What is ENT?

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Ear nose throat (ENT) doctors (Otolaryngologists) are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structure of the head and neck.

Their special skills include diagnosing and managing diseases of the sinuses, larynx (voice box), oral cavity, and upper pharynx (mouth and throat), as well as structures of the neck and face. Otolaryngologists diagnose, treat, and manage specialty-specific disorders as well as many primary care  problems in both children and adults.

The common diseases and conditions treated by ENT specialist or Otolaryngologist include:

Hearing:Perforated Ear Drum,Conductive hearing loss,Sensori – Neural hearing loss,Profound sensori – Neural hearing loss,Unilateral sensorineural hearing loss,Sudden Sensorineural Hearing Loss,Weak tympanic membrane,Otitis media,Otospongiosis,Granulation of External Auditory Canal,Granulation of Tympanic membrane,Keloid,Narrow External Auditory Canal with Osteoma

Voice:Vocal cord polyp,Vocal cord cyst,Vocal cord palsy,Vocal cord nodules, larynx cancer

Nose And Sinus:Preauricular Sinus – Infection,Deviated Nasal Septum,Puss filled sinus infection,Perforated Septum,Polyps within Sinuses,Fractured Nasal bone,Fluid collection in Septum,Spur on Septum,Ethmoidal Polyps,CerebroSpinal Fluid (CSF) leak,Antroconal Polyps

Head And Neck:Growth in Larynx & Trachea,Thyro Glossal Cyst,Ranula below tongue,Tongue tie,Salivary gland disoders,Tongue-tie release,Thyroid disorders and Neck swelling,Enlarged Lymph node,Parotid gland disorders,Tonsil disorders,Foreign body in Head and Neck region,Foreign body in Oesophagus,Head and Neck trauma,Narrowing of food pipe,Lymphnode enlargement

Sleep And Snoring

Balance Disorders-Giddiness

Tinnitus treatment

 

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Pharyngitis

 

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Inflammation of the pharynx that causes a sore throat.

Causes

  • Viral causes are the most common
  • Bacterial causes; Group A β-hemolytic streptococcal infections are considered a potentially serious cause because of the risk of rheumatic fever and glomerulonephritis
  • Chemical irritation
  • Gastroesophageal reflux disease
  • Postnasal drainage from chronic allergies

Symptoms

  • Sore throat
  • Pharyngeal erythema
  • Painful swallowing
  • Fever
  • Cough

Treatment

  • Gargling
  • Ibuprofen or paracetamol to relieve pain and reduce your temperature. ( Don’t give aspirin to children under 16!)
  • If your pharyngitis is caused by a virus, home care can help relieve symptoms.
  • If bacterial, antibiotics, make sure that you take the full course.(Penisiline/If you’re allergic to penicillin, eritromycine)
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Acoustic Trauma (Noise-induced Hearing Loss)

 

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Hearing loss caused by loud noises is called noise-induced hearing loss (acoustic trauma). It can occur from long-term (chronic) exposure to loud noise or from a sudden (acute) loud burst of sound.

Any sound above 85 dB has potential to harm your ears.

As exposure to sounds 85 -120dB are dangerous over 30 minutes,  sounds above 120 dB are dangerous even over 30 seconds!

 

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Causes

Common causes of acoustic trauma include:

  • loud music
  • industriel sounds
  • injury due to blow, explosion, pressure changes

Symptoms

  • Hearing loss
  • Sense of fullness  the ear
  • Noises, ringing in the ear
  • Earache
  • Bleeding from the ear
  • Dizziness

Treatment

The hearing loss may not be treatable. The goal of treatment is to protect the ear from further damage. Hearing aid is prescribed for communication needs. If ear Drum is ruptured, surgery to repair ear drum may be needed.

Ear protection using noise protector ear plugs or ear muffs may prevent the hearing loss from getting worse.

Noise exposure, whether occupational or recreational, is the leading preventable cause of hearing loss. It can be prevented by avoiding “too loud” or “too long” Noise exposure and use of hearing protection when necessary.

 

 

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Chronic Cough

What is chronic cough?

Chronic cough is a cough that persists ( which usually lasts for more than 8 weeks). Chronic cough is not a  disease in itself; rather it is a symptom of an underlying condition.

What are causes of chronic cough?

  • Asthma
  • Allergic rhinitis
  • Cigarette smoking
  • Sinus  problems (for example postnasal drip due to sinus  infection)
  • Esophageal reflux of stomach contents
  • Aspiration of foreign objects into the lungs (usually  in children)
  • Infections such as bronchitis or pneumonia
  • Whooping cough (pertussis) causes an an acute cough in infants and young children; in adults,  can be a cause of chronic cough.
  • Certain medications, notably ace inhibitors (enalapril [Vasotec], captopril [Capoten] etc.) used in  treating high blood pressure, can cause chronic cough.
  • Less common causes of chronic cough include tumors, sarcoidosis, congestive heart failure, or other lung  diseases such as chronic obstructive disease (COPD) or emphysema.

