What is Sinuses?
The paranasal sinuses are air-filled pockets located within the bones of the face and around the nasal cavity. Each sinus is name for the bone in which it is located:

• Maxillary (one sinus located in each cheek)
• Ethmoid (approximately 6-12 small sinuses per side, located between the eyes).
• Frontal (one sinus per side, located in the forehead)
• Sphenoid (one sinus per side, located behind the ethmoid sinuses, near the middle of the skull)

Each of these pockets has an opening that connects to the nose. This opening is called an ostium. The paranasal sinuses are covered with a special lining (or epithelium). The lining secretes mucus, a complex substance that keeps the nose and sinuses moist. The sinus epithelium is ciliated; that is, each cell on its surface has a cilium, which is a relatively long structure that has the capacity to push sinus mucus. This movement of mucus (which is known as mucociliary clearance) is not random; rather, it is programmed so that the mucus moves along in a specific pattern. The sinus do not ‘drain’ by gravity-it is an active process.

Epistaxis or Nasal Bleed

The inside of the nose is covered with moist, delicate tissue (mucosa) that has a rich supply of blood vessels near the surface. When this tissue is injured, even from a minor nick or scratch, these blood vessels tend to bleed, sometimes heavily.

Nosebleeds near the front of the nose, called anterior nosebleeds, are very common since this is the most accessible area to injury. The most frequent location is the nasal septum, the wall between the two sides of the nose. In most cases, this type of nosebleed is not serious. It usually can be stopped with some local pressure and a little patience.

Posterior bleeds usually drain down the back of the throat, but can also bleed out of both nostrils. Also, in most cases of severe nosebleeds, the person has another health problem, such as high blood pressure or a bleeding disorder, or the person takes a blood-thinning medication that slows down the blood-clotting process.

Diagnosis

In otherwise healthy people, most mild anterior nosebleeds can be self-diagnosed and treated at home. If your nosebleed is severe and does not respond to first-aid measures, you will need to see a doctor immediately.

The doctor will review your health history and current medications

Next, the doctor will examine your nose to determine where the bleeding is located. If necessary, he or she may insert a lighted, tube-like instrument called an endoscope into your nose to see the site of bleeding. Blood tests may be done to check for any bleeding abnormalities.

Treatment

If you are bleeding from the front of your nose, begin by trying the following first-aid measures:

• Sit up (so your head is above the level of your heart), lean forward slightly and breathe through your mouth.
• With your thumb and index finger, pinch the entire front of your nose (just above your nostrils and below the hard, bony base) and hold for five minutes.
• At the same time, use your other hand to apply an ice pack or a plastic bag of crushed ice to the bridge of your nose to slow blood flow.
• After you have pinched your nose for five minutes, release it to see if your nose is still bleeding. Keep the ice pack on for another 10 to 15 minutes.
• If your nose is still bleeding, pinch it for an additional 10 minutes.
• Release your nose again. If you are still bleeding, seek emergency medical help.

When simple first aid does not stop a nosebleed, your doctor may treat the problem by:

• Applying medication directly to the inside of your nose to stop the bleeding
• Sealing off (cauterizing) the injured blood vessel with a chemical, such as silver nitrate, or with an electric probe
• Packing your nose with gauze or a sponge
• Using other methods, such as:
  1. Laser therapy – A laser beam seals the bleeding blood vessel
  2. Embolization – A special plug inserted into the bleeding vessel blocks blood flow
  3. Surgery – Ties off a selection of blood vessels

When To Call a Professional

If you cannot stop a nosebleed by using the first-aid measures, call your doctor immediately or go to an emergency room.

Also, contact your doctor if blood continues to ooze from your nose, especially if you also have persistent nasal stuffiness or a foul-smelling nasal discharge. In older people, especially smokers, these can be symptoms of a tumor inside the nose or sinuses. In a young child, these may be signs that a foreign object is lodged in a nostril.

When Is Sinus Surgery Necessary?

Most patients with chronic sinus infections don’t need surgery. Medical treatment and lifestyle changes usually help improve your condition or at least control your symptoms. But if they don’t, surgery may be the best alternative.

What Happens During Sinus Surgery?

Today, functional endoscopic sinus surgery (FESS) is the most common surgical method to treat chronic sinus infections. In a FESS procedure, the surgeon uses a magnifying endoscope through the nostrils to see and remove affected tissue and bone.In general, the goal of sinus surgery is to flush out infected material, open up blocked passages, and keep enough healthy tissue intact so that your nose and sinuses can function normally.

