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When you experience a ruptured eardrum, it’s usually something that happens very suddenly, and you feel a very sharp pain in your ear for a short time. It can also happen that you have an earache for some period of time which suddenly goes away. While these are the two most common indicators are ruptured eardrum, it’s also possible that you don’t have any warning signal at all.
However, if you do experience a ruptured eardrum (sometimes also referred to as a tympanic membrane perforation or a perforated eardrum), it can cause some fairly serious complications. For instance, you could experience some degree of hearing loss, and you could also be subject to more frequent middle ear infections. In some cases, when you’ve sustained a ruptured eardrum it will be necessary to undergo surgery to repair it, although generally speaking if you take steps to protect your ruptured eardrum, it will self-heal within a matter of a few months.
What is a Ruptured Eardrum?
When you talk about a ruptured eardrum, what really happens is that there is some kind of a tear in the membrane between the inner ear and the outer ear. This tympanic membrane, as it is referred to, is comprised of tissue which is very similar to the skin covering your entire body.
The first main function of your eardrum is to detect vibrating soundwaves and to convert those vibrations into impulses which are relayed to the brain as sound. The eardrum also serves as a protective barrier for the middle ear, keeping out foreign objects and water. The natural state of the middle ear is to be sterile, but when the eardrum becomes ruptured it’s possible for tiny debris and bacteria to penetrate the middle ear, and cause an infection which is known as otitis media.
Causes of Ruptured Eardrums
While there are a great number of things which can cause an eardrum to be ruptured, the most common single cause is an infection of the ear. Once the middle ear becomes infected, it allows pressure to build up, and that will press against the eardrum until the pressure becomes so strong that it eventually perforates the eardrum. When this happens, a person might feel the sudden disappearance of pain and pressure which has been there for a long period of time. Along with that sudden stoppage of pain and pressure, there is usually also some draining of pus from the ear to provide a second indication that a rupture has occurred.
The second most common cause of a ruptured eardrum is when someone pokes it with a foreign object. This happens frequently when a person tries to clean out the ear with a cotton swab or a bobby pin, in an attempt to remove wax build-up from inside the ear. Children are generally completely unaware of the eardrum itself, and will sometimes insert objects like a stick or some other long object into their ears, simply out of curiosity.
Symptoms of a Ruptured Eardrum
Many people don’t notice any symptoms at all when their eardrum has been ruptured, and only consult their family doctor after several days have elapsed, with a general feeling of pain or pressure in their ear. If you’re really paying attention, you might notice that when you blow your nose, you can hear air coming out the ear. By blowing your nose, you force air to rise up and fill in the area of the middle ear, thus causing the eardrum to expand outward. When the eardrum has been perforated though, the air simply rushes out, sometimes causing a sound which is noticed by people nearby.
Some of the most common symptoms of a ruptured ear are these:
- a weakness of the facial muscles
- buzzing in the ears
- partial or complete hearing loss
- drainage from the ear which can be either pus or blood
- sudden sharp ear pain
- the sudden absence of ear pain
- continuing ear infections
Diagnosis of a Ruptured Eardrum
If you mention to your family doctor that you have experienced any of the symptoms described above, he/she will generally conduct an otoscopic exam. This type of examination uses an instrument with a light to closely inspect the inside of the ear. In most cases, any tear to the eardrum will be visible during this inspection, unless there is too much wax or drainage for the doctor to see clearly.
In this case, the doctor will have to gently clean out the affected ear before conducting the otoscopic exam. As part of your examination, the doctor may also conduct various hearing tests to determine how much impact the ruptured eardrum has on your hearing. This could involve in audiology test or a tuning fork test, both of which can help to identify the specific level of hearing loss in a patient. In most cases, any hearing loss is temporary and will be overcome when the eardrum heals on its own.
Treatment for a Ruptured Eardrum
For the most part, no specific treatments are called for when an eardrum has been ruptured since the natural healing process will restore the membrane within about three months. In some cases though, your doctor may prescribe a round of antibiotics to help clear up any existing infections. When a patient is experiencing significant pain as a result of the ruptured eardrum, that pain can be treated by over-the-counter drugs such as acetaminophen or ibuprofen.
