Upper Respiratory Tract Infections
Upper respiratory tract consists of the nose, pharynx and larynx. Upper respiratory tract diseases, which are usually caused by the inflammation of these areas, are called upper respiratory tract infections. Symptoms are usually chills and cough, sore throat, runny nose, nasal congestion, phlegm, headache, fever, facial pressure, earache, hypersensitivity to cold and hot weather, and sneezing. Symptoms usually begin 1 or 3 days after exposure to the virus. The duration of this condition usually varies between 7 and 10 days. Sinusitis, Cold, Flu, Laryngitis, Pharyngitis are included in this group of diseases.
Ear and Hearing Examination
Hearing is the event of sound entering the outer ear canal, stimulating the inner ear and transmitting the nerve impulses to the brain. Hearing Loss is the decrease or loss of sound perception as a result of a malfunction in the outer, middle, inner ear and auditory nerve.
Detection of hearing loss is possible with certain tests, the main of which are
. WEBER TEST
. RINNE TEST
. AUDIOMETRY
. TIMPOMETER
. ELECTROPHYSIOLOGICAL AUDIOMETER (ERA,BERA)
AUDIOMETRIC EXAMINATIO is the measurement of hearing and evaluation of hearing functions. The devices used in these measurements are called audiometers.
Nose and Sinus Diseases
Sinusitis
Sinusitis is a disease that occurs when the spaces in the facial bones are filled with inflamed tissue. Nasal congestion is manifested by yellow-green nasal discharge, post-nasal drip, headache and difficulty in smelling.
What is Sinusitis?
Humans have five pairs of sinuses. These are,
cheek sinuses
forehead sinuses
the sinuses between the eyes
the sinuses in the nasal region
The sinuses are part of the nasal system, which produces normal secretions (mucus). Normally, the nose and sinuses secrete about half a liter of mucus per day.
Today, the term "rhinosinusitis" is used instead of the term sinusitis. It occurs when the mucus (snot) produced by the lining mucosa cannot be discharged into the nose.
Occlusion of the nasal discharge channels (ostium) of the sinuses,
Disruption of the system that actively carries the mucus to the ostia in the sinuses,
Change in the mucus content or consistency.
Sinusitis is generally classified as follows:
Acute sinusitis
Chronic sinusitis
Subacute sinusitis
Recurrent
Sinusitis Symptoms
Symptoms vary from person to person. Sinusitis makes itself felt with little pain. The pain rate in sinusitis is around 5%. In general, the symptoms of sinusitis can be described in this way,
Persistent cough that occurs at night or in the morning,
Yellow-green colored thick nasal discharge,
Sensation of pressure around the eyes,
Bad breath
Colds/flu that last more than 10-14 days
Nasal congestion, snoring
Postnasal discharge
Headache that lasts for a long time
Causes of Sinusitis
Although there are many different causes of sinusitis, the most common causes are as follows:
Viral upper respiratory tract infections (URTI)
Mucosal edema that obstructs sinus ostia due to allergies is the second important cause of sinusitis
Intranasal curvatures
Polyps,
Nasal growths (concha hypertrophies)
Enlarged adenoids especially seen in children
Sinusitis has negative effects not only physically but also psychologically.
Does Wet Hair Cause Sinusitis?
When you go out with wet hair, your nasal mucosa will swell up allergically during the hot-cold change, and the holes of the sinuses will easily swell, eventually increasing the risk of sinusitis.
Sinusitis Headache
Lack of oxygen, or negative pressure as a result of lack of ventilation
Those that occur as a result of pressure of inflammatory tissues (polyp) on the tissues
Pain progresses from the sinus region to the upper teeth. It is felt in the cheekbone, nasal and forehead region. Contrary to popular belief, pain in chronic sinusitis is a less common symptom. In malignant tumors of the buccal sinus, pain may only be an advanced complaint. Cysts of the cheek sinuses are also a cause of pain. When the cysts enlarge and cover the inside of the sinus, they cause pain, especially with the pressure they put on the sinus openings.
