Frequent Questions

When water gets into the ear, it may bring in bacterial or fungal particles. Usually the water runs back out; the ear dries out; and the bacteria and fungi don’t cause any problems. But sometimes water remains trapped in the ear canal, and the skin gets soggy. Then bacteria and fungi grow, flourish, and can infect the outer ear.

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    Three million American children under the age of 18 years have varying degrees of hearing loss. You, the parents and grandparents, are usually the first to discover hearing loss in your babies, because you spend the most time with them. If, at any time, you suspect your baby has a hearing loss, discuss it with your doctor.

    Your baby’s hearing can be professionally tested at any age. Computerized hearing tests make it possible to screen newborns. Some babies have more than an average chance of having hearing loss than others. All children should have their hearing tested before they start school. This could reveal mild hearing losses that the parent or child cannot detect. Loss of hearing in one ear may also be determined in this way. Such a loss, although not obvious, may affect speech and language.

    Hearing loss can even result from earwax or fluid in the ears. Many children with this type of temporary hearing loss can have their hearing restored through medical treatment or minor surgery.

    In contract to temporary hearing loss, some children have nerve deafness, which is permanent. Most of these children have some usable hearing. Few are totally deaf. Early diagnosis, early fitting of hearing aids and an early start on special education programs can help maximize the child’s existing hearing.

    Tonsils and adenoids are masses of tissue that are similar to the lymph nodes or “glands” found in the neck, groin, and armpits. Tonsils are the two masses on the back of the throat. Adenoids are high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth without special instruments.

    Tonsils and adenoids are near the entrance to the breathing passages where they can catch incoming germs, which cause infections. They “sample” bacteria and viruses and can become infected themselves. Scientists believe they work as part of the body’s immune system by filtering germs that attempt to invade the body, and that they help to develop antibodies to germs.

    This happens primarily during the first few years of life, becoming less important as we get older. Children who must have their tonsils and adenoids removed suffer no loss in their resistance.

    Tonsillitis and its symptoms

    Tonsillitis is an infection in one or both tonsils. One sign is swelling of the tonsils. Other signs or symptoms are:

    Redder than normal tonsils
    A white or yellow coating on the tonsils
    A slight voice change due to swelling
    Sore throat
    Uncomfortable or painful swallowing
    Swollen lymph nodes (glands) in the neck
    Fever
    Bad breath

    Enlarged adenoids and their symptoms

    If you or your child’s adenoids are enlarged, it may be hard to breathe through the nose. Other signs of constant enlargement are:

    Breathing through the mouth instead of the nose most of the time
    Nose sounds “blocked” when the person speaks
    Noisy breathing during the day
    Recurrent ear infections
    Snoring at night
    Breathing stops for a few seconds at night during snoring or loud breathing
    (sleep apnea)

    Not at all, Tinnitus is the name for these head noises, and they are very common. Nearly 36 million Americans suffer from this discomfort. Tinnitus may come and go, or you may be aware of a continuous sound. It can vary in pitch from a low roar to a high squeal or whine, and you may hear it in one or both ears. When the ringing is constant, it can be annoying and distracting. More than seven million people are afflicted so severely that they cannot lead normal lives.

    In most cases, there is no specific treatment for ear and head noise. If your otolaryngologist finds a specific cause of your tinnitus, he/she may be able to eliminate the noise. But, this determination may require extensive testing including X-rays, balance tests, and laboratory work. However, most causes cannot be identified. Occasionally, medicine may help the noise. The medications used are varied, and several may be tried to see if they help.

    Blockage of the Eustachian tube during a cold, allergy, or upper respiratory infection and the presence of bacteria or viruses lead to accumulation of fluid (a build-up of pus and mucus) behind the eardrum. This is the infection called acute otitis media. The build up of pressurized pus in the middle ear causes earache, swelling, and redness. Since the eardrum cannot vibrate properly, you or your child may have hearing problems.

    Often after the acute infection has passed, the effusion remains and becomes chronic, lasting for weeks, months, or even years. This condition makes one subject to frequent recurrences of the acute infection and may cause difficulty in hearing.

