tinnitus

What is Tinnitus

tinnitus

What is Tinnitus?


Did you ever experience a ringing, hissing or crackling sound in the ears? If you did, you might have experienced a condition medically known as Tinnitus. It can often be a minor, temporary inconvenience but in some cases, it can be a more chronic and persistent problem which requires the help of a medical professional, more specifically an ENT specialist like Dr Rao’s ENT.

Did you know? Tinnitus refers to any abnormal sound in the ear such as ringing, clicking, whistling, hissing, crackling and popping. These sounds may be caused while talking, yawning, gulping food, or any movement of the jaws.

Who is affected by Tinnitus?


Tinnitus is a very common complaint and approximately 7% of the population has experienced it at some stage of their life. Individuals from all age groups – children, teens, adults to senior citizens suffer from this condition but due to different causes. Individuals who are 50 years and above have higher occurrences of Tinnitus.

What are the symptoms of Tinnitus?


Most patients associate Tinnitus with not just physical inconvenience but also mental distress caused by constant ringing sensation in the ears. Tinnitus is known to cause anxiety, lack of sleep(insomnia), poor performance at work and school, irritability and at times even depression. This goes to show Tinnitus is not a condition to ignore.

Causes of Tinnitus


Now that we understand what is Tinnitus and why it is a condition to worry, let’s look at what are the most common causes of Tinnitus.

  1. Damage/loss of sensory hair cells in the cochlea of the inner ear
  2. Ear wax
  3. Ear infections
  4. Eustachian tube dysfunction
  5. TMJ disorders
  6. Foreign object in the ear
  7. Noise trauma
  8. Stiffening of the middle ear bones
  9. Head and neck injuries
  10. Certain medications such as aspirin

Did you know? Most people learn to live with Tinnitus but help is always available from ENT specialists for those who find it unbearable.

  • Damage or loss of sensory hair cells in the cochlea of the inner ear
    The structures inside the ear responsible for hearing are very complex and sensitive. The damage and loss of tiny sensory hair cells in the cochlea which resides in the inner human ear, is one of the most common causes of Tinnitus. This damage tends to happen with age but at times is caused by exposure to loud noises as well. Hence youngsters exposing themselves to loud music and constant usage of headphones should be wary of this potential damage which may result in hearing loss.
  • Ear wax
    Another common reason for Tinnitus is war wax, the same wax which many of us ignorantly clean with cotton swabs. Eardrum is the key component of the ear responsible for conducting the sound entering the ear and any dry residue of ear wax can result in the improper transmission of sound to the eardrum resulting in crackling sound.
  • Ear infections
    Ear infections can affect the functioning of the ear by infecting the ear and its internal components. This may lead to the individual hearing abnormal sounds in the ear. Hence it is advised to maintain ear hygiene and consult an ENT specialist in case of any discharge or infection in the ear.
  • Eustachian tube dysfunction
    Eustachian tube is a 3-4 cm long tube-like structure in the middle ear responsible for air circulation and maintaining the balance of internal and external air pressure in the ear. When the eustachian tube is infected, it results in fluid build-up in the middle ear leading to tinnitus.
  • TMJ Disorders
    Temporomandibular joint syndrome is a pain in the jaw joint caused due to a variety of reasons such as jaw injury, poor posture, arthritis, and other inflammatory disorders. TMJ disorders cause unbearable pain and tenderness in the jaw while eating, speaking or any activity involving jaw movement. TMJ disorders are known to cause tinnitus.
  • Foreign object in the ear
    The presence of foreign objects in the ear is another common cause of crackling or popping sound in the ears. Any foreign object such as an insect that got accidentally trapped in the ear can rub against the eardrum causing tinnitus.
  • Noise trauma
    Children and teenagers are often exposed to noise trauma caused by exposure to high levels of noise. This is often due to the usage of high volume in earphones, exposure to loud music or accidental exposure to noise. Some professions also expose individuals to occupational noise trauma in which cases patients should take precautionary measures to protect their ears. Whatever the reason for exposure, noise trauma can cause tinnitus.
  • Stiffening of the middle ear bones
    Otosclerosis or stiffening of the bones in the middle ear can impact your hearing and cause tinnitus.
  • Head and neck injuries
    In some cases, head and neck injuries are also known to cause tinnitus. The ear comprises of a very delicate and intricate combination of bones that enable us to hear. Any physical force applied to the ear indirectly because of head and neck injuries has the potential to disrupt this mechanism leading to tinnitus.
  • Certain medications – ototoxic drugs
    A good number of medications are known to cause or aggravate tinnitus. Often common medications such as aspirin, antibiotics and not so common drugs used for treating cancers, anti-depressants could cause tinnitus. Most of these drugs are ototoxic, i.e., can damage the auditory nerve. When these medicines are administered incorrectly or in high dosage they can cause tinnitus.

