ENT problems in winters

 Dr Sarfraz Latif an ENT surgeon at Doctor’s Hospital and Medical Centre, Lahore talks about common ENT problems in winters

SN: Is it true that ENT issues commonly occur in winters?sni

They are not directly related. However, cold is one of the many contributing factors that causes sore throat, ear infections and sinus issues. Runny nose is another common problem experienced during winters. The nose warms and moistens cold air passing through it so it matches body temperature. This continuous process may produce water droplets, irritating the nasal lining and glands. Nasal glands then produce excess mucus and lead to runny nose.sni

SN: What causes mucus to drain down the throat?sni

When excess mucus builds up and drips down the back of throat, it is called postnasal drip. Other symptoms of this condition are cough, hoarseness and the urge to clear throat. Factors causing these include nose and throat allergies, structural abnormalities of nose and sinuses, environmental pollution, infections, pregnancy and medications. Sometimes stomach related issues play a role too.sni

SN: Is there any way to treat postnasal drip?sni

Treatment depends on the cause but it can be hard to cure. Generally, allergy is treated with nasal sprays and antiallergic medicines, deviated nasal septum by septoplasty surgery (straightening of wall dividing nostrils) and chronic reflux by oral antireflux medicines and weight loss. Lifestyle modifications can relieve the problem as well.sni

SN: Can a piece of bread or sip of water help push the stuck mucus down?sni

Some patients do experience temporary relief while eating and drinking. However, the best way is to treat the cause and take medicine prescribed by the doctor. Regular use of mask helps too. Also avoid irritants and quit smoking.sni

SN: Explain sinusitis and mention its common causes.sni

Sinuses are air-filled spaces present within skull bone. They are connected to nose which allows them to be ventilated continuously. Any disease or condition causing lack of ventilation leads to inflammation of the nose. This inflammation when spreads to sinuses is called sinusitis. It is common in individuals suffering from nasal allergies. Other causes include recurring nasal infections, nasal polyps and deviated nasal septum (wall separating both nostrils).sni

SN: How is sinusitis related to weather changes?sni

Sudden weather changes (including temperature and humidity) result in swelling of nasal membranes and runny or stuffy nose. This inflammation can spread to sinuses and affect ventilation of sinus cavities.sni

SN: Flu and sinus infection share some symptoms. How can a layman differentiate between them?  Also are they treated differently?sni

Every sinusitis starts with flu like symptoms. If flu persists for more than four to six weeks it is called chronic rhinosinusitis (inflammation of nasal cavity and sinusitis). If the patient has intermittent episodes of flu like symptoms, then it will be called sinusitis. Treatment depends on the cause and can include antibiotics, nasal sprays and antiallergic medicines. Colds are treated supportively.sni

SN: Recommend ways to relieve sinus pressure.sni

Steam, saline flush, head elevation during sleep and sinus massage can help relieve the pressure. Massages can be repeated several times until sinuses are clear from congestion. One can combine massage with other home remedies too like warm compresses or steam inhalation.sni

SN: How does steam inhalation help treat both blocked and runny nose?sni

Steam loosens mucus and have a soothing effect on nasal lining. These factors can help relieve symptoms.sni

SN: Other than steam what measures can relieve nasal congestion?sni

Try to avoid the causative factors. Use nasal sprays, antiallergics and other medicines prescribed by the physician.sni

SN: What is the proper way to clean ears?sni

Most ears do not need cleaning. A healthy ear is actually self-cleaning and natural movements like chewing help expel wax from it.sni

SN: What causes ear dryness? Also what is the proper way to deal with it?sni

Excessive cleaning of ears using cottons buds and pins, glands not producing enough wax and having skin conditions like eczema, psoriasis or dermatitis can cause ear dryness. Majority benefit from getting treatment for underlying skin condition and applying medical grade olive oil. Avoiding cotton buds is useful too.sni

SN: What causes itching and pain inside ear? Can one use oil drops to relieve these symptoms?sni

Dry ear, hard wax, fungal infection and certain skin conditions can cause itching and pain. Medical grade olive oil can only help if the cause is dry ears or hard wax. Thus cannot be recommended to all patients. Better consult an ENT specialist to get proper diagnosis and appropriate treatment.sni