    In infants and toddlers look for:

    Pulling or scratching at the ear (especially if accompanied by the following
    Hearing problems
    Crying, irritability
    Fever
    Vomiting
    Ear drainage

    In young children, adolescents, and adults look for:

    Earache
    Feeling of fullness or pressure
    Hearing problems
    Dizziness, loss of balance
    Nausea, vomiting
    Ear drainage
    Fever

    So, remember . . .
    Otitis media is generally not serious if it is promptly and properly treated. With the help of your physician, you and/or your child can feel and hear better very soon. Be sure to follow the treatment plan, and see your physician until he/she tells you that the condition is fully cured.

    Swimmers Ear Symptoms

    The ear feels blocked and may itch
    The ear canal becomes swollen, sometimes swelling shut
    The ear starts draining and a runny milky liquid
    The ear becomes very painful and very tender to touch, especially
    on the cartilage in front of the ear canal.

    If you experience these symptoms or if glands in the neck become swollen, see your doctor.

    When water gets into the ear, it may bring in bacterial or fungal particles. Usually the water runs back out; the ear dries out; and the bacteria and fungi don’t cause any problems. But sometimes water remains trapped in the ear canal, and the skin gets soggy. Then bacteria and fungi grow, flourish, and can infect the outer ear.

    Allergies involve the immune system. But, the most important reason some people develop allergies and some don’t is thought to be heredity. Preventing exposure in early life seems to decrease the risk of allergies. However new research indicates that exposure to dogs in early life seems to enhance the development of the immune system, thus decreasing the risk the child will develop allergies.

    Sometimes people say that they never had allergy symptoms until they moved to a new area. Moving to a new area may seem to trigger the immune response, but authorities believe these people already had hereditary tendency toward allergies.Migraine headaches are not usually thought to be caused by allergies. However, allergies can cause excess sinus moisture which can promote growth of bacteria. This can result in a sinus infection with resulting pressure and sinus headache.

    It is unlikely that dizziness or nausea is directly related to allergies. Dizziness and nausea can be caused by a number of things, some possibly serious, and these symptoms should always be reported to your physician 

    It is thought that allergies can cause some degree of fatigue. However “trouble sleeping” and “tired all the time” are commonly reported symptoms in every area of medicine. These symptoms should always be reported to your physician, who can do routine testing to see if an underlying medical condition might be causing the problem.

    A sore throat with blisters or enlarged lymph nodes in the neck, especially if accompanied by a fever, is usually not a sign of allergies, but rather a bacterial or viral infection. See your physician.

    Noise in the ears is known as tinnitus. Allergies can cause sensations of fullness or popping in the ears, this is sometimes considered a symptom of allergies. You should see your physician if you experience tinnitus.

    Coughing may be the first sign of asthma, especially in children.

    Chronic changes in voice and trouble swallowing should always be checked out by a physician. These usually do not indicate allergies, but can be symptoms of serious conditions.

    Most patients who’ve reacted to cats have reported symptoms ranging from runny nose and itchy eyes to wheezing and shortness of breath when around cats.  Some respiratory symptoms are quite severe, therefore, causing the person to get away from the cats to breathe.

    The most prominent reactions to cat allergy are respiratory symptoms. However, some patients do report skin allergies to things that cause them respiratory symptoms.

    If your symptoms persist, you should seek medical attention.

    Most medical authorities recognize that smoke is an irritant rather than an allergen.

    However, most experts do agree that wood often contains mold as well as dust mites. For persons allergic to these allergens, having wood logs nearby may cause real problems.

    Many experts also agree that smoke can trigger an allergy attack, especially in asthmatics. So can perfumes and other irritants. While we may not have an allergy to substances like smoke, perfume, cleaning solutions, pollutants from industry, car exhaust, etc., most all of us are affected by these irritants. For the person who has allergies, their allergic trigger may be more sensitive in air polluted by these common irritants.

    Suggestions:

    Keep wood logs outside until ready to burn.
    Change heating/cooling filters regularly.
    Have air ducts cleaned by a professional.
    Use an air purifier to promote clean air in the indoor environment.
    Smokers should be asked to go outside before they light up.
    Choose cleaners designed to clean better with fewer chemicals.

    When a person receives an allergy injection, he is taking into his body a substance he is allergic to. The body begins building antibodies to fight this substance. As the dose is increased, the body continues to build more antibodies toward the offending allergen.

    It’s a delicate balance. Increasing the dose too slowly can delay progress toward enough antibodies to control allergy symptoms. Increasing the dose too fast can cause severe reactions to the shot itself. Your physician will tell you the proper increments of increasing the dose.

