Otitis media with effusion (glue ear)

Glue ear is a common childhood condition in which the middle ear becomes filled with fluid. The medical term for glue ear is otitis media with effusion (OME).

It's estimated that one in five children around the age of two will be affected by glue ear at any given time. 

Causes

While it is not known exactly what causes glue ear, several things have been identified that may increase the risk of children developing the condition.

With glue ear, the Eustachian tube seems to lose the ability to drain away the mucus. The mucus builds up inside the ear, which leads to glue ear. 

The reasons for this loss of function are still unclear, but some suggestions include:

• changes in air pressure inside the ear that lead to a blockage in the Eustachian tube
• inflammation of the Eustachian tube caused by allergic rhinitis, infection or irritants such as cigarette smoke, which causes the tube to narrow
• gastric fluids from the stomach that leak up through the throat and into the Eustachian tube
• inflammation and swelling of the adenoid glands (small lumps of tissue located at the back of the throat that form part of a child's immune system).

Other reasons for glue ear include:

• being bottlefed rather than breastfed
• having contact with lots of other children, such as at a nursery (this may be because of a higher risk of infection)
• cleft palate, (a birth defect where a child has a split in the roof of their mouth)
• Down's syndrome (a genetic disorder that causes learning difficulties and disrupts physical development)
• cystic fibrosis, (agenetic condition that causes the lungs to clog up with thick, sticky mucus)

Symptoms

Glue ear is often not obvious and it usually goes undetected. Often the first thing a parent notices is hearing loss.

Signs that your child may be having problems hearing include: 

• struggling to keep up with conversations and seems inattentive
• becoming aggravated because they are trying harder to hear
• regularly turning up the volume on the TV

Other symptoms that may occur include:

• ear pain
• disturbed sleep
• a feeling of fullness in the ear (this is unusual for young children to articulate)
• ringing in the ear (occasionally mentioned by older children)
• balance problems
• speech delay
• recurrent acute otitis media superimposed on underlying glue ear.

Whether or not fluid is present can be confirmed by an ear examination.

Diagnosis

Otoscopy and ear microscopy is used to evaluate the changes in the external ear canal and eardrum.
Other tests, such as tympanometry, may also be used to examine the middle ear. Tympanometry measures pressure differences between the middle ear and outer ear by measuring how easily the eardrum vibrates back and forth.
To measure whether the fluid is causing hearing loss, a separate hearing test or audiometry is necessary.

Treatment

Most cases of glue ear don't require treatment as the condition will improve  spontaneously, usually within three months.

Treatment is normally only recommended when symptoms last longer than three months and the hearing loss is thought to be significant enough to interfere with a child's speech and language development.

In these circumstances, glue ear can usually be treated using minor surgery, which involves placing small tubes (grommets) in the ear to help drain away the fluid.

Sometimes adenoid hyperplasia may cause obstruction of the Eustachian tubes and therefore be the reason for glue ear. In these cases adenoidectomy is performed and very often at the same time as a grommet insertion.

Earache

Earache is very common medical problem for both children and adults. The pain of earache results from inflammation and swelling of the structures that make up the ear, including the external auditory canal, the tympanic membrane, and the middle ear.

Earache can be a sharp, dull or burning ear pain that comes and goes or is constant. One or both ears may be affected.

Causes

The eustachian tube runs from the middle part of each ear to the back of the throat. This tube drains fluid that is made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. This may lead to pressure behind the eardrum or an ear infection.

• glue ear : a build-up of fluid deep inside the ear (behind the eardrum), which mainly affects children
• an infection in the ear canal (outer side of the eardrum)
• physical damage to the inside of the ear caused by a cotton bud, stick or similar 
• a plug of earwax or another object stuck inside the ear
• ear injury from pressure changes (from high altitudes and other causes)

Referred pain from other anatomically related areas may cause earache:

• arthritis of the jaw
• temporomandibular joint syndrome (TMJ)
• a throat infection, such as tonsillitis or quinsy, which can affect the ear

Vertigo & Dizziness

What is vertigo?

Vertigo is the feeling that you or your environment is moving , tilting, spinning or falling. It differs from dizziness in that vertigo describes an illusion of movement. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving is called objective vertigo. 

During severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall
Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.

What causes vertigo? 

Vertigo occurs when there is conflict between the signals sent to the brain by various balance- and position-sensing systems of the body. Your brain uses input from four sensory systems to maintain your sense of balance and orientation to your surroundings.