The air in the sinus is theoretically at the same atmospheric pressure as the air outside, and the balancing of the pressure is related to the normal permeability of the sinus mouths. The practical consequence of this is the appearance of a pain. It is explained by the obstruction of the sinus opening as a result of inflammatory, allergic and tumoral formations and preventing air permeability. Opening the sinus mouth eliminates pain.
Treatment of Sinusitis
When sinusitis is not treated correctly, it can cause very serious diseases such as chronic pharyngitis, chronic gastritis, reflux, infections and abscesses around the eyes, meningitis, and brain abscess. The diagnosis of sinusitis is made by ear, nose and throat examination and endoscopic examination, direct radiography and sinus tomography methods. In the disease classified as “Acute”, “Subacute” and “Chronic”, acute sinusitis lasts about 4 weeks. It resolves spontaneously or with medication. Chronic sinusitis lasts longer than about 3 months. First, antibiotic therapy is administered. If sinusitis is chronic, that is, it cannot be treated with medication, sinusitis surgery may be considered.
"Endoscopic Sinus Surgery" can be applied to chronic sinusitis patients or "Balloon Sinoplasty Surgery" method can be applied to patients who are deemed suitable. In endoscopic sinus surgery, polyps or other anatomical defects that block the natural channels of the sinuses are corrected and the channels of the sinuses are opened. It is an operation that should be performed carefully in terms of the risk of complications.
Treatment of Sinusitis in Children
Conditions that require surgery for the sinuses in children with sinusitis are cases that are resistant to drug therapy. Surgery is also an important option for the treatment of inflammation around the eyes due to sinusitis. In children with chronic sinusitis and adenoids or who have frequent tonsil infections, not only removal of the adenoid and, if necessary, tonsils, but also an auxiliary treatment is required to treat chronic sinusitis. Endoscopic sinus surgery is preferred in chronic sinusitis that does not heal despite adenoid and tonsil surgeries. The most important purpose of this surgery should be to unclog the sinus openings and to clean the inside of the sinuses. If the most important treatment option suitable for the child is surgery, which should be done without delay.
How to Prevent Sinusitis
It is of great importance to know how to prevent the formation of sinusitis, a disease that can recur even if it is treated. It is recommended to follow these advices to prevent sinusitis;
Influenza infection must be treated under the control of a doctor.
The nose should always be kept open during the infection. For this, using the ocean waters or swimming in the sea is beneficial in terms of emptying the sinuses. The inside of the nose can be washed with a liquid prepared by mixing a teaspoon of salt and half a teaspoon of baking soda into a glass of water at home.
Care should be taken not to go out with wet hair.
One should not be exposed to direct wind.
Allergy treatment should not be neglected.
Nasal bone curvatures should be eliminated by treating the size and swelling of the nasal concha.
False Facts about Sinusitis Disease!
Some methods that are thought to be good for sinusitis among the people can cause some vital results. Some natural therapies, herbal treatments that are thought to be good for sinusitis can be very risky. Plants that are thought to be good for sinusitis should not be sprayed into the nose. Otherwise, if the plant used flows from the back of the nose to the lower respiratory tract, it may cause a laryngeal edema and cause the patient to die. The nose should not be blown quickly, in very severe blowing, the infection in the nose can go to the ear. This can result in otitis media.
Tonsillar Adenoid Diseases
Diseases of the tonsils and adenoids - which are immune-protective elements of the upper respiratory and digestive system - include a wide area such as infection development and even tumors. The most common diseases are infections that develop later. Infections are usually treated with drugs.
Although tonsils and adenoid diseases, which do not cause serious problems, are treated with drugs, sometimes tonsils and adenoids need to be surgically removed. Although there is usually no age restriction for adenoid, tonsil surgeries are generally not considered to be performed under the age of three, except for absolutely necessary cases.
Ear Diseases
The ear consists of three parts called outer, middle and inner. In each of these, local or expansive type diseases may occur.
Outer Ear Inflammation is an infection of the ear canal. It occurs as a result of moist or damage.
Middle Ear Inflammation (otitis media) is the infection of the middle ear section consisting of the eardrum and ossicles. Fluid Accumulation in the Middle Ear (serous otitis media) occurs due to inadequate functioning of the Eustachian tube that carries air from the nasal cavity to the middle ear and untreated middle ear infections.