    However many other factors play a role. Some of these include fever or elevated allergy symptoms before the injection, higher level of exposure to the allergen in the environment, or too long an interval between injections. Any of these can tip the delicate balance and cause a serious systemic reaction to the shot.

    A severe reaction can also be caused by human error resulting in a dose that is too strong. Sometimes a severe reaction occurs for no apparent reason.

    Some physicians do allow self-administration of injections. It is the responsibility of these physicians or their staff to teach where and how to give the injections. They should also provide verbal and written instructions of when to withhold the injection, when to call the physician for further instructions, and what to do if a reaction occurs. These physicians prescribe an EpiPen to be used in case of severe reactions. Be sure you know when and how to use the EpiPen, and what to do next.  It is very important that your E.N.T. doctor know if you are taking a beta-blocker medication.  Beta-blockers affect allergy symptoms and treatments.  Your doctor will discuss this with you and this may affect your ability to administer your injections at home rather than in a clinical setting.  This is especially true if you also suffer from asthma.

    Not at all, Tinnitus is the name for these head noises, and they are very common. Nearly 36 million Americans suffer from this discomfort. Tinnitus may come and go, or you may be aware of a continuous sound. It can vary in pitch from a low roar to a high squeal or whine, and you may hear it in one or both ears. When the ringing is constant, it can be annoying and distracting. More than seven million people are afflicted so severely that they cannot lead normal lives.

    In most cases, there is no specific treatment for ear and head noise. If your otolaryngologist finds a specific cause of your tinnitus, he/she may be able to eliminate the noise. But, this determination may require extensive testing including X-rays, balance tests, and laboratory work. However, most causes cannot be identified. Occasionally, medicine may help the noise. The medications used are varied, and several may be tried to see if they help.

    Otitis media means inflammation of the middle ear. The inflammation occurs as a result of a middle ear infection. It can occur in one or both ears. Otitis media is the most frequent diagnosis recorded for children who visit physicians for illness. It is also the most common cause of hearing loss in children.

    Although otitis media is most common in young children, it also affects adults occasionally. It occurs most commonly in the winter and early spring months

    Blockage of the Eustachian tube during a cold, allergy, or upper respiratory infection and the presence of bacteria or viruses lead to accumulation of fluid (a build-up of pus and mucus) behind the eardrum. This is the infection called acute otitis media. The build up of pressurized pus in the middle ear causes earache, swelling, and redness. Since the eardrum cannot vibrate properly, you or your child may have hearing problems.

    Often after the acute infection has passed, the effusion remains and becomes chronic, lasting for weeks, months, or even years. This condition makes one subject to frequent recurrences of the acute infection and may cause difficulty in hearing.

    In infants and toddlers look for:

    Pulling or scratching at the ear (especially if accompanied by the following
    Hearing problems
    Crying, irritability
    Fever
    Vomiting
    Ear drainage

    In young children, adolescents, and adults look for:

    Earache
    Feeling of fullness or pressure
    Hearing problems
    Dizziness, loss of balance
    Nausea, vomiting
    Ear drainage
    Fever

    So, remember . . .
    Otitis media is generally not serious if it is promptly and properly treated. With the help of your physician, you and/or your child can feel and hear better very soon. Be sure to follow the treatment plan, and see your physician until he/she tells you that the condition is fully cured.

    Swimmers Ear Symptoms

    The ear feels blocked and may itch
    The ear canal becomes swollen, sometimes swelling shut
    The ear starts draining and a runny milky liquid
    The ear becomes very painful and very tender to touch, especially
    on the cartilage in front of the ear canal.

    If you experience these symptoms or if glands in the neck become swollen, see your doctor.

    When water gets into the ear, it may bring in bacterial or fungal particles. Usually the water runs back out; the ear dries out; and the bacteria and fungi don’t cause any problems. But sometimes water remains trapped in the ear canal, and the skin gets soggy. Then bacteria and fungi grow, flourish, and can infect the outer ear.

    Three million American children under the age of 18 years have varying degrees of hearing loss. You, the parents and grandparents, are usually the first to discover hearing loss in your babies, because you spend the most time with them. If, at any time, you suspect your baby has a hearing loss, discuss it with your doctor.

    Your baby’s hearing can be professionally tested at any age. Computerized hearing tests make it possible to screen newborns. Some babies have more than an average chance of having hearing loss than others. All children should have their hearing tested before they start school. This could reveal mild hearing losses that the parent or child cannot detect. Loss of hearing in one ear may also be determined in this way. Such a loss, although not obvious, may affect speech and language.