There are many symptoms of evidence for those unfortunate people who are afflicted by pollen allergies, including persistent runny noses, constant itching, sneezing, and eye irritation. These symptoms, in turn, can lead to other problems such as fatigue, and when medications are used to control the symptoms associated with allergies, that can make a person very drowsy and much less alert.
Scientists are now beginning to study the relationship between high pollen count and the performance of children in school and adults at work. There’s long been a suspicion that there would be a correlation between the two, but until scientific evidence was available to support it, that remained only a suspicion.
This discussion will focus on some recent studies which have been performed, that demonstrate a significant relationship between high pollen counts in the environment and lower performance in school-aged children and adult workers.
Impact of High Pollen Count on Students
Studies conducted at the Norwegian University of Science and Technology by Simon Bensnes have examined the connection between high pollen counts and exam performance on students. The study conducted by Bensnes at that university evaluated the results of year-end exams during a four-year period from 2008 through 2011.
Between 25% and 30% of Norwegian young people have symptoms attributable to pollen allergies, primarily among males. The study closely studied exam scores in specific locations and on specific dates and related that information to the local pollen count on those exam days. The results of the study showed that students exposed to higher pollen counts were definitely impacted by them, especially those students who had pollen allergies.
Whenever the pollen count increased by as much as 20 pollen grains per cubic meter (one standard deviation), the grade of an average student dropped by approximately 2.5%. Assuming that pupils with no pollen allergies suffer no ill effects from the pollen count, results of the study show clearly that one out of every 10 students with a pollen allergy dropped at least one grade, whenever the pollen count increased by as much as a standard deviation.
High Pollen Count Equals Lower Grades
Information gathered from the study made it clear that students who do suffer from pollen allergies tend to get lower grades on exams, on those days where the pollen count increased significantly. After the study was concluded, Bensnes shifted his focus to a higher education setting, attempting to find out if similar results would be reflected by students at an older age.
His findings supported the same kind of statistics that he encountered at the lower academic levels. Whenever random increases in pollen count occurred on the days of exams for students who were allergic to pollen, there was a corresponding downturn in the average exam score for those students. His conclusions were that results demonstrated a clear correlation between increased pollen counts and lower exam scores, ostensibly because students were significantly distracted by the symptoms they were forced to deal with while taking those examinations.
U.S. figures indicate that American schoolchildren miss approximately 2 million school days every single year because of pollen allergies, which keep them in misery. While students with allergies are often given slight accommodations in the form of extended time for taking exams, this doesn’t always produce the desired results. In the same study conducted in Norway by Bensnes, results showed that students with pollen allergies were still at a disadvantage, even when they were given extended time to complete their examinations.
Impact of High Pollen Count on Working Adults
Statistics compiled in Sweden demonstrate that hay fever costs in the neighborhood of SEK 2.7 billion every year, mainly due to absenteeism of employees. Presumably, symptoms caused by hay fever are severe enough that people simply don’t feel up to going to work, and having to deal with all those annoying issues whenever the pollen count would rise significantly.
A study conducted in the US discovered that hay fever victims were subject to reduced mental activity speeds during pollen season, as opposed to any other times of the year. Another study intentionally exposed people with allergies to pollen in a controlled setting, so that the effects could be measured relative to decreased memory, less accurate computation abilities, slower reasoning, and overall reduced mental function, compared to test subjects who had no allergies.
How to Cope With High Pollen Count
So what’s the bottom line for people with pollen allergies? How do students avoid getting lower test scores, how do adults cope with a reduced performance at work, and how do both groups avoid absenteeism whenever pollen counts rise in a given location? Doctors recognize that there is no way that pollen can be completely avoided, simply because it’s all around us in the flowers, trees, grasses, and weeds. However, there are a few things you can do to minimize how pollen count impacts you.