Tinnitus is a common disorder. It can be defined as hearing a nonexistent sound. The sound heard can be intermittent or continuous, can be heard in one ear, both ears, or diffusely in the head.
Cholesteatoma The skin layer covering the ear canal and the outer part of the eardrum in the middle ear is called "cholesteatoma". Surgical treatment is often required.
Otosclerosis is a disease that causes calcification around the stapes and consequently hearing loss.
Nose Aesthetics – Rhinoplasty
Rhinoplasty
With rhinoplasty, it is possible to carry out procedures such as nasal augmentation or reduction, changing the shape of the tip of the nose and adjusting its height, changing the angle between the nose and the upper lip, as well as correction of congenital defects, elimination of traumas and respiratory problems.
Who can receive rhinoplasty?
The appearance obtained after rhinoplasty may not always be as your ideal.
You should make the decision of surgery not according to the desires of others, but only yours and you should talk your desires with your doctor in detail.
Healthy, realistic and rational people who want to improve their appearance, not desiring absolute perfection, are the most suitable candidates for rhinoplasty.
Before rhinoplasty
The most important issue is to explain yourself to your doctor and for your doctor to tell you in detail what to expect after the surgery.
Your doctor will ask you what kind of nose you would like to have.
The structure of your nasal bones and cartilages, the structure of your skin, your age and your expectations are among the factors that directly affect the results of rhinoplasty.
If you have allergies or breathing difficulties, if you regularly use medication, if you smoke, you should tell your doctor before the operation.
Your doctor will give you detailed information about nutrition, smoking, taking or not taking vitamins and other drugs, how to wash your face, whether you can wear glasses or whether you will need a special diet after surgery.
Are there any risks of rhinoplasty?
Rhinoplasty is one of the low-risk surgeries when performed by experienced specialist surgeons. However, infection, nosebleeds or a reaction to the given anesthesia are among the risks that may occur.
When rhinoplasty is done inside the nose, it leaves no visible scars, while in the open technique, the scar is usually not obvious.
How is rhinoplasty performed?
Rhinoplasty is a surgery that usually takes between 1.5-3 hours.
During the procedure, the nasal skin, which covers your nose, is separated via an open technique from the bones and cartilages that make up the nasal infrastructure. The procedure continues with shaping the cartilage and bones and creating a new nose until the desired appearance is achieved.
The rhinoplasty technique is mainly of two types, the "closed technique" in which the incision is made through the nose, and the "open technique", where the incision is made under the nose. With the open technique, the surgeon's dominance of the nose is greater and the structure of the nose is better revealed.
In general, in your surgery, your doctor tries to give the desired shape to the nose via the bones and cartilages of your nose. At this stage, the aim of the physician will be to protect and even strengthen the main skeleton while giving the nose its new shape. For this reason, it will take care to protect certain structures, and it will also put bone or cartilage supports in certain places.
At the end of the surgery, a splint is placed to give the final shape of your nose for 7-10 days.
After rhinoplasty,
It is natural for your nose to feel swollen and painful for the first 24 hours after surgery. You will be given medication to relieve these complaints.
In the first days, there may be bruising and swelling around your eyes, which gradually decreases on the 3rd and 4th days. Cold application can be beneficial in removing swelling and bruising. In general, most of these complaints disappear within 2 weeks. (Sometimes, slight swelling may last for a few months, but only your doctor can notice it)
It is natural to have bloody oozing from the nose in the first 1-2 days after the operation. Nasal congestion may persist for several weeks. In order not to impair tissue healing, you should avoid vigorously cleaning your nose and blowing your nose during this period. Smoking, alcohol or heavy activity is strictly prohibited during this period. You can have bath on the condition that it is with warm water.
Between 7 and 10 days, all the sutures that support your nose and the splint that supports your nose will be removed. Then, you can return to work or school. However, it may take several weeks before you can restore your performance.
You should avoid heavy and strenuous physical activities for 2-3 weeks. You should avoid the impacts.
If you wear contact lenses, you can start using them immediately, but after about 2 months.
