Frequently Asked Questions

Otolaryngologist

What is an Otolaryngologist?

Otolaryngology is the oldest medical specialty in the United States. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), allergy, and related structures of the head and neck. They are commonly referred to as ENT physicians.

Otolaryngologists are ready to start practicing medicine after completing up to 15 years of college and post-graduate training.

What types of medical problems do otolaryngologists treat?

The Ears – Otolaryngologists are trained in both the medical and surgical treatment of hearing loss, ear infections, balance disorders, ear noise (tinnitus), nerve pain, and facial and cranial nerve disorders.

The Nose – Care of the nasal cavity and sinuses is one of the primary skills of otolaryngologists including sinus disease, allergies, nosebleeds, and nasal deformities (both functional and cosmetic).

The Throat – Otolaryngologists manage tonsils and adenoid infections, diseases of the larynx (voice box) and esophagus including voice and swallowing disorders, airway problems including obstructive sleep apnea and snoring.

The Head and Neck – Otolaryngologists are trained to treat infectious diseases of the head and neck area, both benign and malignant (cancerous) tumors including the thyroid, facial trauma, and deformities of the face (both cosmetic and reconstructive).

Ears

What causes an ear infection?

There are three types of ear infections: external (outer) ear infections, middle ear infections, and inner ear infections. An outer ear infection occurs when inflammation and swelling involve the ear canal or the outer ear itself. This can be caused by trauma, bug bites, autoimmune diseases, viruses or bacteria. Outer ear infections are typically painful, involve drainage from the ear, and may cause a decrease in hearing. A middle ear infection is caused by improper drainage of fluid that collects behind the ear drum during a cold, allergy, or upper respiratory infection and the presence of bacteria or viruses. The build up of pressurized pus in the middle ear causes an earache, swelling, and redness. Since the eardrum cannot vibrate properly, the individual may experience hearing problems.

An inner ear infection involves the organs of hearing and balance directly. Individuals have a sudden change in their hearing and/or balance. Oftentimes people experience crippling vertigo, nausea and vomiting. Inner ear infections should be treated as an emergency. High dose steroids are often needed to restore normal inner ear function. Recovery from inner ear infections oftentimes takes weeks to months, and can cause permanent damage to the inner ear organs.

What causes swimmer’s ear?

Swimmer’s ear (otitis externa) is typically a bacterial infection of the ear canal; this differs from otitis media which involves fluid behind the eardrum. Otitis externa is most commonly caused by water getting trapped in the ear canal. It also follows injury to the skin of the ear canal caused by aggressive “cleaning” with Q-tips, bobby pins, match sticks and similar devices. Use of alcohol based over-the-counter ear drops also contributes to outer ear infections.Individuals who spend a lot of time in the water should consult a medical specialist to discuss a prophylactic treatment plan to prevent against these painful infections.

When are ear tubes necessary?

Ear tubes, also called “pressure equalization tubes,” are used to treat recurrent middle ear infections and persistent middle ear fluid in children and adults. Middle ear infections and fluid occur when a pressure difference develops in the middle ear space. This pressure difference creates a vacuum in the space that draws in fluid. For most individuals, middle ear infections improve with proper medication and time. In some cases, however, abnormalities in the anatomy and function of the pressure equalization system make it difficult for the ear to get rid of the fluid. When this happens your physician may recommend surgical placement of a ventilation tube in the eardrum. This “tube” allows fluid to drain from behind the eardrum, and allows for constant equalization of the middle ear space preventing fluid accumulation. The individual typically notices a remarkable improvement in hearing and a decrease in the frequency of ear infections.

Why do I have ear wax?

Ear wax (cerumen) is normal in healthy ears. The purpose of cerumen is to moisturize and protect the skin of the ear canal and to trap dust and particles before they reach the ear drum. Cerumen is formed in the outer part of the ear canal. Normally, wax makes its way to the outer opening of the ear canal, flakes up, and falls out.

How do I remove ear wax?

In most cases, swabbing the opening of the ear canal with the corner of a twisted damp washcloth will remove excessive ear wax. Avoid too much moister or going too deep since prolonged moisture in the ear canal can lead to an infection. Probing with bobby pins, match sticks, Q-tips, etc. is strongly discouraged.