First of all, people who know they have allergies should make a point of checking the pollen count each day, which is available from the National Allergy Bureau. Next, you should find out from your doctor exactly which things you are allergic to, and when you are aware that the particular type of pollen is peaking, you can take preventive measures such as medication. You can also stay indoors when you know the pollen count is high, you can protect yourself when you do have to go outside, and you can take the most effective medication for your type of allergy.
There are many times when both children and adults will experience the condition commonly known as a sore throat, which is characterized by swallowing difficulties, and a painful sensation in the throat itself. This is often due to a cold or some other virus, but there’s also a possibility that you may be experiencing tonsillitis.
Tonsils can become infected by pre-existing viruses or bacteria, and when that happens, they generally become enlarged and cause you to feel a sore throat, possibly a fever, and most likely some difficulty with swallowing. When you have at least five episodes of tonsillitis annually, this is considered a chronic condition.
If tonsils become enlarged for any reason, they can block the airway whenever you’re reclining or trying to go to sleep. This can bring on the condition known as sleep apnea, which can be a dangerous thing all on its own – someone with sleep apnea may experience as many as 50 stoppages of breathing during the course of a night.
In some rare cases, it’s even possible for tonsils to become cancerous, and in that kind of situation, surgery is definitely indicated to remove the tonsils. However, there may be other times as well when removal of your tonsils can be a beneficial thing, as the discussion below will bear out.
When Tonsils Should be Removed
There are two primary reasons why you should consider a tonsillectomy. The first of these is that you have chronic sleep apnea which significantly disrupts your sleep. The other warning sign which may indicate a tonsillectomy is that you’re experiencing recurrent tonsillitis, triggered by strep throat for instance, or some other kind of infection.
There are less common triggers for removal of your tonsils as well, those being the presence of abscesses or tumors. Tonsillectomy is indicated far more often in youngsters than in adults, simply because children generally have less robust immune systems than adults, and they are less well-equipped to fight off viruses and infections.
Historically, removal of the tonsils has led to significantly reduced occurrences of infection for those people who have a chronic history of tonsillitis. Since tonsils don’t provide any really critical function to the body, there are no long-term ill effects which accrue to someone who has them removed, and the recovery time associated with having a tonsillectomy performed is relatively low.
Symptoms of Tonsillitis
As mentioned previously, the primary symptoms of tonsillitis include a painful sore throat, usually on one side or the other. Although this won’t be externally visible, the tonsils also appear to be inflamed and may secrete pus. Someone bothered by tonsillitis may also have difficulty with swallowing, bleeding spots on the tonsils, a runny nose or stuffy nose, a high fever, and swollen lymph nodes in the neck.
When tonsillitis becomes chronic, you may experience seven or more infections in the same year, or at least five infections per year in back-to-back years, or at least three infections annually for a period of three years. This is the medical definition of chronic infection for tonsillitis, but if it seems to you that you’re constantly dealing with the effects of inflamed tonsils, you won’t need to compare your condition to the detailed medical definition.
Both children and adults will experience the same indications for tonsillitis, but adults are far less prone to the condition because as people grow older, tonsils will generally shrink in size, and become much less susceptible to infection.
When Enlarged Tonsils Become Dangerous
One of the most common harmful effects of tonsillitis is that it can trigger sleep apnea, which in turn causes abnormal breathing during rest periods. Children are particularly affected by this, and when they are bothered by sleep apnea, it is generally be manifested as hyperactivity during the waking hours of the day.
Some symptoms which are not quite so apparent are when a strain on the heart or lungs develops. There can also be a hormonal disruption in children, which can promote obesity. While these conditions may be difficult to diagnose on their own, when tonsillitis is suspected and sleep apnea is involved, it’s much easier to associate any other symptoms with their true cause.
How Do Adults and Children Benefit from Tonsillectomy?
Children benefit more frequently from having their tonsils removed than do adults, primarily because children are afflicted more often than older people are by tonsillitis. That means there are more cases of sleep apnea and chronic tonsillitis in young people than there are in adults. Children can definitely benefit by having their tonsils removed when either chronic tonsillitis is involved, or when the condition has led to sleep apnea.
