A New York City ENT doctor deals with a variety of different conditions from performing sinus surgeries to diagnosing ear, nose & throat problems.
Ear Nose Throat
How to Determine if You Have a Ruptured Eardrum
4 years ago
A rupture of the eardrum, or tympanic membrane, can occur suddenly and requires immediate attention from a physician.
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:
- dizziness
- 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
If you suspect that your eardrum has ruptured, consult with a physician immediately for a full diagnosis and treatment recommendation.
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.
Leukoplakia: Causes, Symptoms, and Treatment
5 years ago
Look out for signs of Leukoplakia and talk to a doctor about your condition.
With smoking as the most common cause in today’s society, leukoplakia will see the recipient experience white patches all over the tongue. In addition to the tongue, some also experience these thick patches in the lining of their mouth. If the issue isn’t too serious, it should go away within just a few days but it should also be noted that it can be a sign of something more worrisome such as oral cancer. With this in mind, it’s important to get in contact with a doctor if the problem doesn’t clear after a few days.
Today, we’re going to look into the main causes of leukoplakia as well as the symptoms (so you know what to look for) and how it gets treated!
Causes of Leukoplakia
Despite all the advancements we’ve seen in technology in recent years, we still don’t know exactly why these white spots appear. However, we do know that tobacco exacerbates the problem; this can be both chewing and smoking.
After this, it could be caused by chewing on the insides of our mouth, an inflammatory condition within the body, uneven teeth catching on our cheeks, and perhaps even dentures when they aren’t fitted as they should be. Furthermore, recent research suggests there could be a link between this and the human papilloma virus which is important to note.
The Diseases’ Symptoms
For those who have suffered from the issue, they note ‘strange-looking’ patches inside the mouth. Since most of us look into the mirror when brushing teeth and our tongue is constantly surveying the area, it doesn’t take long to notice something abnormal. Although the most common appearance will be white, we should also say that you might experience spots that are gray, hairy (we’ll discuss this in more detail in just a moment), red, and rough.
To pick up on a few points in the way the appearance can vary, redness is the most common sign of cancer. We recommend contacting a doctor if you see red spots inside your mouth. Furthermore, there is such a thing called ‘hairy leukoplakia’ and the main cause of this will be the Epstein-Barr virus (EBV). Once you have this virus, it will be with you for life even though it doesn’t often cause any problems for the body. With hairy leukoplakia, this is one of the few times it does make itself known.
Receiving a Diagnosis
Typically, leukoplakia can be diagnosed almost instantly with a simple oral exam. As well as your doctor, your dentist should also know the signs and professional help can be important because the majority of us will misdiagnose the issue as oral thrush. With the latter, the patches tend to be softer which causes them to bleed more frequently and this is how you tell the difference.
If the professional can’t advise on the issue immediately, they may request a couple of small tests just to be sure. By knowing exactly what the problem is, they can move forward to the treatment phase with confidence.
If cancer is suspected, a biopsy will be recommended and this is where the professional will remove some tissue from the affected area before sending it to a laboratory for further testing.
Treatment for the Disease
Once they’ve found the issue, how do they treat it? As mentioned previously, a standard case of leukoplakia won’t worry the doctor too much and they’ll suggest keeping an eye on the spots to make sure they disappear. If you smoke or chew tobacco, it’s important to avoid this trigger. If they fade away, you then know this was the cause and your doctor can provide suggestions for future prevention of the issue.
If your doctor suspected something a little more serious, they’ll wait for the biopsy results. If there are any signs of oral cancer, the patch will have to be removed to prevent the cancer from spreading. Ultimately, this procedure will be similar to a biopsy in that they’ll take the small patch with a scalpel or perhaps even laser treatment. If the patches are extensive and these two methods won’t help, full oral surgery will be required.
With hairy leukoplakia, they might be removed but it depends on the circumstances. For example, some retinoic acid antiviral medications can prevent the patches from growing.
Although the majority of cases are harmless, we recommend contacting a doctor if the spots are red in appearance or if they don’t fade away as they should after a few days!
Sleep Disorders Increase Stroke Risk
6 years ago
Stroke risk increases as patients ignore their sleep apnea symptoms.
As sleep disorders become more and more prevalent, so does the risk from not treating them. It’s important to have these disorders diagnosed; otherwise it will evolve into something much worse. In a new study by the American Academy of Neurology, their research suggests that sleep disorders, like insomnia and oversleeping, may increase stroke risk.
Patients and Stroke Risk
A stroke is essentially an attack within the brain that happens when blood vessels are blocked or the brain starts to bleed. It can cause weakness, dizziness, slurred speech, vision problem and numbness. According to the Center for Disease Control (CDC), more than 800,000 people in the United States have a stroke each year, and on average, one American dies every 4 minutes from a stroke.
Disorders, like insomnia and oversleeping, are common among patients who have suffered from a stroke. However, research shows that they also can act as a telling sign. According to Dirk M. Hermann, MD, of the University Hospital Essen, and study author, “People with sleep disorders may be more likely to have another stroke or other negative outcomes than people without sleep problems, such as having to go to a nursing home after leaving the hospital.”
This study stresses the importance of getting tested. Without testing, patients are left undiagnosed and untreated for their sleeping disorders. The negative outcomes of insomnia include depression, daytime sleepiness, fatigue, and irritability. Oversleeping has been known to cause diabetes, obesity, and headaches.
The most common treatment for sleep disorder is a continuous positive airway pressure machine (CPAP). This treatment has proven itself success for resolving sleep disorder. The researchers also note that stroke risk in patients with sleep disorder decreased after receiving this treatment.
Stroke risk certainly increases the longer one waits to be treated. The researchers hope that the study will make more patients aware of the issue.
Oversized Tongue and Tonsils Leave Many at High Risk for OSA
6 years ago
If you are at risk for obstructive sleep apnea (OSA), your doctor is usually the first person to tell you. However, what if this information came from an unlikely source? Like your dentist. A new study shows that the size of your tongue and tonsils could be affecting how much you sleep.
The Research into Oversized Tongue and Tonsils
OSA is the most common form of sleep apnea. The disorder usually causes difficulty breathing, excessive snoring, and unexplained daytime sleepiness. Most people are not even aware that they are suffering from the condition. As with many OSA cases, a complete or partial obstruction of the upper airways causes the disorder.
Thikriat Al-Jewari, an orthodontic researcher at the University at Buffalo, New York, led a new study that suggests your dentist might have an opportunity to identify signs of OSA. The study finds that abnormally large tongue indentations and tonsils are frequent indicators of the condition.
Researchers analyzed and tested over 200 patients at the dental clinics at the University of Dammam’s College of Dentistry in the Kingdom of Saudi Arabia for OSA. Testing for common signs of OSA, and using the Berlin Questionnaire—one of the most validated tests for OSA—they discovered 23 percent of their patients were at risk for OSA. Of those at risk, the most common symptoms were large tongue and tonsils.
Many people who suffer from the condition go undiagnosed and untreated. Unfortunately, patients who remain untreated can endure a worse fate. OSA has been linked to cardiovascular disease, diabetes, depression and more. Al-Jewari’s findings are a crucial step in getting people with OSA the help they need.
“Dentists see into their patient’s mouths more than physicians do and the signs are easy to identify,” says Al-Jewair. He goes on to suggest that if dentists are properly trained to identify signs of an oversized tongue and tonsils, they can point patients in the right direction. Dentists are by no means qualified to give a diagnosis on the matter. However, having these professional look out for the signs of the disorder can significantly help solve the problem of patients who go undiagnosed and continue to live with OSA.