ENT Disorders

Common problems of the ears, nose, and throat

ENT disorder, or ENT syndrome, is a very broad description of a number of different ailments. It refers to any problems or disorders with a person’s ears, nose, or throat. Chances are, if someone has chronic problems in this area, they have been or will be referred to an ear nose and throat specialist called an otolaryngologist.

Causes of these disorders depend on exactly which disorder it is, but is usually a fungal, viral, or bacterial infection of some sort. Environment seems to also play a part. Things such as smoking and excessive drinking, can increase the risk of having chronic problems in this area.

Ear

The ear, as most people know, is the organ responsible for hearing. It also plays a part in maintaining balance. Ignoring problems in the ear can lead to more serious problems – hearing loss, for example – and should not be taken lightly. It is important to seek medical attention if any of the following symptoms last for a day or more:

• Pain
• Difficulty hearing
• Discharge from the ear
• Ringing or buzzing sound
• loss of balance

The ear mainly consists of the outer ear, ear canal, eardrum, middle and inner ear, and eustachian tube. The outer ear and the ear canal are the passageway to the middle and inner ear, which has semi-circular canals positioned on the top of it that help maintain a sense of balance. The eardrum is the thin membrane that receives and transmits sound waves through the ear, and the eustachian tube runs from the middle ear to the nasal cavity. This helps to equalize air pressure which is important to the health of the ear.

A full physical exam is usually required when going to a physician for any ear problems. Though many ear disorders may have the same symptoms, a physician will ask questions, and look inside the ear with an otoscope, which is a special flashlight made for looking into the ear. Either the ear canal or eardrum being swollen or red indicates a problem.

Additional Tests

A pneumatic otoscope is equipped to blow small puffs of air towards the eardrum. If there is an infection present, the buildup of fluids will prevent the eardrum from moving. In a case where the eardrum is blocked from view, either by earwax or some other obstruction, an ear curette is used to remove the obstruction.

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Other possible tests include hearing tests, lab tests, and a tympanometry. During this procedure, a tool called a tympanometer is inserted into the ear canal to measure the eardrum’s response to minute changes in air pressure. The results from this test could indicate the source of the problem.

Otitis media (middle ear infection)

This is the most common ear problem that affects young children, though adults are not immune to it. This happens when the eustachian tube becomes inflamed from something such as a common cold, sinus infection, or allergies. This results in fluid building up in the middle ear. This can cause an infection by either a virus or bacteria. An infection of this nature can cause the eardrum to become inflamed, which may result in a build up of pus or fluid behind the eardrum.

A feeling of blockage or pressure may be felt in the infected ear along with pain and fever. Hearing may also be muffled. Since a small baby is unable to tell a parent what is wrong, it may tug on its ear during an ear infection.

Treatment

The recommended treatment for a middle ear infection is usually antibiotics and a mild over the counter pain reliever. An antihistamine or pain relieving ear drops are also prescribed in certain cases. If the ear does not drain on its own, a myringotomy may be performed.

During this procedure, a small incision is made in the eardrum to allow the built up fluids to drain. The eardrum will then usually heal itself in a couple of weeks. If the eardrum ruptures on its own and doesn’t drain properly, though, the fluid may get trapped in the middle ear and cause frequent and chronic ear infection.

Swimmer’s ear (otitis externa)

Commonly known as swimmer’s ear, an infection of the outer ear canal, happens when water gets trapped here. A fungus or bacteria may then grow in the ear canal. This kind of infection does not just infect swimmers. A person cleaning their ear improperly with a cotton swab can also get swimmer’s ear.

The affected ear may feel blocked and may be accompanied by pain, itching, and a foul-smelling discharge. In some cases, partial hearing loss is reported, but this is only temporary.

An over the counter pain medication is recommended to help pain associated with swimmer’s ear. A doctor will also prescribe antifungal or antibacterial ear drops, and steroid drugs.

Tinnitus

Tinnitus is a condition in which a person often hears noises in their ears. These may sound like a ringing, buzzing, roaring or clicking. Any number of ear problems could attribute to these noises, such as constantly being around loud noises, certain medications, trauma, alcoholism, or high blood pressure. Damaged nerve endings or the bones in the inner ear stiffening can be to blame. Many times, tinnitus is a symptom of an underlying condition, but is usually not serious.

