A New York City ENT doctor deals with a variety of different conditions from performing sinus surgeries to diagnosing ear, nose & throat problems.
Archive for August, 2018
Ear Infection Treatment: When Does Your Child Need Ear Tubes?
4 years ago
Consult with a physician if your child is experiencing chronic ear infections due to persistent inner ear fluid buildup.
Practically all children have one or more ear infections by the time they reach the age of five, but if those ear infections recur again and again, or if your child is subject to fluid buildup, your pediatrician may recommend that your child should have ear tubes installed. It’s dangerous to have fluid buildup in your child’s ears because it can eventually lead to hearing loss, and cause considerable discomfort as well. When your child doesn’t respond to other treatments for ear infections, ear tubes just might be the answer, and they can prevent the possibility of incurring long-term problems with hearing.
Why are There so Many ear Infections?
Ear infections occur when bacteria or viruses accumulate in your child’s middle ear, which is situated right behind the eardrums. Children are far more prone to developing ear infections, simply because their bodies are still growing and changing, at least far more than adult bodies are.
The way that fluids drain out of the ears is via the Eustachian tubes, and for kids, those tubes are smaller and nearly parallel to the ground, which means gravity has less effect and the ears won’t drain very well, even if your child is healthy. When Eustachian tubes get filled with mucus, often as a result of catching a cold, that lack of drainage becomes crucial, because bacteria can thrive in the Eustachian tubes, and that can lead to the development of infections.
Of course, for some kids, it just happens a lot more than for others, but it occurs far more with children as a general group, than it does for adults. When an infection develops in the Eustachian tubes, the fluid has a greater opportunity to build up in that portion of the middle ear, creating much more pressure and pain than normal. This is when you will observe such symptoms as fluid dribbling from the ears, difficulty sleeping, tugging at the ears, balance troubles, and much more fussiness or irritability than usual, particularly when your child is laying down.
Children can experience a weak functionality in the Eustachian tubes, which normally allow fluid to drain from the inner ear, leading to infection.
When Does an ear Infection Require Treatment?
Initially, your doctor will probably await further developments, to see if the infection subsides on its own, particularly if it was triggered by a virus. In other situations, it may be necessary to treat the child with antibiotics in order to kill an infection. However, there are a great many children who develop infections that simply won’t clear up on their own.
For the most part, these won’t really lead to any lasting hearing problems, but if ear infections occur frequently, you may run the risk of developing hearing loss, experiencing delays with speech development and with social skills, physical holes or tears in the eardrum, and it’s even possible that an infection could spread throughout the head.
How can ear Tubes Help?
Some of the best candidates for ear tubes are children who routinely suffer three or more ear infections during a six-month period or those who go through a total of four or more in the course of a single year. Because this kind of frequency represents a danger to long-term health, it may be advisable to thwart the problem in its early stages.
Other good candidates for ear tubes are children who routinely experience fluid buildup, which then causes hearing loss, whether or not an infection has taken place. If your child has been given medication over a long period of time, or if several different programs of treatment have been prescribed without success, those are other scenarios where ear tubes may be the most viable treatment option.
What Exactly are ear Tubes?
The physical appearance of ear tubes is similar to that of a very, very small drinking straw, which means they are circular, hollow, and most often manufactured with plastic or metal. To insert the ear tube, your doctor will make a tiny opening in the child’s eardrum and then put the tube in, so that air is allowed to penetrate to the interior of the middle ear.
This allows airflow into the ear and it maintains even pressure between the inner ear and the exterior environment. It also allows for better drainage, so between the better drainage and the better airflow, the fluid has much less chance to build up, and that means bacteria don’t have a chance to accumulate and develop into infections.
For those children who have experienced hearing loss as a result of fluid buildup, the situation is cleared up almost immediately after ear tubes have been inserted. Children who have experienced delays in learning or social skills, generally improve within weeks of having the tubes inserted.
For some children, ear tubes are meant to be a temporary solution, and these will remain in place for between six and 18 months. After that time, they’ll simply fall out harmlessly on their own, with no intervention necessary. Other types of ear tubes are designed to be more of a permanent solution, and these generally need to be removed by a skilled doctor, if removal becomes necessary. In either case, once tubes have been removed, the eardrum opening gradually closes up all on its own.
A great many children wear ear tubes these days, and all of them are benefiting to some extent by doing so. They are safe, effective, and can make a very positive difference in your child’s life.
Meniere’s Disease: What are the Treatment Options?
