Ear, Nose & Throat

There are many types of throat sprays.  Generally, they can be for pain relief, hydration or anti-septic.  Pain relief throat sprays are good for pain control. Hydrating throat sprays are good for dry mouth and throat. Anti-septic throat sprays help to clean the surface of the wound.  It can help to relief mild throat infections. However, long term anti-septic sprays may alter the mouth natural flora leading to growth of other undesired organism.  As such, doctor advice is needed if long term anti-septic throat sprays are needed. 

Blocked ear may cause poorer hearing.  The extend of hearing loss depends on the severity and cause of ear block.  The treatment of ear block depends on the underlying cause.  

Ear wax is a common cause of ear block.  Beside Q tips and over the counter meds, you may have to see your family doctor for ear drops or ear cleaning.  

The blockage could be wax deeper to where your swab can reach.  The blockage could also be due to your middle or inner ear conditions.  Possible causes of middle ear blockage are fluid behind the ear drum, ear drum perforation, and a mass or growth on the ear drum or in the middle ear space.  It could also be due to a Eustachian tube dysfunction, or sinus issues.  Inner ear causes such as hearing loss and inner ear inflammation are possible too. One of the most important condition to exclude in a male with persistent ear block sensation is nose cancer.  

As the causes are extensive, I suggest a consultation with your GP or an ENT specialist. 

There is a greater concern if it is associated with loud ringing sound, hearing loss and persistent nose block. The most dread condition would be sudden hearing loss and nose cancer.  You may see your nearest family doctor for a check.  

Treatment for sudden hearing loss is time sensitive.  The best outcome is treatment within 24 hours from the onset.  

Generally, any ear pressure that is persistent for more than a week warrants a detail check to rule out nose cancer.  A nose scope is needed to check the back of the nose to rule out a growth.  This is usually performed in the clinic by an ENT specialist.  Please consult your family doctor first if you have further queries.  

There are a few possibility why amoxicillin has not help.  The antibiotics may not work well against the bacterial. The duration may not be long enough.  There may be other causes to your sinusitis, such as uncontrolled allergic rhinitis, foreign body, polyps or even a dental cause.  Hence the treatment of persistent or prolong sinusitis is to treat the underlying cause.  Antibiotics is part of the armamentarium against sinusitis.  You may consider sinus rinse, improve the control of allergic rhinitis (if any) and seek additional help from your family doctor or an ENT surgeon. 

You have chronic sinusitis.  The cause may not be solely due to an infection.  This explains why you did not recover after 4 months.  You need to find out the other contributing causes such as allergy, anatomical obstructions, fungal infections and sometimes dental causes. I suggest seeing a ENT specialist or a rhinologist to determine the underlying cause of the sinus infection.  

Try to identify your triggers and avoid them.  The most common trigger in Singapore is dust mites. Reduce dust mites in your house especially in the bed room. Remove pets from bedrooms if you have pets. You may get over the counter antihistamine.  Boost your immunity to reduce the frequency of flu which tends to worsen allergic rhinitis.  Adequate sleep & hydration, exercise and Vitamin C helps to boost immunity.  Consult your family doctor if you need further advice. 

It is understandable to be concern and worried if the lymph node is present for so long.  First,  it is important to ascertain that the swelling is due to a lymph node.  An examination is needed to properly assess this lump.  Please see your GP for a detail check up and treatment.  If necessary, an aspiration or biopsy may be to determine the nature of the swelling and the underlying cause. 

The chance of it being due to your hypothyroidism is low. 

Continue to return to the same doctor for a follow up.  You have acute sinusitis.  There is a good chance you will be well if properly and adequately treated. Sometimes, you may need a longer course of antibiotics. Your smell should improve once your infection settles. If you have relapsing symptoms or persistent poor sense of smell, please discuss with your primary doctor on whether you need to see an Ear Nose Throat Specialist.  

From your history, it is likely to be an inflammatory lymph node. It will usually become smaller once the infection is treated.  Sometimes, the swelling may not disappear completely.  If it is a few mm, it may be monitored for increasing size or pain.  If you are worried of cancer, please consult a doctor for an assessment. 

Persistent breathy and weak voice is unusual.  It may not be entirely due to the reflux.  the reflux could be only a contributing or aggravating factor. I advice to see an ENT specialist for a proper assessment of the voice and voice box. The first step to recovery fully is to know what could have cause it.  

If your ear pain is persistent despite ear drops and pain killers, please see a ear specialist or ENT specialist.  The infective material trapped within the ear canal may need to be removed to speed up the recovery.  There may be other causes of ear pain too.  Meanwhile, please keep the ear dry, no swimming and don't cleaning of the ear with cotton bud. 

Cobblestone throat is a description of swelling at the back of the throat due to inflammation.  It will not cause your throat to close.  

Dear @Mundinger19. It can take 2-3 days for the antibiotics to be fully removed from the body system. Urticaria/ hives can be triggered by medications/ food. It can also be induced by infection such as that affecting his ears. Oral anti histamines are effective against urticaria and I will suggest you bring your child back to the doctor for an evaluation if the urticaria is till not subsiding. Hope this helps.

Dear @Bachoua94  You might wish to consult your family physician and get your throat examined. Quinsy ( Peri-tonsillar abscess) can present with severe sorethroat and severe pain when eating. If you are diagnosed with this condition, intravenous antibiotics as well as incision and drainage will be required for the tonsillar abscess. Hence I suggest you seek medical attention. Hope this helps.

Hmm..

Dear @Sherry, only the soft palate and part of the throat is seen. Based on what can be seen, It looks normal. Need to correlate to your symptoms for a proper  assessment. I suggest a visit to your family physician for an through checkup if you have any persistent or bothersome symptoms. 

Hi @AmberD. Thank you for the interesting question. For ear infections, evidence supporting alternative therapies is limited. There are some suggestions that acupuncture may help with ear fluid clearance and hence resolution of ear infections, but these are merely postulations and have not been proven conclusively yet. Also, you may want to avoid ear candling, as there have adverse events reported from this practice.  

Antibiotics are indeed effective for clearing ear infections but there are side effects as you mentioned. You may consider non-quinolone based topical ear drop antibiotics (if you have no other contraindications), as this is a topical treatment that avoids the complications of systemic treatment with oral antibiotics. 

Regardless of your eventual choice of treatment, it would be best to get your infection sorted out as soon as possible, even if you do not have much pain or symptoms currently. This is because serious complications can arise from prolonged untreated ear infections such as mastoiditis etc. 

Take care and all the best!