A physician will perform a series of tests in this situation to find the source of the problem. A check for earwax buildup and possibly a complete hearing test will be performed. In cases that no immediate cause can be found, a set of x-rays may be ordered.

Nose

Not only is the nose the organ responsible for our sense of smell, it is also the main entry way for air to get into our lungs. The inside of the nose is divided by the septum, which is comprised of bone and cartilage; on both sides of this, near the middle of the nasal cavity, are a number of small bones called conchae.

These are covered with mucous membranes, which continually produce mucous that helps warm, moisturize, and cleanse the incoming air. The membrane is also covered with hairlike filaments called cilia, which help cleanse the air we breath in. Linked to the nasal cavity are the sinuses – air pockets in the face and skull which are also covered with mucous membranes.

Most problems in the nasal cavity start out with a stuffy nose. This can usually be cleared up with over the counter medications such as decongestants or antihistamines. Often times, a stuffy nose will be caused by a cold or allergies. If the nasal passages continue to be stuffed, there is sinus pain, or bleeding has continues for more than twenty minutes, a trip to the doctor should be seriously considered.

Additional Testing

A doctor may order x-rays or a CT scan of the sinuses to detect a problem in this area. These can show fluid build up in the sinuses or a thickening of the mucous membranes associated with sinusitis. A nasal swab test may also be used to diagnose various strains of influenza or other infections.

An allergy skin test can be used to detect any allergies that may be causing trouble in the nasal passages. During this test, a physician will introduce a suspected allergen just under the skin. Watching for any reaction will determine if a person is allergic to that particular allergen. These are usually done on the forearm or back.

Nosebleeds

Most nosebleeds aren’t considered serious and are usually caused by some sort of trauma. They can originate in the front or the back of the nose.

Nosebleeds from the front of the nose are the most common and are usually caused by such things as nose-picking or inhaling irritable substances. Blood will flow out the nostrils. More times than not, they can be taken care of at home.

Stopping the Blood Flow

To stop the flow of blood, pinching the nose and keeping the head elevated above the heart works in most cases. A cold compress or ice pack may also be applied, but the nose should never be picked or blown when it is bleeding. If the bleeding does not stop within twenty minutes or if the nose may have been broken, medical attention is necessary.

If a nosebleed originates in the back, blood will flow down the back of the nose and throat. This is more serious and requires immediate medical attention.

Some people will experience frequent nosebleeds, which may require a physician’s care. A blood vessel in the nose may be cauterized, or a nasal balloon catheter may be inserted to put pressure on the vessel.

Sinusitis

An infection in the sinuses is referred to as sinusitis. Most of the time, sinusitis starts with a cold or allergies, which cause an increase in mucous production. Sometimes, these may also cause the mucous membranes to swell and cause the mucous to build up and get trapped in the sinuses. Many times this lets bacteria grow in the sinuses.

Pain is often a symptoms of sinusitis. It can be felt in the cheeks, forehead, or upper jaw. Green or yellow foul-smelling discharge, fever, and sore throat also often accompany a sinus infection. This can usually be taken care of at home with over the counter medicines, however if the infection lasts for more than a couple weeks or keeps coming back, a doctor’s care is needed.

Antibiotics and a nasal decongestant are usually the course of action taken by a physician for sinusitis. In more serious or reoccurring cases, a nasal endoscopy may be performed. This involves a doctor inserting a thin, flexible tube with a fiber optic light on it into the nasal passages to see inside the sinuses. Frequent sinus infections can be caused by immune deficiency or a structural abnormality such as a deviated septum.

Postnasal Drip

When mucous is felt dripping down the throat from the back of the nose, it is referred to as postnasal drip. This condition happens when there is an excessive production of mucous – usually caused by infections, allergies, irritation, or a structural abnormality.

If an infection is found, antibiotics are prescribed. If the cause of postnasal drip is due to allergies, antihistamines, decongestants, or immunotherapy may clear it up. Surgery may be required to fix a structural abnormality.

