Archive for March, 2018
Acoustic neuromas are benign tumors that develop very slowly, on the eighth cranial nerve inside the ear, and they can have a major impact on a person. It is known that only about five individuals out of 100,000 actually have acoustic neuromas, but those who do have them may experience symptoms such as facial numbness, vertigo, a slow diminution of hearing in one or the other ear, problems with balance, and possibly tinnitus.
In extreme cases, the tumor itself can grow to a size where it actually becomes life-threatening, so its early detection is very important. The issue with early detection is that, as mentioned, the development of such a tumor is generally slow, which makes the symptoms experienced very gradual in nature.
In many cases, these symptoms are actually just attributed to normal aging and don’t attract any real attention because they’re thought to be a consequence of diminishing capability. Individuals who experience any of the symptoms referenced above should seek medical attention at the earliest opportunity. This is so that if there is an acoustic neuroma in progress, steps can be taken to have it treated before it gets critical.
How Acoustic Neuromas Develop
The cranial nerve where a neuroma begins to develop is the nerve which joins the inner ear and the brain, and it has a profound impact on both hearing and balance. This is why the symptoms of an acoustic neuroma include side effects that are both hearing-related and balance-related. It’s common for people with an acoustic neuroma to have problems with steadiness in their daily routine, even walking around the household.
Hearing can be impacted by the development of tinnitus, and possibly also a direct loss of hearing. As an acoustic neuroma grows larger and larger, it will begin to crowd the brain itself, as well as those nerves which manage facial expression and facial sensitivity. If an acoustic neuroma goes completely undetected and is allowed to continue growing, it can eventually put so much pressure on the cerebellum or brainstem, that a life-threatening situation can occur.
Causes of Acoustic Neuromas
There are two main causes of acoustic neuromas, the first of which is a sporadic form, and the second being related to a syndrome known as neurofibromatosis type II or NF2. Neurofibromatosis II is an inherited condition in which noncancerous tumors grow in the nervous system, and most of the time these noncancerous tumors are acoustic neuromas. For this inherited type of acoustic neuroma, it is fairly common for them to begin development in both of the patient’s ears, before the age of 30. This is a rare disorder that only makes up about 5% of all acoustic neuromas, meaning that the overwhelming majority of acoustic neuromas are of the sporadic form. Unfortunately, doctors and scientists do not yet understand what causes the sporadic form, although at least one risk factor has been identified as exposure to unusually high levels of radiation, primarily in the area of the neck and head.
Treatment for Acoustic Neuromas
There are three primary approaches to treatment of acoustic neuromas: radiation therapy, surgery, and observation. You can think of observation as ongoing monitoring or watchful waiting. Since acoustic neuromas are not cancerous and grow only slowly, there is usually not an immediate or urgent need for any more drastic form of treatment. What happens after the observation period will depend on how rapidly the acoustic neuroma grows, and what kind of impact it’s having on an individual.
Surgical procedures will take one of three tracks. Translabyrinthine surgery calls for an incision to be made behind the ear, so that a portion of the middle ear as well as the bone behind the ear can be removed, and this approach is generally used on tumors bigger than 3 cm. Sub-occipital surgery operates on the back of the head, and can be used for any sized tumors, and unlike translabyrinthine surgery which causes total hearing loss, sub-occipital surgery holds at least the potential for preserving your hearing. Middle fossa surgery also holds out hope for preserving a patient’s hearing, as it removes a small bone piece over the ear canal, so that tumors of a smaller size can be removed.
Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas, as it sends high radiation dosages directly at the tumor, while also limiting damage or exposure to all surrounding tissue. There are two types of radiation therapy which are generally used in the treatment of acoustic neuromas. The first of these is multi-session fractionated stereotactic radiotherapy (FRS). This delivers small doses of daily radiation over a period lasting several weeks, and is generally the more successful of the two radiation approaches. The second method for radiation therapy is known as single fraction stereotactic radiosurgery (SRS). In this approach, hundreds of small radiation beams are directed at the tumor in one comprehensive session. While this has the advantage of requiring only a single treatment session, it has historically been somewhat less effective than the FRS radiation therapy approach.