Treatment for Tinnitus

As described above, tinnitus can be caused by a wide range of issues and an ENT specialist would first diagnose the underlying problem and treat the same. For example, if tinnitus is caused by an ear infection, the doctor would treat the underlying ear infection and the problem would be addressed by the end of the treatment. Similarly, if it is caused due to eustachian tube dysfunction, your ENT surgeon would perform an eustachian tube balloon dilation procedure to clear out the fluid built-up in the middle ear. Once the root cause is address, tinnitus would subside.

Closing remarks

In many cases, patients often cope with tinnitus considering it as a minor inconvenience and also get used to other resulting issues such as insomnia, anxiety, depression, etc. From the causes we listed out above, it is evident that tinnitus is often an indication of a more serious underlying problem. Some of these problems can lead to permanent hearing loss or deafness. You may experience tinnitus after a flight or during adventure sports such as scuba diving due to a sudden change in pressure. Such instances may lead to temporary, short-lived tinnitus. But if you are experiencing repeated and severe episodes of tinnitus, visit an experienced ENT hospital like Dr Rao’s ENT Super Speciality Hospital which is equipped with state-of-the-art ENT facilities and a panel of highly experienced ENT specialists who can provide an accurate diagnosis and administer the right treatment.

Hope we could address your queries about tinnitus. Feel free to drop us a message if you have any queries or book an appointment with the best ENT Hospital in India here.


Eustachian Tube Balloon Dilation at Dr Rao's ENT

Eustachian Tube Balloon Dilation - for the 1st time in India, performed at Dr Rao's ENT Super Speciality International Hospital

Dr Rao’s ENT Super Speciality Hospital is proud to be the first ENT Hospital in India to offer Eustachian Tube Balloon Dilation procedure which is widely used globally to treat Eustachian Tube Dysfunction. In our constant quest to bring the best global ENT practices and standards to India, we have recently started offering the surgical procedure at our state of the art international super speciality ENT hospital.

Dr GVK Chaitanya Rao, our Managing Director and member of American Rhinologic Society (ARS) and European Rhinologic Society (ERS) explains what is Eustachian Tube Dysfunction, what is the procedure for Balloon Dilation and other details about the surgery.

What is Eustachian Tube

The eustachian tube, also known as the pharyngotympanic tube, is an anatomical structure 3-4 cm long that extends from the middle ear to the nasopharynx region. The main functions of the eustachian tube are –

  1. To ventilate the middle ear,
  2. Facilitate the drainage of secretions produced in the middle ear, and
  3. Prevent the reflux of nasopharyngeal secretions into the middle ear.

What is Eustachian Tube Dysfunction?

The eustachian tube, also known as the pharyngotympanic tube, is an anatomical structure 3-4 cm long that extends from the middle ear to the nasopharynx region. The main functions of the eustachian tube are –

  1. To ventilate the middle ear,
  2. Facilitate the drainage of secretions produced in the middle ear, and
  3. Prevent the reflux of nasopharyngeal secretions into the middle ear.

Know more

How is Tubal Dysfunction diagnosed?

There are several tests to evaluate the functionality of the eustachian tube; however, there are still no defined criteria for the diagnosis of tubal dysfunction. Tympanometry and Sonotubometry are the most commonly used tests.

Tympanometry evaluates the ability of the tympanic membrane to transmit sound energy through the middle ear. After examining the external ear with an otoscope to ensure that the path to the eardrum is clean and that there is no perforation in the eardrum, the test is performed by inserting an instrument (tympanometer) into the ear canal. The device changes the pressure in the ear, generates a pure tone and measures the responses of the eardrum to sound at different pressures. This procedure generates a series of data which is plotted on a computer. The resulting graph is cataloged as one of the following 3 groups: normal, low, or excessive.

Sonotubometry is based on the application of a sound source in the nostrils with the placement of a microphone in the external auditory canal to measure the sound transmitted when the eustachian tube opens and closes. This diagnostic test has the advantage of allowing the assessment of eustachian tube regardless of the condition of the tympanic membrane.

