Health Live @ Seniors Today with ENT Specialist Dr Arpit Sharma

On February 20, 2021 Seniors Today hosted yet another Health Live webinar with well-known ENT specialist Dr Arpit Sharma on ENT and head and neck care for senior citizens. Dr Noor Gill captured the takeaways

Dr Arpit Sharma is a Consultant, ENT and Head & Neck Surgery at the P D Hinduja National Hospital and Research Centre, Mumbai. He has also been a faculty at the Seth GS Medical College in Mumbai. He has undertaken special training in Airway Disease Management and Surgery from Switzerland as also special training in Anterior Skull Base at the Center of Cranial Base surgery, University of Pittsburg Medical Center, USA. An awardwinning doctor, Dr Sharma is also trained in Lateral Skull Base in Paris.

Here are the takeaways from the session:

• Age related ENT issues are seen prominently as one ages. This is because as one grows older, the general body functioning slows down and weakness sets in, also involving the weakness of the nerves serving the special senses.

The most common complaint that individuals with age related ENT issues come with are

– Age related hearing loss

– Tinnitus

– Vertigo

• Hearing loss can be:

1. Conductive hearing loss- it is reversible.
2. Sensory-neural hearing loss- the nerves get affected resulting in the loss of hearing. The only solution to this is a hearing aid. These however are usually irreversible.

• If you suffer from decrease in your vision, you immediately visit an ophthalmologist and get yourself corrected glasses. But hesitate in getting yourself a hearing aid because of the social taboos that are associated with it. However, if you get yourself hearing aids, when you need them, it will not just improve your hearing and prevent it from getting worse, it will also help in keeping you socially connected to your near and dear ones, at home and outside.

• There are studies which have been conducted which suggest that if you have been diagnosed with hearing loss early on and take the corrective measures well in time, such individuals tend to have fewer cognitive dysfunctions as they get older.

• The hearing aids are dispensed by the audiologists who sometimes work in conjunction with ENT specialists. You should preferably go with digital hearing aids which are programmable and can decrease the ambient noise- such a hearing aid device should cost you between Rs. 30-40,000

• The second most common complaint the seniors come with is tinnitus. It is the ringing or whistling sound in the ear. As the age increases, the nerves weaken. It is the malfunctioning of the nerves that gives rise to the ringing. The main array of prevention lies in consuming a healthy diet and finding oneself in healthy hearing environments. Sometimes, however, despite taking the necessary precautions, one might still end up with tinnitus with no explainable cause.

• Patients with tinnitus tend to complain that the ringing gets worse at night or while falling asleep. The cause for this is- the ambient noise at night also quietens down at night, the tinnitus persists throughout the day, but the external sounds make it harder to hear it and mask the tinnitus. So, if you have tinnitus and have trouble falling asleep at night, Dr. Sharma recommends that you play some light and soft music in the background or have a fan turned on- this noise will mask your tinnitus.

• The vertigo, also called giddiness or lightheartedness, can be because of multiple reasons, some of which can be because of a defect in the inner ear, the brain, it can be because of cervical problems or because of some other metabolic causes. Certain investigations need to be done to find out the underlying cause for the vertigo.

• Patients who come with vertigo and the cause for the same cannot be established are given supportive measures in the form of head and neck exercises, exercises for balance. They are also given neuro-protective medications which are good for the nerves.

• Ear wax is a growing concern in the seniors. Earwax is produced as a normal physiological phenomenon in every individual, the problem arises when it starts getting produced in large amounts and starts accumulating thus forming a plug and thereby decreasing the hearing capacity. Dr. Sharma recommends that you should visit your ENT specialist to take care of it and as a preventive measure, introduce a few drops of soliwax or waxsol ear drops into your ear every or every alternate Sunday, that can help in warding off the problem. It is nothing but an oil based ear-drop which lubricate the ear canal.

• Dryness in the ear is also a concern which requires lubrication of the ear. Itching of the ear can also be because of the dryness or it can be because of a cold or nasal blockage (since the two- ear and the nose, are connected)

• If diabetic patients have any concerns regarding their ear, they should consult a specialist at the earliest. They should also avoid the use of earbuds, because any injury/trauma to the ear can cause very serious infection of the ear called malignant otitis externawhich can spread along the skull base and the head and have a long standing course.

• Chronic nasal blockage is a common side effect of certain hypertensive drugs, or any other medication that you might be on.

• If you or someone you know has an episode of nasal bleeding, here are a few things you can do:-

– If you feel like the bleeding increases on bending forward, manual compression helps. Manually compress the side you are bleeding from and that should help.

– Applying ice/ ice pack

– If you are hypertensive and have come across an episode of nasal bleeding, it is possible that the bleeding is due to the increased blood pressure. You should immediately go to the hospital and get your your blood pressure checked, if the bleeding is profuse, you will require nasal packing or pressure to stop the bleeding.

• Any non-healing ulcer in the buccal/ oral cavity, any swelling which has not come down in over 2 weeks, any bleeding from either a particular spot or the gums should be looked at.

• Most of the issues of the throat are due to the acid reflux. There may be a silent acid reflux taking place which can present as a pain in the throat or a foreign body sensation or a dry lagging cough.

• This can be acute, chronic or intermittent.
• And the solution to this is early and light dinners, avoid sleeping immediately after consuming a meal and consuming adequate amounts of water.

• Sometimes, the acid reflux can also result in changes in the sinuses and can cause headaches n the morning.

• Tonsil stones, until and unless they are causing pain or other problems, should not be removed. Tonsil stones are like physiological stones which need no removing unless they are giving you trouble. And when it does create a problem, the only solution is removing them by doing a tonsillectomy.

• Betadine gargles have shown to have some protective effect against coronavirus. This is only a protective measure.

• As the age progresses, the ligament around our ear bones become week, thereby increasing the movement of the bones. This in turn stimulates the innermost part of the ear, causing discomfort when around loud noises. In such cases, the best solution is to use cotton or ear plugs to decrease the loud noises from entering the ear.