Hi, it would be important to do a Nasoendoscopy to look at the back of your nose. This is a camera attached to a small flexible tube that can be inserted into the nose. This is to evaluate if there are any growths or swellings in the back of your nose that may be blocking or pressing on the openings of the Eustachian Tubes (the natural ventilation path of the ear that connects to the back of the nose). Usually middle ear infections arise from bacteria that go up the Eustachian Tubes to the middle ear space. Problems with the function of the Eustachian tubes may predispose to middle ear infections. Besides antibiotics, nasal decongestant medications are usually also prescribed to ensure that the mucus from the front of the nose does not drip back and block the opening of the eustachian tubes.
As for white fluid coming out of your ear, that would be unusual in a purely middle ear infection unless there is a hole in the ear drum. When that happens the fluid in the middle ear will leak out through the hole into the external ear canal. In such a situation, I would advise you to start some antibiotic ear drops to your affected ear for at least 1 week to treat the infection. When the infection settles, you should have an examination of the ear drum to see if there is a ear drum perforation (hole). If there is one, you should consider undergoing a surgery to repair the hole when the ear is dry, to prevent a future ear infection.
I would suggest that you undergo a Nasoendoscopy to evaluate your nose and also the deeper portions of your throat. This will allow us to visualise any problems that may arise from the nose that may cause a chronic cough like chronic sinusitis with a constant post nasal drip (backdrip of mucus at the back of the nose). Also other causes such as laryngopharyngeal reflux, where the stomach juice and acids reflux into the throat, can be seen with evidence of swellings and redness of certain portions of your throat. The treatment would depend on the diagnosis made after the Nasoendoscopy. Most times, treatment would begin with some medications, before surgeries may be advised for certain conditions.
The main problems of your nose is nasal obstruction from what sounds like possible Inferior Turbinate hypertrophy or general swelling of the nasal tissues from underlying allergic rhinitis since you are better when you are not exposed to dusty environments. There are permanent solutions to breathing difficulties from such nasal obstruction. They basically involve shrinking the swollen tissues and correcting any other structural deformities of the nose like deviated nasal septums. This will require an examination with a nasoendoscopy first to look for the sites of nasal obstruction before deciding on what types of surgeries are required. The main types of surgery include the following:
1. Endoscopic Inferior Turbinectomy or Turbinoplasty: This involves resecting (cutting away) or trimming of the inferior turbinates which are the tissues located along the side walls of the nose inside. They are often swollen in underlying allergic rhinitis. They occupy significant space in the nasal cavity and after reduction or removal, there is a much larger available space in the nasal cavity to breathe
2. Septoplasty: To correct any deviation of the nasal septum. That would allow the air entry in the ear to be equal on both sides after surgery.
3. Radiofrequency reduction of the Inferior Turbinates: This is similar in intention to a Inferior Turbinoplasty but serves to reduce size of the front 1/3 of the inferior turbinates on both sides. This will result again in more space available in the nasal cavity.
Hi, Gastric Acid reflux can definitely cause the symptoms that you have mentioned. As such, the treatment of acid gastric reflux would include the following:
1. medications to reduce the stomach acid production
2. Lifestyle changes: Avoid certain foods like citrus fruits, chocolate, coffee, tea, fatty and fried foods, garlic and onions, mint flavoring, highly spiced foods. tomato based foods. To sleep with at least 1 firm pillow to elevate the neck slightly. To avoid going to sleep with a full stomach. Best to allow at least 3 hours interval for the stomach to empty from the last meal before bedtime.
3. If the reflux is very severe, it is necessary to have an evaluation of the esophagous and stomach by a gastroenterologist for any predisposing cause for the reflux.
Yes, there is a chance that an unrepaired hole in the ear drum will lead to future middle ear infections and a widening of the ear drum perforation. If you are in good health and under 65 years old, it would be best to undergo a surgery to repair the ear drum perforation as the chance of future infections of the middle ear through entry of bacteria via the perforation, is high.
It is important to complete a Nasoendoscopic examination of the nasal cavity and the openings of the paranasal sinuses. The treatment will depend on the underlying problems seen. These can range for excessive mucus production from allergies, to polyps to sinusitis infections. The treatment methods vary for each and may start with medications first before considering various types of surgery.
There could be several reasons why it hurts, itches and bleeds. There could be small polyp or growth in the inside of the nostril that is traumatised whenever you insert anything into the nose. There could be an infection of the nose and this is aggravated by introducing anything into the nose. I would suggest that you get a review by an ENT doctor who can do a nasoendoscopy. This would allow the doctor visualise the entire nasal cavity to determine if there is any such problem
The ringing in the ears are probably what is commonly known as Tinnitus. Usually this condition is not debilitating. But for some it is very disturbing. It is important to perform a Pure Tone Audiogram to ensure that there is no associated hearing loss on the left ear. If there is, then certain investigations such as an MRI scan of the Internal Acoustic Meatus (MRI IAM) should be performed to ensure there are no sinister causes like a tumour in the brainstem pressing on the hearing nerve. Most times, tinnitus tends to fade into the background after a few months. For those in which the tinnitus does not subside, there are various therapies such as masking therapy, the use of hearing aids, acupuncture as well as some medications that may be of some benefit to a few patients. However, there is no one universal treatment that is effective for all patients with tinnitus and oftentimes there may be a need to trial these different therapies to see which one works for you.
The ringing in the ears are probably what is commonly known as Tinnitus. Usually this condition is not debilitating. But for some it is very disturbing. It is important to perform a Pure Tone Audiogram to ensure that there is no associated hearing loss on the left ear. If there is, then certain investigations such as an MRI scan of the Internal Acoustic Meatus (MRI IAM) should be performed to ensure there are no sinister causes like a tumour in the brainstem pressing on the hearing nerve. Most times, tinnitus tends to fade into the background after a few months. For those in which the tinnitus does not subside, there are various therapies such as masking therapy, the use of hearing aids, acupuncture as well as some medications that may be of some benefit to a few patients. However, there is no one universal treatment that is effective for all patients with tinnitus and oftentimes there may be a need to trial these different therapies to see which one works for you.
The ringing in the ears are probably what is commonly known as Tinnitus. Usually this condition is not debilitating. But for some it is very disturbing. It is important to perform a Pure Tone Audiogram to ensure that there is no associated hearing loss on the left ear. If there is, then certain investigations such as an MRI scan of the Internal Acoustic Meatus (MRI IAM) should be performed to ensure there are no sinister causes like a tumour in the brainstem pressing on the hearing nerve. Most times, tinnitus tends to fade into the background after a few months. For those in which the tinnitus does not subside, there are various therapies such as masking therapy, the use of hearing aids, acupuncture as well as some medications that may be of some benefit to a few patients. However, there is no one universal treatment that is effective for all patients with tinnitus and oftentimes there may be a need to trial these different therapies to see which one works for you.