Voice and Speech Disorders
HOARSENESS
Hoarseness is a problem that should not be ignored. This condition, which is tried to be avoided by drinking something warm, can sometimes be a precursor of very serious diseases. We can list the most common factors that cause hoarseness as follows:
Infections involving the upper respiratory tract sometimes directly affect the vocal cords. Gastric reflux is an important factor that causes hoarseness.
Those who use their voices incorrectly and those who constantly speak loudly may experience hoarseness caused by excessive force. Formations called polyps or thickenings called nodules may develop.
Laryngeal cancers usually develop along with hoarseness. It is particularly associated with smoking and alcohol. Early diagnosis greatly increases the chances of cure.
Diseases that cause paralysis of the vocal cords, which are moving organs, Psychiatric diseases, and changing hormone levels, especially in adolescence and some special conditions, can cause hoarseness.
Our recommendation is to consult a physician for hoarseness that lasts longer than three weeks
Head and Neck Cancers
Head and neck region is of vital importance in the body as it contains many organs, such as lips, tongue, salivary glands, cheeks, floor of the mouth, gingiva, palate, tonsils, nasal cavity, pharynx, larynx, lymph nodes in the neck, nasal cavities, sinuses, ears, neck, thyroid, and facial skin.
Head and neck cancers can produce symptoms in many different ways, especially painless and growing swellings in these areas can be a sign of head and neck cancers.
Salivary Gland Diseases
What is the role of salivary glands in our body?
The salivary glands are responsible for secreting saliva and delivering the secretion into the mouth. There are three types of salivary glands:
1. Under-ear glands
2. Submandibular glands
3. Sublingual glands
What are salivary gland diseases?
1. Salivary Gland Stone: Calcium-rich, fine stones form inside the salivary glands. The exact cause of its formation is unknown. It may occur due to the following reasons:
Dehydration
Decreased food intake
Some antihistamines, blood pressure medications and psychiatric drugs (reduces saliva production), Stone clogs all or part of the secretory duct. The salivary gland swells and begins to ache.
2. Salivary Gland Infection (Sialadenitis): It is a painful infection, usually caused by bacteria. This disease is more common among older adults with salivary gland stones.
3. Viral Infections: Viral infections sometimes also settle in the salivary glands. These symptoms are most common in mumps.
4. Cysts: Babies are sometimes born with a cyst in the parotid gland.
5. Benign Tumors (Non-Cancerous Tumors): These tumors, which are mostly benign, occur mostly in the parotid gland and appear as a slow growing, painless swelling.
6. Malignant Tumors (Cancerous Tumors): Salivary gland cancers are rarely seen. Known risk factors for salivary gland cancer are Sjögren's syndrome and exposure to radiation. Smoking may also play a role in the development of such tumors.
7. Sjögren's Syndrome: It is a chronic, autoimmune disease. The disease is caused by the body's immune system attacking the salivary and lacrimal glands. It is mostly seen in middle-aged women.
What are the symptoms of salivary gland diseases?
Salivary Gland Stone Symptoms
The most common symptom is a painful swelling that usually occurs at the floor of the mouth. The pain may worsen during meals.
Symptoms of Salivary Gland Infection
Painful swelling under the cheek or chin,
Bad tasting discharge from the mouth,
Fever, chills, general weakness in severe cases
Symptoms of Viral Infections
Fever
Headache
Muscle aches
Joint pain
Anorexia
Fatigue
Dizziness and Balance Disorders (Vertigo)
Dizziness and Imbalance (VERTIGO)
Dizziness and imbalance are two different concepts. The term vertigo is mostly used to describe dizziness. It is a condition that is very often caused by inner ear diseases. In case of true dizziness called vertigo, there is often nausea and vomiting as well.
How to Maintain Balance: The brain, spinal cord, inner ear, eyes, joints and muscles can be listed among the organs and systems that play a role in this regard. Any disease affecting these organs, together with dizziness, cannot naturally be evaluated by the specialist of one single field. Although ENT and Neurology doctors examine it initially, it may also be necessary to be examined in ophthalmology, internal medicine or physical therapy branches.
What Kind of Complaints Occur: Each patient describes it differently, most common include that the ground is slipping under my feet, my head is emptying, I am blacking out, etc. In dizziness due to ear diseases, tinnitus, hearing loss, pressure sensation in the ear, nausea-vomiting, ear discharge and abnormal movements in the eyes can be detected. Headache, numbness, paralysis, and eye movement abnormalities may occur in vertigo due to neurological diseases.
