I have been operated upon my ear before .It was initially OK, but now it has again started to discharge. Can something be done?
This problem can be one of many; you may have developed a chronic external ear infection, or there may be a perforation in your ear. The perforation can be closed by an Ant. Window technique tympanoplasty.
• What are the causes of Hearing Impairment?
The possible causes of hearing loss are many. To list a few:
• Exposure to constant noise, trauma / injury
• Genetic causes
• Natural aging process
• Birth defects
• Middle ear infection
• Toxic ear medication
• How can I recognize hearing loss of my child during early childhood?
Even though screening is designed to detect hearing loss as early as possible, some children don’t develop hearing loss until later in life. In those instances, parents, or grandparents are often the first to notice. During the first year, notice whether your baby reacts to loud noises, imitates sounds, and begins to react to his or her name. At age 2, check whether or not your child plays with his or her voice, imitates simple words, and enjoys games. Is a he or she using two-word sentence to talk about and ask for things? At age 3, notice whether or not he or she begins to understand and follows simple directions. If for any reason you think your child is not hearing well, talk to the doctor. Accurate tests are available where even a new born can be diagnosed for even a mild hearing impairment.
• If my child has a hearing loss, can hearing be improved?
Our “Centers of Excellence”, equipped with the most advanced technology, are unmatched in guaranteed state-of-the-art ENT care. We offer the following services to make the child “hear the world”:
• Microsurgery of ear for Deafness, Dizziness, Discharging ear and Facial Paralysis Computer aided Audiometric and Tympanometry
• Infant Screening for early detection of deafness
• Digital hearing aid centre
• Cochlear-implant Centre
• I am an 20 year old girl & I have a severe running nose and it remains blocked most of the time, even more at night. All my friends and family doctor are against my getting operated, saying that sinus problems recur. Is this true?
There are many conditions, which the lay persons & GP’s often tend to group under the heading of ‘sinus disease’. You may be suffering from either or all of these problems: a deviated septum (the central partition between the nostrils), allergies, enlarged turbinate’s, allergic polyps or chronic sinusitis. Sometimes, even enlarged adenoids can persist in adulthood & cause obstruction to nasal breathing. Have you been assessed for allergies? Has a CT scan been performed to analyze sinus disease? Correct recognition of the problem is a pre-requisite for effective treatment, and this is the pitfall that most failures fall victim to. For the most part, if correctly recognized and treated, a beneficial result may be expected.
• I have a nose that appears slightly long & narrow. I also have a blocked nose. My friends tell me to have it corrected. Is it advisable?
Definitely the nose can be brought into harmonious alignment with the rest of your facial features in most cases. This can be performed by a minimal or no external incision. The functional aspect can be simultaneously corrected. It should be correctly assessed by a competent authority, who could advise you more specifically.
• I have 2-3 bouts of sneezing and watering of the nose every month each lasting for a few days. My GP says this is allergy and cannot be cured. Can my allergy be helped?
The physician is right… There is no core. However, there are effective methods of control. You must first find out the source of your allergies. This can be done with allergy testing. You must also see if you have any other disorder like polyp or sinusitis, which also can be treated effectively. A combination of allergy, avoidance, effective medication and immunotherapy can be alleviating your symptoms greatly.
• What causes Snoring?
The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. This is the collapsible part of the airway where the tongue and upper throat meet the soft palate and uvula (the fleshy structure that dangles from the roof of the mouth back into the throat). When these structures strike against each other and vibrate during breathing that is snoring. Persons who snore have at least one of the following problems :
Poor muscle tone (lack of tightness) in the muscles of the tongue and throat. Flabby muscles allow the tongue to fall backwards into the airway or allow the throat muscles to be drawn in the sides into the airway. This occurs when the person’s muscular control is too relaxed form alcohol or from drugs, which cause sleepiness. It also happens in some persons when they relax in the deep-sleep stages.
Excessive bulkiness of tissues of the throat large tonsils and adenoids, for example, commonly cause snoring in children. Over weight persons also have bulky neck tissues. Cysts or tumors could also be present, but they are rare. Excessive length of the soft palate and uvula a long palate may narrow the opening from the nose into the throat. As it dangles in the airway it acts as a flutter valve during relaxed breathing, and contributes to the noise of snoring. A long uvula makes matters even worse. Obstructed nasal airways when a person has a stuffy or blocked-up nose he must pull hard to inhale air through it. This creates an exaggerated vacuum in his throat, in the collapsible part of the airway, and it pulls together the floppy tissues of the throat. So snoring occurs even in people who would not snore if they could breathe through the nose properly. This explains why some people snore only during the hay fever season, or when they have a cold or sinus infection. Also, deformities of the nose or nasal septum frequently cause such obstruction. “Deviated Septum” is a common term for a deformity inside the nose in the wall that separates one nostril from the other.
