Ear, Nose & Throat: 4 DifferENT Conditions

Otolaryngology is a medical speciality that focuses on conditions related to the ear, nose, and throat (ENT). People may face many ENT problems, and doctors often group these conditions together. Some ENT conditions are straightforward and may go away with little to no treatment, while others can be more complex and involve surgery.

While many ENT conditions may be treated by a general practitioner, some people may prefer to see a specialist. Otolaryngologists at My ENT Specialist treat a wide variety of conditions including sinus infections and ear problems. 

This article covers 4 common ENT conditions and the treatment options available.

1. Hearing loss

Hearing loss is a common complaint and it can affect people of all ages.

There are 2 types of hearing loss, conductive hearing loss and sensorineural hearing loss. The first type is caused by a disease that prevents the normal transmission of sound to the inner ear. As a result, sounds may become muffled, or there may be an ‘echo’ in the affected ear and the patient’s voice may seem louder than usual. Examples of conductive hearing loss include impacted earwax, external and middle ear infections, eardrum perforations and fluid in the middle ear.

On the other hand, patients with sensorineural hearing loss may be unable to hear a conversation, especially with background noise. They may have difficulty differentiating words and often misinterpret what was said. Examples of sensorineural hearing loss include deafness and viral infections of the cochlear and auditory nerve.

Symptoms of hearing loss

Hearing loss can affect one or both ears and it may occur gradually or suddenly. The patient may find it difficult to hold a normal conversation, especially in a noisy environment, while others around them may complain that the patient does not respond when called or speaks louder than usual.

Associated symptoms include tinnitus (ringing in the ears) or vertigo (spinning sensation).

Treatment for hearing loss

Treatment for hearing loss depends on the cause and may range from observation and reassurance to medications and surgery. If ear wax or foreign body is found in the ear canal, the ENT surgeon can remove it under a microscope.

A topical antibiotic is used for external ear infections. If there is an eardrum perforation, the underlying infection must be treated. If the perforation lasts for more than 3 months or if there are recurrent ear infections with ear discharge, surgical repair of the ear perforation may be needed.

For patients with presbycusis (hearing loss due to old age), they will be advised to protect their hearing and evaluated on whether they need hearing aid help.

Hearing aids are devices that detect sounds in the environment, and present and amplify them into the user’s external ear canal. They are useful for conductive and sensorineural hearing loss. Modern hearing aids vary from tiny in-ear devices to the traditional behind-the-ear ones. Side effects of hearing aids include a feeling of blockage of the ear, feedback, and greater likelihood of ear infections.

Read about hearing loss detection in children: https://www.healthhub.sg/a-z/diseases-and-conditions/410/child_hearing_kkh

Another option is hearing implants. There are 2 main types of surgical implants. Middle ear implants are for those who have tried hearing aids but did not benefit from them. It can be used for both conductive and sensorineural hearing loss.

Cochlear implants are used in patients with moderate to severe sensorineural hearing loss and can be used in both children and adults.

Having hearing problems? Consult your Otolaryngology specialist at My ENT Specialist.

2. Sinusitis

Sinuses are small air-filled spaces found in our skull, behind our cheeks, between our eyes, and over our forehead. Mucus is produced in our sinuses which may drain into our nasal cavity. When these channels are blocked, pressure builds up and causes pain or discomfort, such as dizziness, clogged nose, and fever.

Getting acute sinusitis after catching a flu or cold is common. While most people will recover on our own, some may need antibiotics.

Sinus problems are very common, with 90% of adults likely to have a sinus problem at least once in their lifetime. Due to the tropical climate in Singapore, sinus problems are more persistent.

Symptoms of sinusitis

Some symptoms include nasal obstruction, yellow or green nasal discharge, and toothache. Some patients may also experience pain or discomfort behind the cheeks, forehead and behind the eyeballs. Reduced sense of smell and bad breath are also symptoms of sinusitis.

Children with sinusitis may appear irritable or breathe through their mouth.

