Q. What is an otolaryngologist?
A. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases of the head and neck. Otolaryngologists are also often referred to as ENT (ear, nose and throat) physicians. Their special skills include diagnosing and managing diseases of the sinuses, larynx, oral cavity, and upper pharynx, as well as structures of the neck and face. Most ENT physicians treat adults and children.
Q. What types of medical problems do otolaryngologists treat?
A. ENT physicians treat and diagnose diseases of:
- The Ears: Medical and surgical treatment of hearing loss, ear infections, swimmer’s ear, balance disorders, dizziness, tinnitus (ringing in the ear), and facial and cranial nerve pain.
- The Nose: Management of the nasal area including allergies, sinus problems, nose bleeds, stuffy nose, nasal fractures and loss of smell. The function and appearance of the nose are also part of an ENT specialist's expertise. This includes both cosmetic and reconstructive plastic surgery such as rhinoplasty (nose job) and deviated septum.
- The Throat: ENT physicians treat diseases of the larynx (voice box) and the upper aero-digestive tract or esophagus, including voice and swallowing disorders. This also includes sore throats, laryngitis, tonsil and adenoid infection, and gastroesophageal reflux disease (Gerd)
- The Head and Neck: In the head and neck area, ENT physicians treat infectious diseases, benign and malignant tumors, facial trauma, and deformities of the face.
Q. What causes an ear infection (otitis media)?
A. An ear infection is caused by bacteria or a virus in the middle ear. This infection often results from another illness - cold, flu, allergy or upper respiratory infection – that causes improper drainage of the fluid that collects behind the eardrum. This in turn causes inflammation in the middle ear that produces the pain of an earache. Otitis media can vary depending on severity.
Q. What causes swimmer's ear (otitis externa)?
A. Otitis externa is a bacterial infection of the outer ear and ear canal that causes inflammation that results in an earache. It is typically caused by exposure to water.
Q. What are "ear tubes"?
A. While the most common treatment for an ear infection is proper medication, sometimes medication is not enough. Persistent infections may require a means to drain fluid and pressure from behind the eardrum. This is done by placing tubes in the ear. Ear tubes are tiny cylinders placed through the eardrum (tympanic membrane) to allow air in the middle ear. They may also be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. The tubes are plastic or metal similar in shape to an empty spool of thread. There are two types of ear tubes: short-term and long-term. Short-term tubes are smaller and generally stay in place six months to a year before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but surgical removal is often necessary. While children are the most common patients for ear tubes some older patients may also need them. The benefits of ear tubes include: reducing the risk of future ear infections, restoring hearing loss caused by middle ear fluid, and improving speech and balance issues.
Q. Why do I have earwax?
A. Earwax (cerumen) is normal to have in your ears. It is secreted by the ear canal and helps with cleaning and lubrication. in addition earwax also helps protect against bacteria, fungi, and insects. However, excess or impacted earwax can press against the eardrum blocking the external auditory canal and impairing hearing.
Q. What is tinnitus (ringing in the ears)?
A. Tinnitus is the perception of ringing in the human ear. In some patients it can sound like a whizzing, buzzing, clicking, roaring, hissing, humming or whistling. It can be perceived in one or both ears. Tinnitus is a very common symptom and can be very distracting and annoying for the patient. There are many causes including a build-up of earwax, allergies, ear infections, circulatory problems, certain medications, and prolonged exposure to loud noises.
Q. What is Ménière's disease?
A. Ménière's disease is a disorder of the inner ear that affects hearing and balance. Classic symptoms of Ménière's disease include vertigo, fluctuating hearing loss in one or both ears, tinnitus in one or both ears, and a sensation of fullness or pressure in one or both ears. While the exact cause is unknown, Ménière's disease is believed to be related to excess fluid in the inner ear.
Q. What is dizziness?
A. Dizziness is a balance disorder that is sometimes caused by an inner ear problem. The feeling of dizziness can be described as feeling woozy, light-headed, floating, giddy, confused or fuzzy.
Q. What is vertigo?
A. The word vertigo comes from the Latin word "vertere" (to turn) and the suffix-igo(condition), thus "a condition of turning about." It is a type of dizziness with the sensation of spinning or swaying while the body is stationary. Vertigo is often caused by an inner ear problem.