What’s wrong with Q-tips?

The problem with Q-tips is that they pack the ear wax from the outer ear canal deep into the ear canal until it jams against the ear drum, much like a cannon being packed with black powder and a tamping rod. Cerumen lodged against the ear drum is much more difficult and painful to get out and can cause a temporary hearing loss.

What is tinnitus (ringing or roaring in the ears)?

Tinnitus is very common and can be annoying and distracting. Almost 37 million Americans have tinnitus in their ear or ears. It may come and go or might be a constant bother. It might be soft or loud, low pitched (roaring), or high-pitched (ringing) kind of sound. More than 7 million people are so badly affected that they can’t lead normal lives.

What might cause tinnitus?

There are various causes including a plug of wax, allergy, ear infection, circulatory problems, certain medications, and prolonged exposure to loud noise.

Hearing Loss

Is it time for a hearing aid?

The best way to answer this question is to be honest with yourself! Are you having difficulty hearing people at a restaraunt or in a crowd? Are you having trouble hearing at meetings, church, work, or school? And, most importantly, are other people telling you that you can’t hear? Hearing loss is a normal and acceptable part of aging. If you notice any change in your hearing you should see a medical specialist. A thorough exam and hearing test will identify any hearing problems. Once a hearing loss is diagnosed a medical specialist will decide if a hearing aid or other medical treatments are necessary. If hearing aids are recommended, make sure there is a trial period offered which allows you to return the hearing aids at a low cost if the performance of the hearing aids is less than satisfactory.If a medical specialist recommends a hearing aid, you should ensure that the right hearing aid is being prescribed for your specific hearing loss. Hearing aids are highly sophisticated pieces of technology, and are not designed as a “one-size-fits-all” product. Your medical specialist’s staff should spend time to educate you about hearing aids and to find the specific aid that fits your hearing needs. There should be an ample trial period that allows you to return the hearing aids at a low cost. You should also be scheduled for return visits in order to discuss your experiences with the hearing aid so that it may be further tuned to meet your satisfaction.

Am I choosing the correct hearing aid, and am I getting a fair price?

Discuss styles and options with your hearing specialist. Together agree on a course of action. Comparison shopping can be a good idea, but, make certain that you are comparing the same styles and types of hearing aid. Not all aids that look the same have the same function. Oftentimes slightly less expensive aids are significantly less sophisticated, which means the sound quality and your satisfaction will be severely diminished. Hearing aid dealers and some franchises can be misleading. Don’t be fooled by savvy marketing and glamorous display cases!

Does it matter where I go for a hearing aid?

Does it matter where you get your glasses or who you see for other health-related issues? Certainly! You should always find a medical specialist that is highly trained with superior knowledge and skills to meet your hearing needs. You should feel comfortable, have an adequate understanding of the problem, and have all or your question answered to your satisfaction. Beware of dealers who are out to sell you something. Hearing aids are sophisticated pieces of technology. For some individuas they can be intimidating and confusing. You should ensure that your specialist possesses all the personality and skills to give you the best experience possible.

I can save money getting a hearing aid through the internet. Is this a good idea?

We do not recommend buying hearing aids over the internet, or buying used aids. For optimal performance and satisfaction, hearing aids need to be specifically sized and tuned for each individual. Improperly fit aids can cause trauma and infections in the ear, and can lead to worsening ear function!

Balance Disorders

What is dizziness?

Dizziness is a general term used to define any kind of dysequilibrium or imbalance. The role of the medical specialist is to further define this sensation in order to determine the underlying cause. Dizziness and imbalance can be caused by problems in the ear or brain, or can be a symptom of a larger medical problem such as stroke, heart disease, or diabetes.

What is vertigo?

The word vertigo comes from the Latin verb “to turn.” Individuals with vertigo often say that they or their surroundings are turning or spinning. Vertigo is often due to an inner ear problem. Each year more than 2 million people visit a doctor for dizziness or vertigo. Vertigo can represent a serious medical condition such as heart attack or stroke. If you experience vertigo you should see a medical specialist immediately as prompt treatment may be required.

What is Meniere’s disease?

