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.

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.

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 sleep 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.

A. Snoring is caused by the vibration of respiratory structures such as the uvula and soft palate because of obstruction of airflow during sleep.

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

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).

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.

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 sleep (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.

A. A tonsillectomy is a 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, sleep apnea, 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.

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 almost 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 causative 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.

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.

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 inflammation 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 nodes, and cold/flu like symptoms.

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 (resonance/sound?) 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.

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 the nose and cheek areas. You can also apply ice to the back of the neck. If symptoms get worse, see a doctor.

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
• Tumors

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.

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.

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.

A. Tinnitus is the perception of ringing in the 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.

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.

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 treatment can vary depending on severity.

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.