How Much Pain Is There With This Surgery?

Every patient tolerates pain differently. Most patients manage sinus surgery pain with oral pain pills.

How Long Is Recovery Time?

Your recovery time depends on your overall health and the kind of sinus surgery you have (ethmoidectomy, maxillary antrostomy, or powered septoplasty with turbinoplasty). Usually, you should plan to be away from work or school for at least 5 to 7 days after surgery.

What is Microdebrider for sinus surgery?

Microdebrider is perhaps one of the most important innovations that have been brought into the field of sinus surgery.The microdebrider is a cylindrical instrument that has a hollow tube with an inner and outer portion.At the end of the tube, both inner and outer portions of the tube have a blade that cuts tissue as the blades move back and forth. The catheter has continuous suction applied to the device so that cut tissue is capture and removed from the surgical area.Microdebrider assisted polypectomy is precise, relatively bloodless surgery.

A lump in the neck
There can be many possible causes for a lump in the neck. It could be caused by a skin condition, such as a cyst (SIST). Swelling of the thyroid, lymph or salivary glands can produce a lump, which could be anything from disease such as mumps to a more serious condition like tuberculosis.

About laryngitis
Singers, public speakers and cheerleaders can sometimes lose their voices. The condition is officially known as laryngitis (LAIR-IN-JITE-IS), and is merely an irritation or inflammation of the voice box and vocal cords.

Cancer of the mouth, pharynx, and larynx
The pharynx (FAIR-INKS) is the medical term for the throat. The larynx is the voice box. Together with the mouth, they provide a starting point for several types of cancer.

Chronic cough
A cough is your body’s natural way of clearing the windpipe and bronchial tubes of secretion. It can also be a response to various environmental irritants such as pollution or tobacco smoke.

Hoarseness prevention and treatment tips
Hoarseness may be nature’s way of getting back at people who talk too much. Overuse of the voice is among the common causes of this condition. Smoking is another.

The thyroid diagnosis
Your thyroid gland produces hormones that control your body’s metabolism. Diagnosis of thyroid problems consists of a simple blood test. The level of these hormones in the blood will quickly determine whether or not your thyroid is functioning properly.

Throat cancer
Sometimes a little hoarseness is nothing more than the result of overusing your voice, but it can also be the first sign of throat cancer. Middle-aged men are most susceptible to cancer of the throat or larynx.

Tonsillectomy
In the early part of the twentieth century, tonsillectomies accounted for almost a third of all the surgeries performed in this country. Removing the tonsils was a standard part of childhood.

Tonsillitis
The tonsils perform an invaluable service during infancy. From their location at the back of the throat, they intercept bacteria from the mouth and allow the body to create antibodies.

Treatment of your thyroid lump
If you have a thyroid lump, the first step is to determine its cause. An ear, nose and throat specialist can run tests to determine the level of hormones in your blood and whether your thyroid is producing too much or too little of them.

Vocal cord facts
You talk on the phone; you talk to friends and family; you probably talk as part of your job. Normal talking is what the vocal cords were designed to do.

Voice disorders
Most parts of the body have specific ways of telling us something is wrong. In the case of the larynx (LAIR-INKS), or voice box, the normal symptom is hoarseness.

What are tonsils?
Tonsils are glands located on sides of your throat, just behind the tongue. They can be seen with the naked eye. Their purpose is to sample incoming bacteria from the mouth and create antibodies to help the body deal with them.

What is a thyroid gland?
The thyroid gland is a small gland in your neck that fits around the esophagus (EE-SOFF-AH-GUS) and windpipe. It produces several hormones that are essential for controlling your body’s metabolism.

What is strep throat?
Strep is the informal term for streptococcus (STREP-TOE-KOK-US), a common bacteria that causes such symptoms as a sore throat, swollen lymph glands and fever.

When is a thyroid gland abnormal?
The hormones produced by the thyroid gland control much of our daily activities. If your thyroid is producing too much or too little of these, it’s probably not operating properly.

TONSILLITIS

What are tonsils

Tonsils are a pair of glands situated in the mouth cavity on either side below the tongue. They function as one of the “defence mechanisms” of our body, fighting infections. They are active till the age of 8 or 10

Should tonsils be removed ?
Tonsils should not be removed if the child is healthy. If they get infected and become the cause of any illness, then they can be removed. Whether their removal will cure the illness or not should be determined. Only after confirmation should the “tonsil operation” be carried out.

