Common Ear, Nose, Throat Problems

Having Pain In the Ear
Earache can be due to causes locally in the ear or referred from other areas.

Common Local causes

1. » Boil in the ear- Severe pain in the ear; increased pain on moving the pinna & jaw
   Analgesics and Antibiotics will be required.
   
   
2. » Impacted wax:- In some people excessive wax may be secreted and deposited as a plug in the ear canal leading to decreased hearing and pain.
   It has to be removed by syringing or instrumental manipulation. Hard wax may require softening with wax solvents before removal.
   
   
3. » Infection of the ear canal ( otitis externa )
   Excessive scratching of the ear canal with match sticks or hair pins leads to trauma in the ear canal and to subsequent infection.
   Systemic causes:Antibiotics taken orally and local application of drops may be required
   
   
4. » Otomycosis ( Fungal infection)
   You may have intense itching in the ear and discomfort due to watery discharge .This is a condition seen commonly in swimmers. Antifungal drops may be required.
   
   
5. » Foreign body in the ear: Children are notorious for putting all sorts of things in their ears. The common objects being pieces of paper, seeds, chalk pieces, beads, ball bearings, broken pieces of match stick, cotton
   Doctoring should be avoided at home and an ENT specialist should be consulted.
   
   
6. » Acute Suppurative Otitis Media ( ASOM)
   
   

It is an acute inflammation of middle ear by pus causing bacteria. This condition is commonly seen in infants and children. Factors interfering with normal functioning of eustachian tube(the canal connecting the ear to the oral cavity) predispose to ASOM.

Common predisposing factors for ASOM are
Recurrent attacks of common cold, upper respiratory tract infections, Measles, Diphtheria.
Infection of the tonsils
Chronic infection of sinuses
Nasal allergy

Feeding a young infant in horizontal position may force fluids through the eustachian tube into the middle ear so they should always be nursed in a position where the head is slightly raised.

Initial complaints consist of deafness and/or mild earache if tube occlusion is prolonged .When earache becomes severe, it is associated with fever, decreased hearing and ringing sensation in the ears. The symptoms might subside with rupture of the ear drum and release of pus, or they may lead to complaints of giddiness, vomiting, tenderness behind the ear, high fever and so on.

An E.N. T specialist should be consulted in the early stages when there is mild earache. Antibacterial therapy, decongestants and antipyretics are needed. A minor surgery which involves incising the ear drum and releasing the pus may be necessary in a few cases.

G. Trauma to the ear. A slap on the ear or very loud noise can cause traumatic rupture of the tympanic membrane(ear drum) and pain in the ear with decreased hearing.
Ear should be examined and appropriate treatment instituted.

Other causes for pain in the ear

• Carious tooth
• Impacted molar
• Osteoarthritis of the Temporomandibular joint
• Acute tonsillitis
• Ulcers of the palate or tonque.

Bleeding from inside the nose. (EPISTAXIS)
Bleeding inside the nose is a common complaint presenting as an emergency and may occur in any age group. The various causes can be
Local causes:
Finger nail trauma due to excessive nose picking; trauma to the nose due to road accident or being hit by a ball or fist
Fracture of the nasal bones
Infections like viral rhinitis or acute sinusitis

Foreign bodies in nose
Deviation of the nasal septum
Atmospheric changes such as high altitudes
Any growth in the nasal cavity

General Causes
Hypertension – commonly seen in old age
Heart disease
Pregnancy
Bleeding disorders – when the patient has a deficiency in the system responsible for control of bleeding and there is an abnormal tendency to bleed
Drugs- Excessive use of analgesics for pain.
Acute general infections like Typhoid, Pneumonia, Malaria, Dengue fever, Measles.
At times the cause of bleeding may not be clear.

Management
Most of the time, bleeding can be controlled by pinching the nose tightly for about five minutes. Ice compress can be applied on the nose. They aid in stopping the bleeding.

If bleeding is profuse, patient should be taken to the doctor.

Hypertensive patients should take their antihypertensive
medication regularly.
Excessive nose picking is a common cause of bleeding in
both children and young adults and should be discouraged.