Is your guy treating his ear, nose and throat right? These are extremely sensitive, so they need tender, loving care. sound bites

sound bites snoring

ear My partner has the awful habit of cleaning his ears with small scissors (yes, scissors!). Isn’t he in danger of an ear infection? Yes, the skin covering the ear canal is thin – sharp instruments can easily traumatise the skin and lead to infection – when this happens, the space may be filled with pus, leading to a hearing loss condition, Otitis Externa. Worse, if the eardrum is perforated, this can lead to middle ear infection called Otitis Media, which can lead to more significant hearing loss. So my advice is: Never introduce sharp instruments into your ear to clear earwax. Is it advisable to go to an ENT specialist for a regular cleansing of the ear? There is no need for regular ear cleansing for a normal person. We all have a natural self-cleansing mechanism in which our earwax is moved out of the ear canal as flakes. In special circumstances, the earwax may accumulate and cause problems. This would necessitate ear cleaning. Using a cotton bud may further aggravate the condition as the earwax may be pushed further into the ear canal and cause an impacted earwax situation. When the person bathes or goes for a swim, the impacted earwax would imbibe the water and lead to ear blockage and ear pain. Then the family physician is required to see and do ear syringing. If it’s still problematic, you need the ENT specialist to clear up the ear with specially designed micro-instruments and with the help of the microscope. So there are certain situations when the ENT specialist is required, but in normal circumstances a visit to the family doctor is good enough. nose Why is my boyfriend always sniffling? The most common cause of sniffling is nasal allergy. In contact with the allergen, your boyfriend may develop rhinitis, or inflammation, leading to copious nasal secretions and causing nasal blockage; sniffling is an attempt to clear the nasal passage. Can anything be done? Avoiding the allergen would benefit him, but this is usually not possible as even cool morning air can be an irritant. So the next thing would be to treat the symptoms with antihistamines, etc. To manage it, he will have to learn Allergen Avoidance (the doctor can advise) and may need oral medications or intranasal steroid spray. Surgical procedures may be necessary in some cases.  throat Why does my guy often get sore throat? Sore throat is a common symptom. Some causes include tonsillitis, pharyngitis, laryngitis or even reflux disease. In chronic tonsillitis, there are recurring attacks as the bugs causing the repeated infection is embedded in the tonsillar tissue. Sometimes, drastic action such as surgical removal is necessary, as multiple antibiotic therapy may not be able to solve the problem. If he is always plagued by sore throat, please advise him to see a doctor. Especially if he is a chronic smoker, aged more than 50 and has been having the sore throat for more than three weeks with blood stains in his throat. Serious infections of the throat include abscess formation, which can be life threatening as it can affect the airway by causing obstruction. The symptoms to look out for include painful throat, high fever, difficulty and painful swallowing, difficulty in breathing and neck swelling. – Dr Tan Nam Guan, Senior Consultant, Department of Otolaryngology, Singapore General Hospital ENT & pituitary tumours The pituitary gland, situated at the base of the brain, controls many glands, including the thyroid, pancreas, ovaries and testes. Because of its remote location, tumours may not be obvious till they are quite large. However, they may present symptoms (caused by excess or deficiency in the hormones produced from the pituitary gland) such as problems with the thyroid, vision, etc. An MRI brain scan can help confirm and localise the presence of tumours. Treatment depends on the type of tumour the patient has, and it can range from localised radiotherapy to surgery. With surgery, it is usually a combined effort where the ENT surgeon opens an access route through the nasal passage, after which the neurosurgeon operates on the pituitary gland. The ENT surgeon is required to complete the procedure.

snoring nuisance Lately, my husband’s snoring has been causing me sleepless nights. He wakes up tired too. Help! Snoring is the sound caused by the vibration of the walls of the air passages and throat when it partially collapses during sleep (airway muscles keep the air passage open when you’re awake).      In people who snore, the upper airway is narrow. This produces vibrations, which are heard as snoring. Snoring without significant stopping of breathing is called primary snoring. Different sleep positions may affect snoring, eg sleeping on the back may make snoring worse. A sleep study should be able to tell if a change in sleeping position will make any difference.      However, snoring when associated with choking, unrefreshing sleep, daytime sleepiness or fatigue is a symptom of Obstructive Sleep Apnoea (OSA). This is a condition where there is repeated upper airway collapse during sleep. This causes breathing to stop and the brain needs to wake up temporarily to open the airway to breathe again before falling back to sleep. On returning to sleep the obstruction occurs again and this cycle repeats. This causes poor sleep quality. Your husband could have this problem. As his snoring is obviously disturbing you – and causing him unrefreshing sleep – I suggest you consult a sleep specialist.  interrupted sleep  Obstructive Sleep Apnoea  CAUSES • Abnormal shape of the facial bones, inherited or developed over time (this may include nasal problems that narrow the nose passage • Tonsils • Adenoid enlargement • Obesity • Increasing age, when tissues in the air passage become more lax TREATMENT OPTIONS • PAP, or Positive Airway Pressure. The most common way of delivering it is CPAP (continuous positive airway pressure). PAP is positive pressure delivered by a machine that blows out air and is connected to a mask (via a hose) worn during sleep. This column of air pressure prevents the airway from collapsing.  • Dental splints are devices (also worn during sleep) that protrude the lower jaw by keeping the lower teeth in a more forward position. By maintaining the lower jaw in a protruded position it enlarges the air space behind the tongue and puts the air passage tissues in greater tension. This decreases the tendency for the airway walls to collapse. • Surgery performed on the areas (eg soft palate) that contribute to narrowing in the air passage. Surgery works by repositioning or removing tissues in or around the airway to enlarge it. Besides surgery done under general anaesthesia, there are also minimally invasive surgical procedures like Pillar Implants and a radio frequency treatment that can be performed under local anaesthesia but these procedures are more effective for simple snoring and mild Obstructive Sleep Apnoea. sleep disorders Sleeplessness before any stressful event is classified as Adjustment Insomnia or Acute Insomnia. This is sleep disturbance associated with an identifiable stressor and lasts a short time until the stressful event passes or when the individual adapts to it. This reaction to a stressful event is quite common and some may even consider it normal.      A sleep disorder is considered serious if it causes severe functional and social impairment, or increases the risk of serious medical diseases, injury or death.      Most sleep disorders are not serious and many people with common problems like insomnia suffer only mild impairment of their daytime activities. They either get used to it or try to cope with it by modifying their behaviour or taking stimulants like tea.  "Snoring by itself is not dangerous, but it may create social problems and cause sleep disturbance to the sleeping partner. On the other hand, untreated OSA may increase the risk of developing high blood pressure, heart disease and stroke. Losing weight if one is obese or stopping smoking are part of the management of OSA and snoring. Avoiding alcohol, keeping to a sleeping schedule and avoiding sleep deprivation is also helpful." – Dr Ignatius Mark, Associate Consultant, Department of Otolaryngology and Sleep Disorders Unit, Singapore General Hospital

The Department of Otolaryngology at Singapore General Hospital offers a complete range of ENT clinical and paraclinical services dealing with problems of the ear, nose and throat. Services include rhinology/endoscopic sinus surgery, head and neck surgery, otology/neuro-otology, voice disorders, sleep apnoea surgery and paediatric otolaryngology.

Call 6222-3322 (main line) or visit www.sgh.com.sg.