- What is middle ear fluid and why does it form in some people's ears?
- Once Middle Ear Fluid Has Formed What Happens?
- How Do You Treat Middle Ear Infections?
- What are the myringotomy tubes?
- What happens to the myringotomy tubes after they're put in?
- What is Meniere's Disease?
- What is Positional Vertigo?
- What is Tinnitus?
- What are the tonsils and adenoids?
- When should tonsils or adenoids be removed?
- What is a "deviated septum"?
- What problems can a deviated septum cause?
- What can be done to improve a deviated septum?
- What is silent reflux?
- How do I know if I have LPR or Silent Reflux?
- How is lpr treated?
- Will i need lpr treatment forever?
- Can children get lpr?
- What about snoring?
- What are some non-invasive Treatments for Snoring?
- Is there a surgical way to treat snoring?
- What is Radiofrequency Assisted Uvulopalatopharyngoplasty?
- What is Sleep Apnea?
- What is the treatment for Sleep Apnea?
Middle ear fluid is a body fluid that forms in the space behind the ear drum. Normally there is air behind the ear drum. Middle ear fluid forms in an ear when air is unable to get into the middle ear through the eustachian tube. It is necessary for air to enter the middle ear through the eustachian tube to replace the air that the body is constantly absorbing from the middle ear.
Each time we swallow, muscles in our mouth pull open the eustachian tube entrance, permitting air from the back of the mouth to enter the middle ear. As long as our eustachian tubes (there are two of them, one on each side) act this way, there is a balance between the amount of air absorbed from the middle ear by the body and the amount entering to replace it.
For a variety of reasons, one or both eustachian tubes may not function well. When a eustachian tube isn't working correctly, air doesn't get into the middle ear. However, air is still absorbed from the ear. This results in a vacuum forming in the middle ear space. A vacuum in the middle ear is the same as suction in the middle ear. This suction draws fluid out of the lining membranes of the middle ear and mastoid. The result is middle ear fluid!
Once Middle Ear Fluid Has Formed What Happens?
The major functions of the ear are hearing and helping to maintain our balance. If fluid fills a middle ear, our balance may be "off". This may be especially apparent in a young child who is just learning to walk. Hearing is affected by fluid in the middle ear because the fluid deadens the transmission of sound through the ear. This is similar to what we experience when there's water in our outer ears after swimming, although in that case water is on the outside of the eardrum.
Initially the hearing loss that middle ear fluid causes is a temporary problem. However, if middle ear fluid is permitted to remain in the ear for a prolonged period of time, permanent damage may result. In young children the hearing loss caused by the presence of fluid may affect speech and language development as well as certain learning processing skills. This is less significant in older children.
How Do You Treat Middle Ear Infections?
Antibiotics are the first line of defense against ear infections. Different germs are killed by different antibiotics, some being more difficult to kill than others. Since we cannot easily take cultures of the infection behind the eardrum, it may be necessary to use more that one antibiotic before finally obtaining an uninfected ear. Occasionally no antibiotic seems to work. When this happens it becomes necessary to puncture the eardrum to let the infection out before a complication occurs. Myringotomy tubes may be placed in the puncture site to keep the eardrum from healing before the infection has adequately cleared.
What are the myringotomy tubes?
Myringotomy tubes are small tubes inserted into your child's eardrum. The procedure is for draining fluid that has built up behind a child’s eardrums. The purpose of the procedure is to restore the normal functioning of the ear.
What happens to the myringotomy tubes after they're put in?
On average, myringotomy tubes stay in the eardrum for six to twelve months, usually closer to twelve. With time, the eardrum "rejects" the tube, pushing it out into the ear canal. With rare exception, the eardrum incision closes in short order.
What is Meniere's Disease?
Meniere's disease is a disease of the inner ear caused by an excess accumulation of fluid in the inner ear. Most patients have one or all of the following symptoms:
- ear fullness
- ear ringing (also called "tinnitus")
- attacks of spinning dizziness (vertigo)
- fluctuating hearing loss
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What is Positional Vertigo?
