Frequently Asked Questions (FAQS)

Oral cavity

Q. What is tonsil and adenoid infection?
A. These glands are at the back of your throat. They help to fight against infections in throat and upper airway. They may get infected occasionally resulting in sore throat, fever and cough.

Q. What is adenoidectomy and tonsillectomy?
A. Tonsillectomy is surgery to remove the tonsils. It is often combined with adenoidectomy which means removal of adenoid tissue.

Q. What happens in the surgery?
A. Your child will be given general anaesthesia before surgery. They will be asleep and pain free. The surgeon cuts or burns away the tonsils (laser is a good option) and after the surgery the tonsillar wound heals naturally without stitches.
Your child will stay in the recovery room after surgery until they are awake and can breathe easily, cough, and swallow. Most children go home several hours after this surgery.

Q. What will happen if my child is not operated?
A. If the child has obstructive sleep apnoea along with adenotonsillectomy then not treating it surgically may have adverse outcomes on the child's health. Child may have severe snoring, heart problems, learning problems, ear discharge, inadequate weight gain and poor feeding, dental abnormalities and breathing problems during the round.

Q. How will the surgery make my child better?
A. After surgery the child has better breathing, has fewer episodes of sore throats, their ears have less chance getting fluid. Other proven benefits are improvement in bedwetting, some seizure disorders, IgA nephropathy and less number of absences from school.


Nose

Q. What are common causes of nasal obstruction?
A. Common causes of nasal obstruction include a Deviated nasal septum, nasal turbinate enlargement, and nasal polyps (whitish nasal mass)

Deviated nasal septum: it is the middle bony structure which divides the two sides of nasal cavity. A deviation or bend in this structure can be present at birth or can occur following a nasal fracture. The obstruction caused by such a deviation can be corrected by surgically straightening the septum, called a septoplasty.

A septoplasty is a minor surgery which is done to correct the deformity of septum. It is usually done and under local anesthesia and scars or incisions are given over nose. This procedure relieves the obstruction of nose and improves the breathing dramatically in obstructed individuals.

Nasal turbinate enlargement: The nasal turbinates are bony and soft-tissue structures present in the nasal wall. They may enlarge more than usual and completely block the nose. This is more common in persons with allergy .Allergy treatment, typically with nasal steroid sprays, may help to decrease this swelling. When allergy management does not sufficiently relieve nasal obstruction, the inferior turbinates can be surgically reduced by different methods like surgery, radiofrequency, laser and cautery. All these procedures cause significant improvement in breathing.

Nasal polyps: Nasal polyp cause nasal obstruction and these are boggy whitish mass like swelling in the nose. Sometimes they look like a bunch of grapes and may come out of the nose. They can be caused by uncontrolled allergy, sinus infections and inflammation. If untreated they can grow in the nasal cavity and sinuses and affect breathing, voice and may cause severe headaches. Nasal polyps are initially controlled with steroid sprays and may need surgery in uncontrolled polyps. Removal by endoscopic (with or without microdebrider) is the standard surgery. Treatment of polyps may also improve the symptoms of asthma (if they co-exist). No incisions or scars are present during or after surgery.

Q. What causes bleeding from nose?
A. Bleeding from nose or epistaxis can result from several causes. In children it is usually from nose picking, foreign bodies or dryness of nasal mucosa. In older people it may be from a spur in the septum, polyps, any benign or malignant tumors (associated with nasal obstruction) or bleeding disorders.

Q. How can it be treated?
A. No, radiation therapy does not hurt while it is being given. The side effects that people may get from radiation therapy can cause pain or discomfort. There are ways that the doctor and a radiation care nurse can help manage side effects.

Q. Is radiation therapy used with other types of cancer treatment?
A. First step is to identify the cause of bleeding. For this nasal examination, nasal endoscopy, x ray or CT scan may be warranted. For bleeding points cautery or septal correction may be needed. For masses and tumors endoscopic or open surgery may be required. It is very important that the cause of bleeding may be ascertained early so that the corrective treatment is instituted at the earliest for maximum.


Ear

Q. What causes ear pain?
A. Ear pain or Otalgia is an earache. Primary otalgia is from pain that originates inside the ear. Referred otalgia is from pain that originates from outside the ear. Ear pain is usually because of infection in outer ear, ear drum or behind the ear drum. Sometimes ear pain can be caused by several other conditions which are not related to ear, such as impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx, cervical root compression, jaw joint inflammation and occasionally malignancy in the throat and larynx.

Q. What causes ear discharge?
A. OOtorhea or ear discharge can be of pus, watery or mucus and pus together. Sometimes it may be mixed with blood. Common causes for ear discharge are Infection in the ear or inner ear.
Injury from a blow to the head, foreign object, very loud noises, or sudden pressure changes (such as in airplanes), resulting in a ruptured or perforated eardrum
Swimmer's ear -- usually accompanied by itching, scaling, a red or moist ear canal and pain that increases when you move the ear lobe.
Long standing ear discharge is usually a sign of chronic infective ear disease like chronic otitis media. All chronic ear infections should be evaluated to rule out unsafe type of ear disease (they have high rate of causing complications).