However, adults may also benefit from tonsillectomies under certain conditions. If an adult should be troubled by sleep apnea, or by the same chronic sore throats that a youngster might, there is a definite possibility that they would enjoy improved sleep and a better quality of life by having their tonsils removed.
Of course, it should be remembered that, as with any other kind of surgery, there are certain risks involved with having your tonsils removed. When surgery becomes a possibility, you should discuss the situation thoroughly with your family doctor, and then consider the risks versus the rewards to be obtained by tonsillectomy.
Almost everyone experiences a runny nose during cold and allergy season and can be a huge nuisance because it’s uncomfortable, to begin with, and it’s also inconvenient to have to keep reaching for tissues in order to try and manage it. After a few hours have gone by, and especially toward the end of the day, you can feel pretty fatigued by having had to deal with the effects of a runny nose all day long.
However, are these symptoms serious enough that you should make an appointment with your family doctor to discuss the situation? For the most part, a runny nose should clear itself up within a couple weeks, but if you find that at the end of that time you’re still dealing with tissues and that exhausted feeling, it’s probably a good idea to call your doctor to have it checked out.
Causes of a Runny Nose
What’s actually happening when you have a runny nose is that there is a great deal more drainage than usual emanating from nasal tissues and the blood vessels surrounding them. This excess drainage is usually triggered by inflammation which occurs when you contract a cold or are suffering from an allergy. Those delicate tissues become irritated and secrete far more fluid than they normally would. When that happens, the excess drainage will either go down the back of your throat, or it will come out of your nose, causing you to reach for the tissue box.
When is it Time to Call a Doctor?
Before calling your doctor and scheduling an appointment to check out your condition, there are a few things you can do at home to see if you achieve any relief from your symptoms. The first thing you can try is a nasal saline spray because this should help flush out anything irritating your nose tissue and blood vessels. An antihistamine can help reduce discomfort and other symptoms associated with an allergy. If you don’t notice any serious improvement by taking these measures, it’s probably time to contact your doctor, before things get any worse. It’s definitely time to call your doctor if you notice any of the following symptoms:
- for babies, the runny nose is making breathing difficult or causing problems with nursing
- for children aged less than two months, when a fever is evident, you should call your doctor right away
- for adults, any kind of head injury followed by a discharge of nasal blood is a warning sign
- high fever
- whenever your nose continues to be runny for a period longer than two weeks
- you notice a yellowish or greenish nasal discharge, especially if it’s accompanied by pain in your sinuses.
How a Doctor can Help Your Runny Nose
Your family doctor may be qualified to make a thorough examination of your runny nose condition, but if it is felt that a specialist is required, then someone who specializes in ear, nose, and throat will provide the best chance for identifying the cause of your runny nose. Once your situation has been diagnosed, it will probably fall into one of these categories, and will require the indicated treatment:
- Foreign object lodged in the nose – it’s possible that some tiny object of debris has become lodged in the nasal passage, and is causing serious irritation to the sinuses. This is far more prevalent in children than it is in adults because children are much more likely to insert foreign objects into crevices. When this is determined to be the cause, your doctor will have some special tools which enable him to get a clear look inside the nasal passage, and gently remove whatever object is causing the problem
- Chronic sinusitis – when your runny nose condition persists for a long period of time and recurs over and over again, you may have chronic sinusitis. In this situation, the most effective treatment is one which has recently been discovered and perfected, known as balloon sinuplasty. This is a minimally invasive procedure which inserts a small balloon on a thin wire inside your nose, to expand and discharge any infection or other unwanted materials. The procedure only takes a half hour or so, and there is very little recovery time necessary, so it has quickly become the de facto standard for treating patients with chronic sinusitis
- Deviated septum – it’s possible that there may be structural problems in your nose and that they’re preventing the normal drainage pattern you should have. If this is the case, surgery may be necessary to restructure the septum, or to remove nasal polyps which may be present, so that the condition is not allowed to persist
- Allergies – it’s pretty well-known that allergies go hand-in-hand with a runny nose, because allergens irritate your sinuses, and that causes your nose to run. One of the most common treatments for allergies is immunotherapy, which involves receiving shots to boost your body’s response to the allergy. The objective of allergy shots is to gradually get your body used to the allergen causing the irritation, so that your immune system will tolerate it better, and will not over-react and cause inflammation, which then triggers a runny nose.