Positional vertigo is another cause of dizzy spells. The dizziness is provoked by movement. There are tiny "stones" that form in the inner ear causing this dizziness. The attacks are usually caused by movement in a certain specific way such as rolling over to the right side in bed. When balance exercises and medical treatment do not stop the dizzy spells, perfusion may stop the dizzy spells and usually does not make the hearing worse.
Sudden hearing loss is a sudden nerve hearing loss that is commonly permanent. It is felt to be caused by autoimmune damage to the inner ear, viral infection of the inner ear as well as other factors. The hearing may be improved by perfusion with methylprednisolone if begun early on in the disease.
What is Tinnitus?
Tinnitus is noise in the ear. It may be a whistling, humming, buzzing or other sounding noise and can be very distressing. Xylocaine is a local anesthetic commonly used in dental work. It is very useful in reducing or eliminating tinnitus in certain patients, especially those with tinnitus in one ear only.
What are the tonsils and adenoids?
The tonsils are a pair of structures that are found on both sides of the mouth, in the back, by the base of the tongue. The adenoids are not usually visible by looking in the mouth. They are a mass of tissue located above the roof of the mouth at the back of the nose. Both the tonsils and adenoids are felt to be components of our immune system. When they're healthy and functioning normally, they help fight infection that enters our body through our nose or mouth. Removing the tonsils and/or adenoids doesn't make us more likely to catch infections, as there are many other immune defense structures in our upper airway that act in their place. As we get older, the tonsils usually shrink in size and the adenoids vanish entirely. There is a wide range of normal size for both of these organs.
When should tonsils or adenoids be removed?
Any child with obstructing tonsils or adenoids and frequent sinus, nose or ear infections or who has significant sleep apnea and has difficulty staying awake during the day is a potential candidate for a tonsil and/or adenoidectomy. If the tonsils and adenoids are large enough to cause heart or lung complications, they both should be removed, with rare exception. Once a tonsillar abscess has occurred, a tonsillectomy is usually indicated to prevent another abscess from forming.
Most specialists agree that six (6) tonsil infections in a year, or four (4) in each of two years or three (3) infections in each of three years, or a single strep infection that cannot be cured by appropriate antibiotics, or a patient acting as a strep carrier and infecting family members despite antibiotics, constitute some of the major indications for a T&A, subject to individual evaluation.
What is a "deviated septum"?
The septum is a wall that divides the nose into two passages. Normally these passages are equal in size. The septum is made of cartilage in the front and very thin bone in the back. It is covered on each side with a skin like lining called mucus membrane.
In simple terms, a deviated septum is a crooked septum. In other words, the septum, or part of the septum, is not in the middle of the nose. A deviation of the septum is caused by trauma. This could be birth trauma or an injury to the nose later in life.
What problems can a deviated septum cause?
If the septum is crooked, it may block one or both sides of the nose to a variable degree. Many people have a mildly deviated septum that they are unaware of, as it is causing no problem. The more deviated the septum, the more problem it becomes. Probably the most obvious difficulty a deviated septum may cause is blockage to the breathing on one or both sides of the nose. This is a simple architectural problem with part of the septum being pushed into the normal opening. The more the septum is pushed into the airway, the more blockages it creates.
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What can be done to improve a deviated septum?
If the septum is crooked enough to cause symptoms such as those previously mentioned, it can be surgically straightened. The operation that accomplishes this is called a septoplasty. In essence, the mucus membranes are peeled off the underlying cartilage and bone by working through the nostrils. No incisions are made on the outside of the nose. Once the underlying septum is exposed, portions of it can be removed and/or moved back towards the middle. The linings can then be stitched back into their normal position covering the septum again.
What is silent reflux?
The term REFLUX comes from a Greek word that means "back flow", and it usually refers to "the back flow of stomach contents". Normally, once the things that we eat reach the stomach, digestion should begin without the contents of the stomach coming back up again . . . refluxing.