• Is Snoring Serious?
Socially – yes. It is disruptive to family life. It makes the snorer an object of ridicule and causes other household members sleepless nights and resentfulness. Snorers become unwelcome roommates on vacations or business trips. And medically – Yes. It disturbs the sleeping patterns of the snorer himself, so that he may not sleep restfully. Furthermore, heavy snorers tend to develop high blood pressure at a younger age than non-snorers.
The most exaggerated form of snoring is known as obstructive sleep apnea, when loud snoring is interrupted by frequent episodes of totally obstructed breathing. This is serious if the episodes last over 10 seconds each and occur more than 7 times per hour. Your physician may recommend a laboratory sleep study as a way of evaluating your symptoms. Apnea patients may experience 30 to 300 obstructed events per night. And many spend as much as half their sleep time with blood oxygen levels below normal. During their obstructive episodes, the heart must pump harder to circulate the blood faster. This can cause irregular heartbeats, and after many years it leads to elevated blood pressure and heart enlargement. The immediate effect of this oxygen starvation is that the person must sleep in a lighter stage and tense his muscles enough to open his airway to get air into his lungs. Persons with obstructive sleep apnea may spend little of their night time hours in the deep-sleep stages that are essential for a good rest. Therefore they awaken exhausted and are sleepy much of the day. They may fall asleep while driving to work or while on the job. Long term damage to the heart and lungs is also observed.
• Can snoring be cured?
This is the question, which is foremost in the mind of the patient. Over the years numerous treatment methods have been tried with varying results. Various mechanical devices have been patented and in fact more than 300 such devices exist. The efficacy of this kind of treatment is always in doubt. Whatever the cause of the snoring, the first line of treatment is always to improve general health. Regular exercises, good sleeping habits combined with avoidance of alcohol and sleeping pills and loss of weight will help a majority of mild and occasional snorers. Heavy snorers, those who snore in any position they sleep in and the so-called “Obnoxious-Snorers” – need more help than the suggestions above. The heavy snorer requires a through examination of the nose, mouth, palate and neck. Treatment will of course depend on the diagnosis. However a majority of patients will benefit significantly from a procedure called “Laser-assisted – Uvuloplasty” – In this technique the excess of tissue in the air passage, which is causing the obstruction, is excised with the help of the CO2. laser. This simple procedure replaces other older and more extensive operations done previously.
• What are adenoids and tonsils?
The adenoids are a single clump of a tissue in the back of the nose (nasopharynx). The tonsils are two clumps of tissue, on either side of the throat, embedded in a pocket at the side of the palate(roof of the mouth). The lower edge of each tonsil is beside the tongue.
• What function do adenoids and tonsils serve?
Aren’t they important? The tonsils and the adenoids are mostly composed of lymphoid tissue, which is found throughout gastro intestinal tract and on the base of the tongue. Lymphoid tissue is composed of lymphocytes; which are mostly involved in antibody production. Since we generally consider antibody production to be a good thing, many studies have been performed to try to clarify the importance of the tonsils. To date, there seems to be no adverse effect on the immune status or health of patients, who have had them removed. Any noticeable effect has generally been positive. It appears that the tonsils and the adenoids were not “designed” to effectively handle the multitude or viral infections that occur in children in an urban population. It is clear that in many cases the tonsil and/or the adenoids become “dysfunctional” and are more of a liability than an asset.
• Why are the adenoids removed?
There are a number of well-established valid reasons for removal (adenoidectomy). Some patients will have more the one reason. The most common are listed below. Blockage of the back of the nose, they are too big. This is now one of the more common reasons for removal. The adenoids may be large enough to cause “mouth breathing”, snoring, or even sleep apnea (blockage of breathing during sleep). This degree of enlargement may be associated with chronic fluid or infection in ears. Inability to breathe through the nose causes a reduction in smell(and therefore taste). This is most commonly seen in preschool children, but can exist as early as several months of age. Chronic and recurrent fluid or infections of the ears The adenoids may be enlarged or chronically infected to the extent that they cause ear problemsï¿½ either recurrent infections or chronic fluid. The infection or blockage may affect Eustachian tube function. An adenoidectomy is often recommended for children to continue to have ear problems after the first set of tubes. We will occasionally recommend an adenoidectomy with the first set of tubes if some of the other problem exists. Chronic or recurrent sinus infections, or “rhino sinusitis” Similar to the problem with the middle ear, enlarged or infected adenoids may cause accumulation of nasal secretions or recurrence sinus infections. Many surgeons feel that an adenoidectomy is the most appropriate surgical procedure for young children with severe sinus problems.