Vision gives you information about your position and motion in relationship to the rest of the world. This is an important part of the balance mechanism and often overrides information from the other balance-sensing systems.
Sensory nerves in your joints allow your brain to keep track of the position of your legs, arms, and torso. Your body is then automatically able to make tiny changes in posture that help you maintain your balance (proprioception).
A portion of the inner ear , called the labyrinth, which includes the semicircular canals, contains specialized cells that detect motion and changes in position. Injury to or diseases of the inner ear can send false signals to the brain indicating that the balance mechanism of the inner ear (labyrinth) detects motion. If these false signals conflict with signals from the other balance and positioning centers of the body, vertigo may occur.

Common causes of vertigo include

• Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction. This type of vertigo is rarely serious and can be treated. 
• Vertigo may also be caused by inflammation within the inner ear (labyrinthitis or vestibular neuritis), which is characterized by the sudden onset of vertigo and may be associated with hearing loss. The most common cause of labyrinthitis is a viral or bacterial inner ear infection. 
• Meniere's disease is composed of a triad of symptoms including: episodes of vertigo, ringing in the ears (tinnitis), and hearing loss. People with this condition have the abrupt onset of severe vertigo, fluctuating hearing loss, as well as periods in which they are symptom-free. 
• Acoustic neuroma is a type of tumor of the nerve tissue that can cause vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss. 
• Vertigo can be caused by decreased blood flow to the base of the brain. Bleeding into the back of the brain (cerebellar hemorrhage) is characterized by vertigo, headache, difficulty walking, and inability to look toward the side of the bleed.
• Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose. 
• Head trauma and neck injury may also result in vertigo, which usually goes away on its own. 
• Migraine, a severe form of headache, may also cause vertigo. The vertigo is usually followed by a headache. There is often a prior history of similar episodes but no lasting problems.
• Complications from diabetes can cause arteriosclerosis (hardening of the arteries) which can lead to lowered blood flow to the brain, causing vertigo symptoms. 

Vertigo prevention

• People whose balance is affected by vertigo should take precautions to prevent injuries from falls. 
• Those with risk factors for stroke should control their high blood pressure and high cholesterol and stop smoking.
• Individuals with Meniere's disease should limit salt in their diet. Christina ENT surgeon 

Treatment

Vertigo Medical Treatment 

The choice of treatment will depend on the diagnosis.
Vertigo can be treated with medicine taken by mouth, or drugs given through an IV, to alleviate the symptoms.
In addition to the drugs used for benign paroxysmal positional vertigo, several physical maneuvers can be used to treat the condition.
Vestibular rehabilitation exercises, also referred to as Epley maneuvers, consist of having the patient sit on the edge of a table and lie down to one side until the vertigo resolves followed by sitting up and lying down on the other side, again until the vertigo ceases.

Other vertigo exercises:

1. Eye exercises, can help people with vertigo overcome this uncomfortable sensation, by turning the eyes upward and then downward for 20.repetitions
2. One head exercise to treat vertigo is the side-to-side turning exercise (Hamid's Exercise). This exercise is exactly as simple as it sounds, but will likely produce feelings of dizziness.
3. Brandt-Daroff Exercise can help with vertigo. This exercise is much simpler than the vestibular rehabilitation exercise. It only entails leaning to whichever side of the body that elicits the most severe sensation of vertigo. In a seated position, quickly lean to one side until your ear rests on the bed or sofa on which you're sitting. Allow the dizziness to subside before returning to an upright position. Repeat 20 times twice a day. If you also experience dizziness while returning to an upright position, allow the sensation to subside before leaning again.

Sinusitis

Rhino-Sinusitis

What is sinusitis?

The sinuses are a connected system of hollow cavities in the skull surrounding the nose.The paranasal sinuses open into the nasal cavity and are lined with cells that make mucus to keep the nose from drying out during breathing and to trap unwanted materials so that they do not reach the lungs.Sinusitis is an inflammation, or swelling, of the tissue lining the sinuses.
There are several types of sinusitis. 

Health experts usually identify them as follows:

• Acute, which lasts up to 4 weeks
• Subacute, which lasts 4 to 12 weeks
• Chronic, which lasts more than 12 weeks and can continue for months or even years
• Recurrent, with several attacks within a year.

Symptoms

• Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat
• Nasal obstruction or congestion, causing difficulty breathing through your nose
• Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead
• Aching in your upper jaw and teeth
• Reduced sense of smell and taste
• Cough, which may be worse at night.

