JOBURG ENT

Epistaxis

DevOpsDR — Thu, 27 Aug 2020 06:44:11 +0000

Epistaxis

Epistaxis or nosebleeds can occur spontaneously or follow trauma or irritation in the nose. Common causes are nose picking and drying of the nasal lining.

Dr. M. G. Lamola

“Epistaxis or nosebleeds can occur spontaneously or follow trauma or irritation in the nose. Common causes are nose picking and drying of the nasal lining. “

There are a couple of things that can help prevent nose bleeds. The goal is to prevent drying out of the nasal lining. Here at home you can use Saline drops or Nozoil . The other options need a prescription.

First aid treatment. Tips : you pinch the nose 5-10 mins non-stop. If it does not stop you can repeat. By the third time you need to be making your way to the Emergency Room. Lean forward so you don’t choke on the blood or blood clot. Massive nose bleeds can be an emergency when one can go into shock because of loss of large volume of blood. Research showed that the volume lost is often under-estimated. Once a towel gets soaked then the loss is significant.

At the ER you will be assessed for shock and the blood loss replaced, bleeding disorders and hypertension will be treated. A vasoconstrictor and a local anaesthetic soaked cotton wool can be put into the nose and the soft part pressed for 10 mins If the bleeding slows down, one can identify the bleeding point and “burn or coagualate” the bleeding blood vessel to stop the flow. This can be done in the rooms if the bleeding is more anterior. For posterior bleeds a general anaesthetic and theatre will be required. For the patient with severe epistaxis we go with cameras in the nose to clamp the main blood supply of the nose through a procedure called a Sphenopalatine artery ligation (SPAL) or an anterior ethmoidal artery ligation.

For those patients who cannot undergo Anaesthesia or choose another option, the bleeding artery can be blocked by Radiologist during embolization wherein catheters are used to inject material into the artery to block it. Hope you enjoyed this. Good night

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Epiphora

DevOpsDR — Thu, 27 Aug 2020 06:36:42 +0000

Epiphora

Constant tearing is real. The condition is called epiphora. Causes can be from overproduction of tears or poor drainage into the nose leading to tearing down the face.

Dr. M. G. Lamola

“Constant tearing is real. The condition is called epiphora. Causes can be from overproduction of tears or poor drainage into the nose leading to tearing down the face. “

This condition is frustrating and irritating. Diagnosis is by history and observation of the lids. The normal system has interconnected holes and tubes that finally drain into the nose. If the obstruction is in the segment in the nose, your ENT and opthalmologist can help relieve that. There are tests to identify the level of the obstruction.

Treatment includes treatment of infections, punctal irrigation, placement of temporary or permanent tubes and a surgical procedure called a DCR which the wide opening of the nasolacrimal duct into the nose. Endoscopic DCR is done through the nose to avoid a scar on the face.

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Tonsillitis

DevOpsDR — Thu, 27 Aug 2020 05:45:18 +0000

Tonsillitis

Tonsillitis refers to inflammation of the two round structures at the back of the throat. Inflammation is associated with pain, swelling, redness and fever. The inflammation can be caused by bacteria or viruses. Treatment is given depending on the cause.

Dr. M. G. Lamola

“Tonsillitis refers to inflammation of the two round structures at the back of the throat. Inflammation is associated with pain, swelling, redness and fever. The inflammation can be caused by bacteria or viruses. Treatment is given depending on the cause. “

Tonsil stones are white-yellow hard particles that form on tonsils. They form from trapped food particles and debris that harden over time. Treatment : remove the tonsils.

Frequently Asked Questions :

1. When should tonsils be removed ?
A.When you have a number of episodes of tonsillitis as follows :
7 times in 1 year
5 times a year for 2 years in a row
3 times a year for 3 years in a row
B. When an episode is associated with pus that forms an abscess more than once (Quinsy)
C. When large tonsils cause other problems such as sleep apnea, a common disorder in which you briefly stop breathing many times a night. In the short term, sleep apnea makes you tired during the day. For kids, it can even make them hyperactive. If it’s not treated, it can be serious. It may lead to obesity, heart problems, and other issues.
D. Children who develop fits because of a high temperature. In this case having frequent infections can be damaging to the child’s development.

1. What do the Tonsils actually do?
Tonsils assist the body in its defense against incoming bacteria and viruses by helping the body to form antibodies. However when they turn around and are harmful to individuals, they should be removed.

2. Is tonsillitis contagious?
Yes it is contagious. Germs can spread directly by contact or by air. Practicing good hygiene is important.
3. Can large and painful tonsils be a sign of cancer ?
Yes it can be. However, the symptoms will include a sore throat that lasts a long time, difficulty swallowing, a lump in the neck, and unexplained weightloss. In general any sore throat that goes on longer than 2-4 weeks should be checked out.
4. What happens to untreated tonsillitis ?
When there is an acute infection which shows as pain, fever, swelling and redness of tonsils one should really get checked so that the appropriate treatment is given. When not treated the disease can have complications which can be around the tonsils e.g. abscesses that can spread into the neck and chest or complications that are far away e.g. infection spreading through the blood to other distant organs. Therefore care should be taken when there is an acute infection as explained above.

I hope I have answered most of the questions that I often get asked. If you can think of any question not covered feel free to ask. Regrettably I cannot give direct medical advise to a patient I have not examined.

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Childhood Hearing Loss

DevOpsDR — Thu, 27 Aug 2020 05:08:04 +0000

Childhood Hearing Loss

Hearing loss (HL) in children can be congenital ( birth defects ) or acquired. 60 % of the causes are preventable but even in the 40 %, appropriate and timely interventions can help ensure that the child reaches their full potential. See other posts on HL on the news feed.

Dr. M. G. Lamola

“Hearing loss (HL) in children can be congenital ( birth defects ) or acquired. 60 % of the causes are preventable but even in the 40 %, appropriate and timely interventions can help ensure that the child reaches their full potential. See other posts on HL on the news feed. “

Strategies for prevention and care of #Childhood hearing loss:

Strengthen immunizations to prevent infections.
Implement new baby screening and early intervention programmes. Screening can be done at one month
Train Primary care workers on the management of ear diseases
Make hearing devices acccessible.
Regulate and monitor the use of oto(ear)toxic drugs though their need may be unavoidable
Raise awareness about ear care e.g. avoid insertion of substances in the ears, do not treat a painful ear in a child with home remedies. Have them checked by an ENT especially if repeated infections.

Causes of #ChildhoodHearingLoss . The 60% figure can rise sharply to 75% in places with limited resources and as low as 45% in developed countries with better mother and child services. Oto (ear)toxic drugs given to pregnant women and their children are also an important cause.

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