SN: Why do some begin to cough while eating, talking or laughing? Also are the reasons different in elderly?sni

Cough reflex is the body’s way to protect the lungs. It forcefully pushes out potentially harmful substances of the air from lungs. Stray particles of food may enter the airway while eating. Likewise, dust, dander, pollen and other particles can enter the windpipe while talking and laughing eliciting a cough reflex. Causes are similar in the elderly and the condition is usually not associated with complications. But sometimes this can be due to nerve paralysis which requires ENT examination and management by neurophysicians.sni

SN: How can one prevent cough reflex?sni

Be mindful and do not talk while eating. Use masks to prevent the entry of dust and other particles into windpipe. Seek professional help if suffering from nerve paralysis.sni

SN: If sweet foods worsen cough, how is honey effective in relieving it?sni

Sweet foods do not worsen cough unless an individual is allergic to them. Like other sweet foods honey makes a coating or film over throat and leaves a soothing effect. It has anti-inflammatory properties too.sni

SN: Rice are soft and easy to swallow but are usually avoided in case of cough and sore throat. Why is it so?sni

This is a common misconception. Rice do not aggravate symptoms of cough or sore throat. However excessively oily, spicy or sour rice can adversely affect the throat.sni

SN: Which foods can help heal a sore throat?sni

Warm liquids like broth and tea, warm water, honey and lozenges (medicated tablets that dissolve in mouth to stop cough temporarily) leave a soothing effect on the throat. Avoid extremely sour, oily and spicy food.sni

SN: Why do babies vomit mucus?sni

Mucus is naturally produced in digestive tract and babies continuously swallow saliva produced in mouth. As their digestive tract is immature, it is natural for them to vomit mucus in the initial months. It should not be a cause for concern unless it is frequent.sni

SN: How effective are anti-allergies or anti-histamines in treating throat problems? Is it alright to use them regularly?sni

They can help treat throat problems due to postnasal dripping caused by nasal allergies. Individuals with severe allergies can take them but avoid continuous and prolonged use. Furthermore, most modern antiallergics do not have major side effects but doctors ensure appropriate medicine is given depending on medical history of patient.sni

SN: How useful are flu shots and who should get them?sni

Flu shot is a vaccine for the influenza virus. Influenza causes common cold. Like other viruses, it has the ability to mutate rapidly. Therefore, flu shots are prescribed during flu seasons. Individuals at risk of recurrent viral infections like medical professionals, shopkeepers and pregnant women are advised to take these shots.sni

SN: What are the problems of people with crooked nose bone?sni

They can have aesthetic, functional or both concerns. Functionally, after nose trauma, nasal septum may turn or deviate to one side. This can impair the passage of air and lead to difficulty breathing. Some patients may want to aesthetically enhance their nose even without associated breathing problems. ENT surgeon chooses the surgical intervention based on patient’s requirements. Septorhinoplasty (surgical procedure for improving nose appearance and treating breathing problem) is appropriate for both functional and aesthetic concerns.sni

SN: When is antibiotic needed to treat ENT problems?sni

Antibiotics are specifically tailored to combat bacterial infections. Many different bacterial infections can affect ear, nose and throat. These include tonsillitis, discharging ears and sinus infections etcetera. Unnecessary use of antibiotics especially for viral infections should be avoided to prevent antibiotic resistance.sni

SN: What causes distorted sense of smell?sni

This condition is called parosmia. A large number of patients presented with it after being affected with COVID-19 virus. Smell therapy is highly effective in it which involves training the brain to remember original smells of certain substances, often prescribed in the form of essential oils. Some other causes are certain medicines, neurological problems and bacterial infections. These are treated with suitable medicines, withdrawing potential triggers and surgery (in severe cases).sni

SN: Suggest ways to maintain good ENT health.sni

Urban centers, like where I practice, have high levels of pollution. Therefore, I recommend use of masks to protect nose and throat. Consult an ENT doctor earlier if a problem of the ear, nose or throat is affecting quality of life. Also avoid cotton buds and excessively sour, oily and spicy food.sni