Meniere’s disease is a disorder that produces a group of symptoms: sudden attacks of whirling dizziness, tinnitus or head noise, a feeling of pressure or fullness in the ear, and a fluctuating hearing loss. While the underlying cause is not known, it is believed to result from a fluctuation in the pressure of fluid that fills the inner ear. An attack may last from a few days to several weeks. Following a severe attack, most people find that they are so exhausted that they must lie down or sleep for several hours. The attacks vary in frequency from every few weeks to every few years. The disorder affects five out of ten thousand people, most of whom are over 35 years old. Medical treatments and education about specific lifestyle and diet changes can control this condition. Meniere’s can lead to permanent hearing loss and balance dysfunction. If you experience any of these symptoms you should see a medical specialist immediately.

Is there a treatment for dizziness?

Dizziness is treatable! In order to properly treat this condition, the underlying cause must be determined. Some forms of dizziness can be treated with medications, other forms require weeks or months of therapy. Prompt evaluation by an ear specialist is necessary. Primary care physicians and hospitals do not possess the necessary equipment to adequately evaluate inner ear problems. Don’t live with your dizziness, have it evaluated and treated immediately

Nose & Sinuses

Why can’t I breathe through my nose?

Nasal obstruction has many causes. Anatomical problems such as a deviated septum or enlargement of the turbinate bones in the nose can significantly obstruct airflow. Allergies, chronic sinus infections, and a variety of other medical conditions can also cause chronic nasal congestion. Nasal obstruction can lead to headaches, facial pressure, and can adversely affect quality of life. Only a comprehensive exam by a medical specialist can determine the exact causes of this problem. Treatment options include medical and surgical therapies.

What causes a nosebleed?

The nose can bleed for a variety of reasons:

  • Allergies, infections, or dryness can cause itching and lead to picking of the nose.
  • Vigorous nose blowing can rupture superficial nasal blood vessels in the elderly and the young.
  • Clotting disorders that run in families or are due to medications
  • Fractures of the nose or the base of the skull can cause bleeding and should be regarded seriously when the bleeding follows a head injury.
  • Rarely, tumors (both malignant and nonmalignant) have to be considered, particularly in the older patient or in smokers.

What can be done to stop a simple nosebleed?

First, help the person stay calm, especially a young child. A person who is agitated may bleed more than someone who’s been reassured and supported. Then:

  • Pinch all the soft parts of the nose together between your thumb and the side of your index finger.
  • Press firmly but gently with your thumb and the side of your index finger toward the face, compressing the pinched parts of the nose against the bones of the face. Keep your chin forward.
  • Hold that position for a full five to fifteen minutes by the clock.
  • Keep the head higher than the level of the heart. Sit up or lie back a little with the head elevated.
  • Apply ice – crushed in a plastic bag or washcloth – to nose and cheeks.
  • If the bleeding does not stop within 20 minutes, seek immediate emergency treatment.

What are sinuses?

Sinuses are air-filled spaces in the bones of the face and skull. There are 4 major sinuses on each side. The sinuses are located in the cheeks, between the eyes, in the forehead, and behind the nose in the center of the skull. The sinuses help reduce the weight of the skull. Normal function of the sinuses requires open nasal cavities that are free of anatomical obstruction, allergies, or other disease. Sinuses can become for a host of reasons, leading to facial or dental pain, nasal congestion, fever, and infection. Sinus problems can be chronic and adversely affect quality of life. Most sinus problems can be alleviated with medical treatments or surgery.

What does sinus surgery accomplish?

Endoscopic sinus surgery enlarges the natural opening to the sinuses. The procedure is particularly successful in removing areas of obstruction and allowing the normal flow of mucus. Sinus surgery should be reserved for individuals who suffer from a single sinus infection that lasts for longer than 3 months, or for those individuals who suffer from recurrent sinonasal problems. Because of the risks, discomfort and recovery time, sinus surgery should only be used when other medical therapies have failed.Traditional sinus surgery requires using a blade to widely open the sinuses. Because the blade has to cut through bone, there is risk of injury to the eye and brain. More recently, a procedure that utilizes a balloon catheter to gently dilate open the natural sinus openings has become available. Balloon sinuplasty is revolutionizing sinus surgery with less risk and pain, and faster recovery time. Ask your sinus specialist if your a candidate for this procedure.