Q. What causes a nosebleed (Epistaxis)?
A. Nosebleeds, or hemorrhaging from the nose, are a common occurrence. There are two types of nosebleeds: anterior (most common) and posterior (less common, will most likely need medical attention). A nosebleed can occur for a variety of reasons:
- Allergies, infections or dryness that can lead to picking of the nose
- Clotting disorders
- Fractures of the nose or base of the skull
Q. What can be done to stop a simple nosebleed?
A. It is important to stay calm and help the person having the nosebleed stay calm as well. Pinch all the soft parts of the nose together between your thumb and the side of your index finger. Or, if possible, soak a cotton ball with Afrin, Neo-Synephrine, or Dura-Vent spray and place this in the nostril. With your thumb and the side of your index finger press firmly but gently toward the face, compressing the pinched parts of the nose against the bones of the face. Hold this position for about five minutes, the whole time keeping your head at a higher level than your heart. Keep your head elevated even if you sit down or lay down. Apply ice to nose and cheek areas. If symptoms get worse, see a doctor.
Q. What is sinusitis and how is it treated?
A. Sinuses are air-filled spaces within the bones around your nose. The sinuses are divided into four subgroups: maxillary sinuses (under the eyes), frontal sinuses (hard part of the forehead), the ethmoid sinuses (between the nose and eyes) and the sphenoid sinuses (under the pituitary gland). The role of the sinuses is very much debated, but a number of functions have been proposed:
- Decreasing the relative weight of the skull.
- Increasing of the voice.
- Creating a buffer against blows to the facial area.
- Insulating and protecting sensitive structures, like dental roots, in the nasal cavity.
- Humidifying and heating of inhaled air in this region since air turnover is slow.
Sinusitis is an inflammation of the sinuses that may or may not be due to infection. Inflammation can occur in any of the sinuses. A feeling of pain, pressure or headache is felt, with the location of the pain dependent on which sinuses are inflamed. Sinusitis can be acute, subacute, or chronic. Acute sinusitis usually can be helped with antibiotics. Nasal irrigation or flushing is another treatment that may help. If chronic sinusitis does not go away, nasal surgery is another possible option.
THROAT & NECK
Q. What causes laryngitis?
A. Laryngitis is an inflammation of the vocal cords due to things such as viral, bacterial or fungal infections, overuse of the vocal cords, excessive coughing, alcohol consumption and smoking. This inflamation causes a hoarse voice or even a complete loss of voice. It can be acute or chronic (lasting more than three weeks). Other symptoms include a dry, sore throat, coughing, difficulty swallowing, fever, swollen lymph glands, and cold/flu like symptoms.
Q. What are common treatments for laryngitis and how can it be prevented?
A. The cause of the laryngitis usually determines what treatment is implemented. Usually antibiotics or other types of medication will suffice. Sometimes speech therapy is helpful if persistent hoarseness or loss of voice occurs. Some helpful tips to prevent hoarseness include:
- Do not smoke and avoid second-hand smoke.
- Avoid excessive intake of substances that dehydrate the body such as alcohol and caffeine.
- Drink plenty of water.
- Humidify your home.
- Avoid spicy foods.
- Try not to put unnecessary strain on your voice.
Q. What is tonsillitis?
A. Tonsillitis is an infection of the tonsils. There are three types of tonsillitis - acute, subacute, and chronic. Acute tonsillitis can be caused by a viral or bacterial infection. Subacute and chronic tonsillitis are usually always caused by a bacterial infection. Symptoms of tonsillitis include a severe sore throat, difficulty swallowing, headache, fever and chills. The tonsils look red, swollen and can sometimes be covered with patches of white (pus). Treatment of tonsillitis includes pain management medications and antibiotics (if the causitive factor is bacterial). Chronic cases may indicate a need for a tonsillectomy. Gargling with a solution of warm water and salt may reduce pain and swelling.
Q. What is a tonsillectomy?
A. A tonsillectomy is surgical procedure in which the tonsils are removed. Sometimes the adenoids are removed as well. A tonsillectomy is performed if a patient has chronic tonsillitis, has sleep apnea, has difficulty eating or swallowing or has multiple bouts of peritonsillar abscess. Tonsillectomies are usually performed on children but can be performed on adults as well.