Other signs and symptoms can include: 

• Ear pain
• Headache
• Sore throat
• Bad breath (halitosis)
• Fatigue
• Fever

When to see a doctor:
Symptoms that don't improve within a few days or symptoms that get worse
A persistent fever
A history of recurrent or chronic sinusitis

Diagnosis

Physical exam.

To look for the cause of your symptoms, your doctor will feel for tenderness in your nose or throat. Your doctor may use a tool to hold your nose open and apply medication that constricts blood vessels in your nasal passages. Your doctor will then shine a light into your nasal passages to look for inflammation or fluid. This visual inspection will also help rule out physical conditions that trigger sinusitis, such as nasal polyps or other abnormalities.

Nasal endoscopy. 

A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses

Imaging studies. 

Images taken using computerized tomography (CT) or magnetic resonance imaging (MRI) can show details of your sinuses and nasal area. These may identify a deep inflammation or physical obstruction that's difficult to detect using an endoscope.

Nasal and sinus cultures. 

Laboratory tests are generally unnecessary for diagnosing acute sinusitis. However, in cases in which the condition fails to respond to treatment or is progressing, tissue cultures may help pinpoint the cause, such as identifying a bacterial cause.

Allergy testing. 

If your doctor suspects that the condition may be brought on by allergies, an allergy skin test may be recommended. A skin test is safe and quick, and can help pinpoint the allergen that's responsible for your nasal flare-ups.

Treatment

Acute sinusitis

• Antibiotics to control a bacterial infection, if present
• Pain relievers to reduce any pain
• Decongestants (medicines that shrink the swollen membranes in the nose and make it easier to breathe.

Chronic sinusitis

• Nasal steroid sprays are helpful for many people..
• Saline (saltwater) washes or saline nasal sprays can be helpful in chronic rhinosinusitis because they remove thick secretions and allow the sinuses to drain.
• Oral steroids, such as prednisone, may be prescribed for severe chronic rhinosinusitis. However, oral steroids are powerful medicines with significant side effects, and these medicines typically are prescribed when other medicines have failed.
• Surgery 

When medicine fails, surgery may be the only alternative for treating chronic rhinosinusitis. The goal of surgery is to improve sinus drainage and reduce blockage of the nasal passages. 

Nasal surgery usually is performed to accomplish the following:

• Enlarge the natural openings of the sinuses
• Remove nasal polyps
• Correct significant structural problems inside the nose and the sinuses if they contribute to sinus obstructionAlthough most people have fewer symptoms and a better quality of life after surgery, problems can reoccur, sometimes even after a short period of time.

Allergic Rhinitis

Allergic Rhinitis

Symptoms
Rhinitis, also known as Hay Fever, refers to inflammation of the nasal passages. This inflammation can cause a variety of annoying symptoms, including sneezing, itching, nasal congestion, runny nose, and post-nasal drip (the sensation that mucus is draining from the sinuses down the back of the throat).

Causes
Allergic rhinitis is caused by a nasal reaction to small airborne particles called allergens (substances that provoke an allergic reaction). In some people, these particles also cause reactions in the lungs (asthma) and eyes (allergic conjunctivitis). The immune system is designed to fight harmful substances like bacteria and viruses. But when you have allergic rhinitis, your immune system overreacts to harmless substances and release immune system chemicals causing a reaction that leads to the irritating signs and symptoms of hay fever.

Seasonal hay fever triggers include:

• Tree pollen, common in the spring
• Grass pollen, common in the late spring and summer
• Ragweed pollen, common in the fall
• Spores from fungi and molds, which can be worse during warm-weather months

Year-round hay fever triggers include:

• Dust mites or cockroaches
• Dander (dried skin flakes and saliva) from pets, such as cats, dogs or birds
• Spores from indoor and outdoor fungi and mold. 

Diagnosis

The diagnosis of allergic rhinitis is based upon a physical examination and the symptoms described above. Medical tests can confirm the diagnosis and identify the offending allergens.

It is often possible to identify the allergens and other triggers that provoke allergic rhinitis by:

• Recalling the factors that precede symptoms
• Noting the time at which symptoms begin
• Identifying potential allergens in a person's home, work, and school environments.
• Skin tests and allergy blood tests may be useful for people whose symptoms are not well controlled with medications or in whom the offending allergen is not obvious

Treatment
The best hay fever treatment is to avoid the substances that cause the reaction. However, this isn't always possible, and additional treatment may be needed along with strategies to prevent exposure.

Lifestyle and home remedies to limit exposure:
Although you can't stay indoors during all pollen and ragweed seasons, avoiding peak exposure times can help. Use your air conditioner in your home and car, and wear a dust mask when working in the yard.

