A Brief Overview of Ear Nose and Throat (ENT)

1. Persistent Nasal And Sinus Congestion or Infections

Cause

Nasal and sinus congestion and infections can be caused by allergies, a viral cold, or a bacterial infection.

Symptoms

Sinus congestion can cause facial pain and pressure, a stuffy and runny nose, headache, and postnasal drip. Sinus infections can cause fever, fatigue, and bad breath.

Treatments

• ENT Non-Invasive Treatment: Treatment for sinus congestion and infections may include taking steroid nasal sprays, decongestants, antihistamines, and antibiotics.
• ENT Surgical Treatment: The most common surgical treatment for persistent sinus congestion or infections is functional endoscopic sinus surgery (FESS). This procedure involves using a small, rigid camera and instruments to open blocked sinuses and remove tissues that cause congestion or infection. Other surgical treatments include septoplasty, reduction of interior turbinates and submucosal diathermy.

2. Ear Pain, Infection, or Hearing Loss:

Cause

Ear ache, infection, and hearing loss can be caused by a variety of issues, including an infection, injury, or an underlying medical condition, including cholesteatoma or nasopharyngeal masses or tumours.

Effect

Symptoms of ear ache, infection, or hearing loss can include pain, itchiness, discharge, dizziness, ringing in the ears, and hearing difficulties.

Treatments

• Non Invasive Treatment for ear pain, infection, or hearing loss can include oral and topical antibiotics, antifungal medications or steroids and microsuction of ears. Patients may require radiological investigation including MRI scans.
• The surgical treatment options for ear pain, infection, or hearing loss will depend on the underlying cause of the issue and include tympanostomy, insertion of ventilating tubes, tympanoplasty, and mastoid surgery, and sometimes surgical biopsies. 

3. Tinnitus (Ringing in the Ears):

Cause

Tinnitus can be caused by a variety of factors, including exposure to loud noises, ear infections, wax buildup, medications, and underlying medical conditions.

Symptoms

Tinnitus can cause a ringing, whistling, buzzing, or hissing sound in the ears that can range from mild to severe.

Patients should seek medical advice and possibly further investigation, including hearing tests and MRI scans.

4. Balance Problems:

Cause

Balance problems can be caused by a variety of issues, including inner ear infections labyrinthitis, head trauma, medications, and underlying medical conditions, including Benign paroxysmal positional ventigo (BBPV) and Meniere's disease. One should also consider neurological and cardiovascular causes of balance problem.

Symptoms

Balance problems can cause dizziness, nausea, difficulties in walking, light-headedness and ear symptoms including tinnitus, deafness and ear fullness.

Treatment

• Non-invasive Treatment for balance problems can include medications, vestibular rehabilitation, physiotherapy including Epley maneuver and lifestyle changes. Patients would normally need an MRI scan of the brain to exclude neurological causes.
• There are several surgical treatments available for balance problems, depending on the cause, but these are rarely necessary.

5. Voice Changes, Hoarseness, or Vocal Cord Dysfunction:

Cause

Voice changes, hoarseness, or vocal cord dysfunction can be caused by a variety of issues, including voice abuse or misuse, allergies, a cold, or an underlying medical condition including benign or malignant tumours.

Symptoms

Voice changes, hoarseness, or vocal cord dysfunction can cause difficulty speaking, a feeling of dryness in the throat, and a loss of vocal range.

Any patient who has had any voice changes for over 2 weeks should seek medical advice.

6. Neck Masses or Enlarged Lymph Nodes:

Cause

Neck masses or enlarged lymph nodes can be caused by a variety of issues, including infection, cancer, or an underlying medical condition, including thyroid diseases and salivary gland diseases.

Symptoms

Neck masses or enlarged lymph nodes can cause pain, tenderness, and swelling in the neck and breathing and swallowing difficulties.

Patient with persistent neck masses or enlarged lymph nodes should seek medical advice.

7. Sore Throat and Swallowing Difficulties:

Cause

Sore throat +/- swallowing difficulties can be caused by viral upper respiratory tract infection (URTI), bacterial infections including tonsillitis, glandular fever (infectious mononucleosis) and sometimes tumours of the throat.

Symptoms

Patients may experience sore throat, pain and difficulty in swallowing, fever and tiredness.

Treatments

Non invasive treatments include antibiotics, painkillers and mouth gargles.

Surgical treatments would depend on the underlying causes and may include tonsillectomy and surgical biopsies.

8. Sleep Apnoea

Cause

Sleep Apnoea can be caused by excessive body weight (high BMI), nasal and throat problems and sometimes a combination of the above.

Symptoms

Snoring and daytime sleepiness are common symptoms but if sleep apnoea is not treated, patients can develop high blood pressure, heart and lung diseases and stroke.

Treatments

Non-invasive treatments include Continuous Positive Airway Pressure (CPAP) machine and dietary control.

Surgery may be necessary and it includes septoplasty, reduction of inferior turbinates and uvulopalatopharyngoplasty (UPPP).