How is chronic cough treated?

The treatment of cough is directed toward the particular by the cause.  It is very important to see a doctor.

ADDİTİONAL Symptoms in chronic cough:

İf you have any of these symptoms you have to be more alert! (SERİOUS DİSEASE?)

  • Systemic symptoms – fever, sweats, weight loss (tuberculosis, lymphoma, bronchial carcinoma).
  • Haemoptysis (tuberculosis, bronchial carcinoma).
  • Significant dyspnoea (heart failure, COPD, fibrotic lung disease).

Are there home remedies for chronic cough?

  • Stay hydrated. Fluids can help thin secretions.
  • Gargling with hot saltwater can help cleanse the throat and rid it of mucus.
  • Elevate your head with extra pillows at night to ease a chronic dry cough.
  • Cough drops may soothe an irritated throat.
  • Do not smoke or use tobacco products.
  • Avoid inhaled irritants such as smoke, dust, or other pollutants.
  • Honey is often can be an effective treatment for a persistent cough. Add honey to hot tea, or even grape juice.
  • Ginger, prepared as a tea, is often used to help reduce symptoms of chronic cough and clear the nasal passages.
  • Other herbs such as eucalyptus or mint are often used to relieve cough symptoms.

 

Can chronic cough be prevented?

 

  • Don’t smoke, as smoking is the most common cause of chronic cough.
  • Talk to your physician about managing your asthma, postnasal drip, or GERD to avoid cough symptoms.
  • Stay away from others known to be sick with bronchitis or pneumonia.
  • Eat fruit. Research suggests that diets high in fruit fiber and flavonoids  may prevent chronic productive cough.
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Acoustic Neuroma

An acoustic neuroma is a benign tumor that develops on the nerve that connects the ear to the brain. The tumor usually grows slowly. As it grows, it presses against the hearing and balance nerves. At first, you may have no symptoms or mild symptoms. They can include

  • Loss of hearing on one side
  • Ringing in ears
  • Dizziness and balance problems

The tumor can also eventually cause numbness or paralysis of the face. If it grows large enough, it can press against the brain, becoming life-threatening.

Acoustic neuroma can be difficult to diagnose, because the symptoms are similar to those of middle ear problems. Ear exams, hearing tests, and scans can show if you have it.

If the tumor stays small, you may only need to have it checked regularly. If you do need treatment, surgery and radiation are options.

If the tumors affect both hearing nerves, it is often because of a genetic disorder called neurofibromatosis.

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Complications of Sinusitis

Complications of Sinusitis

The complications of sinusitis are due to blockage of sinus ostium, mucose gland ostiums, extension of the infection to the bones or to close structures.

  • mucocele
  • osteomyelitis
  • orbital complications: edema, cellulitis, abcess, cavernous sinus thrombosis
  • menengitis
  • brain abcess
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Sinusitis

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Sinusitis

Infection of the sinus cavities often occurs due to inflammation and obstruction of the sinus drainage pathways.

Causes are; viral rhinitis, allergy, trauma and dental infection. Also septal deviations, nasal polyps etc.

Typical symptoms of a sinus infection include facial pain and pressure, nasal obstruction, yellow or green nasal drainage, fatigue and fever.

Treatment of a sinus infection may include nasal nasal saline irrigation, decongestants and antibiotics.

  • Antibiotic therapy should be prescribed for 10 to 14 days.
  • Nasal saline irrigation helps to remove secretion
  •  Systemic decongestants improve nasal obstruction but these should be used with caution in patients with hypertension, urinary retansion, or coronary artery (heart) disease.
  • Topical decongestant sprays is helpful in same way but should not be used for more than 3 days.
  • Antihistamines are helpful if an allegic component is present.
  • People with chronic sinus drainage may benefit from endoscopic sinus surgery.
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Goitre (thyroid swelling)

What İs A Goitre?

A goitre is an enlarged thyroid gland. A goitre can mean that all the thyroid gland is swollen or enlarged, or one or more swellings or lumps develop in a part or parts of the thyroid. Some people with a goitre (but not all) have an underactive or overactive thyroid. This means that they make too much or too little thyroid hormone. There are various causes of goitre and treatment depends on the cause.

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The thyroid gland is in the lower part of the front of the neck. It lies just in front of the windpipe (trachea). It has a right and left lobe which are connected together by a narrow band of thyroid tissue. You cannot usually see or feel a normal thyroid gland. If the thyroid enlarges, it causes a swelling in the neck which you can see – a goitre.

The thyroid gland makes thyroid hormones – called thyroxine (T4) and triiodothyronine (T3). These hormones are carried round the body in the bloodstream. Thyroxine and T3 help to keep the body’s functions (the metabolism) working at the correct pace. Many cells and tissues in the body need thyroxine and T3 to keep them working correctly.

