Pediatric Ear, Nose and Throat Services - Coastal Ear Nose & Throat

1. KnowMoreAboutPediatricEar,Noseand Throat

2. KnowMoreAboutTonsilsand Adenoids Twomassesoftissuethataresimilartothelymphnodesor“glands”found intheneck,groin,andarmpits.Tonsilsarethetwomassesonthebackof thethroat.Adenoidsarehighinthethroatbehindthenoseandtheroofof themouth(softpalate)andarenotvisiblethroughthemouthwithout specialinstruments. Tonsilsandadenoidsareonthebody’sfirstlineofdefense—ourimmune system. They “sample” bacteria and viruses that enter the body through the mouth or nose at the risk of their own infection. But at times, they become more of a liability than an asset and may even trigger airway obstruction or repeated bacterial infections. Your ear, nose, and throat specialistcansuggestthebesttreatmentoptions.

3. KnowMoreAboutEarinfections Otitismediameansinflammationofthemiddle ear. The inflammation occurs as a result of a middleearinfection.Itcanoccurinoneorboth ears.Otitismediaisthemostfrequentdiagnosis recorded for children who visit physicians for illness. It is also the most common cause of hearinglossinchildren. Althoughotitismediaismostcommoninyoungchildren,italsoaffectsadults occasionally.Itoccursmostcommonlyinthewinterandearlyspringmonths.

4. KnowMoreAboutEarTubes Painfulearinfectionsareariteofpassageforchildren—bytheageoffive,nearlyeverychildhasexperiencedatleastone episode. Most ear infections either resolve on their own (viral) or are effectively treated by antibiotics (bacterial). But sometimes,earinfectionsand/orfluidinthemiddleearmaybecomeachronicproblemleadingtootherissuessuchas hearingloss,behavior,andspeechproblems.Inthesecases,insertionofaneartubebyanotolaryngologist(ear,nose, andthroatspecialist)maybeconsidered. Ear tubes are tiny cylinders placed through the ear drum (tympanic membrane) to allow air into the middle ear. They also may be called tympanostomytubes,myringotomytubes,ventilationtubes,orPE(pressure equalization)tubes. These tubes can be made out of plastic, metal, or Teflon and may have a coating intended to reduce the possibility of infection. There are two basic typesofeartubes:short-termandlong-term.Short-termtubesaresmaller andtypicallystayinplaceforsixmonthstoayearbeforefallingoutontheir own.Long-termtubesarelargerandhaveflangesthatsecuretheminplace foralongerperiodoftime.Long-termtubesmayfalloutontheirown,but removalbyanotolaryngologistisoftennecessary.

5. KnowMoreAboutHearingLoss Hearinglossinchildrencanbetemporaryorpermanent.Itisimportanttohavehearinglossevaluatedbyaphysicianwho canruleoutmedicalproblemsthatmaybecausingthehearingloss,suchasotitismedia(earinfection),excessiveearwax congenitalmalformations,oragenetichearingloss. If it is determined that your child’s hearing loss is permanent, hearing aids may be recommended to amplify the sound reaching your child’s ear. Ear surgery may be able to restoreorsignificantlyimprovehearinginsomeinstances.Forthosewithcertaintypesof profoundhearinglosswhodonotbenefitsufficientlyfromhearingaids,acochlearimplant maybeconsidered.Unlikeahearingaid,acochlearimplantbypassesdamagedpartsofthe auditory system and directly stimulates the hearing nerve and allows the child to hear louderandclearersound. You will need to decide whether or not your deaf child will communicate primarily with oralspeechand/orsignlanguage,andseekearlyinterventiontopreventlanguagedelays. Research indicates that habilitation of hearing loss by age six months will prevent subsequent language delays. Other communication strategies such as auditory verbal therapy,lipreading,andcuedspeechmayalsobeusedinconjunctionwithahearingaid orcochlearimplant,orindependently.

6. KnowMoreAboutNasalObstruction Nasalobstructionisasymptomratherthanastand-alonediagnosis, and there is a wide range of medical and structural problems that can affect your ability to breathe properly. Structural problems causedbydeformitiesofthecartilageorbonystructuresofthenasal frameworkarecommoncausesofnasalobstruction.Theseincludea deviated nasal septum, nasal polyps, large adenoids, as well as swollenturbinatetissue,andnasalvalvecollapse.Othercausesmay benon-anatomicalandduetoconditionsthatcausethenasallining toswell,includingchronicsinusitisorseverenasalallergies.Eachof these nasal obstructions can often be corrected using a variety of surgicaltechniques.