Q. What is tinnitus?
A. Tinnitus is the perception of sound within the human ear in the absence of corresponding external sound.

Q. What causes Tinnitus?
A. Tinnitus is not a disease but a symptom resulting from a range of underlying causes that can include ear infections, foreign objects or wax in the ear, nose allergies that prevent (or induce) fluid drain and cause wax build-up. Tinnitus can also be caused by natural hearing impairment (as in aging), as a side-effect of some medications, and as a side-effect of genetic (congenital) hearing loss. However, the most common cause for tinnitus is noise-induced hearing loss

Q. What causes hearing loss?
A. There are several reasons for hearing loss, however some of the common possibilities are :
1. Heredity
2. Trauma
3. Certain medicines
4. Long-term exposure to loud noise
5. Aging

Q. How is hearing loss treated?
A. There are two main types of hearing loss. One happens when your inner ear or auditory nerve is damaged. This type is permanent. The other kind happens when sound waves cannot reach your inner ear. Earwax build-up, fluid or a punctured eardrum can cause it. Untreated, hearing problems can get worse. If you have trouble hearing, you can get help. Possible treatments include certain medicines, surgery, hearing aids, special training and cochlear implants.

Q.What are Hearing aids?
A. A hearing aid is a body worn apparatus which typically fits in or behind the wearer's ear, and is designed to amplify and modulate sound for the wearer.

Q. What is a Cochlear Implant?
A. A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin.

Q. How does a cochlear implant work?
A. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn. However, it allows many people to recognize warning signals, understand other sounds in the environment, and go to a regular school and enjoy a conversation in person or by telephone.


Throat

Q. What are the causes of hoarseness?
A. Hoarseness is having difficulty producing sound when trying to speak, or a change in the pitch or quality of the voice. The voice may sound weak, very breathy, scratchy, or husky. Hoarseness that lingers for weeks or months may be caused by a variety of problems. Some causes are minor, while others are serious.

Minor causes are more common and usually because of inflammation of the larynx (laryngitis). This may be due to viral, bacterial, acid reflux, excessive smoking and alcohol and voice abuse. These conditions can be managed by antibiotics, conservative measures and speech therapy.

Major causes can be from vocal cord palsies, vocal cord tumors and growths, cancer of larynx, congenital problems of larynx to name a few.

Q. When can hoarseness be a serious problem?
A. You should immediately consult your ENT specialist if the hoarseness is accompanied with the following signs and symptoms.

1. You also have difficulty breathing or swallowing
2. Hoarseness is accompanied by drooling, especially in a small child and all children less than 3 months old.
3. Hoarseness has lasted for more than 1 week in a child, or 2 weeks in an adult.
4. Hoarseness with choking or severe coughing on feeding.
5. Hoarseness with an associated neck mass.

Q. How is hoarseness evaluated and treated?
A. Hoarseness is evaluated by a proper history and examination by fiber optic laryngoscope / stroboscope. It can show and diagnose most of the laryngeal problems. However for biopsy or detailed examination a direct laryngoscopy may be warranted.
They are treated according to the cause. For laryngeal growths and tumors a microlaryngeal surgery (MLS) may be warranted. For correction of voice, phonosurgery in the form of thyroplasties or MLS may be done. For laryngeal cancers, options include laser excision, open surgery and radiotherapy.


Head and Neck Cancers

Q. What are Head and Neck cancers?
A. Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat and lymph nodes in the neck. Most begin in the moist tissues that line the mouth, nose and throat. Symptoms include :

1. A lump or sore that does not heal
2. A sore throat that does not go away
3. Trouble swallowing
4. A change or hoarseness in the voice
5. Using tobacco or alcohol increases your risk. In fact, 85 percent of head and neck cancers are linked to tobacco use, including smoking and smokeless tobacco. If found early, these cancers are often curable.

Q. How are head and neck cancers diagnosed?
A.To find the cause of symptoms, a doctor evaluates a person's medical history, performs a physical examination, and orders diagnostic tests. The exams and tests conducted may vary depending on the symptoms. But the usual battery of tests may include a combination of these tests :

1. Routine blood investigations
2. X ray, ECG, pulmonary function test
3. CT Scan (CAT Scan), MRI and sometimes PET
4. Laryngoscopy, esophagoscopy, bronchoscopy and nasopharyngoscopy.

Q. How are Head Neck Cancers treated?
A.Treatments may include surgery, radiation therapy, chemotherapy or a combination. Treatments can affect eating, speaking or even breathing, so patients may need rehabilitation.