People who aren’t usually affected by sinus problems such as inflammation and infections probably think that the worst time for sinus flareups is either the spring or summer, when seasonal allergies kick in as a response to increased pollen in the air, as well as other triggers. However, almost anyone who is subject to seasonal allergies and sinus issues can tell you the real truth of the matter: many of the worst symptoms associated with sinus infections actually occur during the winter.
That means that the whole catalog of sinus issues, i.e. congestion, facial pressure, post-nasal drip, headaches, stuffy nose, runny nose, and headaches, are all as likely as not to be more severe during the cold season. Below you will find some of the reasons why that is true, and why there’s really no respite from the effects of sinus infection, despite what the calendar might say.
Less Humidity in the Air
During the cold winter months, there is usually far less moisture in the air, and far less in the home or office setting as well. Part of the reason for this is that furnaces or other heating systems are running so frequently that they dry the air out. When the air becomes that dry, it has a tendency to irritate the lining of your throat and of your nose, which in turn will exacerbate any issues with your sinuses. The best way to manage this situation is to install a humidifier in your home or in your area at the office, that will supply moisture to the air, and cause much less irritation to your nose and throat.
Increased Presence of Mold
Surprisingly, there are a number of triggers which can worsen your allergies or sinus symptoms during the winter time, especially around holiday season. At that time, most people will actually bring into the household some of the very items that can lead to a worsening of sinus symptoms. For instance, the fragrances given off by scented candles, which are very common during the holidays, can actually cause significant irritation to your sinuses.
The same is true of many holiday decorations such as wreaths, plants, Christmas trees, poinsettias, and a whole host of other decorative but potentially irritating sinus triggers. All these have the potential to develop mold growth, which can cause noticeable problems for your allergies and sinus condition.
It’s also very possible that tree decorations and ornaments which you have stored in the basement for the past 11 months can develop mold, while just sitting in a damp area out of sight. The best prevention for eliminating mold on holiday decorations is to store them in plastic containers which are airtight, and will not allow moisture inside. Before you bring a Christmas tree into the household, you should shake it down vigorously so unwanted debris will fall off. The best way to avoid the irritation that comes from scented candles and similar materials is to stop using them entirely if you notice that they are beginning to irritate your nose and throat. You should also keep in mind that any of the symptoms you might potentially experience from mold growth or fragrances burning in the household, will be made worse by having all the windows and doors closed.
Increased Likelihood of Colds and or Influenza
It’s much more common for people to contract influenza or common colds during the wintertime than it is during the summer or spring. Because this is so, it often causes the lining of your nose to swell up, and an increased amount of mucus is produced by the nose as well. All of this contributes to reduced efficiency of drainage, and it also causes an accumulation of mucus. If mucus is allowed to build up at any specific site in the body, it will invariably trigger the development of bacteria, and once that happens, you can expect a sinus infection to follow shortly thereafter, with all the nasty associated symptoms.
The best way to protect yourself against contracting influenza is to make sure that you are vaccinated with the seasonal strain of flu vaccine. Good hygiene is a must during winter times for preventing colds, because that’s one of the most common ways for bacteria to be spread among people. That means it’s very important for everyone in the household to wash their hands frequently, and to make sure noses are covered up when sneezing, such as into the elbow. When everyone in the household practices good hygiene, the chances for contracting colds and/or the flu diminish significantly.
It is especially easy during the winter months for pet dander, allergens, dust, and debris to become trapped inside the household, where they can all become triggers for sinus symptoms. There are a number of ways that you can address this, in order to minimize the impact of all those miscellaneous trapped substances.
Rugs, for instance, are known to be very effective traps for all these kinds of materials, and that means they should be frequently vacuumed and/or shaken outside so that as much debris as possible can be removed from the household. Old furniture is another major trap for debris, so these pieces should also be scoured to whatever extent is practical, to remove debris. Air filters are obvious traps for dust and debris, and they should either be cleaned regularly or replaced entirely, so that clean air is always circulating in the interior. If you have pets, they should be groomed regularly, so that they can be kept free of all kinds of harmful material that could be become a trigger for your wintertime sinus symptoms.
