Ask the Otolaryngologist

By admin

By Jeff Phillips, M.D.

Dr. Jeff Phillips attended college at the University of Wisconsin-Madison, where he also completed his medical school training. He then completed his residency training in Otolaryngology-Head and Neck Surgery (Ear, Nose & Throat Surgery) at Louisiana State University, and moved back to Wisconsin to complete fellowship training in Sleep Medicine & Surgery. He is board certified in Ear, Nose & Throat by the American Academy of Otolaryngology-Head & Neck Surgery and in Sleep Medicine by the American Academy of Sleep Medicine.

My partner snores … a lot! Is there anything that can be done to mitigate his snoring?

Snoring is a very common problem that people of all ages can experience. In fact, nearly half of the population will experience snoring at some time in their life. Fortunately, there are many things that can be done about snoring. The first step is to determine if your partner also has problems with sleepiness during the day, poor sleep in general, or has gasping or choking awakenings during the night to suggest breath-holding spells, called “apneas.” These can be a sign of sleep apnea and should be evaluated by your doctor. However, not all people who snore have sleep apnea.

Simple lifestyle changes and sleep hygiene can go a long way to help with snoring. Elevation of the head of your bed about 30–45 degrees can help. Sleeping on your side instead of your back can also be effective in some cases. Setting regular bedtimes and wake times can help, and avoidance of alcohol, heavy meals and late night eating can also help. Treating nasal congestion and nasal allergies allows for better nasal breathing. Your ENT doctor can help you improve your nasal breathing with either medications or surgery when needed. Staying at a healthy weight can also be helpful. If these measures do not address the snoring, there are also oral appliances (mouthguards) that can be made for snoring and sleep apnea that are very effective. A number of minimally invasive office procedures are also available to help snoring that does not respond to these therapies.

Why do our noses run when we eat hot or spicy foods?

A runny nose, or “rhinorrhea,” while bothersome, is also a protective mechanism to help the nose flush out irritating substances like viruses, bacteria and seasonal allergens. However, there are also irritants in certain types of foods. In hot and spicy foods, one of these irritants is capsaicin, which will trigger the same response. Your nose will want to flush the irritant in the hope that it can protect you from getting the substance in your lower respiratory tract and lungs. There are other oils in foods like horseradish, wasabi and mustards that have the same effect. If your mouth is on fire and your nose is like a faucet, try quenching the sensation with milk instead of water. This has been found to be more effective at breaking up the particles causing the irritation. And just to be clear, try DRINKING the milk. I wouldn’t recommend pouring it in your nose!

How is a sinus headache different from a regular headache?

When someone refers to having a “sinus headache,” the nature of this description can be misleading. Often, many people refer to symptoms of pain, pressure and discomfort that is believed to be caused by either acute or chronic sinusitis, a disorder of inflamed sinuses. While headaches are a common symptom of acute or chronic sinusitis (when combined with other common symptoms of nasal drainage, post-nasal drip, congestion and facial pressure), headaches and facial pain without these other symptoms are very unlikely to be related to the sinuses at all. Even in the case of patients with chronic sinus disease and allergies, many patients with headaches are more likely to be experiencing a form of migraines triggered from sinus inflammation and chronic nasal congestion.

I swim often, but don’t use ear plugs. Can the water damage my ears? And what exactly is swimmer’s ear?

Unless you have a hole or perforation in your ear drum or a known chronic ear canal problem, a little water in your ears will likely not cause a problem. The water will drain out of your ears on its own over the course of the following 24 hours. However, if the water stays in your ear canal for a longer period of time, especially if you have a small cut or break in the skin in your ear canal, it can lead to a painful, acute infection of the ear canal and outer ear called “acute otitis externa,” also known as “swimmer’s ear.” This can occur when the thin skin of the ear canal or outer ear is damaged, and bacteria or fungus invade the deeper layers of skin, causing a localized infection. Common symptoms include pain in and around the ear canal and outer ear (auricle) itself, a swollen ear canal, drainage from the ear canal and hearing loss. Keeping your ears dry, avoiding use of Q-tips, and seeing your doctor as soon as possible are the initial recommended steps.

Why do we have tonsils?

Tonsils are a functional part of your immune system. Much like the lymph nodes in your body, tonsils can help fight infection by trapping and responding to viruses and bacteria that enter your throat. Also like the lymph nodes in your neck, the tonsils will swell up and become red and painful when they are fighting infection.

So, why do we remove the tonsils then, and how can people survive without their tonsils? Fortunately, in people with a normal immune system, there is enough lymphatic tissue and multiple immune defense systems to fight bacteria and viruses to allow us to rid the body of these organisms. In some cases, multiple tonsil infections per year can lead to chronically inflamed and infected tonsils that become problematic for a person. Large tonsils can also contribute to breathing obstruction and sleep apnea. In these cases, it may be useful to remove the tonsils.

Is there any reason (aside from bad manners) that I shouldn’t pick my nose?

You bet! Aside from being impolite, nose picking is one of the most common causes of nose bleeds. While crusts in the nose can be irritating at times, removing them briskly can often lead to small cuts and raw surfaces along the delicate nasal lining. There are many small blood vessels here, particularly along the nasal septum, and removing the crusts can lead to bleeding. Nose picking and plucking nose hairs can also lead to breaks in the nasal lining that allow bacteria to invade and cause local infections, which can be painful and may even lead to a more serious infection.


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