The term Laryngopharyngeal Reflux (LPR) refers to the back flow of food or stomach acid all of the way back up into the larynx (the voice box) or the pharynx (the throat). LPR can occur during the day or night, even if a person who has LPR hasn't eaten a thing.
Not everyone with reflux has a lot of heartburn or indigestion. In fact, many people with LPR never have heartburn. This is why LPR is called SILENT REFLUX, and the terms "silent reflux" and "LPR" are often used interchangeably. Because LPR is silent, it is sometimes difficult to diagnose.
How do I know if I have LPR or Silent Reflux?
Chronic hoarseness, throat clearing, and cough as well as a feeling of a lump in the throat or difficulty swallowing may be signs that you have LPR. Some people do have heartburn, too. Some people have hoarseness that comes and goes, others have a problem with too much mucus or phlegm. If you have any of these symptoms, and especially if you smoke, you should ask your doctor about LPR. The specialist who most often treats people with LPR is the Otolaryngologist (Ear, Nose, and Throat Physician).
How is lpr treated?
Treatment for LPR should be individualized, and your doctor will suggest the best treatment for you. Generally, there are several treatments for LPR:
- changing habits and diet to reduce reflux
- medications to reduce stomach acid, and
- surgery to prevent reflux
Will i need lpr treatment forever?
Most patients with LPR require some treatment, most of the time, and some people need medicine all of the time. Some people recover completely for months or years, and then may have a relapse.
Can children get lpr?
Yes, throat and lung breathing problems in infants and children can be caused or worsened by LPR. LPR is more difficult to diagnose in children, so that infants and children who may have LPR should be taken to specialists for pH-metry and other tests.
What about snoring?
Snoring affects up to 50% of men and 25% of women. It is due to the vibration of the soft tissues in the back of the throat. During sleep, the tissues of the palate relax causing vibrations that are heard as snoring. By itself, snoring is not a medical disease, however it can cause significant social and marital problems. Sometimes it is a sign of a serious medical disorder in which breathing is reduced during sleep
What are some non-invasive Treatments for Snoring?
Avoidance strategies (partner uses earplugs, etc.); Conservative self treatments (Avoidance of alcohol, tobacco, sleeping pills, antihistamines, etc.); Devices such as continuous positive airway pressure (CPAP) devices.
Is there a surgical way to treat snoring?
Nasal surgery, tonsillectomy and adenoidectomy or laser and radiofrequency surgery.
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What is Radiofrequency Assisted Uvulopalatopharyngoplasty?
Radiofrequency Assisted Uvulopalatoplasty (RAUP) is a highly successful procedure to help your snoring. In RAUP, the vibrations of the soft tissues (palate) which cause snoring are reduced. A device using radiofrequency waves is inserted into the palate in several places. During the healing process, the normal tissue is replaced by a small amount of scar tissue. This new tissue is smaller and firmer; therefore, the vibrations of the palate are lessened and snoring is improved. This technique is called Radio Frequency Tissue Ablation (RFTA).
What is Sleep Apnea?
Obstructive Sleep Apnea (OSA) is a disorder that is associated with significant medical and social problems. Apnea means lack of breathing.
People with sleep apnea do not breathe properly during sleep. The muscles at the back of the throat relax during sleep, obstructing the airway. Sleep is interrupted by the brain to "wake up"- just enough to unplug the airway. When this occurs the person sounds like he/she is gasping. The breathing improves but only until the next time the obstruction occurs. This cycle can last for ten seconds and can occur hundreds of times each night.
What is the treatment for Sleep Apnea?
The specific treatment performed depends on each patient's unique needs:
- CPAP (continuous positive airway pressure) This is a mask worn over the nose that is attached to an air compressor. The air pressure holds the airway open.
- Oral appliances: These can prevent the tongue from collapsing the airway.
- Surgery : The goal of surgery is to relieve the physical abnormalities that cause the airway to collapse.