    Hearing loss can even result from earwax or fluid in the ears. Many children with this type of temporary hearing loss can have their hearing restored through medical treatment or minor surgery.

    In contract to temporary hearing loss, some children have nerve deafness, which is permanent. Most of these children have some usable hearing. Few are totally deaf. Early diagnosis, early fitting of hearing aids and an early start on special education programs can help maximize the child’s existing hearing.

    You may not have heard of it, but you use it hundreds of times every day. It is the Temporo-Mandibular Joint (TMJ), the joint where the mandible (the lower jaw) joins the temporal bone of the skull, immediately in front of the ear on each side of the head. A small disc of cartilage separates the bones much like in the knee joint, so that the mandible may slide easily. Each time you chew you move it. But you also move it every time you talk and every time you swallow (every three minutes or so). It is, therefore, one of the most frequently used of all joints of the body and one of the most complexes.

    You can locate the joint by putting your finger on the triangular structure in the front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and shut it. The motion you feel is the TMJ. You can also feel the joint motion in your ear canal.

    These maneuvers can cause considerable discomfort to a patient who is having TMJ trouble, and physicians use these maneuvers with patients for diagnosis.

    Symptoms of TMJ

    Ear pain
    Sore jaw muscles
    Temple/cheek pain
    Jaw popping/clicking
    Locking of the jaw
    Difficulty in opening the mouth
    Frequent head/neck aches

    Meniere’s disease, also called idiopathic endolymphatic hydrops, is a disorder of the inner ear. Although the cause is unknown, it probably results from an abnormality in the fluids of the inner ear. Meniere’s disease is one of the most common causes of dizziness originating in the inner ear. In most cases only one ear is involved, but both ears may be affected in about 15% of patients. Meniere’s disease typically starts between the ages of 20 and 50 years. Men and women are affected in equal numbers.

    Tonsils and adenoids are masses of tissue that are similar to the lymph nodes or “glands” found in the neck, groin, and armpits. Tonsils are the two masses on the back of the throat. Adenoids are high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth without special instruments.

    Tonsils and adenoids are near the entrance to the breathing passages where they can catch incoming germs, which cause infections. They “sample” bacteria and viruses and can become infected themselves. Scientists believe they work as part of the body’s immune system by filtering germs that attempt to invade the body, and that they help to develop antibodies to germs.

    This happens primarily during the first few years of life, becoming less important as we get older. Children who must have their tonsils and adenoids removed suffer no loss in their resistance.

    Tonsillitis and its symptoms

    Tonsillitis is an infection in one or both tonsils. One sign is swelling of the tonsils. Other signs or symptoms are:

    Redder than normal tonsils
    A white or yellow coating on the tonsils
    A slight voice change due to swelling
    Sore throat
    Uncomfortable or painful swallowing
    Swollen lymph nodes (glands) in the neck
    Fever
    Bad breath

    Enlarged adenoids and their symptoms

    If you or your child’s adenoids are enlarged, it may be hard to breathe through the nose. Other signs of constant enlargement are:

    Breathing through the mouth instead of the nose most of the time
    Nose sounds “blocked” when the person speaks
    Noisy breathing during the day
    Recurrent ear infections
    Snoring at night
    Breathing stops for a few seconds at night during snoring or loud breathing
    (sleep apnea)

    Difficulty in swallowing (dysphagia) is common among all age groups, especially the elderly. The term dysphagia refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. This may be caused by many factors, most of which are not threatening or temporary. Difficulties in swallowing rarely represent a more serious disease, such as a tumor or a progressive neurological disorder. When the difficulty does not clear up by itself, in a short period of time, you should see an otolaryngologist – head and neck surgeon.

    Any interruption in the swallowing process can cause difficulties. It may be due to simple causes such as poor teeth, ill fitting dentures, or a common cold. One of the most common causes of dysphagia is gastroesophageal reflux. This occurs when stomach acid moves up the esophagus to the pharynx, causing discomfort. Other causes may include: stroke; progressive neurologic disorder; the presence of a tracheostomy tube; a paralyzed or unmoving vocal cord; a tumor in the mouth, throat, or esophagus; or surgery in the head, neck, or esophageal areas.