7. KnowMoreAboutNasalPolyps Nasal polyps are benign growths that develop within the lining of the nasal passages or sinuses. If large enough, these growths may block the passages andcausebreathingdifficulties,sinusinfectionsorothercomplications.Nasal polypscanaffectanyone,buttheyoccurmorefrequentlyinadults. Medicationsmayshrinkoreliminatenasalpolyps,butsurgeryissometimes neededtoremovethem. SymptomsofNasalPolyps Nasalcongestion Runny nose Headache Facialpain Lossofsmellortaste Sinus pressure Snoring Ifthenasalpolypissmall,patientsmaynotexperienceanysymptomsandmaybeunawarethattheyeven haveanasalpolyp.

8. KnowMoreAboutAdenoidHypertrophy Thetonsilsaretwomassesoftissuefoundoneithersideofthebackofthethroat.Theadenoidsarelocatedhighinthe throatbehindthenoseandroofofthemouth.Togethertheyformpartoftheringofglandulartissueatthebackofthe throat.Thetonsilsandadenoidsassistthebodyindefenseagainstinfectionby"sampling"enteringbacteriaandviruses andbecominginfectedthemselves.Theythenhelpformantibodiestoresistandfightfutureinfections.However,the tonsilsandadenoidsoftenbecomesusceptibletorecurrentbacterialinfectionsandcaneventriggerairwayobstruction. Bacterial infections of the adenoids can be treated with various antibiotics. Patients can also help relieve symptoms by gettingrestanddrinkingplentyofliquids.Surgicalremovalisconsideredwhenconditionsareresistanttomedicaltherapy orfrequentlyrecur. Anadenoidectomyisthesurgicalremovaloftheadenoids,glandslocatedbehindthenoseabovetheroofofthemouth.The function of the adenoids is to help fight ear, nose and throat infections by screening bacteria as they enter the body. At times,however,theadenoidsthemselvesmaybecomechronicallyinfectedandrequireremoval;thisconditionisknownas adenoiditis. Themajorityofadenoidectomiesareperformedinchildren,frequentlyincombinationwithtonsillectomies.Insuchcases, the procedure is called an adenotonsillectomy. The adenoids usually shrink by adolescence, so adults rarely undergo the procedure.

9. KnowMoreAboutAdenoidHypertrophy Thetonsilsaretwomassesoftissuefoundoneithersideofthebackofthethroat.Theadenoidsarelocatedhighinthe throatbehindthenoseandroofofthemouth.Togethertheyformpartoftheringofglandulartissueatthebackofthe throat.Thetonsilsandadenoidsassistthebodyindefenseagainstinfectionby"sampling"enteringbacteriaandviruses andbecominginfectedthemselves.Theythenhelpformantibodiestoresistandfightfutureinfections.However,the tonsilsandadenoidsoftenbecomesusceptibletorecurrentbacterialinfectionsandcaneventriggerairwayobstruction. Bacterial infections of the adenoids can be treated with various antibiotics. Patients can also help relieve symptoms by gettingrestanddrinkingplentyofliquids.Surgicalremovalisconsideredwhenconditionsareresistanttomedicaltherapy orfrequentlyrecur. Anadenoidectomyisthesurgicalremovaloftheadenoids,glandslocatedbehindthenoseabovetheroofofthemouth.The function of the adenoids is to help fight ear, nose and throat infections by screening bacteria as they enter the body. At times,however,theadenoidsthemselvesmaybecomechronicallyinfectedandrequireremoval;thisconditionisknownas adenoiditis. Themajorityofadenoidectomiesareperformedinchildren,frequentlyincombinationwithtonsillectomies.Insuchcases, the procedure is called an adenotonsillectomy. The adenoids usually shrink by adolescence, so adults rarely undergo the procedure.