Throat

The throat is responsible for getting air into the lungs, food into the stomach, and speech. It starts at the back of the nasal cavity, down to the trachea and esophagus. When food passes down the throat, a small flap called the epiglottis closes over the windpipe to prevent food from becoming lodged in an airway.

An infection in any part of the throat can cause a sore throat. This is one of the most common ailments and usually can be taken care of at home. At times, an antibiotic is required to clear up an infection and rarely, surgery. Smoking and excessive alcohol use can irritate the sensitive throat tissues and cause chronic sore throats.

Testing for Infection

To test for throat infections, a doctor may do something called a rapid strep test. The back of the throat is swabbed and tested for the streptococcus bacteria. This usually takes less than a half hour. If nothing is found with the rapid strep test, a throat culture may be ordered. These results may take a few days, but can detect infections and are fairly accurate.

A doctor may perform a laryngoscopy. During this procedure, a light and tiny mirror are used to inspect the back of the throat. Another version of a laryngoscopy involves a flexible tube with a tiny light and camera to inspect the back of the throat.

Pharyngitis (sore throat)

Soreness in the throat, the constant urge to swallow, and difficulty swallowing are signs of a sore throat. Nine times out of ten, sore throats are caused by viruses. Warm salt water gargles, fluid intake, throat lozenges, and rest are is the recommended treatment to clear it up. If the sore throat is accompanied by fever, swollen lymph glands, or stomach ache, it could be more than a simple sore throat. A physician should be called.

At times it can be caused by a bacteria called streptococcus. Strep throat is reported in 10% of Americans per year. Along with pain in the throat, it may be accompanied by fever, headache, and muscle or joint pain. In this case, an antibiotic is needed and may be prescribed along with a mild pain killer.

Tonsillitis

Located on each side of the throat, the tonsils are thought to have no real purpose after the age of five. When the tonsils become inflamed and infected, this is called tonsillitis.

Tonsillitis is characterized by a sore throat, fever, chills, painful swelling of the lymph glands and difficulty swallowing. Head, ear, and muscle aches are also reported.

If the infection is bacterial, an antibiotic is needed, but treatment for tonsillitis is just like any other sore throat – painkillers, rest, and fluids. In some rare instances, if chronic infections are found in the tonsils, surgery may be performed to remove them. It is thought that removing the tonsils entirely may be less expensive than repeated treatment of chronic sore throats.

Laryngitis

The larynx is the upper part of the trachea responsible for speech. commonly referred to as the voice box, it contains the vocal cords. Laryngitis is when the vocal cords become inflamed. It may accompany another local infection or an infection in the upper respiratory system.

Hoarseness or total loss of the voice are the main symptoms of laryngitis. Pain, tickling, or swelling in the throat are other common symptoms along with a cough and fever.

Most instances of laryngitis can be treated at home by resting the voice and throat lozenges. If the infection is bacterial, it will require an antibiotic. If the hoarseness lasts more than two weeks or it becomes difficult to breath, medical attention in required.

Natural remedies

It is always best to consult a physician before trying any natural or herbal remedy for any ailment. For many though, they work and they work well. As with any medical problem, there are a few natural remedies for ear, nose, and throat disorders.

Yogurt

When taking a prescription antibiotic, eating yogurt may help prevent ear, nose, and throat infections from coming back again and again. It contains live bacteria that helps the human body by helping the infection fighting bacteria in our bodies.

Garlic

Garlic contains something called allicin and can be used as a natural antibiotic. It does not kill the helpful bacteria in our bodies that we need to naturally fight infection like prescription antibiotics do. Sucking on a slice of garlic for about 15 minutes will help ease a throat infection. The odor free garlic capsules now commonly sold in stores will not work for this. The allicin is what causes the strong “garlicky” smell, and the allicin is what gives garlic many of its medicinal qualities.

Kelp

Though it tastes quite nasty, a tea made from powdered kelp can coat the throat and kill the streptococcus bacteria that causes strep throat.

Lemon and Honey

A sore throat can be eased by drinking a mixture of honey and lemon. Tea with honey and lemon added may also help.