Advanced Ear Nose Throat Endoscopy Centre

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ADENOIDS

Where are adenoid?

The adenoid is a lump of tissue at the back of the nose above the tonsils. In order to see them, your physician can look through your mouth and view the back of your nose using a mirror, may choose to look with a flexible camera in the nose, or may use an x-ray.

What is the adenoid?

The adenoid is basically a lymph node. A lymph node contains “lymphocytes”, which are cells that help to fight infection. The adenoid is a part of a group of lymph nodes that include the tonsils, found around the back of the throat (known as Waldeyer’s ring). Together, they act to help process infections in the nose and throat.

What is adenoiditis?

Unfortunately, sometimes the adenoid tissue gets infected and the infection can last for weeks or months. This is called adenoiditis. If you have adenoiditis, you may have a runny or stuffy nose, post-nasal drip, headache or cough.

How is adenoiditis treated?

Usually adenoiditis responds to antibiotics taken by mouth. If antibiotics fail to get rid of the infection, the adenoid tissue may have to be removed.

What is adenoid hypertrophy?

In most children, the adenoid enlarges normally during early childhood, when infections of the nose and throat are most common. They usually shrink as the child gets older and disappear by puberty. However, in some children, the adenoid continues to become larger and block the passage behind the nose. This can result in snoring, breathing through the mouth, and/or a HYPONASAL sound to the speech (sounds like talking with a stuffed nose). Additionally, this can result in OTITIS MEDIA (middle ear infections) because of blockage of the eustachian tube (the tube that connects the ear to the throat).

When is adenoidectomy (removal of the adenoids) a consideration?

Some of the guidelines that I follow in order to consider an adenoidectomy are:

Chronic infection of the adenoid (sinus-like symptoms) despite adequate treatment.
Adenoid hypertrophy (enlargement) causing mouth breathing, nasal blockage, snoring, restless sleep.
Recurrent ear infections

What is involved with removing the adenoids?

Every patient who is to undergo removal of adenoid tissue is first screened to make sure they are not at an increased risk to have HYPERNASAL speech (sounds like talking through the nose) following surgery. The surgery is done through the mouth under a general anesthetic. Many times we use cautery (removal with suction and heat) to perform the surgery, resulting in very little, and many times, no blood loss. This surgery is performed on an outpatient basis and lasts about 20 minutes.

HEARING LOSS
Hearing loss that occurs gradually as you age (presbycusis) is common.

Hearing loss is defined as one of three types:

1. Conductive (involves outer or middle ear)

2. Sensorineural (involves inner ear)

3. Mixed (combination of the two)

Aging and chronic exposure to loud noises both contribute to hearing loss.

Other factors, such as excessive earwax, can temporarily reduce how well your ears conduct sounds.

SYMPTOMS

Signs and symptoms of hearing loss may include:

1. Muffling of speech and other sounds

2. Difficulty understanding words, especially against background noise or in a crowd.

3. Frequently asking others to speak more slowly, clearly and loudly.

4. Needing to turn up the volume of the television or radio

5. Withdrawal from conversations

6. Avoidance of some social settings

CAUSES
To understand how hearing loss occurs, it can be helpful to first understand how you hear.

HOW YOU HEAR

Your ear consists of three major areas: outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum. The eardrum and three small bones of the middle ear amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in a snail-shaped structure in the inner ear (cochlea).

Attached to nerve cells in the cochlea are thousands of tiny hairs that help translate sound vibrations into electrical signals that are transmitted to your brain. Your brain turns these signals into sound.

HOW HEARING LOSS CAN OCCUR
Causes of hearing loss include:

1. Damage to the inner ear. Aging and exposure to loud noise may cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals aren't transmitted as efficiently, and hearing loss occurs.

2. Higher pitched tones may become muffled to you. It may become difficult for you to pick out words against background noise.

3. Gradual buildup of earwax. Earwax can block the ear canal and prevent conduction of sound waves. Earwax removal can help restore your hearing.

4.Ear infection and abnormal bone growths or tumors. In the outer or middle ear, any of these can cause hearing loss.

5.Ruptured eardrum (tympanic membrane perforation). Loud blasts of noise, sudden changes in pressure, poking your eardrum with an object and infection can cause your eardrum to rupture and affect your hearing.

RISK FACTORS
Factors that may damage or lead to loss of the hairs and nerve cells in your inner ear include:

1.Aging. Degeneration of inner ear structures occurs over time.

2.Loud noise. Exposure to loud sounds can damage the cells of your inner ear. Damage can occur with long-term exposure to loud noises, or from a short blast of noise, such as from a gunshot.