There are a lot of wonderful things about springtime that makes people very anxious for its arrival, as winter snows and cold weather begins to fade away. But for the millions of people afflicted by allergies, there can be a serious downside to the spring season as well. This is the time of year when pollen count increases dramatically, along with mold and other airborne irritants. All of these will have allergy sufferers scrambling for tissues, eye drops, and allergy medications.
Once the allergy season gets in full swing, it’s difficult to do anything but manage the symptoms of your allergies and try your best to reduce the misery you go through on a daily basis. However, before your allergies really have a chance to ramp up, there are some things you can do proactively to minimize the effects you might be subject to during the full season.
Consult Your Allergist
Rather than waiting for allergies to come to you, why not get ahead of the game this season and consult your allergist before things get out of control? Talk to your doctor about which antihistamines work best, and which have been shown to be the most effective in your area of the country. There are different plants and weeds in every area, so the medications which are most effective for your particular region might be the ones you should start using. Ideally, you should also settle on an antihistamine which doesn’t make you drowsy at work.
Close out Pollen
To whatever extent is reasonably possible, try to keep pollen and other irritants out of your home, so that at least you can enjoy a safe haven from them when you’re not physically outdoors. This will mean keeping doors and windows shut so that pollen and other materials can’t invade the home. If you haven’t done your spring cleaning yet, make sure to clean the carpeting and upholstery, and change the air filters so that they can effectively trap anything that does get indoors.
When you do have to make trips outdoors, you might want to get into the habit of changing your clothes once you’re inside. Pollen is known to stick to many different fabrics, and you’ll be giving them a free ride into your home, and then wearing them for a while unless you change immediately.
Showering before bedtime is another good idea because any pollen which has attached itself to you will be transferred down the drain, instead of onto your pillow where it can torment you through the night. Make sure your air conditioning filters are high-quality filters that trap a very high percentage of all pollutants and pollen so that it doesn’t keep circulating around the home.
Be on the Lookout for Mold
Pollen isn’t the only irritant you need to be on the lookout for, because mold is another pollutant which can trigger and aggravate your allergy symptoms. There are several common places where mold can routinely have the best chance for forming and developing, including your kitchen, basement, and bathroom, all of which are areas having considerable moisture, and providing an opportunity for leaks.
When you do discover mold in any area of the household, you should remove it promptly with water and a disinfectant cleaner. If mold has settled on any fabrics in your home, try to clean them off with soap and water, but if that fails, you will probably be forced to throw them away. This might seem undesirable from the standpoint of losing a favored item of your wardrobe, but if mold can’t be removed, it will only come back to torment you the rest of the season.
Make a systematic examination of your household to find any leaks there may be around windows or pipes, or anywhere around your roof. When you do find any leaks, repair them as quickly as possible, and make sure there is no material which remains saturated with water, allowing mold to grow.
After you’ve done your mold investigation and cleanup, if you discover any persistent re-growth of mold, you’ll need to check again for any leaks, or you may have to check on the level of ventilation in that particular room. If air can’t circulate in any specific area, it’s possible that moisture can accumulate as the temperature rises, and that can also promote the growth of mold.
Plan Your Outdoor Visits Wisely
Obviously, you won’t get through an entire pollen season without going outdoors, even if you’re one of those people who doesn’t mind being shut in for a relatively long period of time. But you can plan ahead of time to avoid the very worst times of day for peak pollen count, and then stay indoors when you know those are in effect.
Early mornings often have such high pollen counts, so it would be better to plan your outdoor trips later in the day to avoid getting exposed to too much pollen. When you have an extended stretch of weather which is hot and dry, that can also be prime pollen count time and something to be avoided. Rainy days are generally much lower for pollen count, so if you don’t mind getting a little wet, and you don’t mind the gloom of a rainy day, those might be the best days for you to be more active outside.
