natural opening to the sinuses, leaving as many cilia in place as possible. Otolaryngologist head and neck surgeons have found endoscopic surgery to be highly effective in restoring normal functioning to the sinuses. The procedure removes areas of obstruction, resulting in the normal flow of mucus.
22 ) What does the evaluation of a neck lump entail?
The evaluation of a neck lump, nodule, or mass is performed by the otolaryngologist. It is important to assess a history of smoking in a patient with a neck nodule. A complete head and neck exam is essential to view the entire upper aerodigestive tracts (breathing/swallowing passage). During the ENT office exam, the location of the nodule can often given a clue as to its identity. CT and MRI scanning and other radiographic evaluation is sometimes necessary. Fine needle aspiration (please see thyroid nodule above) is often a centrally important test in the work-up of a neck nodule and represents a microscopic biopsy that usually provides definitive diagnosis without surgery.
23 ) What is a myringotomy?
Ear Tubes : Inserting ear tubes, or performing a myringotomy with tubes, is an operation in which a small cut is made in the ear drum to relieve pressure caused by pus or fluid in the middle ear. A small tube may then be placed in the cut to allow fluid to drain from the ear and air to pass inside. The tube usually falls out on its own in about a year and the cut heals. While myringotomy is done on both adults and children, it is done most often on children. In fact, it is the most common operation done on children. Myringotomy is generally done to treat ear infections that have not responded well to other treatments, hearing loss due to fluid build-up, and in children, delayed speech development caused by the hearing loss. The benefits of having a myringotomy include less frequent ear infections, hearing improvement, and improvement of speech in adults, as well as children.
24 ) What is allergy testing?
If you are "allergic", you are reacting to a particular substance. Any substance that can trigger an allergic reaction is called an allergen. To determine which specific substances are triggering your allergies, your allergist will safely and effectively test your skin or blood, using tiny amounts of commonly troublesome allergens. Allergy tests are designed to gather the most specific information possible so your doctor can determine what you are allergic to and provide the best treatment.
25 ) What is an otolaryngologist?
An otolaryngologist, or ear, nose, and throat doctor, is a specialist trained in the diagnosis and treatment of problems of the head and neck. Our physicians are among the finest in their field, and have been educated and trained at some of the finest medical schools in the world. All of our practitioners are board certified by the American Board of Otolaryngology-Head and Neck Surgery. Take a moment to read more about our doctors at Physicians and Staff.
26 ) What is nasal endoscopy?
An endoscope is a special fiberoptic instrument for the examination of the interior of a canal or hollow viscus. It allows a visual examination of the nose and sinus drainage areas.
27 ) What is sinusitis?
Sinusitis is an inflammation of the membrane lining of any sinus, especially one of the paranasal sinuses. Acute sinusitis is a short-term condition that responds well to antibiotics and decongestants; chronic sinusitis is characterized by at least four recurrences of acute sinusitis. Either medication or surgery is a possible treatment.
28 ) What is Snoring?
I'm sure just about everyone is somewhat familiar with snoring. You probably know at least one person who snores. It could be your bed partner, your parents, or even your child. Some laugh and make jokes about it, but it can be a symptom of a serious disorder called obstructive sleep apnea. If it is obstructive sleep apnea, then it is no laughing matter. That individual needs to be evaluated by a sleep specialist.
Snoring is a noise produced when an individual breathes (usually produced when breathing in) during sleep which in turn causes vibration of the soft palate and uvula. All snorers have incomplete obstruction ( a block) of the upper airway. Many habitual snorers have complete episodes of upper airway obstruction where the airway is completly blocked for a period of time, usually 10 seconds or longer. This silence is usually followed by snorts and gasps as the individual fights to take a breath. When an individual snores so loudly that it disturbs others, obstructive sleep apnea is almost certain to be present. There is snoring that is an indicator of obstructive sleep apnea, and there is also primary snoring.
Primary Snoring, also known as simple snoring, snoring without sleep apnea, noisy breathing during sleep, benign snoring, rhythmical snoring and continous snoring is characterized by loud upper airway breathing sounds in sleep without episodes of apnea (cessation of breath).
29 ) What is tinnitus?
Tinnitus can be described as "ringing" ears and other head noises that are perceived in the absence of any external noise source. Tinnitus is classified into two types:
Objective Tinnitus, the rarer form, consists of head noises audible to other people in addition to the sufferer. The noises are usually caused by vascular anomalies, repetitive muscle contractions, or inner ear structural defects. The sounds are heard by the sufferer and are generally external to the auditory system. This form of tinnitus means that an examiner can hear the sound heard by the sufferer by using a stethoscope. Benign causes, such as noise from TMJ, openings of the eustachian tubes, or repetitive muscle contractions may be the cause of objective tinnitus. The sufferer might hear the pulsatile flow of the carotid artery or the continuous hum of normal venous outflow through the jugular vein when in a quiet setting. It can also be an early sign of increased intracranial pressure and is often overshadowed by other neurologic abnormalities. The sounds may arise from a turbulant flow through compressed venous structures at the base of the brain.
Subjective Tinnitus. This form of tinnitus may occur anywhere in the auditory system and is much less understood, with the causes being many and open to debate. Anything from the ear canal to the brain may be involved. The sounds can range from a metallic ringing, buzzing, blowing, roaring, or sometimes similar to a clanging, popping, or nonrhythmic beating. It can be accompanied by audiometric evidence of deafness which occurs in association with both conductive and sensorineural hearing loss. Other conditions and syndromes which may have tinnitus in conjunction with the condition or syndrome, are otosclerosis, Meniere's Disease, and cochlear or auditory neve lesions. Hearing loss, hyperacusis, recruitment, FMS, and balance problems may or may not be present in conjunction with tinnitus.