For year-round allergies, you can take the following measures.

• Get rid of carpets and upholstered furniture.
• Wash bedding every week in very hot water.
• Keep stuffed toys out of the bedroom.
• Cover pillows and beds with allergen-proof covers

Medication: For mild allergic rhinitis, a nasal wash can help remove mucus from the nose. You can buy a saline solution at a drug store or make one at home using one cup of warm water, half a teaspoon of salt, and pinch of baking soda. Patients with intermittent symptoms are often treated adequately with oral antihistamines, decongestants, or both as needed. Regular use of an intranasal steroid spray may be more appropriate for patients with chronic symptoms.

Immunotherapy: This includes regular injections of the allergen. Each dose is slightly larger than the dose before it. Allergy shots may help the body adjust to the substance that is causing the reaction (antigen).

Medical acupuncture: Acupuncture offers a natural and effective treatment of allergic rhinitis, one which is free of unwanted side-effects. Fine needles are placed at strategic points for 15-20 minutes. Normally 5-15 treatments are needed for the ultimate therapeutic result.Christina 

Adenoid Hypertrophy

Adenoids are a mass of lymphoid tissue situated high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth without special instruments.

Tonsils and adenoids are the body’s first line of defense as part of the immune system. They “sample” bacteria and viruses that enter the body through the mouth or nose, but they sometimes become infected. At times, they become more of a liability than an asset and may even cause airway obstruction or repeated bacterial infections
The adenoids begin to grow in the first year of life, peak in size between age one and five, then slowly get smaller as a child grows. While the occasional teenager may still have adenoids big enough to cause blockage of the nose, this is rare and the adenoids typically shrink away before adolescence.

What are the symptoms of adenoiditis, or enlarged adenoids? 

The symptoms of adenoiditis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of adenoiditis. However, each child may experience symptoms differently. 

Symptoms may include:

• breathing through the mouth
• noisy breathing
• snoring
• nasal speech
• periods at night when breathing stops for a few seconds

Complications in adenoid hypertrophy

The adenoids are in the midline of the nasopharynx, and the Eustachian tubes open from either ear to the right and left of them. Eustachian tubes ventilate the middle ear. 

Very large adenoids will block air passage in both the nose and the ears. This obstruction of normal air ventilation can lead to both sinusitis and otitis media (middle ear infections with effusion) with congestion, pain and some hearing loss.

Childhood obstructive sleep apnea (OSA) syndrome is characterized by episodic upper airway obstruction due to enlarged adenoids,that occurs during sleep.(Snoring and apnea). Therefore the child is sleepy, tired and drowsy during the day

Due to nasal airway obstruction caused by the enlarged adenoids the sense of smell is decreased and hence the child's appetite.

Treatment
Antibiotics initially may be used for recurring infection of the adenoids and adenoid hypertrophy. If medical management isn't effective, surgery is indicated. 

Adenoidectomy, the treatment of choice for adenoid hyperplasia, commonly is recommended for the patient with recurrent or prolonged mouth breathing, nasal speech, adenoid facies, recurrent otitis media, constant nasopharyngitis, and nocturnal respiratory distress. This procedure usually eliminates recurrent nasal infections and ear complications and reverses secondary hearing loss.

Adenoidectomy should be performed in conjunction with tympanotomy tube placement when the adenoidal hypertrophy contributes to ear disorders. Antibiotics may be used to treat infection. Decongestants may be used to decrease edema.

HPV and Oropharyngeal Carcinoma

Cancer caused by HPV represent 5% of all cancers, including all cervical cancers.
Research indicates that infection with this virus is a risk factor for oral and oropharyngeal cancer. In fact, HPV-related oropharyngeal cancer in the tonsils and the base of the tongue has become more frequent in recent years. HPV is most commonly passed from person to person during sexual activity, including oral sex. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. HPV vaccines protect against certain strains of the virus.

The Human Papilloma Virus (HPV) is a group of more than 150 types of viruses. They are called papilloma viruses because some of them cause a type of growth called a papilloma. Papillomas are not cancers, and are more commonly called warts.

Infection with certain types of HPV can also cause some forms of cancer, including cancers of the penis, cervix, vulva, vagina, anus, and throat. Other types of HPV cause warts in different parts of the body.

HPV can be passed from one person to another during skin-to-skin contact. One way HPV is spread is through sex, including vaginal and anal intercourse and even oral sex.

HPV types are given numbers. The type linked to throat cancer (including cancer of the oropharynx) is HPV16.