Types of Goitre

Diffuse smooth goitre

This means that the entire thyroid gland is larger than normal. The thyroid feels smooth but is larger than normal.

There are a number of causes. For example:

  • Graves’ disease – an autoimmune disease which causes the thyroid to swell and make too much thyroxine. In autoimmune disorders your body produces an antibody that damages a different part of your body – in this case, your thyroid.
  • Thyroiditis (inflammation of the thyroid) – which can be due to various causes. For example, a viral infection can cause viral thyroiditis.
  • Iodine deficiency. The thyroid needs iodine to make thyroxine and T3. If you lack iodine in your diet, the thyroid swells as it tries to make enough thyroxine and T3.
  • Some medicines such as lithium can cause the thyroid to swell as a side-effect.
  • Hereditary factors – some people inherit a tendency for a thyroid to swell. In particular, it may swell at times of life when you may make more thyroxine and T3 – for example, when you are pregnant, or during puberty.
  • Any other disorder which causes problems making thyroxine or T3, may cause the thyroid to swell.

Nodular goitres

A thyroid nodule is a small lump which develops in the thyroid. There are two types:

  • A multinodular goitre. This means the thyroid gland has developed many lumps or nodules. The thyroid gland feels generally lumpy.
  • A single nodule. Causes include:
    • A cyst (a fluid-filled benign tumour).
    • An adenoma (a solid benign tumour).
    • A cancerous tumour (rare).
    • Other rare causes.
  • In many cases there are no symptoms apart from the appearance of a swelling in the neck. The size of a goitre can range from very small and barely noticeable, to very large.
  • Most goitres are painless. However, an inflamed thyroid (thyroiditis) can be painful.
  • If your thyroid makes too much or too little thyroxine or T3, this can cause a range of symptoms.
  • A large goitre may press on the windpipe or the gullet (oesophagus). This may cause difficulty with breathing or with swallowing.

Treatment depends on the cause, the size of the goitre, and whether it is causing symptoms. For example:

  • If you have a small goitre that is not due to a cancerous nodule, and your thyroid is making the correct amount of thyroxine and T3, then you may not need any treatment.
  • You will need treatment if you make too much or too little thyroxine or T3.
  • An operation to remove some or all of the thyroid may be an option in some cases.
  • Radioactive iodine treatment may be an option for a goitre causing an overactive thyroid:
    • This involves taking a drink, or swallowing a capsule, which contains radioactive iodine.
    • The radioactive iodine builds up in the thyroid gland.
    • As the radioactivity is concentrated in the thyroid gland, it destroys some thyroid tissue.
    • You may need to take thyroxine tablets after having radioactive iodine, if too much of the thyroid is destroyed.
  • If you have cancer of the thyroid, you will probably need an operation to remove the cancer and some of the thyroid gland.
  • Iodine replacement is given if the goitre is due to lack of iodine in the diet.
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Salivary Gland Diseases

Acute Sialadenitis

Acute sialadenitis is the acute inflamation of the gland.

It causes erythema, pain, tenderness, swelling and purulent discharge from the affected salivary gland duct.

Found in debilitated and dehidrated patients, especially with major surgery, trauma, radiation therapy, immunosuppression, chemotherapy, or Sjögren’s syndrome.

Treatment: Rehidration, warm compress,  sialogogues to stimulate salivary secretion, and regular, gentle gland massage, antibiotics, oral irrigations. If there are attacks more than approximately 3 times per year or severe attacks, surgical excision of the affected gland should be considered

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Nasal Foreign Body

Nasal foreign bodies are although more frequently seen in the pediatric setting, they can also affect adults, especially those with mental retardation or psychiatric illness. Children’s interests in exploring their bodies make them more prone to lodging foreign bodies in their nasal cavities.

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Nasal foreign body in nasal cavity is associated with malodorous rhinorrhea and is often unilateral.

Intranasal buttons or disc batteries are associated with liquefaction necrosis of the nasal mucosa and resultant septal perforation. these must removed emergently; it harbors the potential for morbidity, and even mortality, if the object is dislodged into the airway.

Removal of the Foreign Body

  • Easily visualized, nonspherical, nonfriable foreign bodies can removed by direct instrumentation. The instruments include hemostats, alligator forceps, and bayonet forceps.
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  • Small, round objects that are not easily grasped by direct instrumentation can removed bay baloon catheter approach.
  • Suction technique is ideal for easily visualized, smooth or spherical foreign bodies.
  • Rarely, a foreign body may be so posterior that the above techniques will not work. In these cases, it may be necessary to induce further posterior displacement of the object into the oropharynx for removal. Of course, this requires general anesthesia, endotracheal intubation, and esophageal occlusion.
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Nasal Fractures in children

Nasal fractures are the most common facial fracture in childhood. It may occur after relatively minor nasal trauma. Also greenstick fractures may occur.

Diagnosis : radiograps may not be helpful in the pediatric population.

Treatment: closed reduction is preferred for fractures associated with deformity of the nasal dorsum.

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