• Should the tonsils be removed also?
In general only if they are enlarged or otherwise have been causing problems themselves. The tonsils rarely, if ever, are associated with ear disease. However, if we are removing adenoids because they are enlarged or obstructed, we tend to be relatively aggressive with borderline enlarged tonsils. Too often, several months later, when we left such tonsils, they become enough of a problem to warrant removal.
• What are the complications of adenoidectomy?
Complications are rare, and usually minor. Anaesthetic risk is usually related to the health of the patientï¿½ serious anesthetic complication can occur, but are very unusual. Bleeding is rare, we have had no serious bleeding in over 300 patients, and only a few minor bleeding episodes. The adenoid “bed” usually becomes superficially infected, and can cause 7-10 days of bad breathe, but serious infections are very rare. If adenoids are routinely removed in all children, without careful consideration and examination, a few children will have “velopharyngeal insufficiency”, meaning that sounds or liquids can escape up the back of the nose; effecting speech and/or swallowing. We have never encountered that complication, but it has been reported by others surgeons. In other words some children should not undergo adenoidectomy because of their special anatomy.
• Will the child outgrow the problem?
In general yes, the adenoids usually shrink (regress) in the second decade of life. However, years of any of the problems above may be too high of a price to pay for waiting. In particular, blockage and sleep apnoea may result in permanent adverse changes in facial or dental development in addition to the adverse effects on growths and learning caused by the chronic poor sleeping.
• How are adenoids removed?
Now best technique is endoscopic adenoidectomy with the powered instrument (micro debridor). It is a direct vision technique. So all adenoid tissue will be removed, no chance of residual adenoid. So no chance of recurrence also.
• What should we expect post operatively?
Adenoidectomy is much less painful than a tonsillectomy. Most children need no pain medications a few benefit from acetaminophen (Tylenol) bad breathe for 7-10 days. A few children will complaint of a stiff or sore neck (from irritation of the neck muscles underneath the adenoid bed). We do not limit activity (playing or swimming), although some surgeons do so. The patient may consume a normal diet. We usually see patients 2-4 weeks post operatively to ensure normal function and healing.
Head and Neck Cancer
• Cancer spread after touching with scalpel – is it true?
Ans: It is purely wrong concept- it spreads automatically. If you remove properly chance of spread is less. If you use laser scalpel laser itself prevents spread of cancer.
• Can cancer be cured?
Yes, cancer can be cured depending upon cancer staging and site.
• Which are the lasers most widely used in ENT surgery?
The CO2 and diode lasers are presently the most widely used lasers in ENT surgery. We use the diode surgery for indication in the oral cavity and nose while the CO2laser is used for surgeries in the throat (vocal cords and for snoring).
• How is laser surgery useful in indications of ENT surgery?
The surgical laser is used to give minimal thermal damage to the tissue. A laser beam is very precise and thus causes minimal trauma to the tissue. Due to this there is minimal tissue damage which gives less post surgery pain. The laser beam also seals small blood vessels as it cuts thus giving a dry field and a minimum of blood loss.
• Which are the surgeries which are performed in ENT?
Surgical laser is most widely used in the field of ENT surgery. Some indications include removal of tonsils, turbinate reduction, snoring, and surgeries for the vocal cord. Kindly refer to list of indications listed in the site.
• Is there any harmful radiation due to the laser beam? Is it safe?
The laser beam used in ENT surgery is totally safe and emits no harmful radiation (like those emitted by x rays or atomic radiation.) The laser device is totally safe and the laser is used for surgeries in new born infants, children and pregnant women, too. It also has no adverse effect on patients with cardiac problems. Laser surgery is absolute safe.
• Is the recovery faster?
The laser beam is a light scalpel. The post op pain is less and there is less scaring/ tissue damage thus giving better results. (Additionally, the red light used in lasers serves as a bio stimulation tool and there is extensive literature in its support). Q. Is there any diet restriction before or after the laser surgery? The normal conditions which apply for traditional surgery are followed.
• Can there be any tissue infection due to the laser beam?
The CO2laser beam is a no contact technique. Thus no chances of infection arise due to the laser beam. For contact lasers the fibers are made aseptic and no contamination can arise due to it.
• Is the surgery costly?
The laser surgery in ENT is in most cases a day care surgery. This reduces cost of staying in the hospital. Internationally lasers are used to perform surgery on a day care basis. The surgical laser minimizes blood loss and thus chances of giving additional blood are extremely rare. This is also a cost saving factor.
• Are there any long term problems due to a laser?
No. since the laser beam is a light scalpel there are no known cases of long term problems due to the surgical laser.
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