Most people with HPV infections of the mouth and throat have no symptoms, and only a very small percentage develop oropharyngeal cancer. Oral HPV infection is more common in men than in women. In some studies, the risk of oral HPV infection was linked to certain sexual behaviors, such as open mouth kissing and oral-genital contact (oral sex). The risk also increases with the number of sexual partners a person has. Smoking also increases the risk of oral HPV infection. At this time the US Food and Drug Administration has not approved a test for HPV infection of the mouth and throat.

People with oral and oropharyngeal cancer linked with HPV infection tend to be younger and are less likely to be smokers and drinkers.

Oropharyngeal cancers that contain HPV DNA tend to have a better prognosis than those without HPV

Risk Factors:

Number of sexual partners: The greater the number of sexual partners, the more likely you are to contract a genital HPV infection; and when engaging in oral sex, this also holds true for oral infections. Having sex with a partner who has had multiple sex partners also increases your risk.

Weakened Immune: Systems: People who have weakened immune systems are at greater risk of HPV infections. Immune systems can be weakened by HIV/AIDS or by immune system-suppressing drugs used after organ transplants


Oral Cancer Signs and Symptoms:

This list considers both oral cancers from HPV and those from tobacco and alcohol

• An ulcer or sore that does not heal within 2-3 weeks
• Difficult or painful swallowing
• Pain when chewing
• A persistent sore throat or hoarse voice
• A swelling or lump in the mouth
• A painless lump felt on the outside of the neck, which has been there for at least two weeks.
• A numb feeling in the mouth or lips
• Constant coughing
• An ear ache on one side (unilateral) which persists for more than a few days.

HPV Vaccines

Two vaccines known as Gardasil and Cervarix protect against the strains of HPV that cause cervical cancers (HPV16 and 18), Garadsil also protects against two versions that cause genital warts (HPV6 and 11). Since they block people from ever getting HPV16, it is not much of a scientific leap to extrapolate that to "if you can't get the virus, you can't get things the virus might cause". Using this logic, many in the science community recommend vaccinating to protect people from the various different cancers associated with the virus such as oropharyngeal. The foundation also believes this to be worth doing, and has advocated at the CDC for vaccination of boys, not only to help reach the point of "herd immunity" in our country protecting our next generation from HPV caused cervical cancers, but also other HPV cancers as well including oropharyngeal.

The National Advisory Committee on Immunization Practices recommends routine HPV vaccination for girls ages 11 and 12, as well as girls and women ages 13 to 26 if they haven’t received the vaccine already. The Gardasil vaccine has also been approved for use in boys and men, 9 through 26 years old.

Cellulite Acupuncture

Cellulite is a common term used to describe superficial pockets of trapped fat, which cause uneven dimpling or “orange peel” skin. It appears in 90% of post-adolescent women and is rarely seen in men. 

Common but not exclusive areas where cellulite is found, are the thighs, buttocks, and the abdomen. Contrary to popular belief, cellulite is not related to obesity, since it occurs in overweight, normal, and thin women.Predisposing Factors: 

• Poor circulation of lymph due to excess of fat, 
• Lack of exercise 
• Fluid retention contributes to cellulite formation. This may explain its formation in some women who are not overweight.
• Rich foods. 
• Excess of tobacco and alcohol.. 
• May also be hereditary.

Cellulite Acupuncture

This specially designed treatment helps to reduce and eliminate the unsightly appearance of cellulite through an intensive system that cleanses the body to improve cellular integrity and circulation.

Based on the principles of Traditional Chinese Medicine and Natural Health, Acupuncture involves the insertion of very thin, disposable needles into acupuncture points located on and around the troubled areas.

Acupuncture for Cellulite Reduction will help to:

• Prevent further accumulation of fat deposits
• Increase circulation
• Boost fat metabolism
• Improve texture and muscle tone
• Detoxify skin tissue
• Helps to eliminate "orange peel" appearance of the skin
• Smooth, firm and tighten the skin

What does the Treatment entail?

Acupuncture treatments for cellulite are performed by inserting needles along specific meridians, which may vary based on the size, age and genetics of the patient. Individual needs will also determine whether the use of electronic stimulation is needed. In a traditional acupuncture treatment, needles may be inserted directly on the areas with cellulite or in areas distal, or further from the center of the body. Both methods are considered appropriate in the treatment of cellulite. If the practitioner determines that electronic stimulation is needed, small electrodes which send small micro-currents to the surrounding area will be attached to the needles. The average acupuncture treatment lasts between 20 and 40 minutes, depending on need.

