Ear, Nose and Throat (ENT Surgery)

Glue ear is a condition that results when the air-filled passages within your middle ear become blocked with a glue-like fluid. It is usually caused by an infection, or repeat infections, in the ear or nearby structures in the back of the nose (the adenoid glands). Children are commonly affected by glue ear, but it can be difficult to notice. Your child may complain of hearing loss or earache, or you may notice that they have trouble paying attention. Adults who have glue ear should be seen by an Ear, Nose and Throat (ENT) specialist as soon as possible.

In most cases, glue ear will get better on its own. Once diagnosed with glue ear, your doctor will likely perform some hearing tests and repeat them after around 3 or 4 months to see if there has been an improvement. Hearing returns to normal within a year in around 90% of cases.

If problems persist, then surgery may be recommended. This may involve inserting a grommet to help fluid drain from the ear, or removing the adenoid glands to relieve fluid build-up.

Sinusitis (inflammation of the sinuses) is a common condition. If the symptoms persist for over 3 months, it becomes known as ‘chronic sinusitis’.[i]

The main symptoms of sinusitis include:

• Nasal congestion, blockage or obstruction
• Nasal discharge (this can also stimulate coughing)
• Facial pain or sinus pressure, (which may also feel like a sinus headache)
• Reduced or lost sense of smell

Chronic sinusitis treatment can be medical or surgical:

Medical treatment is usually based on the use of ‘intranasal’ preparations, such as nasal irrigation (a special system that helps to wash out your sinuses) and steroid-based medications that can be inhaled through the nostrils for targeted symptomatic relief.

If symptoms are severe and not remedied with medical therapy, surgical intervention may be warranted. Surgery can be used to correct structural problems in the sinuses, such as polyps or a deviated nasal septum that may be contributing to symptoms. This can be done using specialised equipment and an endoscope (a small camera) to access the nasal passages under a general anaesthetic.

Tinnitus is the medical word used to describe the sensation of sound in your ears when there is no external sound present. This sensation is often described as a continuous ringing, humming or buzzing, and can be present in one or both ears. It is not always clear what causes tinnitus, but it can be associated with hearing loss. It has also been linked to other medical conditions such as diabetes and high blood pressure.

Often symptoms of tinnitus can settle on their own. If your symptoms are severe or not getting better, you may need to be referred to an Ear, Nose and Throat (ENT) specialist who will be able to assess your symptoms, examine your hearing and rule out any medical problems which may be contributing and requiring treatment.

Dizziness is a word that can be used to describe a number of different sensations. Most commonly, it is used to refer to ‘vertigo’ – a feeling of the world spinning around you. Some people may use it to describe a loss of balance or even feeling faint.

Vertigo is caused by a problem with your inner ear, such as an infection or a condition called BPPV (benign paroxysmal positional vertigo), where certain head movements can make the sensation worse. The vast majority (99%) of people who suffer from vertigo will recover with time and without any treatment.

Other causes of dizziness include low blood pressure, anxiety, abnormal heart rhythms or problems with your nerves. Some rare causes of dizziness can be more serious and so need more prompt evaluation by a specialist.

If dizziness is troubling you, or you notice associated symptoms such as headaches, hearing or visual loss, weakness or numbness in your limbs, speech problems or chest pain then you should speak to a doctor as soon as possible.

Hearing tests are painless, non-invasive investigations that allow doctors to assess hearing and determine the degree of a person’s hearing loss.

Pure Tone Audiometry is used as a standard assessment tool for adult hearing Sounds of different pitch and volume are played into your ears and the person conducting the test will ask you which sounds you are able to hear.

The above tests are used to determine the type and amount of hearing loss you are experiencing and will be used as an aid in diagnosis.

When we sleep, the muscles in our throat become relaxed, so the passage for the air we breathe becomes narrower. Snoring is the noise made by the vibrations of the soft tissues in the throat and nose as air passes through the narrowed airway. Approximately 41.5% of the UK population snores, and this can cause varying problems.

If the passage for the air becomes too narrowed, this can affect your breathing, resulting in a condition known as ‘sleep apnoea’. In sleep apnoea, you may stop breathing for a little while whilst you are asleep, which will eventually wake you up feeling breathless. This can have a significant effect on your overall sleep quality, often causing people to feel very tired during the day.

There are several strategies available to both reduce snoring and help with the symptoms of sleep apnoea:

• If you are overweight, weight loss can help to reduce the narrowing of the airway whilst you sleep
• Maintaining a healthy lifestyle, including minimising the use of alcohol and smoking, helps to prevent snoring
• Nasal sprays can be used to reduce nasal congestion and blockage
• A special device known as a Mandibular Advancement Device (MAD) is a small device that is worn in the mouth during sleep to prevent your tongue from obstructing your airway
• Once a specialist has made a diagnosis of sleep apnoea, in some cases, a CPAP machine can be used. This is a special mask that you can wear that is attached to a machine designed to help you with your breathing

There are many reasons why a lump or bump can appear in the neck or throat. If the lump is at the back of your throat, it may be due to an infection causing your tonsils or adenoid glands to become swollen and painful. A hard lump that can be felt lower down in your neck might be a lymph node or gland, which can commonly swell up in response to infections or inflammation. If the lump is just under your skin, it may be a small cyst or benign growth.

If you notice that you have developed other symptoms alongside the lump in your throat, such as a hoarse voice, difficulty swallowing or coughing up blood, or if you have been unintentionally losing weight then you should see your doctor immediately.

If you are concerned about a lump in your neck you should seek medical advice for an assessment. Your doctor may wish to perform an ultrasound scan to look at the lump in greater detail and will able to help you to decide on any treatment if necessary.

The thyroid is a gland in the neck that produces different types of thyroid hormones to help to regulate your body’s metabolism. Sometimes the gland produces too much or too little thyroid hormone, which can lead to specific symptoms.

Hyperthyroidism (too much thyroid hormone) results from an overactive thyroid gland, and can lead to:

• Weight loss despite increased appetite
• Palpitations
• Sweating
• Intolerance of heat
• Irritability, agitation or nervousness
• Diarrhoea
• Tiredness

Hypothyroidism (too little thyroid hormone) occurs due an underactive thyroid gland, and can lead to:

• Weight gain
• Sensitivity to cold
• Constipation
• Tiredness
• Depression
• Dry skin and hair