The two most common causes of a loss of smell are allergies or some kind of injury to the nerve tissue from a viral upper respiratory infection. Patients who lose their sense of smell as a result of a respiratory infection will generally be able to date the time of their smell loss to the same time as the respiratory infection they experienced. In general, these tend to be older patients, and the loss of smell that they have incurred is more typically partial than total in nature.
Unfortunately, there is no effective treatment for this situation because viral damage cannot normally be repaired. While it is possible that some patients will recover their sense of smell over time, these patients are definitely in the minority, and comprise less than 20% of the total number of patients experiencing smell loss. It is however, certainly possible that people who experience temporary smell loss after an upper respiratory infection recover it within a few days of being restored to normal health from the infection.
Smell Loss from Sinuses or Allergies
The other most common cause of smell loss is rhinitis, which is an inflammation that occurs in the nose, nasal polyps, or sinusitis. All three of these are considered to be ongoing processes, in that they recur during the lifetime of the patient, and as such, have an ongoing effect on the sense of smell.
Since this is the case, the development of smell loss tends to be a much more drawn-out process, as opposed to the upper respiratory infection cases, which are more spontaneous in nature. People who are troubled with smell loss due to allergies or sinus problems often report improvements in their sense of smell on a temporary basis, for instance after vigorous exercise, showering, or some other activity which elevates one’s heart rate.
It’s also possible for temporary smell improvements to be experienced when taking corticosteroids, antibiotics, or some other kinds of medication, but, in most cases, the improvement eventually subsides, and the loss of smell returns. It’s fairly common in such cases for there to be accompanying symptoms such as post-nasal drip, problems with breathing through the nose, or nasal allergies. Interestingly, the development of smell loss does not result in a loss of taste, or at least that has not been reported by any significant number of studied patients.
For people who have experienced both an upper respiratory infection and an ongoing process like sinusitis, it will usually be very difficult to pinpoint the time of your smell loss. There is a reason, though, that dating the time of smell loss can be important, because of the two types of smell loss, only sinusitis is treatable and reversible. As previously mentioned, viral damage to the nose cannot be repaired, and that means the sense of smell will also be unlikely to improve for the vast majority of patients.
Treatments for Smell Loss
When a doctor is able to determine whether a patient’s loss of smell was triggered by allergies, there are some treatments which may help recover and restore the sense of smell. Antihistamines, antibiotics, and corticosteroids have all proven to be at least somewhat effective in restoring the sense of smell, because they work to decrease inflammation in the nasal passageways, and these are the primary causes of smell loss in the first place.
For patients who have had some physical damage to the nose, such as a deviated septum or nasal polyps, surgery may also be an option to repair the problem. However, the correlation between surgery and successful restoration of the sense of smell is not strong, so for any specific situation, a patient should discuss surgical options with their doctor.
Patients who have suffered a loss of smell following some kind of severe trauma to the nose or an upper respiratory viral illness, have very few treatment options available to them currently. Corticosteroids are sometimes used to provide benefits for some patients, but the success rate is not particularly promising.
New research has shown that attempting to retrain a person’s sense of smell can achieve modest successes, since it attempts to stimulate the regenerative capabilities of the body’s olfactory network. Part of this therapy involves exposing a patient to familiar odors which are very strong and recognizable, so as to promote the recovery of a sense of smell. The theory behind this is that it helps to rewire that area of the brain which processes smells.
Currently, research is underway to explore other avenues for the restoration of the sense of smell in patients who were thought to have experienced total loss. While medical treatments have not been shown to be universally effective, some patients have experienced small gains in their sense of smell when using phentoxifylline, gabapentin, theophylline, various antidepressants, and some kinds of antibiotics. In the future, it is likely that other treatment approaches will be discovered, and that many more patients will be able to cover some sense of smell even after a traumatic upper respiratory viral infection.
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.