The nasal fluid produced by your body is known as mucus, although it has many more colorful names which younger people are especially fond of using. Contrary to popular belief, nasal fluid is not an offensive fluid from the body, and is not something that should be thought of as poorly as it is. In truth, nasal fluiid is one of the body’s most important lines of defense, playing a critical role in the protection against infections and various types of irritants.
What Exactly is Mucus?
Everyone is aware that our noses are used to smell things, but that’s certainly not the only role they play in human health. Their role, which not many people actually consider, is as a protection against inbound irritants, and in this capacity, mucus is one of the most important agents involved in the protection process.
Most people recognize mucus as a runny, nasty-looking substance that often dribbles out of the nose, but in actuality, it’s a very complex substance that works hard to keep sinuses and the interior of the nose moist. There are components of mucus which determine its thickness, elasticity, and stickiness, all of which are important in its role as defender against incoming irritation. Most people produce between one pint and one quart of mucus each and every day.
What Mucus Does
The primary role of mucus is to trap incoming irritation such as animal dander, pollen, mold, smoke, and bacterial substances. By smoothing the lining of the nose and trapping all these types of foreign substances and debris, they are prevented from reaching the interior respiratory system where a great deal of damage could be done. The vast majority of mucus is simply swallowed, along with all the material that it may have trapped. Whatever those foreign substances were, they become neutralized in the gastrointestinal tract, and are then expelled from the body.
This is the more invisible component of mucus removal, and not the one people commonly associate with the process. The more visible process for mucus removal is blowing your nose into a handkerchief, and this of course removes all unwanted material without the need for having it processed in the interior of the body. However, as stated above, this occurs far less frequently than the swallowing process, where most unwanted debris is managed.
Normal Mucus Content
Most of the time, people don’t really think about mucus or what is contained in it, and this is perfectly normal, because it should be unnoticeable if everything in the body is as it should be. Healthy mucus is colorless and is typically quite watery and thin. In the absence of any disease or infections in the body, the cilia of the nose move very gently in tiny waves to move mucus, along with any trapped materials, toward the back of the throat.
These cilia have been compared to tiny brooms which sweep materials clear of nasal passages to keep the breathing process running smoothly. When sinuses are in a good state of health, they are typically empty, because these cilia are working constantly to remove mucus and trapped materials. The end result of this constant sweeping is that the mucus is ushered toward drainage openings into the nasal cavity, and from there it can either be expelled by blowing the nose, or it will simply be swallowed and processed in the gastrointestinal tract.
Indicators of Mucus Problems
There are several indicators which tell you there’s some kind of problem with mucus, often because it’s associated with an infection. Since mucus is normally clear, if you should observe that it becomes yellow, brown, green, gray, white, or even bloody, this could be a sign of a major infection from bacteria, virus, or fungus particles.
The reason for this color change is that the white blood cells in mucus produce enzymes to repel invaders when they encounter any kind of infectious organism. The enzymes produced by the mucus have a tendency to turn it green, and if that remains in place overnight, it can then change into several other colors as described above.
Another indicator of a problem with mucus is the amount that the body generates. Healthy people will generally have clear-colored mucus, and will not even notice any amounts that are produced by the body, since all the work is carried on in the background. Whenever you begin to cough up significant amounts of mucus, that is a likely indicator of an allergic reaction or some kind of infection.
The thickness of mucus is also a frequent indicator of ill health, because thick mucus can clog the throat and become noticeable as it impacts the voice. Thick mucus inhibits vocal cord movement, and the associated post-nasal drip may cause persistent coughing, as well as changes in taste or in smell.
There may also be a burning sensation in the throat because mucus is dripping down the throat, and since it’s naturally acidic, that can be an irritation to the lining of the throat. That’s why it’s very common for someone to wake up with a sore throat when there’s some kind of infection occurring in the body – mucus drainage, which has occurred during sleep hours, has caused noticeable irritation in the lining of the throat.