3.Heredity. Your genetic makeup may make you more susceptible to ear damage from sound or deterioration from aging.

4.Occupational noises. Jobs where loud noise is a regular part of the working environment, such as farming, construction or factory work, can lead to damage inside your ear.

5.Recreational noises. Exposure to explosive noises, such as from fi****ms and jet engines, can cause immediate, permanent hearing loss. Other recreational activities with dangerously high noise levels include snowmobiling, motorcycling, carpentry or listening to loud music.

6.Some medications. Drugs such as the antibiotic gentamicin, sildenafil (Vi**ra) and certain chemotherapy drugs, can damage the inner ear. Temporary effects on your hearing — ringing in the ear (tinnitus) or hearing loss — can occur if you take very high doses of aspirin, other pain relievers, antimalarial drugs or loop diuretics.

7.Some illnesses. Diseases or illnesses that result in high fever, such as meningitis, may damage the cochlea.

COMPLICATIONS

Hearing loss can have a significant effect on your quality of life. Older adults with hearing loss may report feelings of depression. Because hearing loss can make conversation difficult, some people experience feelings of isolation. Hearing loss is also associated with cognitive impairment and decline.

The mechanism of interaction between hearing loss, cognitive impairment, depression and isolation is being actively studied. Initial research suggests that treating hearing loss can have a positive effect on cognitive performance, especially memory.

PREVENTION

The following steps can help you prevent noise-induced hearing loss and avoid worsening of age-related hearing loss:

1. Protect your ears. Limiting the duration and intensity of your exposure to noise is the best protection. In the workplace, plastic earplugs or glycerin-filled earmuffs can help protect your ears from damaging noise.

2. Have your hearing tested. Consider regular hearing tests if you work in a noisy environment. If you've lost some hearing, you can take steps to prevent further loss.

3. Avoid recreational risks. Activities such as riding a snowmobile, hunting, using power tools or listening to rock concerts can damage your hearing over time. Wearing hearing protectors or taking breaks from the noise can protect your ears. Turning down the music volume is helpful too.

WHEN TO SEE A DOCTOR

If you have a sudden loss of hearing, particularly in one ear, seek immediate medical attention.

Talk to your doctor if difficulty hearing is interfering with your daily life. Age-related hearing loss occurs gradually, so you may not notice it at first.

DIAGNOSIS
Tests to diagnose hearing loss may include:

1. Physical exam. Your doctor will look in your ear for possible causes of your hearing loss, such as earwax or inflammation from an infection. Your doctor will also look for any structural causes of your hearing problems.

2. General screening tests. Your doctor may use the whisper test, asking you to cover one ear at a time to see how well you hear words spoken at various volumes and how you respond to other sounds. Its accuracy can be limited.

3. App-based hearing tests. Mobile apps are available that you can use by yourself on your tablet to screen for moderate hearing loss.
Tuning fork tests. Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your doctor detect hearing loss. This evaluation may also reveal where in your ear the damage has occurred.

3. Audiometer tests. During these more-thorough tests conducted by an audiologist, you wear earphones and hear sounds and words directed to each ear. Each tone is repeated at faint levels to find the quietest sound you can hear.

TREATMENT

Options include:

1.Removing wax blockage.

2. Surgical procedures. Some types of hearing loss can be treated with surgery, including abnormalities of the ear drum or bones of hearing (ossicles). If you've had repeated infections with persistent fluid, your doctor may insert small tubes that help your ears drain.

3. Hearing aids. If your hearing loss is due to damage to your inner ear, a hearing aid can be helpful. An audiologist can discuss with you the potential benefits of a hearing aid and fit you with a device. Open fit aids are currently the most popular, due to fit and features offered.

4. Cochlear implants. If you have more severe hearing loss and gain limited benefit from conventional hearing aids, then a cochlear implant may be an option. Unlike a hearing aid that amplifies sound and directs it into your ear canal, a cochlear implant bypasses damaged or nonworking parts of your inner ear and directly stimulates the hearing nerve. An audiologist, along with a medical doctor who specializes in disorders of the ears, nose and throat (ENT), can discuss the risks and benefits.

“It is far preferable to listen to clear speech in clear noise than distorted speech in distorted noise.”

Advanced Ear Nose Throat (ENT) Endoscopy Centre.
Address: Near Hazratbal Shrine, Fire Station Building.
Timing:
Monday - Saturday
4.30pm to 7.30pm (winters)
4.30 pm to 8.30 pm (Summers)
Sundays: 10.30am - 12.30pm
For Appointments call: 7006036893

Also available at Shifa Medical Centre, Magarmal bagh.
Timing: 10.30am - 4pm
Monday to Saturday
0194-2473383, 2473648