10. KnowMoreAboutSpeechDelay Asaparent,youknowyourchild.Youlistentohim/hertalkandhowhe/shecommunicates.You alsolistentoother childrenofthesameageandcompareyourchild’sdevelopmenttotheirs. Knowingwhatisnormal,andwhatisnot,inyourchild’sspeechandlanguagedevelopmentmayhelpyoudetermine whetherornottobeconcerned. Speechhastodowiththesoundsthatcomeoutofourmouths.Itincludesarticulation,thewaysoundsandwords areformed.Itcanbefrustratingwhenspeechisnotunderstoodbyothers,asinstutteringormispronunciation. Languageismuchbroader.Itreferstotheentireprocessofexpressingandreceivinginformationinameaningful way.Itisunderstandingandbeingunderstoodthroughcommunication–verbal,nonverbalandwritten.Itcanalso beameasureofintelligence.Languagedelaysaremoreseriousthanspeechproblems. Althoughproblemsinspeechandlanguagediffer,theyalsooverlapinmanyways. Achildwhohasalanguageproblemmaybefinewiththepronunciationofwordsbutmaynotbeabletoputmore thantwowordstogether. Foranotherchild,itmaybedifficulttounderstandtheirspeech,buttheytrytousewordsandphrasestoexpress ideas. Anotherchildmayspeakverywellbutmayhavedifficultyfollowingdirections.

11. KnowMoreAboutNosebleeds Thenoseisanareaofthebodythatcontainsmanytinybloodvesselsor arterioles that can break easily. In the United States, one of every seven peoplewilldevelopanosebleedsometimeintheirlifetime.Nosebleedscan occur at any age but are most common in children aged 2-10 years and adultsaged50-80years.Nosebleedsaredividedintotwotypes,depending onwhetherthebleedingiscomingfromthefrontorbackofthenose. Tipstopreventanosebleed Keep the lining of the nose moist by gently applying a light coating of petroleum jelly or an antibiotic ointment with a cotton swab three times daily,includingatbedtime.CommonlyusedproductsincludeBacitracin, AandDOintment,Eucerin,Polysporin,andVaseline. Keepchildren’sfingernailsshorttodiscouragenosepicking. Counteracttheeffectsofdryairbyusingahumidifier. Useasalinenasalspraytomoistendrynasalmembranes. Quitsmoking.Smokingdriesoutthenoseandirritatesit.

12. KnowMoreAboutPostNasalDrip Glandsinyournoseandthroatcontinuallyproducemucus(onetotwoquartsaday).Mucusmoistensandcleansthenasal membranes,humidifiesair,trapsandclearsinhaledforeignmatter,andfightsinfection.Althoughitisnormallyswallowed unconsciously,thefeelingofitaccumulatinginthethroatordrippingfromthebackofyournoseiscalledpost-nasaldrip. Thissensationcanbecausedbyexcessivelythicksecretionsorbythroatmuscleandswallowingdisorders. WhatCausesAbnormalSecretions? ThinSecretions: Increasedthinclearsecretionscanbeduetocoldsandflu,allergies,coldtemperatures,brightlights,certainfoods/spices, pregnancy,andotherhormonalchanges.Variousdrugs(includingbirthcontrolpillsandhighbloodpressuremedications) and structural abnormalities can also produce increased secretions. These abnormalities might include a deviated or irregularnasalseptum(thecartilageandbonydividingwallthatseparatesthetwonostrils). ThickSecretions: Increasedthicksecretionsinthewinteroftenresultfromdrynessinheatedbuildingsandhomes.Theycanalsoresultfrom sinusornoseinfectionsandallergies,especiallytofoodssuchasdairyproducts. If thin secretions become thick, and turn green or yellow, it is likely that a bacterial sinus infection is developing. In children,thicksecretionsfromonesideofthenosecanmeanthatsomethingisstuckinthenosesuchasabean,wadded paper,orpieceoftoy.Ifthesesymptomsareobserved,seekaphysicianforexamination.

13. KnowMoreAboutSinusitis Haveyoueverhadacoldorallergyattackthatwouldn’t goaway?Ifso,there’sagoodchanceyouactuallyhad sinusitis. Experts estimate that 37 million people are afflicted with sinusitis each year, making it one of the most common health conditions in America. That number may be significantly higher, since the symptoms of bacterial sinusitis often mimic those of colds or allergies, and many sufferers never see a doctorforproperdiagnosisandtreatment. When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis. Symptomsofchronicsinusitismaybelessseverethanthoseofacute;however,untreatedchronicsinusitiscan causedamagetothesinusesandcheekbonesthatsometimesrequiressurgerytorepair.