When should tonsils be removed ?
Removal of tonsils would be beneficial only under the following circumstances :

• When the child develops fever with irritation or pain in the throat, tonsils swell and they cause a sort of pain or stiffness in the neck. In medical parlance, this is called “acute tonsillitis”. It occurs six or seven times a year for a period of 2 years.
• When tonsils develop an abscess with pus it causes severe pain even while swallowing saliva. The abscess has to be drained of the pus by making a small cut on it. In such cases it is good to remove the tonsils to avoid such repeated occurrences.
• Sometimes, tonsils get excessively enlarged causing problem in swallowing food. And removal of tonsils does solve this problem.
• Infected tonsils which accumulate pus may sometimes release toxic substances in the body. These toxins may infect heart, kidney, skin and eyes. Before performing a heart operation or any other major operation tonsils are removed. If cancer of tonsils is suspected, tonsils are removed and examined.

Is the operation risky ?
The main risk is excess bleeding. The chances of death due to excess bleeding are 1 per 10,000 operations. Generally treated as a minor operation

Does removal of tonsils affect body’s defence against infection ?
No. Tonsils are removed only when they get infected. Infected tonsils are useless as a defence mechanism. And, removal of such tonsils does not cause any harm.

What is the proper age at which operation is performed ?
If the operation is a must, due to the reasons described above, then the age of the patient does not matter. Generally, it is performed between the age of 4 to 8 years. In some instances, it may have to be done at 2 or even at 55 years.

What care should be taken after operation ?
The patient regains consciousness usually after 2-3 hours. Till that time he/ she should be kept in bed (lying on one side, and not flat on his/her back), so that the saliva and blood accumulate in the mouth and do not enter the breathing passage. After hours the patient is given cold water first and then ice cream. It is possible that on the first day the patient may have bloodstained saliva or even some blood in the spittle. The patient may vomit once or twice throwing out blackish blood. There is nothing to worry about it. On the first day, mild fever and pain in the ear is also known to occur. However, persistent red saliva or violent bloody vomiting should be viewed seriously and the doctor must be immediately informed about it. For a week after operation avoid hot, strong & spicy food. Eat only cold, mild and bland food such as kheer, rice, milk, curds etc.

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How do we speak?

Two white folds, known as the true vocal folds, are present at the inlet of our breathing pipe. These vocal folds allow us to talk when they come together and vibrate. When they move apart, they form an inverted “V” and allow air to enter the breathing pipe and lungs for us to breathe.

What are the causes of voice disorders?

Infection, injury, paralysis, or tumours of the voice box may result in a hoarse, breathy or painful voice. Children can occasionally be born with an abnormal voice box. Vocal abuse and misuse may lead to the formation of vocal nodules, polyps or cysts.

When should I consult a laryngologist?

A Laryngologist is an ENT Surgeon who specialized in the diagnosis and management of disorders of the voice – box (Larynx).

Please consult a Laryngologist in case of voice change persisting for more than 2 weeks or in cases of repeated attacks of voice change.

What tests will help diagnose the problem?

Diagnostic laryngoscopy which is seen on the T.V. monitor and recorded. A diagnostic laryngoscopy study allows detection of even vary early nodules, polyps, cancer etc.

This is an OPD procedure which is not painful. In small childrens a flexible Telescope is used. Sometimes

What are treatment options available?

1. Infections of the larynx usually need Medications.
2. Small vocal nodules respond well to Speech Therapy.
3. However larger nodules, polyps and cysts need remove and state-of-the art “Microlaryngeal surgery ” helps in achieving an excellent post-operative voice with a scar less surgery.

If vocal fold paralysis does not improve in 6 months then Thyroplasty surgery gives back a strong voice to the patient. Voice surgeries can also be performed to change the pitch of the voice to make the voice more “masculine” or “feminine”.

Who is an Audiologist?

The person who has a qualification of 4yrs degree course from a recognized university in speech & hearing. It is desirable he/she has completed 2 yrs masters degree programme also.

Who can Dispense of the Hearing Aid?

The person who has Indian Speech & Hearing Association registered or bachelor degree holder audiologist.

Who needs a Hearing Aid?

