Good news! Montgomery County ENT Institute has partnered with TruHearing to provide low cost, quality hearing solutions for individuals struggling with hearing loss, but were unable to afford help. Retirees and members of many union plans now have access to these new programs. If you have found the cost of obtaining new hearing aids beyond your reach, or if you want to experience the benefit of new technology available in hearing aids today, give use a call at 215 887 7380 today. We can schedule an appointment for you, and help you determine if you qualify for these exceptional programs.
What is laryngopharyngeal reflux, or LPR?
This is a common disorder where acidic contents from the stomach go up beyond the esophagus and into the area around your voice box creating irritation and inflammation. Small amounts of acid can damage this area of your throat since it is not equipped like the esophagus to handle acid exposure. As few as 3 reflux episodes can cause severe laryngeal inflammation and injury.
What is “silent reflux”?
This is the name given to LPR since many patients do not experience classic heartburn or indigestion, and in fact, may be completely unaware it is occurring. Some common symptoms of LPR include hoarseness, a feeling of mucus in the throat, or throat clearing. It may occur when you are upright or lying down.
How is LPR diagnosed?
Swelling and irritation around the voice box can be indicative of acid reflux. Your ENT provider has special scopes to visualize this area in the office.
A 24 hour pH probe monitor is a great test to objectively measure and confirm acid reflux. This test detects acid that occurs above your esophagus. A small probe is placed into one nostril and sits above the back of the throat. It does not interfere with eating, drinking or sleeping. This test is more sensitive in diagnosing LPR than traditional pH testing. Additionally, this test is easy to administer, is more comfortable and less expensive than standard pH manometry.
What is the best treatment for LPR?
Your doctor may prescribe a Proton-Pump Inhibitor (PPI) or a different class of antacid medication. It is important to take the medication every day as prescribed. It can take 4-6 weeks for the inflammation to appear improved on exam.
Besides medication, lifestyle changes are very important. Elevation of the head of the bed (using wooden blocks or a wedge pillow) is a great way to decrease acid reflux at night. Some studies show this to be more effective than medication. Avoidance of caffeine, chocolate, acidic juices (OJ, Grapefruit), peppermints, and spicy food help. It is beneficial to stop eating 2-3 hours before lying down, and to eat smaller, more frequent meals rather than large meals.
Why is it important to treat LPR?
Laryngopharyngeal reflux has serious potential consequences. Barrett’s esophagus is a precancerous condition of the esophagus that happens in a small percentage of people who have acid reflux. Chronic acid exposure creates changes in the esophagus which can potentially become cancer of the esophagus. It is important to have routine checkups with your ENT provider.
Dealing with a skin cancer can be a very stressful experience. When the cancer is on the face, it may pose serious functional and cosmetic issues. Facial skin cancers can be removed and repaired by a Facial Plastic Surgeon. Sometimes the cancer may be removed with a procedure called Mohs Surgery, performed by a specially trained Dermatologist called a Mohs Surgeon. Repairing the resulting defect may require a Facial Plastic Surgeon.
Dr. Ondik is a Board Certified Facial Plastic Surgeon and has extensive experience in repairing all areas of the face, including total nasal reconstruction. Dr. Ondik will coordinate with your Dermatologist or Mohs Surgeon to remove and/or repair the resulting skin cancer defect. He will spend time explaining the repair options. Each skin cancer repair is carefully chosen to restore the function of the facial component and ensure the most cosmetically superior result.
In recent months there has been some exciting developments in hearing research. The New York Times recently reported that pharmaceutical companies have turned their attention to helping people with ear disorders. Hearing loss, tinnitus and dizziness occur when there is significant damage to structures inside the ear, called hair cells. They are using gene therapy to help regenerate areas of the cochlea where hair cells have been damaged. Some companies are having small successes, others, not so much. The good news is that they seem to be on the right track and we are monitoring their every discovery. Take a look at the article. Let me know if you found it as fascinating as I did.
An effective way to treat seasonal grass or ragweed allergy. This is a convenient option for patients who are not able to commit to weekly allergy shots, patients who have a needle phobia, or patients who suffer from seasonal allergies due to grass or ragweed. A rapidly dissolving tablet is placed under the tongue every day in order to reduce allergic symptoms. Therapy should start around January for grass, and May for ragweed, and should be continued throughout the season. The first tablet is given in the office and the patient is observed for 30 minutes. A prescription is given for the grass tablets to be taken at home. Grastek is approved to treat children 5 years and older; Oralair is approved for ages 10-65 years old; Ragwitek is approved for adults 18-65 years old.
There are many causes of dizziness, but one particular cause can be easily treated. Read more about a common type of dizziness called BPPV:
While there has been an explosion of injectable fillers being used for facial lines and wrinkles, many patients are not aware that these same fillers can be used to improve the shape of the nose. The procedure is called “liquid rhinoplasty” and uses injectable fillers to smooth out depressions or hollows. In some cases the filler can also be used to help camouflage small bumps or humps on the nose. The procedure isn’t permanent, but the results may last up to a year or slightly more. It may be perfect for the patient that has a small nasal imperfection that isn’t interested in surgery.