One of the things that makes ENT such an interesting speciality is the wide variety of symptoms that patients present with. However, as a patient this one of the reasons ear, nose and throat symptoms can be so worrying. These symptoms often give rise to anxiety, which can lead to other problems such as poor concentration, sleeplessness and forgetfulness, which makes matters worse.
Snoring. Most of us do it occasionally, and the majority of people see it as just a minor annoyance. However, it can be a symptom of more serious conditions, such as sleep apnoea, so if you are aware that you snore regularly and are worried you might have sleep apnoea (see below) it might be worth seeking expert advice.
You may be wondering what Nick Park’s lovable plasticine characters have to do with ear, nose or throat conditions – the answer is, very little other than sharing a name with a medical device which can help alleviate ear problems in young children.
Painful ear infections
Children can be prone to suffering from ear infections. These can be very painful, resulting in repeated trips to the doctor and time off school. There is, however, an effective treatment for recurring ear infections, a tiny tube called a grommet that is inserted into the middle ear.
The very short procedure takes place while the child is under general anaesthetic. The grommet’s tubular shape allows air to pass through into the middle ear (behind the ear drum) which helps drain the excess fluids which cause ear infections.
Treatment for glue ear
Grommets can also help treat ‘glue ear’, which is a condition that commonly affects children. It is caused when the middle section of the ear becomes filled with fluid due to the malfunction of the tube that drains the middle ear to the back of the nose (the Eustachian tube). Often the first symptom of glue ear is that children struggle to hear clearly, although it is not usually painful.
If glue ear doesn’t settle of it’s own accord, grommets can help the excess fluids drain away, providing an easy and effective solution to this problem.
Grommets are tiny plastic tubes, a couple of millimetres wide, that come out of their own accord, usually after ten to twelve months. There is no need for a follow up procedure to remove the grommet. As a general rule, children will grow out of conditions such as repeated ear infections and glue ear. Grommets can help alleviate matters whilst this occurs.
Preparing your child for surgery
Going into hospital can be unnerving for people of any age, but is especially so for children. However, the operation is quick and it won’t be long before it’s time to go home – generally patients can expect to go home around two hours after the procedure has been completed. Most children need only one day off school.
Mr Julian Hamann, a father of three, is experienced at putting children at ease before their procedure. He understands that explaining the process in terms they can understand is important in alleviating their anxiety.
Nosebleeds are unpleasant, and happen for a number of reasons. Most nosebleeds are relatively harmless, although very rarely they may be a symptom of something more serious. In most cases, simple preventative steps can be taken to try and reduce their frequency. In order to establish whether or not you should seek medical attention, it is helpful to understand why nosebleeds occur.
There are two broad types of nosebleed:
- Anterior – this means the bleeding has started towards the front of your nose
- Posterior – these are less common and start at the back of your nose
What causes anterior nosebleeds?
Anterior nosebleeds are more common, and are rarely a cause for concern. They result from the delicate blood vessels near the entrance to your nose bursting.
This may be due to physical causes, such as an injury or bump to the nose; blowing your nose very hard; inserting fingers into the nose (a common problem in small children) or nasal complaints such as a cold or sinusitis.
Environmental factors can also cause anterior nosebleeds. These include allergies such as hay fever; changes in altitude; rapid changes of air temperature; dry air or overuse of over-the-counter decongestant sprays.
Anterior nosebleeds are generally self-limiting.
More serious conditions
Posterior nosebleeds can be more serious. The blood is coming from larger arteries, located further back in the nose. Therefore, the flow can be harder to control. The blood is also more likely to run into the throat.
These nosebleeds can result from head or facial injury. Very rarely, they may be symptomatic of nasal tumours. Some people are more prone to this type of nosebleed.
Both anterior and posterior nosebleeds can be exacerbated by certain types of medicine, such as those prescribed for blood thinning (for example, aspirin or warfarin). Some herbal medicines, such as gingko biloba, can also increase the risk of bleeding.
People suffering from high blood pressure may have an increased susceptibility to nosebleeds. Nasal problems such as a bend in the middle partition of the nose (septal deviation) or chronic rhinitis or sinusitis also leave people more vulnerable to nosebleeds.
When to seek medical advice
Nosebleeds are rarely serious, and it is important to stay calm. You can apply pressure to the middle partition at the front of the nose by pinching the nostrils, and most nosebleeds will stop of their own accord. If you think you may be suffering from one of the more serious types of nosebleed, or you have been experiencing blood flow for more than 20 minutes, it is sensible to seek medical attention.
If you are experiencing frequent nosebleeds you may be referred to an ENT surgeon. Consultant ENT surgeon Mr Julian Hamann can investigate and treat nosebleeds. Treatment is often simply a matter of cauterising the ‘bleeding point’ in the nose, sealing it to prevent recurrence of the problem.
Balance is controlled by a complex network of signals that are sent to the brain from our eyes, inner ears and other sensory systems, via our skin, muscles and joints. It is a delicate equilibrium – if something malfunctions within this system that affects our balance, it can be an unsettling and very disconcerting experience.