Q. What are the adenoids?
A. The adenoids are a mass of lymphoid tissue in the back of the nose, where the nose bends into the mouth. Adenoids are part of the immune system - they trap infectious viruses and bacteria, and produce antibodies. The adenoids can become infected and enlarged. Enlarged adenoids can obstruct airflow so that breathing through the nose becomes more difficult. Additional symptoms include breathing through the mouth instead of the nose most of the time, noisy breathing during the day, ear infections, snoring at night, breathing that stops for a few seconds at night during snoring (sleep apnea), hearing loss due to middle ear fluid, unusual facial qualities(for example, an extremely elongated face with a high palatal arch and widened nose), speech impediment or delayed speech development. An adenoidectomy or removal of the adenoids is usually the chosen form of treatment.
Q. What is an adenoidectomy?
A. An adenoidectomy is the surgical removal of the adenoids. The surgery is common and most often done as an outpatient procedure. The procedure can be combined with a tonsillectomy.
Q. What is the thyroid?
A. The thyroid gland is found in the neck below the Adam’s apple. The gland produces a hormone called thyroid hormone that plays a role in the metabolism of the body. Thyroid hormone influences essentially every organ, every tissue and every cell in the body. It is a butterfly-shaped gland whose two lobes lie on either side of the upper trachea (windpipe) just below the larynx (voice box).
Q. What is a throidectomy?
A. Removal of both lobes of the thyroid is a total thyroidectomy. Removal of one lobe is called a hemi-thyroidectomy. The procedure is done under general anesthesia through a transverse incision below the collar line. This incision heals well with minimal scarring. A hemi-thyroidectomy (removal of one lobe of the gland) takes about 2 hours while a total thyroidectomy is a 3-4 hour procedure. The incision is usually closed with nylon sutures that are removed 5-7 days after surgery. The procedure is done for the following reasons:
- Suspicion or the presence of thyroid cancer
- Abnormal findings in a needle biopsy
- Multiple nodules
- Pressure on the trachea or esophagus
- Graves disease/Thyrotoxicosis
Q. What causes snoring?
A. Snoring is caused by the vibration of respiratory structures such as the uvula and soft palate because of obstruction of airflow during sleep.
Q. What is sleep apnea?
A. Sleep apnea is a treatable disorder in which a person stops breathing during sleep, often hundreds of times during the night. There are three different types of apnea: obstructive, central, or mixed. Obstructive sleep apnea (OSA) is the most common category of sleep disordered breathing. People who have OSA stop breathing repeatedly during sleep because the airway collapses. Airway collapse may be due to such factors as a large tongue, extra tissue in the airway, or decreased muscle tone holding the airway open. As a result, air is prevented from getting into the lungs. Key signs and symptoms include excessive daytime sleepiness, loud or disruptive snoring, gasping or choking during sleep. People who do not seek diagnosis and treatment for OSA can be at risk for high blood pressure, irregular heart rhythms or heart disease, heart attack, stroke, and an increased likelihood of driving or work-related accidents.
Q. What is an allergy?
A. An allergy is a disorder of the immune system. Allergic reactions occur to environmental substances known as allergens. Common allergens include pollen, dust mites, mold, animal dander, insect stings, latex, and certain food and medications. Mild allergic reactions may include eczema, hives, nasal congestion and red, watery eyes.
Q. What causes a person to develop an allergy?
A. There is no standard way for an allergy to begin. The onset of an allergy may be sudden or gradual. Symptoms usually begin after a stress to the immune system.
Q. What is hay fever (allergic rhinitis)?
A. Hay fever is caused by pollens of certain seasonal plants, airborne chemicals and dust particles in people who are allergic to them. Symptoms include sneezing, runny nose, and itchy eyes. Hay fever usually occurs in people during the months of May through late June. Skin testing is the most common form of allergy testing. For individuals who cannot undergo a skin test, a RAST blood test may be used to determine specific allergen sensitivity. Avoiding pollen is the best way to decrease allergy symptoms. Taking antihistamine drugs is the most common option of treatment. In addition, nasal sprays may also be used.