What is the Course of Treatment?

A typical course of treatment consists of a two to three month period. Ideally, for optimal results, consecutive sessions within a week are recommended. However, depending on the individual, these sessions may vary.

Each session lasts approximately one hour and best of all, there is no pain, no down-time, no side effects and no risk of disfigurement or scarring.

Results to treatment will vary depending on the individuals willingness to follow the prescribed protocol, which also involves, diet and exercise.

Cellulite Acupuncture is ideal for any and all health-conscious individuals in any age group. This is the safe, effective and natural treatment method to help minimize or reduce not only cellulite but excessive weight as well.

Noise Induced Hearing Loss

Noise and hearing loss
Sudden hearing loss produced by a sudden and very loud noise (blast injury) is called acute acoustic trauma. If the sound is loud enough, it can cause the eardrum to rupture or the person to have a complete loss of hearing. When the ears are exposed to extremely loud noises, or to prolonged loud noises, inner ear structures can be damaged. This can lead to noise-induced hearing loss.

According to the American Academy of Otolaryngology-Head and Neck Surgery, noise is damaging if:

• You have to shout to be heard.
• Your ears hurt.
• Your ears ring.
• You have difficulty hearing for a couple of hours after the exposure.

How does a loud noise cause hearing loss?

Loud noises can cause damage to the hair cells in the inner ear and to the hearing nerve, called sensorineural hearing loss or nerve deafness. Sensorineural hearing loss also can be caused by infection, head injury, aging, certain medications, birth defects, tumors, problems with blood circulation or high blood pressure, and stroke.



Damage can occur from a brief, intense noise such as an explosion, or from continuous loud noises such as noises in a loud work environment. Hearing loss from loud noises may be immediate or occur slowly over years of continuous exposure.

Immediate hearing loss is often accompanied by tinnitus, or ringing in the ears or head. Immediate hearing loss can occur in one or both ears and often involves severe damage to the inner ear structure.

Prolonged exposure to noise can actually change the structure of the hair cells in the inner ear, resulting in hearing loss. Tinnitus, which is the sound of ringing, roaring, buzzing, or clicking inside the head, often occurs with prolonged noise exposure damage, as well.

Hearing loss from noise can be permanent or temporary.
Noises that cause hearing loss

Hearing loss can occur after a one-time exposure to a loud noise or after repeated exposure to varying loud noises. Exposure to loud noises can occur at work, at home, or at play.

Diagnosis

Whenever one is exposed to very loud noise or an explosion especially if it is accompanied by a decrease in hearing (hearing loss) and ringing (tinnitus) should contact the ENT surgeon immediately. According to international guidelines the visit to the otorhinolaryngologist should
take place within 48 hours because immediate treatment is extremely important for the outcome.

The otolaryngologist will examine the ears and the hearing with otoscopy, tympanometry, sound reflexes and an audiogram in both air and bone conduction.

The objective is to determine the extent of hearing loss, to identify which frequencies are affected and to determine if the damage includes the auditory nerve. 

The main treatment of acute acoustic trauma is cortisone, which can be administered orally or intravenously and often is combined with cortisone administration into the middle ear (increases the chances of success). Usually up to  five intratympanic effusions are recommended with an interval of 3.5 days each. Intratympanic cortisone injections are administered painlessly and safely when by physician.

The prognosis is generally good if there is early diagnosis and treatment. Early treatment can save the patient's hearing!

Weight Loss and Reduction of Fat with Acupuncture

Acupuncture for Reduction of Fat

Acupuncture is a natural method that works from within, without any risks and side effects! 

The results attained from acupuncture for a weight-loss protocol are the weakening and reduction of cellulite and fat. 

Furthermore, acupuncture minimizes the appetite and induces lipolysis. 

• Reduces appetite and the desire for food consumption 
• Reduces the saturation time (feeling satiated). 
• Stimulates cell metabolism, 
• Stimulates the immune system helping to secrete hormones for beauty and longevity eg. serotonin, endorphins, etc. 
• Mobilizes and regulates the basal metabolic rate. 
• Helps insomnia or colitis which are symptoms that may coexists.

What does the Treatment Entail?
The certified acupuncturist takes the patient's history and depending on the patients' needs selects the appropriate method and number of sessions. The needles are inserted in the specific points at every session for approximately 20-45 minutes. The treatments can be combined with electroacupuncture and auricular acupuncture for ultimate results. 