What are the indicators of Eustachian Tube Dysfunction?

Many of the chronic pathologies of the middle ear are caused because of improper functioning of the eustachian tube leading to reduced ventilation of the middle ear. Balloon dilatation of eustachian tube improves the patency of cartilaginous part of eustachian tube and acquires great value in the treatment and prognosis of serous otitis media, tympanic membrane perforation, chronic otitis media, and cholesteatoma.

What is the procedure for Eustachian Tube Balloon Dilation?

Balloon dilatation of the eustachian tube can be performed under general or local anesthesia. This procedure involves the introduction of an inflatable catheter into the eustachian tube through the nasopharynx. Once the catheter is inserted, the balloon at its distal end is inflated by the introduction of saline solution, up to a pressure of 10 atmospheric pressure. The balloon is kept inflated at this pressure for two minutes. Then, the balloon is deflated and the catheter is removed under endoscopic vision. The postoperative period is practically painless, allowing patients to return to their normal lives within a few hours.

This procedure is based on the idea that temporary dilatation of the eustachian tube can improve symptoms (loss of hearing, pain and auditory fullness, otorrhea, tinnitus, and dizziness) of patients with tubal dysfunction.

Know more

What is the clinical effectiveness of Eustachian Tube Balloon Dilation?

The data on the effectiveness of balloon dilation are based on several comparative studies. In all the studies an improvement was observed in the evaluated variables (tympanometry, mucosal inflammation, improvement of general symptomatology, quality of life).

The proportion of patients whose tympanogram results were classified as A (normal) after the intervention varied between 90-97% (1) (2). The duration of follow-up ranged between 2 months and 4.2 years.

With regards to the findings obtained with the otoscope, it was evidenced that 100% of the patients who presented with retractions of the tympanic membrane before the procedure were free of them after the intervention (2).

To evaluate the improvement of symptoms, a group of German researchers used a composite scale whose values ​​ranged from 0 to 10; Values ​​above 5 indicated functional Eustachian tubes. The mean preoperative value was 2.71 and the postoperative value at 2, 12 and 24 months of follow-up was 5.46; 6.07; and 6.14, respectively (3) (4). In the studies that used this scale, 78% of the eustachian tube balloon dilatation treated patients showed an improvement at 2 months of follow-up.

Several studies have evaluated the inflammation of the middle ear mucosa on a scale of 1 (normal) to 4 (severe), obtaining a pre-surgical mean of 2.8 and 1.4 after the eustachian tube balloon dilatation intervention, evidencing an improvement in the inflammation after surgery in more than 80% of patients (1).

Regarding long-term results, 87% of the population showed persistent improvement of symptoms at 34 months of follow-up (5). The need to repeat the procedure was similar in different studies (2) (5) (6), within a range of 8-10%.

After the eustachian tube balloon dilatation intervention, the quality of life of patients improved both in general health and specifically in relation to the disease. In a study using the Glasgow Benefit Inventory (GBI) questionnaire, a statistically significant improvement was obtained in the global score, in the “general health” subscale and in the “physical health” subscale (7).

What are the risks involved?

Based on the available studies, the safety and tolerability of balloon dilation in adults is good, presenting with mild adverse effects in very few cases. These effects are usually self-limiting or can be treated with local decongestants.

The most frequent adverse event has been the appearance of slight bleeding in the nasopharyngeal region. Otitis media and emphysema have also been observed in the facial area in some cases.

References

  1. Silvola J, Kivekas I, Poe DS. Balloon Dilation of the cartilaginous portion of the Eustachian tube. Otolaryngol Head Neck Surg. 2014;151:125-30.
  2. McCoul ED, Anand VK. Eustachian tube balloon dilation surgery. Int Forum Allergy Rhinol. 2012;2:191-8
  3. Schröder S, Reineke U, Lehmann M, Ebmeyer J, Sudhoff H. Chronic obstructive eustachian tube dysfunction in adults: long-term results of balloon eustachian tuboplasty. HNO. 2013;61:142-51.
  4. Sudhoff H, Schröder S, Reineke U, Lehmann M, Korbmacher D, Ebmeyer J. Therapy of chronic obstructive eustachian tube dysfunction: evolution of applied therapies. HNO. 2013;61:477-82.
  5. Catalano PJ, Jonnalagadda S, Yu VM. Balloon catheter dilatation of Eustachian tube: a preliminary study. Otol Neurotol. 2012;33:1549-52.
  6. Poe DS, Silvola J, Pyykko I. Balloon dilation of the cartilaginous eustachian tube. Otolaryngol Head Neck Surg. 2011;144:563-93.
  7. Bast F, Frank A, Schrom T. Balloon dilatation of the Eustachian tube: postoperative validation of patient satisfaction. ORL J Otorhinolaryngol Relat Spec. 2013;75:361-5.