14. KnowMoreAboutAirwayandBreathing Disorders Laryngomalacia Sometimes babies have noisy breathing. This can be due to congestion, or it can be a condition of the larynx called laryngomalacia. Laryngomalacia is a congenital softening of the tissues of the larynx, commonly known as the voice box, abovethevocalcords.Laryngomalaciaisthemostcommoncauseofraspy,noisybreathingininfancy.Ithappenswhenthe structure of the larynx is floppy and malformed. This causes the tissues to fall over the airway, partially blocking it and creatingnoisewhenbreathing. Tracheostomy A tracheostomy is a surgical procedure to create an opening through the neck into the trachea (windpipe). A tube is usually placedthroughthisopeningtoprovideanairwayandtoremovesecretionsfromthelungs.Thistubeiscalledatracheostomy tubeortrachtube. Bronchoscopy Abronchoscopyisatestperformedtoviewanddiagnoseproblemsinthebronchialtubesorrelatedtolungdisease.The procedureisperformedusingabronchoscope,adeviceusedtoseetheinteriorofthelungs.Thedoctorinsertsthislong tube through the nose or mouth, into the trachea and then into the patient’s lungs. A bronchoscopy is usually recommendedwhenthepatientshowssignsoflungdisease.

15. KnowMoreAboutLaryngomalacia Sometimes babies have noisy breathing. This can be due to congestion, or it can be a condition of the larynx called laryngomalacia.Laryngomalaciaisacongenitalsofteningof thetissuesofthelarynx,commonlyknownasthevoicebox, abovethevocalcords. Laryngomalacia is the most common cause of raspy, noisy breathing in infancy. It happens when the structure of the larynxisfloppyandmalformed.Thiscausesthetissuestofall overtheairway,partiallyblockingitandcreatingnoisewhen breathing. At Coastal Ear, Nose, and Throat, we often conduct a nasopharyngolaryngoscopy to evaluate problems with a child’sbreathing.Weuseaverytinycamerathatresemblesapieceofspaghettiforthetest.Thecameraisinserted intothebaby’snostrilanddownintothelowerpartofthethroat.Thisallowsourdoctorstoseethelarynxarea. Ifwethinkyourchildhaslaryngomalacia,wetheninvestigatetheextenttoseewhetherthelowerairwayis affected.Othertestssuchasmicrolaryngoscopycouldbeusedatthatpoint.

16. KnowMoreAboutLaryngoscopy &Nasopharyngoscopy Alaryngoscopyisaprocedurethatexaminesthelarynx,orvoicebox, whichcontainsthevocalcords.Thisprocedurecanbeperformedfor many reasons, including diagnosing a persistent cough, hoarseness or bad breath, to detect a mass or tumor on the vocal cords, or to treatconditionsofthethroatandlarynx. Whattoexpectduringlaryngoscopyprocedure During the procedure, Your physician will be able to see the voice box and vocal cords with clarity because they are magnified and illuminated. Videos are produced during the examination and can be reviewed immediately afterwards. In most cases, the laryngoscopycanbeperformedoutpatientwithverylittlenecessary recoverytime.

17. KnowMoreAboutVoiceDisorder As part of the normal aging process, the muscles that sustain and support ourvocalfolds(cords),aswellasthestructureofthelarynx(voicebox),may alter and change. These changes, that can affect the way we use our voice andthewayitsounds,usuallyoccurafterage60. Symptoms: Ifyouhavepresbyphonia,youmayexperience: Occasionalorfrequentbreaksinyourvoice Breathyvoice Tensioninthelarynx Suddeninterruptionsinnormalspeechflow Reducedhighsandlowsinvocalrange Reducedvolume Hoarseness Vocalfatigue Theseverityofsymptomsvariesfrompersontoperson.Butevenifyoursymptomsareinitiallymild,theymay worsenovertimeifyoudon’treceivetheappropriatetreatment.

18. KnowMoreAboutNasalFracture In cases of facial trauma, nasal fractures are a common type of bone injury. This is largely due to the prominence and centrallocationofthenoseonthefaceandtheweaknessofthenasalcartilage.Anasalfractureiscommonlytheresultof an injury from a car accident, a fall, a physical altercation, or a sports related injury. Untreated nasal fractures can negativelyaffectboththeappearanceandthefunctionofthenose.Functionalproblemsincludechronicnasalobstruction orblockage,andapredispositionforsinusitis,infection,andnosebleeds. SymptomsofNasalFractures Nasal fractures often go unnoticed by both physicians and patientsasacombinationofthesymptoms,includingtenderness, hemorrhaging,anddeformity,maynotoccurforlongoratall. Additionalsymptomsofnasalfracturesmayinclude: Tenderness Swelling Difficultybreathingthroughthenose Crooked appearance of the nose Bruising Nosebleeds Pain

19. KnowMoreAboutNeckMasses Neckmassesinchildrenaremostoftenbenign.Oneofthemostcommonlydiagnosedbenignneckmassesisanenlarged lymphnode.Lymphnodeshelptofightinfection,sotheywilloftenswellupduringanupperrespiratoryinfection.Usually, these“swollenglands”aretenderduringthecourseoftheinfection.Mostofthetime,theywillshrinkdownastheinfection resolves. On occasion, enlarged lymph node(s) can become an abscess (collection of pus) which requires intravenous antibioticsandsurgery. Anothercommonneckmassisacyst,whichisfilledwithfluid.Manycystsinthe headandneckarecongenital,thatis,theyhavebeenpresentsincebirth.Despite their presence in the neck, an actual lump may not appear until much later in life.Infact,somecongenitalneckcystsdonotgetdiagnoseduntiladulthood. Themostcommonbenignneckmassesarebranchialcleftcysts,thyroglossalductcysts, epidermoid cysts, dermoid cysts, lymphangiomas, and hemangiomas. These masses cancauseacosmeticdeformity,astheybulgeoutfromtheneck.Inaddition,manyneck masses cause symptoms, especially if they get infected. For this reason, surgical removalisgenerallyrecommendedformostneckmasses.

20. KnowMoreAboutTongueTie/Ankyloglossia Whenwesay,“tonguetied,”mostofusthinkofasituationwhenwearetooexcitedto express ourselves verbally. Although not a medical condition, tongue tie is the name for a fairly common condition that limits the movement of the tongue – medically referredtoasankyloglossia. Before we are born, a strong cord of tissue called the frenulum is positioned in the center of the mouth and guides the development of the oral cavity. As we grow and develop,itthinsandrecedestoasmallthinpieceoftissuethatattachesthebottomof thetonguetothefloorofthemouth.Insomechildren,thefrenulumisespeciallytight or fails to recede and may cause difficulty with tongue movement. Ankyloglossia or tonguetiecancauseeatingorspeakingdifficultiesinsomechildren. In infants, tongue tie can present with trouble sucking or poor weight gain. In breastfed infants, it can cause trouble with latching, or the mother may experience pain when the baby is nursing. Some mothers give up nursing because of tongue tie that is not recognized. In toddlers and older children, tongue tie can be a cause of trouble with speech articulation, especially consonant sounds. Signs that your child mayhavedifficultyduetotonguetieincludeaV-shapednotchatthetipofthetongue, inabilitytostickthetongueoutpastthegums,orsimplydifficultylickinganicecream coneorlollipop.

21. KnowMoreAboutBone-anchoredhearing aid(BAHA) Bone-anchored hearingdevicesareimplantabledevicesusedtoimprovehearingbytransmittingsounddirectlytotheinner earthroughtheskull.Soundenergycausesvibrationsintheskullwhicharetransmittedto the inner ear,whichresultsin hearing.Theyhavebeensuccessfullyused toimprovepatients'hearingformorethan30years. Boneanchoredhearingdevicesmaybeaneffectivesolution formultiplevarietiesof hearing loss. Some patients are incapable of wearing hearing aids due to the size of the earcanal,chronicdrainage,orseverehearingloss.ABAHAmaybeasolutionforthese patients,howeveraboneanchoredhearingdevicesarenotasolutionforeverypatient. Whetherornot aboneanchoredhearingdevicemaybeaneffectivesolutionforyouwill dependonyourtypeof hearingloss,quantityof hearingloss,physicalexamination, andhearinghistory.ThisinformationwillbediscussedwithyourCoastalproviderto determineif a boneanchoredhearingdeviceisrightforyou. Each bone-anchored hearing device consists of an implanted titanium fixture and a detachable sound processor that clips onto that fixture. Using a minimally invasive procedure, a bone anchored hearing device is surgically implanted in the skull behind the ear. Surgery is performed on an outpatient basis, meaning patients can return home after the procedure. After healinghasoccurred andthedevicehasintegratedintotheskull,theboneanchoredhearingdeviceisactivated,facilitating hearing.