1. If people complain that you are not following cessation.
2. If friends and family members complain that you do not respond even if they call you by name.
3. If you feel that people talking around your are constantly mumbling or their voices are blurry.
4. If you hear male voices better but have difficulty in following women’s voices.
5. If you are missing common sounds of bikes or ringing of phone or door bell.
6. Difficulty in following conversations in public or within a group of people.
7. If you have difficulty hearing television and/or the telephone.
8. If you are frequently asking others to repeat themselves, even in quiet rooms.
9. If people are complaining that you turn the TV Volume too high.
10. If you have trouble hearing birds or wind in the trees.

What cares should be taken after the fitting of a Hearing Aid?
FOR ADULTS

• AUDITIORY TRAINING
• REPROGRAMMING
• DETAILS PRODUCT TRAINING

FOR PEDIATRICS

• REGULAR MONITORING OF EAR MOULDS
• AUDITORY TRAINING
• SPEECH & LANGUAGE THERAPY
• PARENTAL TRAINING
• CARE OF ASSOCIATED PROBLEMS

How would you know whether or child has hearing loss or not?

• Monotonous crying ( child has one type of crying, differential crying cannot be heard)
• Child does not respond to loud sounds like by blinking eyes or turning head.
• Cessation of activities, sudden crying
• Hyperactive
• Delayed speech & language development. ( a two year old normal hearing child has a vocabulary of 270 words and a 3 year old normal hearing child has 900 words)
• He/she does not respond if called from the other room.
• The child may speak too loudly or too softly.
• He/she may put T.V. or radio on high volume.
• The child may have difficulty paying attention for a continuous period of time. He/She will not be able to focus and listen.
• The child may use lot of signs while speaking.
• The child may use only few words, and may not be able to speak meaningful sentences.

What are price range of hearing aid?

It purely depends on the type of loss and daily needs of a person. For example, a person of 45 years of age who usually attends 3-4 meetings in a day and has a hearing loss of moderate degree would need a binaural directional fitting. Which might cost Rs. 50000/-

Which brand are good?

Nowadays different companies have different technology so as per your need the audiologist will decide which brand suits you best.

What types of speech and language disorders affect school aged children?

These are the most common types of speech disorders that are seen in school aged children:

• Speech sound disorders – (difficulty pronouncing sounds)
  
• Language disorders – (difficulty understanding what they hear as well as expressing themselves with words)
  
• Cognitive-communication disorders – (difficulty with thinking skills including auditory processing, perception, memory, awareness, reasoning, judgment, intellect and imagination)
  
• Stuttering (fluency) disorders – (interruption of the flow of speech that may include hesitations, repetitions, prolongations of sounds or words)
  
• Voice disorders – (quality of voice that may include hoarseness, nasality, volume (too loud or soft)
  

Do speech language disorders affect learning?

Since speech and language skills are essential to academic success and learning, the ability to communicate with peers and adults in a school setting is essential for a student to succeed in school. Learning takes place through communication such as reading, writing, gesturing, listening, and speaking and so strong skills in all these make for a successful student.

How will a speech language disorder affect school performance?

Children with communication disorders frequently do not perform at grade level and may struggle with reading, have difficulty understanding and expressing language, misunderstand social cues, avoid attending school, show poor judgment, and struggle with test taking. Difficulties in listening, speaking, reading, or writing will lead to problems in production, comprehension, and awareness of language sounds, syllables, words, sentences, and conversations. Reading and writing problems will also lead way to problems with communication, thinking, and learning.

How do I, as a parent, make sure that my child gets the speech and language support that they need?

It is very important that if you notice that your child might be showing signs of a speech disorder that they get assessed and/or screened so that a treatment plan can be established. Speech Tails offers a free assessment and will let you know where your child stands in speech development when compared to their peers and also offers a treatment plan based on the test results. If speech therapy is needed, Speech Tails offers an online based speech therapy that is convenient and effective in helping your child with their speech disorder.

How do parents and school personnel work together to insure that children get the speech-language support they need?

Parents and teachers should refer any student who shows signs of a speech-language disorder or delay to the school-based child study team. Screening, assessment, and treatment of communication problems may involve cooperative efforts with:

SLPs work with diagnostic and educational evaluation teams to provide comprehensive language and speech assessments for students. Services to students with speech-language disorders may be provided in individual or small group sessions, in classrooms when teaming with teachers or in a consultative model with teachers and parents. SLPs integrate students’ speech-language goals with academic outcomes and functional performance.