Take the Sleepiness test

Epworth Sleepiness Scale

Do you have sleepiness issues?

Do you suspect having sleep issues? Do your friends and family constantly keep reminding you to freshen up? How likely are you to doze off or fall asleep in the different situations such as while reading, watching tv, etc?

The Epworth Sleepiness Index helps you assess your sleepiness by quantifying your chances of dozing off in different situations. Even if you have not done some of these things recently try to determine how they would have affected you. The Epworth Sleepiness Scale helps understand if a patient needs medical attention or not. If you have a Sleepiness Issue, you can always consult the Sleep Disorder Specialists at Dr Rao’s ENT. We are equipped with state of the art sleep lab to assess problems such as sleep apnea & snoring to help provide the right treatment.

Go ahead and answer few simple questions to find for yourself your sleepiness index!

To know more visit this link.


Dr Chaitanya Rao undergoes Advanced Sinus Training at IRCAD Taiwan

Dr Chaitanya Rao undergoes Advanced Sinus Training at IRCAD Taiwan in a quest to become the best Sinus Specialist in Hyderabad (India)

We are proud to share that our Managing Director, Dr GVK Chaitanya Rao, has undergone training in advanced Sinus Surgery at IRCAD, Taichung, Taiwan. Dr Chaitanya Rao who is a member of American Rhinology Society(ARS) and European Rhinologic Society(ERS), joins the list of select ENT Specialists from India to have undergone this training. His areas of expertise include Nose & Sinus surgeries and this training extends his expertise further & places him as the best Sinus Specialist in Hyderabad (India).

About IRCAD, Taiwan

The course was held at IRCAD Taiwan between 15-16 February, 2019 for select ENT Professionals of various nationalities with the objective of equipping them with advanced techniques in Sinus Dissection. The course also gives insights into the global best practices and learn from the peer group.

Advantage to Dr. Rao's ENT patients

Dr Chaitanya Rao believes that in order to deliver the best treatment to patients, doctors need to constantly keep themselves up-to-date with the emerging methods and the training at IRCAD was in this direction. He firmly believes that continuing medical education should be part of every ENT specialists’ DNA. Dr Chaitanya supports his belief by training other ENT specialists through Dr Rao’s ENT Workshops.

With medical advancements, surgeries are becoming safer, efficient and less worrisome to patients. Therefore, by undergoing regular CME programs, doctors can ensure these advancements reach the patients.

Through these programs our doctors will also get exposure to the global best practices. These practices are absorbed into the processes we follow at Dr Rao’s ENT. It has been the vision of our founder & renowned ENT Specialist, Dr GVS Rao, to constantly drive knowledge up-gradation and this has been an integral part of our approach since inception.

Objectives of the training were as follows

  • Structured anatomic preparation, each step referring to clearly defined anatomical landmarks, after concise lectures and master dissection.
  • Dissection training with HD-videoendoscopy, a large variety of microsurgical instruments, shaver and navigation.
  • Intensive supervision with a experienced supervisor.
  • Specific adjunctive course material like access to essential videoclips of all important surgical steps.
  • Each complete, nature-identical anatomical specimen is subjected to preparation by two participants.


Free ENT Screening Camp in association with VR4U in Manikonda, Hyderabad

Dr Rao’s ENT Super Specialty International Hospital in association with VR4U Group organized a free ENT Screening Camp in ZPH Govt School, Manikonda on 27 January, 2019. We are happy to do our bit in spreading awareness about ENT Health and thank all our patrons who participated in the camp to make it a success.


14th Asia Oceania ORL & HNS - 71st AOICON 2019

Dr Rao’s ENT is proud to have successfully hosted the 14th Asia Oceania ORL & HNS – 71st AOICON 2019 as Surgical Venue. Dr Jacques Magnan & Dr Didier Portmann, renowned international ENT Specialists appreciate the contribution of Dr Rao’s towards the success of the conference. We are happy to share our coverage on TV5.


Why ear discharge can indicate a more serious condition and should never be ignored

Ear Discharge can indicate something serious as in the case of Mr Loganathan from Tamil Nadu who has been suffering from severe ear discharge coupled with intense headaches and sharp pain in the right ear! On medical investigation, it was found that the discharge was caused due to Cerebrospinal Fluid(fluid surrounding the brain) leaking through his ear. Mr Loganathan was saved by timely medical intervention and surgery.

Our expert take, “Ear discharge can often be due to ear wax but can also indicate something more serious such as ear infection, ruptured ear drum, mastoiditis, head injury, etc. Ear discharge is just a symptom which can have a serious underlying cause. If you notice ear discharge in your family member, rush to your nearest ENT specialist like Dr Rao’s ENT to get a thorough diagnosis as any delay can prove fatal depending on the cause.”

The problem –

Mr Loganathan met with a road accident in 2010 where he escaped a head injury, following which he underwent tympanomastoidectomy (surgery to treat infections) in his right ear. In 2012, Mr Loganathan was given ear drops to dissolve the ear mass in his external ear.

Know more here – http://www.newindianexpress.com/cities/chennai/2018/dec/18/namakkal-native-suffers-brain-palpitation-apollo-docs-save-life-1913304.html

Symptoms –

  • Mass in his external ear
  • Severe ear discharge
  • Pulsating sound in his right ear
  • Pink, insensitive mass filling his external auditory canal

Treatment –


Breathing through the mouth - Causes, symptoms & harmful effects

Is mouth breathing bad for your health?

In human beings nasal passages perform multiple tasks, the air we breathe when it goes through the nasal passages gets warmed, humidified and filtered before it reaches our lungs. Dust, allergic items like pollen and other debris which may carry microbes are removed thereby acting as a natural filter and a first line of defence. We are deprived of these benefits when we breathe through our nose. Also nose performs the dual purpose of sensing smell which is totally lost when we breathe through our mouth.

 

What are the types of mouth breathing?

Mouth breathing can be classified into three types –

  1. Obstructive
  2. Habitual
  3. Anatomic

What causes mouth breathing?

There may be various causes for mouth breathing and it may vary from children to adults. The common causes of mouth breathing are as follows –

  1. Blocked sinuses
  2. Swollen tonsils or adenoids
  3. Deviated septum
  4. Obstruction of nostrils
  5. Facial irregularities
  6. Dental issues
  7. Allergies
  8. Chronic respiratory infections

Children or adults who breathe through their mouth chronically may be deprived of sleep which may cause long periods of fatigue, affecting studies and work. Prolonged mouth breathing may result in facial and dental abnormalities making matters worse. It is also noticed that mouth breathing may result in insufficient oxygen supply causing heart issues, high blood pressure, snoring and sleep apnea.

Hence it is highly advisable to visit an ENT doctor if you notice a prolonged period of mouth breathing. Often in kids, mouth breathing manifests as mouth odour, snoring and irritable behaviour due to insufficient sleep.

You can consult a doctor if your family members exhibit any of the following symptoms –

  1. Snoring
  2. Bad breath
  3. Dry mouth and hoarseness of voice
  4. Chronic fatigue and tiredness
  5. ADD (Attention Deficit Disorder)
  6. Nasal tone while speaking

Early detection always results in taking necessary corrective measures thereby preventing lasting damage and issues at school or work. Book an appointment with the ENT experts at Dr. Rao’s ENT to diagnose your mouth breathing issues.


Stridor – Nothing sound about this!

Stridor is usually caused by a blockage in the windpipe or obstruction in the upper airway. It is important to detect the cause for the proper treatment of Stridor, as it can occur due to illness, infection, the presence of foreign objects or congenital throat abnormalities.

Types

Inspiratory Stridor: It is caused by airway obstruction above the glottis.

Expiratory Stridor: It is indicative of an obstruction in the lower trachea.

Biphasic Stridor: It suggests a lesion in or below the glottis.

Causes

Laryngomalacia is the most common cause of chronic Stridor in children. Croup is indicative of acute Stridor.

Anatomy: The anatomical structure of a child’s airway can also be a cause of Stridor. The upper airway in children is shorter and narrower than that of an adult, and is therefore, more likely to lead to obstruction breathing problems.

Larynx Collapse
: This is a very common cause for Stridor. The narrowed or collapsed parts of the larynx (commonly referred to as voice box) cause obstruction in the airway.

Subglottic Hemangioma: Arare airway disorder in children, it is characterised by the formation of a mass, consisting of blood vessels in the voice box, which causes obstruction in breathing. The child may require a surgery if the obstruction is severe.

Vascular Rings: It is an unusual condition when the abnormal formation of the aorta or other structures like arteries or veins compress the airway or windpipe.

 

Tonsillitis and ViralCroup can also cause Stridor in children.

Symptoms

Abnormal sound: Stridor can be identified with the abnormal sound when we breathe in or out.This sound indicates a problem with the tissue above or near the vocal cords.

Windpipe blockage: Expiratory Stridor creates discomfort particularly during breathing out, and is accompanied by abnormal sounds.The reason could be a blockage in the windpipe.

Shortness of breath: The individual may not be able to take deep, long breaths because of the narrowing of the windpipe.

Diagnosis
Identifying and establishing the exact cause for Stridor is of utmost importance to treat Stridor accurately. The specialist may ask you questions that include:

  • Whether skin and nails have changed colour to blue
  • Whether the child has inserted any foreign object in the nose/mouth
  • If the person is finding it difficult to breathe
  • The rate of breathing
  • If the person is suffering from a cold or bronchial infection

The consulting physician may also prescribe tests such as X-rays, bronchoscopy and laryngoscopy for better diagnosis.

 

In the event that your specialist presumes a disease, he/she may advise you to undergo a sputum culture. This test checks mucus from the lungs for infections. It enables the specialist to check whether a contamination, for example, Croup is present or not.

Treatment
Treatment options vary from person to person, depending on the age, cause and severity of the problem.

The Specialist may also:

  • Suggest that you visit an ENT specialist
  • Prescribe oral or injected medication to reduce swelling in the airway
  • Recommend hospitalization or surgery in acute cases


Rheumatic Fever – Symptoms, Causes and Diagnosis

Everything in this universe is consequential, so is human life on this planet. A human body is probably the finest machine that one can find on this planet, and everyone should treat their bodies as they would treat a prized possession. We should ensure that we take a proper care of bodies. Rheumatic fever is an inflammatory disease that arises as the result of the untreated or inadequately treated strep throat or scarlet fever. A throat infection which is caused by the bacterium Streptococcus pyogenes, if left untreated may cause rheumatic fever.

Children belonging to 5-15 years of age are commonly diagnosed with the disease but it could also happen to the adults. This disease still remains common and prevalent in South Central Asia and African counties. Rheumatic fever could be a serious life-threatening disease because if it is not treated properly it can lead to Rheumatic heart fever. Rheumatic heart fever can cause infection to the valves and heart failure.

Causes of Rheumatic fever:

Rheumatic fever is caused by Group A Streptococcus bacterium which causes strep throat, and in some individuals, it may also cause an inflammatory disease called scarlet fever.

The strep bacteria have a similar protein that resembles the one found in certain tissues of the body. It manipulates the immune system into the treating the body’s own tissues as an infection and produces the antibodies which attack the body tissues specifically the tissues of heart, joints, skin and nervous system.

Symptoms:

Rheumatic fever symptoms do not remain same for all and may vary from person to person. These symptoms usually develop within 2-3 weeks after strep throat infection manifests. The symptoms include the following.

  • Painful joints or arthritis
  • Fever with a temperature above 101F
  • Sore throat
  • Fatigue
  • Nausea and vomiting
  • Headache
  • Swollen tonsils
  • Difficulty in swallowing
  • Chest pain
  • Difficulty in breathing

Treatment:

Treating the rheumatic fever involves completely getting rid of the traces of the Group A Streptococcal bacterium, treating the symptoms and controlling the inflammation. It includes the following

Anti-inflammatory treatment:

Anti-inflammatory treatment includes the prescription of pain relievers like aspirin or naproxen to relieve the pain, break the fever and reduce the inflammation. If the patient does not respond to the medication, the doctor might recommend corticosteroids.

