ENT (Ear, Nose, and Throat) Specialty

Hearing loss is one of the most common conditions that otolaryngologists diagnose and treat.

This condition often develops with age as a natural result of ageing. Other causes include chronic ear infections, trauma to the ear or head, extended exposure to loud noise, and even certain ototoxic medications.

Signs of hearing loss include:

• Difficulty hearing other people clearly
• Ringing in the ears
• Muffled sounds
• Frequently asking others to repeat themselves

Vertigo is a sensation that you or the environment around you is spinning or moving. It can cause a person to feel lightheaded and unbalanced.

Common causes of vertigo include disorders of parts of the ear and brain that regulate balance. Other causes include benign paroxysmal positional vertigo (BPPV), head injury, inner ear infection and Ménière's disease.

Symptoms include:

• Loss of balance
• Dizziness
• Nausea or vomiting
• Ringing in the ears (tinnitus)
• Headache

Obstructive sleep apnoea (OSA) is a common condition that interrupts normal breathing during sleep due to a relaxed and narrowed airway.

Common symptoms include:

• Noisy and laboured breathing
• Loud snoring
• Repeated short intervals where breathing is interrupted by snorting or gasping
• Morning headaches
• Tiredness during the day

This is an infection of the middle ear characterised by inflammation (swelling and redness) and the accumulation of fluid behind the eardrum due to an infection such as cold.

Symptoms include:

• Pain in the ear
• Fever
• Mild hearing loss – if the middle ear has a fluid accumulation
• Discharge from the ear
• Loss of balance (rarely)

It is the inflammation of the inside of the nose caused by allergens such as pollen, mould, dust, or skin flakes from certain animals.

Symptoms of allergic rhinitis include:

• Runny or blocked nose
• Itchiness
• Sneezing

This happens when the nasal passages are blocked, causing difficulty in breathing through the nose. It may be due to various conditions like cold, infection of the sinus, allergic and non-allergic rhinitis, swollen turbinates, nasal polyps, nasal cysts, or tumours and deviated nasal septum.

Nose bleeds occur due to a broken blood vessel in the nose. These are often not serious and can be treated at home. It can be heavy or light and last for a few seconds to minutes.

The inflammation of the tonsils is called tonsillitis. It is usually caused by viral or bacterial infection.

Symptoms include:

• Red and swollen tonsils
• Sore throat
• Cough
• Difficulty swallowing
• Swollen and painful lymph nodes in the neck
• High fever over 38oC
• Bad breath
• Headache
• Nausea

The treatment depends on the cause and severity of hearing loss.

• Conductive hearing loss: Treatment for conductive hearing loss is usually temporary and treatable. This condition can be treated with medication or minor surgery. For example, removing earwax build up with drops or surgically draining fluid from the middle ear.
• Sensorineural hearing loss: Treatment for sensorineural hearing loss is permanent. There are several options to improve hearing ability such as using a digital hearing aid and cochlear implants.

Vertigo treatment depends on the cause and severity of the symptoms.

During an attack of vertigo, lying still in a dark, quiet area may relieve nausea and lessen the spinning sensation. You may also be prescribed medicine.

You should also avoid stressful situations, as anxiety can exacerbate vertigo symptoms.

Treatment for Obstructive Sleep Apnoea (OSA) includes:

• Lifestyle changes: Quit smoking; lose weight if obese or overweight; limit alcohol consumption
• Continuous positive airway pressure: This treatment is needed for those with moderate to severe OSA. A small pump that provides a constant flow of compressed air through a mask covering the nose or the nose and mouth. The compressed air prevents your throat from closing.

Most middle ear infections (otitis media) resolve within three to five days without specific treatment.

Analgesics can be used to relieve pain. Antibiotics are not routinely used to treat otitis media. However, those with chronic infection may require short courses of antibiotics.

It may be impossible to entirely avoid allergens; however, you can take measures to minimise exposure to a specific allergen that you suspect is triggering your allergic rhinitis. As a result, your symptoms will improve.

For mild conditions, over-the-counter medications such as non-sedating antihistamines would help and routinely rinsing your nasal passages with a saltwater solution to remove irritants.

Speak to your doctor if none of the methods above help alleviate your symptoms, as you may require stronger medication such as a corticosteroid nasal spray.

After the doctor has identified the source of nasal obstruction, treatment includes washing with nasal rinses, medications and sometimes, surgery.

Nose bleeds are often not serious and can be treated at home. To stop a nosebleed at home:

• For at least 10 to 15 minutes, sit down and pinch the soft part of your nose just above your nostrils.
• Lean forward and breathe through your mouth to prevent blood from draining down the back of your throat.
• Place a towel-covered ice pack or bag of frozen veggies on the bridge of your nose.
• Stay upright instead of lying down, as this will decrease the pressure in the blood vessels of your nose and prevent further bleeding.

If bleeding still persists, then further treatment is required at the hospital.

Treatment options for tonsilitis include at-home care and rest, saltwater gargles, analgesics, antibiotics, and in some cases, surgery.