Electroacupuncture: (stimulation of acupuncture points with low voltage electrical impulses) offers significant advantages in areas that are difficult to treat, such as the inner thigh, arm and abdomen. 

All treatments are painless, each session lasts 20 to 45 minutes, twice a week for one month, depending on the problem. The result is immediately visible in one month. Specific dietary instructions and increased activity are suggested, as acupuncture is an adjuvant treatment.

Acupuncture for weight loss is becoming a commonly used method of treatment for all ages, as it has no contraindication when applied by a qualified physician. 

Facial Rejuvenation with Acupuncture

Cosmetic acupuncture
'Cosmetic' acupuncture is the latest weapon in the anti-ageing war, and a favourite among stars such as Angelina Jolie, Gwyneth Paltrow and Jennifer Aniston.

What is Cosmetic Acupuncture?

Cosmetic Acupuncture is a form of treatment that uses tiny needles on the face and body to enhance and renew the skin. Cosmetic Acupuncture can provide a pain-free and natural way to reduce the appearance of wrinkles and support a healthy complexion.

Acupuncture and Chinese Medicine has always possessed a focus on health and longevity, which has included the physical appearance.

Benefits of Cosmetic Acupuncture

• Increase in collagen production, improving the elasticity of your skin.
• Remove fine wrinkles in the skin.
• Lighten deeper lines in the face.
• Strengthen the facial muscles, helping flatten wrinkles and lift droopy eyelids.
• Increased blood circulation in the face, improving complexion.
• Clear or reduce age spots, rosacea, and acne.
• Pain free and natural therapy that improves your appearance.
• A treatment that benefits your overall health.

How Does Cosmetic Acupuncture Work?

Cosmetic Acupuncture for facial rejuvenation works by balancing the needs of the body and encouraging the flow of blood and energy to the face.

During the Cosmetic Acupuncture treatment for facial rejuvenation, thin sterile needles will be inserted into the face and body to adjust the flow of energy. Additionally, these facial needles are able to increase the tone of the facial muscles, pulling the skin tight and flattening wrinkles. There is usually no pain and only a mild distending feeling at the sites of needles insertion during the treatment.

Cosmetic Acupuncture Treatment Protocol

A typical protocol provides treatment two times per week for approximately 5 weeks, for 10 total treatments. Each treatment lasts approximately 40- 60minutes. While the results can last several years, monthly maintenance visits are recommended. Remember, Cosmetic Acupuncture is not a instant facelift, but a gradual improvement of your skin’s condition and facial muscle tone over the treatment course.

The acupuncturist may also include body acupuncture points during the treatment to support facial complexion, as well as manage other health complaints. Acupuncture treatment can also help reduce stress, insomnia, hot flashes, anxiety, pain, and many other conditions during the sessions. Improving other aspects of health will support.

You will not only look younger, but also feel younger!

Tinnitus (Ringing in the ears)

Tiresome Ringing in the Ears

Tinnitus is a ringing, swishing, or other type of noise that seems to originate in the ear or head. Most people will experience tinnitus or sounds in the ears at some time or another.

Tinnitus can be extremely disturbin. In many cases it is not a serious problem, but rather a nuisance that may go away. However, some people with tinnitus may require medical or surgical treatment.

Tinnitus can arise in any of the four sections of the hearing system: the outer ear, the middle ear, the inner ear, and the brain. 

Some tinnitus or "head noise" is normal. 

A number of techniques and treatments may be of help, depending on the cause:

1. Some of the most common include a sound of crickets or roaring, buzzing, hissing, whistling, and high-pitched ringing
2. Other types of tinnitus include a clicking or pulsatile tinnitus (the noise accompanies your heartbeat).
3. The most common type of tinnitus is known as subjective tinnitus, meaning that you hear a sound but it cannot be heard by others. 
4. A much more uncommon sort is called objective tinnitus, meaning your doctor may sometimes actually hear a sound when he or she is carefully listening for it.

Tinnitus Causes 

Tinnitus is not a disease in itself but rather a reflection of something else that is going on in the hearing system or brain.

Probably the most common cause for tinnitus is hearing loss. 