Major diseases causing dizziness and imbalance
1- Causes related to the ear:
It is the organ responsible for 70% of all true vertigo; Meniere's disease, positional vertigo, chronic diseases of the ear with discharge, ear diseases due to the effect of the balance nerve after a viral infection, less blood flow to the inner ear.
2- Traumas:
Nausea and vomiting may occur together with an extremely restrictive vertigo after a skull fracture. Even if the patient moves his head in the slightest way, he may experience a significant dizziness attack.
3- Infection:
After severe flu infections, ear-related dizziness may occur.
4- Neurological diseases:
Multiple Sclerosis, various brain tumors, Parkinson's disease, etc.
5- Allergic causes:
In spring and autumn, pollen and allergic vertigo attacks may occur in allergic people.
6- Cervical causes:
They do not cause dizziness except for advanced neck hernias. Dizziness and balance disorders require medical teamwork (Audiometric tests, electronystagmography, electroencephalography). It is possible to get clear answers about the location and name of the disease. There are measures to reduce dizziness. For example, a person with Meniere's disease should avoid stressful environments, alcohol, caffeine, and excessively salty foods. Benign Paroxysmal Positional Vertigo (BPPV) should avoid sudden head movements. Driving a car, using a dangerous tool, doing a job that requires attention must be avoided.
What Is Seen During Examination:
Dizziness is due to a disease in the inner ear, and there is usually no problem found out during ear examination. There may be dizziness due to middle ear infections affecting the inner ear.
What Kind of Tests are Done:
If it is decided that there is no ear-related disease as a result of the examination, your doctor will refer you to other branches. When deciding on this, some examinations are usually done. Among these examinations, the most common test - called audiometry - is applied. Computed tomography or magnetic resonance (MR) examination can be performed. Some blood tests may also be added to the tests. Such tests are usually performed to rule out more serious problems such as tumors.
How to Treat:
Since dizziness is not a disease itself but a symptom of another disease, the main cause must be treated first. Dizziness due to ear diseases (excluding tumors) usually disappears spontaneously in a short or long time. Because the other ear compensates for the problem of the sick ear over time. Sometimes this can take up to 6 months or 1 year. If the vertigo is positional vertigo (BPPV), it is treated with some movements called the Epley maneuver. These movements allow some particles in the inner ear to settle into place. For other reasons, it is necessary to use drug therapy. Patients with severe dizziness may sometimes need to be hospitalized with serum administration. The treatment of dizziness due to tumors is removal of the tumor, that is, surgery. Surgery is also sometimes performed in Meniere's disease that does not respond to drug therapy.
Meniere's Disease
It is the disruption of the balance of fluid in the inner ear.
The true cause of the disease is unknown.
In Meniere's disease, the pressure of this fluid increases. The increased pressure causes tinnitus, a feeling of stuffiness in the ear, decreased hearing, and a feeling of dizziness.
It may be accompanied by nausea, vomiting, loss of balance, sweating and diarrhea.
Attacks are usually of sudden onset and their duration can vary from 20 minutes to 24 hours. In many cases, the attacks come one after the other. There are frequent recurrent attacks that last for weeks, and a return to normal is observed, which takes weeks or months. Hearing loss is due to damage to the auditory nerve.
Rarely, only intermittent dizziness may occur, without hearing loss, ear pressure, or tinnitus.
Meniere's disease usually occurs in one ear, but both ears may be involved.
Drug therapy: The aim of drug therapy is to reduce the fluid pressure in the inner ear. This is achieved by eating less salt and using diuretics.
Salt causes water to remain in the body, so salt restriction is applied. This treatment can be applied for months or even years.
Surgical treatment: It is performed in cases where drug therapy is not successful and there is severe dizziness. The type of operation depends on how much hearing is lost. The tinnitus may get lessen or stay the same.
Snoring and Sleep
Apnea What is Sleep Apnea, How Is It Treated?
