Answers to your common ENT complaints

• Sudden ear pain
  Sudden ear pain in a young child with a history of ear manipulation or swimming may be a diagnosis of acute otitis externa(AOE). Pain is from a swelling of the ear canal. It is best not to put anything into that particular ear and give the child one dose of an anti inflammatory drug. It is further recommended that the child see an ENT specialist the soonest time to determine exact cause of pain. Acute otitis media(AOM) may likewise cause a sudden and severe ear pain. Often AOM is accompanied by fever and cough/colds. Management will differ between AOE and AOM. It is therefore necessary that the patient sees an ENT immediately for proper diagnosis and treatment.

 




• Allergic rhinitis
  Allergy is an unusual reaction of our normal body defenses, i.e. the immune system, to substances we are exposed to. The nose when exposed to noxious elements reacts by producing mucus discharge, and by congestion. We sneeze and blow our nose as it becomes itchy. This spectrum of symptoms is known as allergic rhinitis. Allergen avoidance is the best option for treatment. However, if dust avoidance is inevitable, your ENT doctor can prescribe medications like antihistamines and nasal sprays to stop the symptoms or at least provide relief.

• Hoarseness
  Hoarseness reflects any abnormality in phonation. It may be breathy, coarse, watery/wet or gargly vocal quality. There are no specific features of hoarseness that are definitively diagnostic; hence an investigation by the voice and swallowing specialist/expert is obligatory once it persists for more than two weeks. The direct visualization of the larynx (voice box) by rigid or flexible fiber optic endoscopy is essential to verify the different causes of hoarseness.
  

Changes in voice quality may be due to the following:
Inflammation – as a consequence of vocal abuse or infection
Trauma – from intubation, thyroid surgery, blows to the anterior neck
Allergy – due to edema of the vocal cords
Dehydration – as part of a sicca(or drying) syndrome
Endocrine disorders – from lesions in the pituitary, thyroids, adrenals, gonads
Tumors – which may be benign or malignant(cancer)

 

• Bleeding nose
  Because the air that passes through the nose needs to be warmed and humidified, a good part of the internal nose is supplied by a lot of blood vessels. Nose bleeding or epistaxis is due to a number of causes. The more common causes are: Trauma (from nose picking or a direct injury to the external nose), hypertension, foreign body, vigorous nose blowing, blood disorders and tumors. Epistaxis that has occurred for some time needs investigation by an ENT specialist. If there is active bleeding, the patient should remain calm and the nasal ala should be pinched for 5 to 10 minutes. A cold compress on the forehead and nose may also help control the bleeding. It is best to consult your ENT the soonest time to determine the cause.

 




• Neck mass or swelling
  A neck mass is most often a benign lymph node inflammation especially when a patient has an infection in the mouth or throat or the upper respiratory tract. At other times, a neck swelling may be a primary infection in the neck (e.g. tuberculosis). Both conditions, inflammatory node and an infection in the neck will require management; oftentimes, with an anti-inflammatory and antibiotics. If the neck mass or swelling should persist following adequate treatment, it is necessary for the patient to seek consult with an ENT-Head and Neck Surgeon for its proper diagnosis (immediate histopathology diagnosis) and management. There are cases when a neck mass is malignant and will require immediate attention. As a general rule, a patient should seek opinion for a mass of 6 weeks duration.

 




• Snoring
  Snoring may be a usual part of your sleep – by you or by your partner. Snoring may not be normal and may in fact be a health risk. It is a predisposing factor to diseases like hypertension, diabetes and even weight gain. It is produced by narrowed air passages anywhere from the nose, oral cavity or throat. This can be evaluated by direct visualization of your airway (no anesthesia needed!) in the clinic by your ORL specialist. ICOHNS is equipped with the necessary instruments for this.

 




• Sore throat
  Sore throat is a common complaint among all ages. The usual causes of this may be as simple as irritation from the food you eat, inflammation, infection or as serious as having cancer. For simple causes, this may be prevented by avoiding the food or beverages that irritate your throat. Anti-allergy or anti-inflammatory drugs may ease the discomfort. It is best to see your ENT specialist if there is bothersome sore throat for more one two weeks.

 




• Lump in the throat
  A complaint of a lump in the throat will warrant an ENT consult especially if such a complaint is persistent. Diagnoses are varied. Some patients will be found to have normal airway and passageway for food. Others will be noted to have huge tonsils, laryngeal or hypopharyngeal mass, reflux disease or even a neurologic problem. It is therefore necessary that a good ENT examination to include endoscopy of the pharynx and larynx be made.

 




• Chronic cough
  A cough of more than four weeks duration needs an ENT evaluation. Coughing, as we know, is not a disease; it is a reflex and may be a manifestation of disease. The lungs, the trachea, the larynx, the pharynx and the nose form the airways and involvement of one or two of these may manifest as coughing. Disease entities as asthma, allergy, pneumonia, reflux, infection, inflammation, and even tumors may present with chronic cough. A thorough history and clinical evaluation are mandatory. Initial evaluation must also include endoscopy and radiography for a good diagnosis.