• As we age, or because of trauma to the ear (through noise, drugs, or chemicals), the portion of the ear that allows us to hear, the cochlea, becomes damaged. This tinnitus can be made worse by ear infection or excess wax in the ear. 
• Tinnitus caused by ear trauma is usually noticed in both ears, because both ears are usually exposed to the same noises, drugs, and other influences
• Loud noise exposure is a very common cause of tinnitus today, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise from firearms, high intensity music, or other sources.
• Other causes of tinnitus include drugs such as aspirin (if overused), aminoglycoside antibiotics (a powerful form of infection-fighting drug), and quinine.
• Meniere's disease includes dizziness, tinnitus, and fullness in the ear or hearing loss that can last for hours, but then goes away. This disease is actually caused by a problem in the ear itself. The tinnitus is merely a symptom.
• A rare cause of subjective tinnitus includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus.
• Causes of objective tinnitus are usually easier to find.
• Pulsatile tinnitus is usually related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear.

When to Seek Medical Care

Most newly noticed tinnitus should be evaluated by a physician. Because tinnitus is usually a symptom of something else, if it begins suddenly, visit a doctor. This is particularly important if the tinnitus is only heard on one side. 

Although the majority of cases of tinnitus are not caused by any acute problems, certain symptoms need to be evaluated to determine whether or not a more serious medical condition is causing the symptoms.

Any time that tinnitus comes on suddenly, particularly in one ear or is associated with hearing loss, seek an immediate evaluation. Sudden hearing loss is often accompanied by tinnitus, and there are medications that may help to restore that hearing. Also certain types of tumors can cause sudden hearing loss and tinnitus that warrant an evaluation.

Medical Treatment
Treatment for tinnitus depends on the underlying cause of the problem.

In the majority of cases, tinnitus is caused by damage to the hearing organ. In these cases, there is normally no need for treatment other than reassurance that the tinnitus is not being caused by another treatable illness.
In the very rare instance where the tinnitus is extremely bothersome, there are a number of treatment options:

• Some of the most helpful include antianxiety or antidepressant medication and sometimes maskers-small devices like hearing aids that help to block out the sound of the tinnitus with "white noise."
• For people who are bothered by tinnitus only when trying to sleep, the sound of a fan, radio, or white noise machine is usually all that is required to relieve the problem.
• Most people with tinnitus find that their symptoms are worse when under stress, so relaxation techniques can be helpful.
• Avoiding caffeine is advised, as it may worsen symptoms.
• Biofeedback may help or diminish tinnitus in some patients.
• Avoid aspirin or aspirin products in large quantities
• Hearing loss worsens the effect of tinnitus, so protection of hearing and avoiding loud noises is very important in preventing worsening of the symptoms.

In cases where the tinnitus is caused by one of the other rare problems (such as a tumor or aneurysm), treatment of the tinnitus involves fixing the main issue. Although this does not always resolve the tinnitus, some people note relief of their symptoms. Only a very few cases of tinnitus are caused by identifiable, repairable medical conditions.

Nose Bleeds/Epistaxis

Nose- bleeds/Epistaxis

60% of the general population has had at least one episode of a bleeding nose. Nose-bleeds can occur at any age but are most common in children aged 2 to 10 years and adults aged 50 to 80 years. 

 

Nosebleeds can be dramatic and frightening. Luckily, most nosebleeds are not serious and can be handled fairly easily. They are divided into two types, depending on whether the bleeding is coming from the anterior (front of thenose) or posterior (back) of the nose.

Anterior nosebleeds make up more than 90% of all nosebleeds. The bleeding usually comes from a blood vessel at the very front part of the nose. Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a doctor.
Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually comes from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

Causes 

• Allergic rhinitis
• An object stuck in the nose
• Barotrauma
• Blowing the nose very hard
• Chemical irritants
• Direct injury to nose, including a broken nose
• Hereditary hemorrhagic telangiectasia
• Nose picking
• Overuse of decongestant nasal sprays
• Repeated sneezing
• Surgery on the face or nose
• Taking large doses of aspirin or blood-thinning medicine
• Upper respiratory infection
• Very cold or very dry airRepeated nosebleeds may be a symptom of another disease such as high blood pressure, allergies, a bleeding disorder, or a tumor of the nose or sinuses.

Treatment

Home treatment for Nosebleeds 
A small amount of bleeding from a nosebleed requires little intervention. 

To stop a nosebleed:

• Remain calm.
• Sit up straight.
• Lean your head forward. Tilting your head back will only cause you to swallow the blood.
• Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier.
• Spit out any blood in your mouth. Swallowing it may make you vomit.

After the bleeding has stopped

Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours.
Ice packs may help.
Exposure to dry air, such as in a heated home in the winter, can contribute to the problem.
Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.
If the bleeding does not stop then medical intervention is required by an ENT surgeon, as nasal packing or cauterization may be required in order to stop the bleeding.

Seek medical care immediately if:

• The bleeding lasts for more than 20 minutes
• The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose