Professional voice users like teachers & singers can develop vocal cord nodules or a thickening of both their vocal cords if they strain, misuse or overuse their voice. If diagnosed early, then conservative treatment including voice rest and medication with some steam inhalation will usually resolve the problem. However, if the nodules are longstanding, then sometimes surgery is indicated. This is done through the mouth with the help of a magnifying surgical microscope in the operation theatre, under general anesthesia.
This is usually due to allergy to inhaled allergens, especially those due to the dust mites on the bed and pillow. Proper regular cleaning of the bedding and pillow is required to improve the symptoms. Also, using an air purifier in the bedroom may help. An examination of the nose to rule out the presence of allergic swelling or ‘polypi’ in the nose or sinuses will be required. Medications may be prescribed if the above measures do not help in improving the symptoms.
Usually seen in people who have an allergic tendency, especially seasonal allergy. Also, some of the people may be suffering from an underlying sinusitis, which is exacerbated whenever the weather changes. A complete history, nasal examination and nasal endoscopy will be required to find the cause for the recurrent colds and prescribe treatment.
First of all it is important to confirm the fact that sinusitis is the cause of the headache. This requires a detailed history taking, ENT examination and a Diagnostic Nasal Endoscopy. The endoscopy tells the doctor the areas of blockage in the sinus drainage paths which are responsible for the accumulation of mucus and the attacks of sinusitis. Medications are then prescribed as a large percentage of cases of sinusitis are curable with medicines. However, if the medicines are not able to cure the person or the endoscopy shows a severe blockage that cannot be treated with medicines, then Endoscopic Sinus Surgery is prescribed. Milder cases can be treated with a relatively new technique called Balloon Sinuplasty.
Balloon Sinuplasty is a minimally invasive technique where a slender balloon catheter is passed into the sinus openings and then inflated for about 10 seconds. Then the catheter is removed. The balloon opens the thin passages through which the sinus drains. These openings remain patent even many years after the procedure. This procedure has brought relief to thousands of patients suffering from sinusitis all over the world.
All causes for such cough have to be ruled out to isolate the actual cause for the cough. Usually, a persistent post nasal drip from allergy or sinusitis, mild bronchospasm or laryngo-pharyngeal reflux are the common causes. Other reasons like chest infection or some restrictive lung diseases may also have to be ruled out by further tests. Treatment of the underlying cause will usually cure the cough.
OSAS or Obstructive Sleep Apnoea Syndrome is responsible for sleeping persons to have many episodes of obstructed breathing at night. This leads to disturbed sleep and daytime sleepiness. Some of the patients may feel that they wake up at night with a choking feeling. OSAS is a disease that needs treatment, as it is suspected to be cause high blood pressure, stroke (paralysis attack), daytime driving accidents and even death at night while sleeping. A test called a sleep study or polysomnogram is done at night which identifies the severity of the sleep apnoea. Treatment is traditionally with a positive pressure machine called a CPAP which the patient has to wear at night around his mouth or nose. However, compliance with this device is low. Newer surgical techniques for snoring and sleep apnoea are giving good results, and the patients do not need to wear the CPAP machine at night.
Heavy snoring disturbs those sleeping around the patient. Sometimes, snoring is so loud that it can be heard in the next room. Such “heroic’ snoring needs treatment, as it severely disrupts the sleep of the spouse and others in the family. All causes of obstruction to the airflow are investigated and treatment usually involves surgery to bypass the obstructions.
Bad odour from a person’s nose is usually due to an infection in the sinuses, called sinusitis. It can also indicate a growth in the nose or sinuses. An ENT exam is necessary to try and find the cause. A nasal endoscopy may be required to further have a better look inside the nose. If the patient gets a bad odour in his own nose, but other people do not, then it is important to get ENT consult immediately. An MRI may also be required in such cases.
Bad odour from one’s mouth can also be due to deposits between the teeth and gums, which results in an inflammation called gingivitis. A visit to the ENT doctor is however mandatory to rule out the other causes.
Many people mistakenly think that their recurrent sore throat is due to tonsillitis. However, all cases of sore throat are not tonsillitis. An ENT consult is necessary to come to a diagnosis so that treatment can be started. Reasons for a sore throat are many and could be allergy, acid reflux, sinusitis, tonsillitis, vitamin deficiency, chewing paan masala or betel nut, smoking etc to name a few. Treatment would depend on the cause.
Deviations of the nasal septum, enlarged turbinates, nasal allergy, infections of the nose or sinuses, enlarged adenoids etc may be responsible for the nasal blockage. When we lie down, the blood pools in the nasal lining, causing it to swell up a bit. This is normal. However, a person with a compromised airway will feel blocked up whenever they lie down, especially at night. A nasal examination will confirm the diagnosis. Treatment would depend on the cause. For example, medications to control the allergy will help those with allergic swelling of the lining in the nose. Sometimes, minor procedures may be needed to open up the passages in the nose, so that you can start breathing well through your nose.
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