22. KnowMoreAboutCochlear Implants Acochlearimplantisanelectronicdevicethatrestores partialhearingto the deaf.Itissurgically implantedin the innerearand activated by adevicewornoutside the ear. Unlike a hearing aid, it does not make sound louder or clearer.Instead,thedevicebypassesdamagedpartsofthe auditorysystemanddirectlystimulatesthenerveof hearing,allowingindividualswhoareprofoundlyhearing impairedtoreceivesound.

23. Know MoreAboutTracheostomy Atracheotomyisasurgicalprocedureused tomakeanopeninginthewindpipe(trachea)to removeanobstruction or allow air to pass through to the lungs. This procedure is performed to relieve breathing problems and is often performedinemergencysituationsaftermoreconservativeattemptshavefailed. Atracheotomymaybeperformedto bypassan obstructionintheairway, toprovidelong-termbreathingsupportor to provide a temporary airway during another procedure that might restrict breathing. The inserted tube can remaininplaceaslongasbreathingsupportisneeded,andcanbetemporaryorpermanent. An emergency tracheotomy is a quick procedure that involves a cut in the larynx and the insertion of a tube to provide oxygen to the patient. Non-emergency procedures are more thorough, making a cut in the neck and separating the neck muscles before cutting into the trachea. An oxygen tube is then inserted to let the patient breatheandhelpremove the obstruction. Patientsmayexperiencedifficultybreathingandspeakingwiththetracheotomytubeinplace.Dependingon how longthetubeisneeded,itmaybeclosed upwithstitchesorsurgically.Recoveryfromatracheotomytakesafew weeks and may require speech therapy along with plenty of rest. While this is generally considered a safe procedure,therearerisks associated withanysurgicalprocedure.Talk to your doctoraboutyourtreatment

24. KnowMoreAboutAllergicandChronic Rhinitis Allergic rhinitis (hay fever) is an especially common chronic nasal problem in adolescents and young adults. Allergies to inhalants like pollen, dust, and animal dander begin to cause sinus and nasal symptoms in early childhood. Infants and young childrenareespeciallysusceptibleto allergicsensitivitytofoodsandindoor allergens. WhatareAllergicRhinitisSymptoms? Symptomscanvarywiththeseason and typeofallergen and include sneezing,runnynose,nasalcongestion,and itchyeyes andnose.Ayear–longexposureusuallyproducesnasalcongestion(chronicstuffynose). In children, allergen exposure and subsequent inflammation in the upper respiratorysystemcausenasalobstruction.This obstruction becomesworsewith thegradualenlargementofthe adenoid tissueandthetonsils inherent withage. Consequently, theyoung patientmayhavemouth–breathing,snoring,andsleep – disordered breathing such as obstructive sleep apnea. Sleep problems such as insomnia,bed-wetting,and sleepwalkingmayaccompanythesesymptomsalong with behavioral changes including short attention span, irritability, poor school performance,andexcessivedaytimesleepiness.

25. KnowMoreAboutNasopharyngeal Tumors A nasopharyngeal tumor is a growth that forms in the nasopharynx, or the uppermost portion of the throat that is found behind the nasal cavity. The nasopharynxservesasapassagewayforairfromthenose to the throat and eventually to the lungs. A tumor in the nasopharynx may be either benign or malignant. Nasopharyngeal tumors that are malignant, or cancerous, may spreadtosurroundingtissueandotherpartsof thebody. SymptomsofNasopharyngealTumors Thesymptomsofanasopharyngealtumormayinclude: Pain Persistentsorethroat Earache Nosebleeds Hoarsevoice

26. KnowMoreAboutTearDuctObstruction Atearductobstruction,alsoknownasdacryostenosisor nasolacrimal ductobstruction,isacommonconditionthat affectsmorethanfivepercentofallinfantsandispresentatbirth.Tearsusuallydrainthrough smallopeningsinthe corners of the eyelids, known as puncta, and enter the nose through the nasolacrimal duct. When an obstruction exists,tearscannotproperlydrainfromtheeyesandmaywellup on thesurfaceofthe eyeandoverflow on the eyelashesandeyelids.Theeyelidsmayalsobecomeredandswollenwith yellowor green discharge. Many infants are born with nasolacrimal duct obstruction. The tear drainagesystemmaynotbefullydevelopedortheremaybean abnormality in the tear duct. A thin membrane often remains over the opening that empties into the nose in congenitally blocked tear ducts. Although more common in infants, nasolacrimal duct obstructionmayalsooccurinadultsandmaybecausedbyinfection, injuryor a tumor.