4 years ago
Ménière’s Disease occurs when cochlear pressure increases due to fluid buildup and can produce dizziness and vertigo.
The medical condition known as Ménière’s disease is characterized by severe dizziness or vertigo, a ringing which is sensed in the ears (tinnitus), and a sensation of fullness in the ear. Most commonly, this disorder affects only a single ear at a time. It can develop at any age but is far more likely to occur in adults aged between 40 and 60.
The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that somewhere around 615,000 persons in the U.S. currently are afflicted by this disorder and that each year there are approximately 46,000 new cases which develop.
Some people experience Ménière’s disease as attacks of dizziness, which either occur suddenly or following a brief period of muffled hearing. Sometimes these attacks are experienced one after another, for days at a time, and in other cases, people experience standalone attacks of dizziness, followed by episode-free periods. In some cases, attacks of Ménière’s disease can cause such extreme vertigo that the person afflicted will completely lose their balance and fall spontaneously.
What Exactly is Ménière’s Disease?
The symptoms attributable to Ménière’s disease are generally caused by an accumulation of fluid in those sections of the inner ear which comprise a structure known as the labyrinth. This labyrinth is home to the organs responsible for balance, which are the semicircular canals and the otolithic organs. The labyrinth also contains the organs responsible for hearing, known as the cochlea.
Compositionally, the labyrinth has two distinct sections, referred to as the membranous labyrinth and the bony labyrinth. The membranous portion has a fluid called endolymph, which stimulates certain receptors coincident with body movement. Those receptors then transmit signals to the brain, relative to the movement and position of the body.
In the cochlea, whenever sound vibrations are sensed, fluid compression occurs, and that triggers sensory cells to send data signals to the brain. When a person is troubled by Ménière’s disease, the endolymph accumulation in the labyrinth disrupts normal balance, as well as the signals which are transmitted between the inner ear and the brain. As a result, the affected person experiences vertigo and some of the other symptoms caused by Ménière’s disease.
Causes of Ménière’s Disease
Scientists and doctors are unsure of what the triggers are for this disorder, so there are various speculative answers which professionals ascribe to. Some believe that it is caused by blood vessel constriction similar to that which occurs during migraine headaches. Others believe that the causes of the disease are more attributable to autoimmune reactions, allergies, and viral infections. It has been noted that Ménière’s disease seems to recur in specific families, leading other scientists to believe that genetic variations may be the primary cause of the affliction.
Diagnosing Ménière’s Disease
The primary method for diagnosing Ménière’s disease is by observation of the symptoms generally associated with the disorder. Medically, these are considered to be the presence of tinnitus, a temporary hearing loss, the sensation of fullness in the ear, and at least two episodes of vertigo which persist for a period of 20 minutes or more.
A special doctor known as an otolaryngologist will generally be charged with diagnosing the condition, and since this kind of doctor is a specialist with ear, nose, and throat, he/she is best equipped to make the diagnosis. At the time of examination, a patient may be administered a hearing test to determine the extent of any hearing damage. It’s also possible that a doctor would request MRIs or CTs, to scan the entire brain.
The dizziness and vertigo associated with Ménière’s Disease can seriously affect your day to day life.
Treatment for Ménière’s Disease
While there is no known cure for Ménière’s disease, your family doctor will probably recommend a combination of treatments which will at least help you manage the symptoms associated with the disorder. Those recommendations will generally include some of the following:
- cognitive therapy – this is a kind of talk therapy which encourages people to share their interpretation of life experiences and how they react to them. Some people benefit significantly by discussing their unexpected attacks and anxieties
- dietary changes – it appears that chocolate, caffeine, and alcohol may exacerbate symptoms experienced by someone suffering from the disorder, and by reducing intake of these, sometimes symptoms will subside
- medication – since one of the primary symptoms of the disorder is dizziness, there are some medications which can be used to manage that dizziness and shorten the duration of the attack
- lower salt intake – it can be helpful in some cases to ingest less salt and to use diuretics so that the body does not retain excess fluid, which can be a contributing factor in the ear
- surgery – when there are no other alternatives, surgery is sometimes carried out on the endolymphatic sac, so as to decompress it
- alternative medicine – scientists have not been able to determine the effectiveness of alternative types of approaches, but there are healers who insist that acupuncture or herbal supplements can have a positive impact on this disease
- injections – sometimes an injection of antibiotics into the middle ear helps to control vertigo experienced by a sufferer, but this is not commonly recommended, because it can promote hearing loss.