From earwax to nasal sprays

From earwax to nasal sprays

Published: 10/25/2022 18:02:45

Modified: 10/25/2022 18:02:30

Dr. Chandler Marietta of Concord Hospital Otolaryngology-Laconia breaks down the specialty and offers pearls—key information—for the general population.

What is otorhinolaryngology? what do we do?

Otorhinolaryngology is a surgical specialty commonly known as ENT or ENT. As the name suggests, otolaryngologists or otorhinolaryngologists operate and perform procedures to solve ear, nose or throat problems; however, it is a bit more complicated. In fact, we perform almost all surgeries and procedures in the head and neck region with the exception of the brain, spine, eyes, and teeth. We treat diseases, disorders or injuries of the bones of the face, oral cavity, lips, tongue, tonsils, paranasal sinuses, salivary glands, thyroid, lymph nodes and skin, among others. As a result, there is considerable overlap with other specialties such as dermatology, plastic surgery, gastroenterology, allergy/immunology, and oncology. This leads to interdisciplinary collaboration and strong care.

What is earwax? You should
take it off?

Earwax, or cerumen, is good! That’s right, you didn’t read it wrong! There is a perception in our society that it is bad, dirty and/or unhealthy, but that is far from the truth! Earwax is nature’s way of cleaning and preventing ear canal infections. Made in the middle part of the ear canal, earwax is acidic, which prevents infection, and its stickiness allows it to trap debris. The skin migrates from the eardrum and carries the wax with it, which can then be cleaned off when it reaches the opening of the canal. In addition to the above, one pearl that most ENT doctors would like the general public to know and accept is that cotton swabs are not recommended for use in the ears. Also, other commercially available methods of wax removal are not recommended. Once again, earwax has a very important function and should generally be left alone. Trying to remove it with cotton swabs tends to push more than is removed on the swab. If this occurs, the accumulated wax can lead to complications such as hearing loss, infection, or erosion of the skin and bone of the ear canal. In the relatively rare times when earwax can cause symptoms and/or problems, it’s best to see an ENT doctor or medical professional who can safely remove it.

When is hearing loss an emergency?

In the field of otolaryngology, sudden hearing loss is considered a semi-emergency. In most cases, hearing loss can be attributed to problems that are easily fixed, such as blockage by wax or fluid in the middle ear space. However, if it is related to the inner ear, treatment as soon as possible is paramount, ideally within 72 hours. To help distinguish between a middle ear problem and an inner ear problem, you can scratch the scalp behind the ear; if you can’t hear it on that side, seek medical attention as soon as possible; if you can hear it, then it is recommended to seek medical attention, but it is probably not inner ear loss.

Are there any problems with steroid nasal sprays?

If used correctly, no. Problems arise due to a lack of understanding of nasal anatomy. If you put the applicator directly into your nose and spray up and in, like most people do, you will only spray the septum. The septum is the tissue structure that separates the right and left nasal cavities, and if it is sprayed over and over again, it can dry out and bleed. Also, the medication doesn’t get where it needs to go and doesn’t do much good. Therefore, another ENT pearl is to point towards the interior of the nasal cavity and also towards the place where the paranasal sinuses drain: outwards, upwards and slightly backwards. If you use the opposite hand and aim at the inner corner of your eye inside your nose, the spray should hit the right spot to relieve symptoms and prevent bleeding. Another point is that although steroid nasal sprays are very effective, it can take up to a month to determine if the spray will be helpful, so stick with it!

What tools are used in this specialty?

There are numerous tools used in this surgical specialty, but one of the most used and one that revolutionized the practice of our specialty, among others, is the endoscope. An endoscope is a small telescope, it can be straight and rigid or long and flexible. Sometimes they are angled to help look around corners, and sometimes a camera is attached to help with viewing. We have many “holes” in the head and neck region; endoscopes allow us to see inside all these “holes”. In some circumstances, it also allows us to dispense with numerous or large incisions. This minimally invasive approach to diagnosis and treatment not only improves care through better visualization, but can also result in shorter recovery times for patients.

Dr. Chandler Marietta of Concord Hospital Otolaryngology-Laconia spoke about the surgical specialty of otolaryngology, also known as ear, nose, and throat (ENT) at the July Concord Hospital Trust “What’s up, doc?” Donor Conference Series. The monthly series, supported by the Walker Lecture Fund, features Concord Hospital medical staff members speaking with Concord Hospital Trust donors about new and innovative medical treatments and services. You can view Marietta’s presentation on the Concord Hospital YouTube channel at: youtube.com/concordhospital.

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