27. KnowMoreAboutTearingAndEye Surgery Grave’sdiseaseisanautoimmunedisorderthatcausesthethyroidgland to produceanexcessiveamountofthyroid hormonewithinthebody.Thisoverproductioncreatesmorehormonesthanthebodyneedsandcausesmany important bodily functions to speed up. The thyroid is a butterfly-shaped gland located in the front of the neck and controlsmetabolism,heartandnervoussystemfunctionsaswellasothermetabolic functions.Anoverproduction of thethyroidhormonecanlead to hypertension,weight loss, irregularheartbeatandeyeproblems. In addition to other symptoms, Grave’s disease may also cause a condition known as Grave’s ophthalmopathy in which the immune system attacks the muscles and other tissue around the eyes. This causes an inflammation and abuild-upof tissue aroundtheeye,whichinturn,maycausetheeyeballstobulgeout.Additionaleye-related Dryandirritatedeyes Excessive tearing Swollen eyelids Doublevision Light sensitivity Pressureorpain Difficultymovingthe eyes symptomscausedbyGrave’sophthalmopathymayinclude:

28. KnowMoreAboutAnosmia(Lackof Smell) Anosmia is a condition in which a person completely loses the sense of smell. Depending on the reason for its loss, theconditionmaybetemporaryorpermanent.Commoncausesoftemporaryanosmiainclude colds,allergiesand sinusinfections,andviralinfectionssuch astheflu.Agingisalsoafactor. CausesofAnosmia More-seriouscausesof total orpartiallossofthesenseofsmellincludethefollowing: Birthdefectssuch asbone deformities Brain tumors Certainmedications Cocaineabuse Diseases such as Alzheimer's, Parkinson's and multiple sclerosis Hormonedisturbances Injurytothenose Nasalpolyps Nutritionaldeficiencies Radiationtherapyforheadorneck cancer Smoking Toxicchemicalexposure

29. KnowMoreAboutCerebralSpinalFluidLeaks Cerebrospinal fluid (CSF) surrounds the brain and spine, and is encased in a membrane known as the dura. Sometimes, a CSF leakdevelopsfromadefectinthedura,allowingfluidtoleak from the nose or ear. CSF leaks can be caused by head injuries, various surgeries, or spontaneously from high pressure inside theskull. Symptoms of a CSF leak include a watery, clear discharge from the nose or ear, and a headache that is more painful when standinguprightthanwhenlyingdown.Ifaccompaniedby nausea, photosensitivity and a stiff neck, an infection may be present.If aCSFleakisnotrepaired,seriousandpotentiallyfatal complications, including meningitis or swelling of the brain, may arise.

30. KnowMoreAboutSinonasaland SkullBaseTumors Thenasalcavityandsurroundingsinusesassistinmaintainingthe functionalityandstructureof the headandneckarea. Most tumors of the sinuses are benign, but may result in troubling symptoms such as nasal obstruction, facial pain, visual difficulties, sleepapnea,snoringandchronicsinusinfections.Sinustumors may be diagnosed through endoscopic examination through the nose, or throughimagingtechniquessuchasX-rays,CTscansorMRIscans. When small benign tumorsarepresent,particularlyiftheyarenotinterferingwiththepatient'squalityoflife,they may only necessitate ongoing observation by the physician. In a small number of cases the mucosa lining of the noseandsinusescanbesusceptible to abnormalcelldevelopment,whichcanlead to theformationofcancerous tumors. Malignant cancers of the nose and sinuses are, however, quite rare. When they do occur, they are most often composed of squamous cells, and do not often metastasize. Nonetheless, any malignant growth in the nose orsinusesmustberemoved.

31. ContactUs CoastalEar,Noseand Throat Address:3700Route33 Neptune,NJ07753 (732)280-7855(main) (732)280-7815 CoastalEar,Noseand Throat Address:1301Route72 Unit 340 Manahawkin,NJ08050 (609)978-0590 (732)280-7815 CoastalEar,Noseand Throat Address:100Commons Way #210 Holmdel,NJ07733 (732)280-7855 (732)-280-7815 ForMoreDetailsVisitUs: https://coastalearnoseandthroat.com/services/pediatric-ear-nose-and-throat/