Ear Infections

Do you have ear pain? There are many causes of ear pain, but one of the biggest causes are infections. There are two main types of ear infections that your doctor may identify and treat. The first kind is an infection of the ear canal known as “otitis externa.” An infection in this portion of the ear can be caused by trauma from cleaning (i.e., using Q-tips or bobby pins) or from repeated water exposure (i.e., “swimmer’s ear.”) In both cases the skin that lines the ear canal becomes inflamed and infected.

Patients may notice that moving their ear makes the pain in the ear canal feel much worse. As the infection progresses the ear canal may begin to swell shut and there may be foul smelling drainage from the ear. This condition is called “otitis externa” by physicians.

The other common type of ear infection is called “otitis media”. Otitis media is an infection that occurs in the area behind the eardrum known as the middle ear. Your doctor may look in your ear and see that your eardrum is swollen and red. In some cases the infection may cause enough pressure to burst the eardrum. If this happens you may notice a relief in the pain along with bloody drainage in your ear canal.

Patients that get repeated episodes of otitis media may have other medical conditions that make them prone to this type of ear infection. The most common condition is known as “Eustachian tube dysfunction”. The Eustachian tube is a tube that connects the area behind the eardrum (the middle ear) to the area at the back of your nose. The Eustachian tube helps to equalize the air pressure in the middle ear. The tube is typically collapsed and closed, but it does open temporarily when you chew, yawn or try to “pop your ears.”

Many conditions such as allergies or the common cold cause the opening of the Eustachian tube to swell shut. When this occurs, patients may complain of pressure or fullness in their ears that may last for several weeks. If left untreated the middle ear has a chance of filling with clear watery fluid that in turn may become infected, causing the symptoms of otitis media.

Sore Throat

Sore throat is a very common problem. There are several causes of sore throats that your physician may choose to investigate.

One of the most common reasons for a sore throat is a viral infection. Possible viruses include the common cold, mononucleosis, and other infections such as mumps, herpangina and influenza. Many of these viruses will resolve quickly, but mononucleosis (also known as the “kissing disease”) may take much longer than a week to resolve. Patients may notice enlargement of their tonsils with white patches on their surface. Other symptoms include swollen lymph nodes, fevers and chills, fatigue and enlargement of the liver and spleen.

Bacterial infections such as strep throat are another common cause of sore throats. “Strep” is short for a type of bacteria known as streptococcus. These bacteria can remain in the tonsils and cause recurrent infections. It is important that a culture is taken of the tonsil using a swab when a patient is suspected of having a strep throat. Symptoms of a strep throat often include throat pain, white patches on the tonsils, fevers, swollen lymph nodes and, in children, a headache or a stomach ache. It is important to treat a Strep throat to prevent possible complications such as rheumatic fever. Patients who suffer from recurrent strep throat may benefit from a tonsillectomy. Your ENT will help you decide whether this procedure would be appropriate.

Sore throats can also be caused by post-nasal drip. Post-nasal drip is when excessive mucus produced in the nose drains down the throat causing irritation. Your physician may see evidence of post-nasal drip on examination. Post-nasal drip may occur over a short period of time due to the common cold, however, constant post-nasal drip may be the result of environmental allergies such as dust, pollen or molds.

Reflux can be another source of throat irritation. Reflux occurs when stomach acid travels upward in the esophagus. When reflux occurs only in the esophagus patients will experience the sensation of heartburn. If stomach acid travels upwards further it will spill into the voice box causing laryngopharyngeal reflux (LPR), commonly known as “silent reflux.” Patients with LPR will experience throat irritation near the level of their vocal cords. Patients may feel the need to constantly clear their throat or they may feel like something is stuck in their throat. Some patients will also develop hoarseness in their voice.

There are many other causes of sore throat including other serious infections and tumors. If you have a sore throat that persists longer than a week, you should meet with your physician to be evaluated.

Hoarseness

The word “hoarseness” describes an abnormal changes in the voice and can describe any condition from nearly no voice at all to a gravely, strained, weak, or breathy voice. Hoarseness is a common problem that almost every patient will experience at some point in his or her lives. There are several causes of hoarseness that range from temporary conditions such as laryngitis to more serious causes such as cancer.

One of the most common causes of hoarseness is laryngitis. In laryngitis, the vocal cords become swollen, usually due to the common cold or other viral illness. In most cases, this type of hoarseness will resolve on its own. Hoarseness may also be due to overuse or misuse of your voice. For example, excessive yelling or voice overuse.

Patients may also become hoarse from a condition called reflux. Reflux occurs when stomach acid travels upward in the esophagus. When reflux occurs only in the esophagus patients will experience the sensation of heartburn. If stomach acid travels upwards further it will spill into the voice box causing laryngopharyngeal reflux (LPR), commonly known as “silent reflux.” Patients with LPR may experience hoarseness and throat irritation near the level of their vocal cords. Patients may also feel the need to constantly clear their throat or they may feel like something is stuck in their throat.

Vocal cord nodules (often called “singer’s nodules”), vocal cord cysts and polyps all account for another group of disorders that can lead to hoarseness. Each of these conditions shares the feature of having a bump or nodule on the vocal cord that interferes with the functioning of the voice.

Smoking may lead to chronic hoarseness, also known as “smoker’s voice,” but there is a chance hoarseness may be a symptom of laryngeal cancer. Laryngeal cancer is much more common in smokers, but it may also occur in non-smokers.

There are many other causes of hoarseness, such as neurological or other medical conditions. Whatever the cause of the hoarseness, your ENT will need to perform a detailed evaluation including examination of your voice box and vocal cords using a special flexible scope that can get an up close look at the potential problem.

Tinnitus

Tinnitus refers to a sound that one may hear in the ears or head. It can be caused by a number of different issues. Most commonly, it can be from an ear disorder. If you develop this suddenly and it is very loud, you should be examined by the doctor. Often times, a hearing and pressure test on the ears will be done to find the cause. Tinnitus can become chronic as well and may be a sign of some other weakness in the inner ear system. Your physician will be able to diagnose the cause and recommend treatments.

Vertigo

Vertigo refers to a sense of motion about the head. We often ask if one feels the room is spinning or the head is spinning. This is different from dizziness or lightheadedness. Sometimes, both can occur. Vertigo can be caused by inflammation of the inner ear but could also have other causes. It is best to have an evaluation by the doctor to determine the cause. There are medications available to treat this but other treatments may be warranted as well.