    ——————————————————

    Symptoms of Swallowing Disorders may include:

    Drooling
    A feeling that food or liquid is sticking in the throat
    Discomfort in the throat or chest (when gastroesophageal reflux is present)
    A sensation of a foreign body or “lump” in the throat
    Weight loss and inadequate nutrition due to prolonged or more significant problems
    with swallowing, and Coughing or choking caused by bits of food, liquid, or saliva
    not passing easily during swallowing, and being sucked into the lungs.

    The term REFLUX comes from a Greek word that means “backflow”, and it usually refers to the “back flow of stomach contents”. Normally, once the things that we eat reach the stomach, digestion should begin without the contents of the stomach coming back up again . . . refluxing. Not everyone with reflux has a lot of heartburn or indigestion.

    Control your lifestyle and your diet!

    If you use tobacco, QUIT. Smoking makes you reflux. After every cigarette, you
    have some LPR.

    Don’t wear clothing that is too tight, especially around the waist (trousers, corsets, belts)
    Do not lie down just after eating . . . in fact; do not eat within three hours of bedtime.

    You should be on a low fat diet.
    Limit your intake of red meat
    Limit your intake of butter
    Avoid fried foods.
    Avoid chocolate
    Avoid cheese
    Avoid eggs
    Specifically avoid caffeine (especially coffee and tea), soda (especially cola) and mints
    Avoid alcoholic beverages, particularly in the evening.

    Hoarseness is a general term that describes abnormal voice changes. When hoarse, the voice may sound breathy, raspy, strained, or there may be changes in volume (loudness) or pitch (how high or low the voice is). The changes in sound are usually due to disorders related to the vocal cords that are the sound producing parts of the voice box (larynx). While breathing, the vocal cords remain apart. When speaking or singing, they come together, and as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal cords prevent them from coming together properly and changes the way the cords vibrate, which makes a change in the voice, altering quality, volume and pitch.

    Acute laryngitis
    Vocal nodules
    Gastroesophageal Reflux
    Smoking

    Hoarseness lasting longer than two weeks especially if you smoke
    Pain not from a cold or flu
    Coughing up blood
    Difficulty swallowing
    Lump in the neck
    Loss or severe change in voice

    If you smoke, quit
    Avoid agents which dehydrate the body, such as alcohol and caffeine
    Avoid secondhand smoke
    Drink plenty of water
    Humidify your home
    Watch your diet: Avoid spicy foods
    Try not to use your voice too long or too loudly
    Use a microphone in situations where you need to protect your voice
    Seek professional voice training

    Avoid speaking or singing when your voice is injured or hoarse. Don’t sing when
    you are sick.

    Acute bacterial sinusitis is an infection of the sinus cavities caused by bacteria. It is usually preceded by a cold, allergy attack, or irritation by environmental pollutants.Unlike a cold or allergy, bacterial sinusitis requires a physician’s diagnosis and treatment with an antibiotic to cure the infection and prevent future complications. Normally, mucus collecting in the sinuses drains into the nasal passages. When you have a cold or allergy attack, your sinuses become inflamed and are unable to drain. This can lead to congestion and infection. Diagnosis of acute sinusitis is based on a physical examination and a discussion of your symptoms. Your doctor also may use X-rays of your sinuses or obtain a sample of your nasal discharge to test for bacteria.

    As always, an ounce of prevention is worth a pound of cure. To avoid developing sinusitis during a cold or allergy attack, keep your sinuses clear by:

    Using an oral decongestant or a short course of nasal spray decongestant
    Gently blowing your nose, blocking one nostril while blowing through the other
    Drinking plenty of fluids to keep nasal discharge thin

    Avoiding air travel. If you must fly, use a nasal spray decongestant before
    takeoff to prevent blockage of the sinuses allowing mucus to drain

    Avoiding contact with things that trigger allergy attacks. If you cannot, use
    the over-the-counter or prescription antihistamines and/or prescription nasal
    spray to control allergy attacks.

    Allergy testing, followed by appropriate allergy treatments, may increase your
    tolerance of allergy-causing substances

    The glands in your nose and throat continually produce mucus (one to two quarts a day). It moistens and cleans the nasal membranes, humidifies air, traps and clears inhaled foreign matter, and fights infection. Although mucus normally is swallowed unconsciously, the feeling that it is accumulating in the throat or dripping from the back of your nose is called post-nasal drip. This feeling can be caused by excessive or thick secretions or by throat muscle and swallowing disorders.

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