Read about chronic sinusitis: https://www.healthhub.sg/a-z/diseases-and-conditions/226/chronic_sinusitis_ttsh

Treatment for sinusitis

For symptoms that are mild and occur immediately after a cold, painkillers can help relieve the pain and nose drops can decongest the nose. Applying a warm pack over the face can reduce discomfort as well.

Some sinusitis may not go away on its own and may cause secondary bacterial infection. Antibiotics will often clear up the symptoms.

A nasal douche with sodium bicarbonate solution can help wash away the infection, reduce the congestion and promote healing.

Alternatively, nasal steroid sprays are great for providing symptomatic relief. They can help to reduce inflammation and swelling.

If you are experiencing sinusitis, consult your family doctor at My Family Clinic for a specialist referral.

3. Obstructive sleep apnea (OSA)

Obstructive Sleep Apnea (OSA) is a form of breathing disorder that occurs during sleep. Patients with OSA have difficulty breathing when they sleep because their upper air passages in the nose and throat obstruct more easily than those without OSA. This may be caused by nasal blockage, enlarged tonsils, a small sized jaw, or a large tongue in relation to the mouth.

During these obstructive episodes, the patient may find it difficult to breathe and may stop breathing partially or completely. The oxygen concentration in the body drops, causing the patient’s oxygen level to decrease. The heart must now pump harder and faster to supply oxygenated blood to the rest of the body. Since the heart and brain’s blood supply is potentially easily compromised, this can lead to serious long-term consequences if left untreated.

Occurrence of OSA

Upper airway obstruction from OSA may occur anytime during sleep. They occur more frequently during deep sleep and dream sleep because the muscles are more relaxed during these periods.

Read about obstructive sleep apnea: https://www.webmd.com/sleep-apnea/understanding-obstructive-sleep-apnea-syndrome

Treatment for OSA

Sleep hygiene may sufficiently treat mild OSA. It may include lying on the side, avoiding alcohol and cigarettes before bedtime, having regular and sufficient sleep, and propping the back with a wedge pillow while sleeping.

Weight loss can also help manage OSA. Fat deposited within the tongue, muscles and soft tissues of the upper airway and neck increases the likelihood of them collapsing during sleep.

For mild to moderate OSA, the mandibular advancement appliance can help. It advances the lower jaw and tongue and increases the tension in the muscles to keep the upper airway open during sleep.

Alternatively, patients may be recommended to use a continuous positive airway pressure device, which is worn during sleep. The patient wears a mask over their nose and air is blown into it to keep the airway open. This treatment method has the best treatment outcomes in the management of OSA.

Surgery is another treatment option, although not everyone is suitable for surgery. It can be performed on the nasal cavity to reduce nasal obstruction, and on the throat to increase the dimensions of the upper airway. It can also be performed on the tongue to reduce volume and advance the tongue.

4. Vocal nodules and polyps

Vocal cord lesions are one of the most common voice conditions. They include vocal nodules and vocal polyps, which are abnormal growths on the vocal cords. Vocal nodules are thickened areas that typically occur on both vocal folds, while vocal polyps are growths that usually occur on one vocal fold and may look like a swollen bump or blister.

Symptoms of vocal nodules and polyps

A hoarse and rough voice, lowered pitch, and breathy voice are some of the symptoms. Others include voice breaking, frequent throat clearing, and vocal fatigue.

Treatment for vocal nodules and polyps

The treatment method depends on the cause of the vocal nodules or polyps, their size, and other medical problems that may affect the voice. Patients may be advised to treat their reflux, nasal allergies, and thyroid problems for the vocal nodules to go away. Other ways include quitting smoking, seeing a vocal therapist, or having a period of voice rest. Vocal surgery will only be considered if all these treatment options fail.

If you are facing any of the above conditions, consult one of our qualified Otolaryngology specialists at My ENT Specialist for diagnosis and treatment. They care for patients with a wide variety of ENT conditions, including sinus infections, ear problems, swellings in the head and neck region, and nasal allergy.