Throat

What causes laryngitis?

Swelling of the vocal cords prevents them from coming together properly which makes a change in the voice. Acute laryngitis usually occurs due to swelling of the vocal cords from a common cold, upper respiratory tract viral infection, or irritation caused by excessive voice use such as screaming at a sporting event or rock concert.

What can you do to prevent and treat mild hoarseness?

If you smoke, quit.

  • Avoid substances that dehydrate the body, such as alcohol and caffeine. Avoid secondhand smoke.
  • Drink plenty of water.
  • Humidify your home.
  • Watch your diet – avoid spicy foods.
  • Try not to use your voice too long or too loudly.
  • Seek professional voice training.
  • Avoid speaking or singing when your voice is injured or hoarse.

What are the symptoms of tonsillitis?

  • Swelling of the tonsils
  • Redder than normal tonsils
  • A white or yellow coating on the tonsils
  • A slight voice change due to swelling
  • Sore throat
  • Uncomfortable or painful swallowing
  • Swollen lymph nodes (glands) in the neck
  • Fever
  • Bad breath

What are the symptoms of enlarged adenoids?

  • Breathing through the mouth instead of the nose most of the time
  • Nose sounds “blocked” when the person speaks
  • Noisy breathing during the day
  • Recurrent ear infections
  • Snoring at night
  • Breathing stops for a few seconds at night during snoring or loud breathing (sleep apnea)

When is the removal of tonsils and/or adenoids recommended?

The two primary reasons for removal of tonsils and/or adenoids are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or adenoids. Recent studies also indicate the removal of adenoids is a beneficial treatment for some children with fluid in the middle ear.

What causes snoring?

Snoring occurs when floppy tissue in the airway relaxes during sleep and vibrates. Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons, and it usually grows worse with age.

What can you do to help “light” snoring?

Adults who suffer from mild or occasional snoring should try the following self-help remedies:

  • Adopt a healthy and athletic lifestyle to develop good muscle tone and lose weight.
  • Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
  • Avoid alcohol for at least four hours and heavy meals or snacks for three hours before bedtime.
  • Establish regular sleep patterns
  • Sleep on your side rather than your back
  • Tilt the head of your bed upwards four inches.

Allergies

When does an allergy begin?

Allergies occur after a person with allergic tendencies is repeatedly exposed to the substance in his/her environment or his/her diet. It is estimated that at least 20% of the population is likely to develop some kind of allergy.

What causes a person to develop an allergy?

There is no standard way for an allergy to begin, and the onset may be sudden or gradual. For a person to become allergic to a substance, he/she must be exposed to it more than once, and generally that exposure is quite frequent. Often symptoms develop after an unusual stress to the immune system such as following a severe viral infection.

What is hay fever?

“Hay fever” was named because of nasal symptoms developing during hay season, but most nasal allergies are called “hay fever.” “Hay fever” occurs most frequently during the spring, summer or fall when trees, grasses and weeds produce pollen. One of the principal offenders is the ragweed plant which produces pollen from late summer until frost.

What substances from pets cause allergic symptoms?

Animals produce various substances that can cause an allergic reaction. The main culprits are proteins in the urine, saliva, or dander (dead skin flakes). In cats, for example, the main substances that cause problems are proteins found in cat saliva which often mixes with house dust. In rodents such as mice, rats or guinea pigs, it appears that urine contains the substance that most commonly causes allergy.

Should an otolaryngologist (ear, nose & throat doctor) treat my allergies?

An otolaryngologist is a doctor specializing in the treatment of ear, nose and throat diseases. Half of the problems these physicians encounter are probably due, either directly or indirectly to allergy. Chronic nasal congestion and post nasal drip, seasonal or constant, is often allergic and may be complicated by chronic sinus and middle ear disease. Hearing loss, dizziness, headaches, weeping ear canals, and chronic sore throats may be due to an allergy. The otolaryngologist who does his/her own allergy treatment is able to follow the patient’s progress with specialized examinations and nose and throat medical and surgical treatment. An otolaryngologist not providing allergy care may refer you to a colleague for such care.

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