People who have hyperacusis hear things a little differently than people with relatively normal hearing. With this medical condition, ordinary sounds like running water, the ticking of a clock, or the timer alarm on your microwave not only sound extremely loud, but also can actually be painful. This doesn’t mean that their hearing is more acute, or that patients with this condition are able to hear more sounds than the rest of us – it just means that all normal sounds you may hear in a typical day are heard at a higher level of volume. This is not just a temporary inconvenience a with minor impact; it can literally have a profound effect on a person’s quality of life, because the condition doesn’t ever take a break – it’s there all the time.
How Does Hyperacusis Develop?
Scientists are not exactly sure what causes this condition to develop in any one person, but studies which have been conducted seem to point to exposure to one of several triggering conditions as a cause. One of the most prominent of these is noise related to a daily job routine: for instance, someone working in a factory with heavy machinery, or where a repetitive loud noise recurs throughout the eight-hour shift.
Traumatic head injuries are another possible cause of hyperacusis, with many of today’s hyperacusis patients having experienced some significant blow to the head in their past. Chronic ear infections are another culprit, because even though they can be cleared up with medication, the damage they do while the infection is rampaging can persist beyond the duration of the infection itself.
Migraine headaches are thought to be another possible cause of hyperacusis, since many current hyperacusis patients also experience migraines, or have had them in their medical history. There also seems to be a correlation between patients who have contracted Lyme disease or TMJ Syndrome in their past, although it is not known exactly what from those two conditions leads to the development of hyperacusis. Lyme disease is spread by a tick which can commonly be found in fields and woods, and may be brushed up against by a person. Temporomandibular Joint (TMJ) Syndrome is a disorder which causes pain in the muscles and joints of the jaw.
As far as the physiology behind the actual triggering of hyperacusis, that’s the part of the equation that scientists and researchers have yet to confirm. At present, it seems likely that the fibers of the ear which regulate sound have been somehow compromised, and that the auditory nerve has suffered significant damage. Another school of thought holds that the brain’s central processing system affects how the brain evaluates sound, and for some reason magnifies it beyond its true level. And naturally enough, since there are primarily these two major theories about what actually happens in hyperacusis, there is also another group of scientists who believe that a combination of those two is the real answer to the problem.
Relationship to Tinnitus
While most people have probably not heard of hyperacusis, the medical condition of tinnitus is probably much more well-known. While these two conditions are not at all same thing, they do have a relationship, in that both represent departures from the norm in the way that sounds are heard. People with tinnitus experience several different abnormal sounds in their hearing, sometimes even when there is no actual noise being generated in the surroundings.
This can be felt as a ringing noise, or some kind of whistling, hissing, or buzzing, and it’s easy to see how this can be so distracting that a person’s quality of life could easily be diminished. Although hard statistics are not available to support this, it is estimated that more than 60% of patients who have tinnitus also have hyperacusis. So in addition to hearing a persistent buzzing or whistling sound in the ears, a patient who experiences both of these medical conditions would also sense ordinary sounds at several times their true volume.
Having either one of these medical conditions could have a profound impact on your daily life, but just imagine being troubled by both of them at the same time! Patients who are known to suffer from both medical conditions generally find it extremely hard to just get through a normal day. As a result, there’s a strong tendency for such individuals to withdraw from life to a significant extent, and become socially isolated. This in turn, can easily slide into depression and add to the list of medical conditions the individual would have to deal with.
Treatment for Hyperacusis
Treating hyperacusis requires a two-pronged approach, but it does not really result in a cure for the condition. People who have hyperacusis are generally counseled so as to help lower their reactions to loud sounds, and a process known as acoustic therapy helps to retrain the ear to hear sounds at a more normal level. While there are no actual medical or surgical procedures at present which can offer significant help, some success has been achieved by the counseling/retraining program. Not surprisingly, the same approach has been used with tinnitus, with similar success.