F. A. Q. ....
.................................................................................................................................................................................................................................
 

Is there any simple tips to Safeguard from ENT problems?
Yes, there are certainly few things if maintained properly can safegurde from ENT problems.
Smoking and other environmental pollutions are basically irritants to nasal mucosa and causes rhinitis. However they are troublesome in allergic or other rhinitis patient. Increasing incidence of nasal allergy might be attributed to these factors.
 
Once a sinus problem always a recurrent problem, this dictum is not true. Deviated septum, allergic rhinitis etc. require attention and treatment. Sinus infection is usually controlled with good antibiotics and endoscopic techniques available these days.
 
Prolonged use of nasal drops damages nasal mucosa and resultant condition is not easy to treat .It is addictive and caused more damage and blockage on long term use.
 
Antibiotics - misuse, injudicious and inadequate use leads to resistant strains, incomplete resolution or alteration of immune system.
 
Snoring should no more be taken lightly and requires proper assessment and treatment wherever possible. It can spell serious problems sometimes. Snorers are more prone to heart attack, high B.P. and cerebra vascular strokes.
 
Stammering or stuttering is not an organic disease. It is abrupt interruptions of speech along with repetitive utterance of sounds or syllables or initial consonants or words. It requires psychotherapy (building confidence and encouragement, removal of fears and pressures) and speech therapy.
 
Oral sub-mucous fibrosis is very common. Paan Parag, Paan Masala, Betel nut and Tobacco are proven causative factors. Since treatment is difficult, prevention is very important. Abandon and discourage their regular use.
 
Repetitive throat clearing should not be done as it damages the vocal cords. Our speech clinic offers sessions on voice care for the professional voice also.
 
Every throat problem is not tonsillitis, Sinusitis, irritants (spicy food, alcohol, Paan Parag, Paan Masala, betel nut, Paan etc.) acid reflux from stomach into throat, all are causes of sore throat.
 
Tonsils are body defense and removal only essential if this defense become notorious and troublesome to body.
 
Unexplained weakness with sore throat may be initial symptom of AIDS.
 
Earache is often, due to Eustachian tube dysfunction due to cold or sinus infections, tonsillitis, teeth problems, temporo-mandibur joint problems, cervical spondylitis etc.
 
Nagging discomfort in throat, progressive hoarseness, cough may be features of cancer. Cancer-phobia can occur due to diagnosis of cancer in family or in any close friend, proper ENT consultations is must and very useful .
 
Oral health - tobacco, betel nuts, gutka, paan masala and thaini in all forms are harmful and produce cancer or pre-cancerous conditions. Do not use them. Recurrent aphthous ulcers in oral cavity may be due to peptic ulcer or gastro-intestinal problem.
 
Rinsing mouth with plain water after each meal and regular brushing at bed time and also in the morning are essential. Dental flossing may also be needed. Regular tongue cleaning is must. Regularly massage your gums.
 
Discourage excess sweets, sweet drinks, chocolates, candies, gums, ice-cream etc. they all are factors for dental caries or decay. Drinking water should have 0.7 - 1.2 ppm fluoride level.
 
Do not use teeth for opening soft drink bottles or for breaking nuts or any such activity.
 
Antiseptic mouth or throat gargling should only be used as per advice of the doctor; avoid long term use.
 
Prevention of foreign body - infants and children under two years of age should not be allowed to eat peanuts and their play area should be cleared of small objectives that could be inhaled. Adults should set good example by never placing pin or clips in their mouth

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
  • B.E.R.A./O.A.E./S.S.E.P./M.A.S.T.E.R
  • Digital hearing aid centre
  • Cochlear-implant Centre

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 typanoplasty. 99% success rate.If a mastodectomy has been performed, you may have an open cavity which can be repaired byposterior canal reconstruction technique.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.

What are the causes of Hearing Impairment?
The possible causes of hearing loss are many. To list a few:

  • Exposure to constant noiseTrauma / Injury
  • Genetic causes
  • Natural aging process
  • Tumors
  • Birth defects
  • Illness
  • Middle ear infection
  • Toxic ear medication

After tonsillectomy adenoidectomy voice will be bad or not?
It is wrong concept, Voice box (larynx) is situated far away from tonsil and adenoid, no chance of voice problem - Only nasal voice will improve after Endoscopic Adenoidectomy.

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.

How to suspect hearing loss in a child? 
Hearing loss in a child should be suspected, if response of your child is not appropriate. When the child is Lazy, Inattentive or Naughty. When there is delay in speech development. For further detail look in common warning signs. 

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.

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 sleepapne(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 problems� 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 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.

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.

What is an allergy? 
An allergy is an abnormally high sensitivity to a certain substance, such as dust, pollens, foods, or drugs. Symptoms of allergies usually include inflammation, sneezing, itching, and skin rashes. 

What causes an allergy? 
An allergic reaction occurs when your immune system reacts to a foreign substance from the outside world. When your immune system mistakes these normally harmless foreign substances as dangerous invaders, you body sends out antibodies to attack them. 

How are allergies diagnosed? 
At Krishna eye and ENT hospital, an allergist or immunologist can diagnose your allergies using allergy skin tests. This test indicates if your immune system reacts to specific allergens. 

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 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.

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.

Why ENT care now? 
Concept of good health care is shifting from Mortality care to Morbidity care. ENT specialist has 3 of the 5 special senses, namely Hearing, Smell and Taste under its care. The 6th newly included special Sense of Balance is also related to the ear. Care of hearing, taste, smell, voice and balance care come under ENT. So morbidity and wellness care is incomplete without ENT care. 


What is sinusitis and how is it treated? 
Sinusitis is an inflammation of the sinuses which may or may not be due to infection. Inflammation can occur in any of the sinuses. Patients usually feel a combination of pain, pressure or headache. Sinusitis can be acute or chronic---if it's acute sinusitis, it can usually be treated with medication.