Sleep apnea is defined as snoring and respiratory arrest during sleep. Constituting an average of one-third of human life, sleep is of great importance for a healthy life. While poor quality sleep causes complaints such as being asleep all the time, lack of concentration, it can also cause sleep apnea, which can cause high blood pressure, heart rhythm disorders, paralysis or sudden death at night.
What is Sleep Apnea?
Sleep apnea is one of the most important diseases caused by snoring and can be expressed as cessation of breathing during sleep. Sleep apnea, which means that breathing stops and becomes shallow during sleep, can recur many times throughout the night. During sleep apnea, the muscles that keep the upper airway open relax. Not being able to breathe for at least 10 seconds as a result of obstruction of the airway by the root of the tongue or soft palate or overgrown tonsils is called sleep apnea.
Although respiratory effort continues during sleep apnea, this effort, which increases after a while, stimulates the brain and the airway is opened. The person who snores until his breathing stops continues to breathe and snore again with a loud grunt.
It is known that when necessary precautions are not taken, sleep apnea leads to carelessness, increasing the risk of traffic accidents by 7-8 times and causing work accidents. Although the incidence of sleep apnea is 1-4%, it can be better understood how important a problem, compared that diabetes mellitus has an incidence rate o 3% and with asthma being 5%.
Causes of Sleep Apnea
Sleep apnea is caused by the relaxation of the muscles in the throat to close the space through which the air will pass. Strictures in the upper airway can cause deterioration of the airway from childhood, which can cause sleep apnea syndrome. Being overweight, having large tonsils and adenoids can also be shown among the causes of sleep apnea. Sleep apnea can occur not only in adults, but also in children.
Snoring in people with sleep apnea syndrome occurs 3-4 times more often, loudly. In addition to snoring, shortness of breath, frequent sighing, trying to wake up with fluttering movements, frequent and long-term pauses in breathing, waking up tired in the morning are also seen in people with sleep apnea syndrome. Although not the exact cause of sleep apnea, 30-50% of patients with sleep apnea syndrome have hypertension.
Sleep Apnea Symptoms
The most important symptom of sleep apnea is the cessation of breathing during sleep. Other sleep apnea symptoms can be listed as follows:
Restlessness during sleep
Snoring
Frequent urination
Sweating
Dry mouth
Reflux
Witnessed respiratory arrest
In addition, headache, forgetfulness, poor concentration, depression, inability to wake up rested, extreme sleepiness and fatigue are among the symptoms of sleep apnea that can be seen during the daytime.
People with sleep apnea symptoms may encounter many serious conditions during the day. Examples include Sudden death, stroke, heart attack and heart failure during sleep, difficulty in losing weight if the patient is obese, respiratory failure, sexual reluctance and impotence in lung patients, uncontrolled diabetes. In addition, sleep apnea can cause traffic and work accidents as it will cause constant fatigue and lack of concentration during the day.
Sleep Apnea Test
Sleep apnea test is the most important step in the detection and treatment of the disease. "Polysomnography" is a test in which brain activity and respiratory events are recorded during the night. In order to have a sleep apnea test, patients must stay in a sleeping room for one night.
How to Prevent Sleep Apnea?
Obesity sleep apnea can be reduced by 50% by losing weight. Also, avoiding alcohol and sleeping pills, quitting smoking, and not sleeping on your back also reduce discomfort.
Sleep Apnea Treatment
It should be evaluated by an otolaryngologist in terms of surgical intervention.
In the treatment of advanced sleep apnea, positive air pressure (CPAP) therapy should be applied.
Functional Endoscopic Sinus Surgery
Sinuses are hollow cavities located around the nose and eyes, in the forehead area, which lighten the head area. They produce mucus, which moisturizes the inside of the nose and also has a protective effect against undesirable factors such as dirt and infection. Sinusitis surgeries can be considered as an option in patients with structures that obstruct these cavities, such as polyps, with recurrent or persistent sinusitis, and in patients with abnormal sinus structure. The surgery is for clearing the congestion in the way the sinuses open into the nose and ventilating these cavities again. Clearing these pathways allows for normal flow of mucus, reduction in facial pressure and pain, preservation of olfactory functions, and easier breathing. Endoscopic sinus surgery takes an average of two hours and requires an overnight stay in the hospital. It does not cause any swelling or redness on the face.