Antibiotics: You will be treated with antibiotics like penicillin to destroy all the traces of the strep bacteria. This antibiotics medication may continue for 5 years to prevent the recurrence of rheumatic fever. In case of a damage to the heart, the doctor will recommend antibiotics medication for 10 years or longer


Alcohol effects on Sleep Apnea

Sleep apnea and alcohol is a dangerous cocktail mix. Alcohol consumption before going to bed can induce sleep apnea and other sleep disorders. A study by the researchers reveals that the alcohol consumption at night may cause obstructive sleep apnea, since alcohol tends to relax the muscles in your body which include the throat muscles that collapse, blocking the airway that leads to the lungs. When the airway is blocked, the brain usually sends a signal forcing you to wake up and clear the airway passage. Alcohol reduces the chances of your reflexes, diminishing the chances of your awakening from the sleep during the sleep apnea.

Does alcohol invite the Sandman?

Not really. In fact, alcohol decreases the amount of your REM sleep. It is a myth that a swallow of your favorite drink before going to bed will help you sleep well because the human body tends to develop tolerance to the alcohol after a few nights.

Lack of sleep forces you to increase the quantity of the alcohol consumption, but it results in frequent disruption of the rest. When your body metabolizes the alcohol, it causes excessive sweating, loud snoring, headaches and the regular visits to the bathroom apart from the sleep apnea.

So, Quit alcohol?

If you are diagnosed with sleep apnea, the best advice is to abstain from alcohol. If you wish to enjoy a drink or two (not more than that), consider drinking several hours before you go to sleep. Limit the alcohol consumption if you have to drink.

Does alcohol affect men and women differently?

Sleep apnea is relatively common among the males than the females. However, women absorb alcohol more because they have fewer enzymes to break down the alcohol molecules. Women are likely to get the higher concentration of liquor despite drinking the same amount as men, which may cause disrupted sleep, snoring, nightmares and headaches.

Women are advised to have alcohol at least 4 hours before the sleep, and the quantity should be restricted to as minimum as possible.

If you have snoring or OSA (Obstructive sleep apnea), it is time to visit best ENT doctor in hyderabad at Dr. Rao’s ENT hospitals


Snoring in children

Snoring in children

Mouth breathing and snoring in children is not healthy. Snoring in children is caused because of enlarged adenoids, tonsils, with or without co-existing allergies. If medical treatment is unsuccessful and the problems are recurrent, surgical removal should be planned.

Adenoids and snoring

Adenoids is a lymphoid tissue sac situated in the roof of the throat behind the soft palate, where the nose opens into the throat.

It is a vestigial organ whose absence will not have any adverse effects on the human body. It is seen in children up to 7 years of age, after which they atrophy and disappear entirely.

Adenoids enlarge in size due to recurring nose and sinus infections, which do not give an opportunity for adenoids to subside in size. Adenoids also act as a reservoir for bacteria during infections and protect them from the antibiotic action, slowly releasing them later leading to recurring nose and sinus infections.

Adenoids block the eustachian tube openings present just behind the nose. Proper functioning of eustachian tube is essential for ventilation of the ear, the absence of which leads to ear pain, ear blockage, fluid formation in the middle ear. Children with fluid in the middle ear may complain of intolerance to loud sounds.

Tonsils and snoring

Tonsils, another vestigial organ, when enlarged also lead to snoring by compromising the space available behind the mouth, through which air has to pass once it reaches the back of nose while breathing.

Allergic rhinitis and snoring

Allergic rhinitis causes enlargement of tissues of the nose, especially turbinates compromising the nasal space available for the air to flow through.

Snoring is harmful

Breathing through the nose is essential as nose acts as an air conditioner and filter protecting the lungs from harm and stress. Enlarged adenoids and tonsils cause mouth breathing which causes bypassing of critical functions in the nose.

Snoring is associated with sleep apnea in most of the children which cause disturbed sleep. Children with sleep apnea struggle for breath while asleep, and keep moving all around the bed in the process of finding a sleeping position where they can breathe well. Sleep apnea causes the child to be cranky, hyperactive. The child will lack concentration and stability. Most of these children tend to overeat causing obesity.

Management of snoring in children

Medical management with nasal decongestants, oral decongestants, nasal washes, nasal steroid sprays can be tried for snoring and mouth breathing.

Despite long-term medication, if the resolution of symptoms is incomplete or symptoms are recurring on a regular basis, we have to plan for surgical removal of adenoids, tonsils with or without turbinate reduction for allergic patients. If the fluid is present in the middle ear, grommetplacement in eardrum can be clubbed with adenotonsillectomy.

Allergic children will have to use anti-allergic medication and nasal sprays even after surgery to mellow down the hyper-reactivity of the nose in response to exposed allergens.