On Saturday, August 28 2021, Seniors Today hosted leading ENT surgeon Dr Aiay Doiphode as part of its weekly Health Live @ Seniors Today webinar series. Dr Doiphode spoke and answered questions on ENT Care for Senior Citizens. Dr Noor Gill captured the takeaways
Dr Ajay Doiphode is a senior and well-known ENT surgeon practising for over 20 years. He has performed more than 5,000 successful ENT surgeries till date. He did his M S (ENT), Masters in ENT from the prestigious KEM Hospital and the G S Medical College, Mumbai. He has a Fellowship in Functional Endoscopic Sinus (FESS) from Austria and a Fellowship in Cochlear Implants and Implantable Hearing Aids from Germany.
Dr Ajay Doiphode is currently President of the Mumbai ENT Association. He is Honorary Head Of Unit in HBT Municipal Hospital and is also attached to Nanavati Max Super Speciality Hospital. He has two private clinics in Vile Parle and Andheri. Dr Ajay ‘s special interests are Endoscopic Nose, Sinus and Skull base Surgeries, Endoscopic Ear Surgeries and Thyroid Gland Surgeries.
With senior citizens, initially the higher frequency hearing is affected which does not cause much problem. It is only once the lower frequencies start getting affected that the patient starts complaining that he can’t hear or that he has to keep the television volume very high or is unable to hear clearly in a noisy room.
Senile deafness is not a pathology but an age related problem which affects most of the senior citizens by 60 years of age. It typically starts in one ear and goes on to affect both ears.
Some other causes of senile deafness related hearing loss include
- Nerve deafness
- Sudden sensorineural hearing loss- in this condition, you wake up one fine day and you cannot hear anything, this might be associated with some dizziness or there might be some nausea and vomiting. The patient typically complains of sudden hearing loss in one of the ears.
This is an emergency medical condition. If treated within the first 48-72 hours, the hearing recovery is near normal. But if there is a delay in the treatment it can lead to permanent hearing loss.
- Exposure to loud noises
- Ototoxic drugs ie drugs which can cause weakness or degeneration of the hearing nerves.
Common drugs that can be ototoxic are- antibiotics, certain anticancer drugs, certain non steroidal anti-inflammatory drugs, anti malarial drugs such as quinine and chloroquine can also cause hearing loss.
It is very important to note and report any hearing related symptoms such as any diminished hearing, fullness in the ear, any buzzing or ringing sound in the ear or any vertigo. These symptoms should be noted especially if you’re undergoing treatment for a chronic illness such as tuberculosis or cancer. It is important to notify your treating doctor of the new symptoms you have noticed.
The treatment will be stopped temporarily and a hearing assessment will be done. If it is confirmed that the cause for the problem is the ototoxic drug, then an alternate or substitute drug will be started or you can take a drug holiday for a few days, as advised by your physician.
Other causes for hearing loss can be a structural or anatomical defect in the ear.
It can be a perforation in the ear drum
Cholesteatoma, it is a non malignant disease
Analogue hearing aids used to amplify all the sounds. It not just amplifies the close-by noises but also the ambient sounds which used to pose a problem when an individual would go to a noisy environment.
This problem has been overcome by digital hearing aids and programmable hearing aids where we can selectively programme the hearing aids according to your individual hearing requirements in such a way that the unwanted hearing is filtered but the necessary hearing is restored.
The only problem with these is that they are costly and not indigenous
Tinnitus is a symptom and not a disease. It is a ringing sound in the ear. And since it is a symptom, the cause for it needs to be investigated and found. The most common cause for tinnitus in the elderly is senile hearing loss. If you are not wearing your hearing aid, your hearing loss will continue to deteriorate.
Tinnitus is a very disabling symptom since we do not have any permanent solution and it can affect you so much that even your sleep can be affected.
Vertigo is another problem that is seen in the elderly, one of the causes for it can be the ageing of the vestibular system but there might be other causes.
Vertigo is also a symptom and not a disease itself.
Nose bleeds or epistaxis is another problem that is experienced by the elderly.
A lot of elderly people and senior citizens have hypertension as a comorbid condition or are cardiovascular patients or on anti platelet drugs (blood thinners). So, if you have a sudden rise in your blood pressure, you will have spontaneous bleeding from the nose. The higher the blood pressure, the more the bleeding.
In this case, stay calm. Try to pinch your nostril and give pressure on the bleeding portion. You might have to tilt a little forward with your mouth open so that the blood doesn’t go into the throat and you’re able to spit it out.
Ice can be applied.
If you have a sphygmomanometer at home, check your blood pressure. If your blood pressure has shot up significantly, you have to get that under control immediately.
If the bleeding still doesn’t get controlled, Dr Ajay advises that you push a clean cloth into your nostril till the time you don’t reach the hospital where you can seek medical intervention.
Winters and summers are two seasons where the chances of bleeding through the nose are high. Do not remove the crust from your nose and moisturise it well.
Polyp is a benign, non-cancerous growth on the vocal cord. It is usually on one vocal cord but sometimes it can be bilaterally present as well. The most common presenting symptom is hoarseness, huskiness or change of voice. Sometimes it can cause breathlessness also.
There is no medical management for polyps. It is better if it is surgically removed/ operated and the excised specimen needs to be tested and sent for histopathological examination for cancer also.
Wax is a natural secretion which is secreted by the wax glands and it is secreted for a purpose- it keeps the ear canal for going dry, it is antibacterial, it helps to trap dust and it is produced daily and it also has an auto cleansing mode. Which means that what is produced, once it serves its purpose, it gets excreted and propelled by our jaw movements.
Only people who tend to fidget with this natural process with ear buds or by introducing any foreign objects, they disrupt this process, push the wax further inside towards the narrowest portion of the ear causing more ear wax secretion and wax deposition. Eventually these individuals will have blockage, pain, hearing issues and sometimes the problem can be so much so that it might require medical attention.
- You don’t need to clean your ears regularly. You don’t need to put anything inside your ears.
- Get your ears examined annually, if there is wax, there is special equipment and instruments that an ENT specialist will use to clean it for you.
Dr Ajay Doiphode can be reached at firstname.lastname@example.org