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Why Do I Have Earwax?

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Woman with Ear Pain

Earwax or “cerumen” (si-ROO-men) is a normal substance made by our bodies to clean, protect, and “oil” our ears. It acts as a self-cleaning agent to keep our ears healthy. Dirt, dust, and other small pieces of stuff stick to the earwax which keeps it from getting farther into the ear. Chewing, jaw motion, and growing skin in the ear canal help to move old earwax from inside our ears to the ear opening, where it then flakes off or is washed off when we bathe. This normal process of making wax and pushing the old wax out continues nonstop. 

Cerumen is formed in the outer two-thirds of the ear canal and not the inner-third that ends at the eardrum. Impacted earwax (brownish mass) can completely obstruct the ear canal. 

What Does It Mean if My Earwax Is Impacted?
At times, your ear’s self-cleaning process might not work very well and may lead to a buildup of earwax. When this happens, earwax can collect and block or partly block your ear canal. This is impaction. Impacted earwax can cause symptoms like hearing loss, itching, or ear pain. The impaction also makes it hard for your health care provider to see in your ears. You can have symptoms when your ear canal is completely blocked by earwax or only partly blocked.

The Symptoms of Earwax Impaction:

  • Ear pain
  • Itching
  • Feeling of fullness in the ear
  • Ringing in the ear (tinnitus)
  • Hearing loss
  • Discharge coming from the ear
  • Odor coming from the ear
  • Cough
  • Change in hearing aid function

You should see your health care provider if you have symptoms and you are not sure if they are caused by earwax. You might have a different ear problem that needs medical care.

Who Is More Likely to Get Earwax Impaction? It can happen to anyone, but is more common in the following…

○ Elderly people

○ People who use hearing aids or earplugs

How Is It Treated? Earwax impaction is diagnosed through a physical examination and review of your medical history. Your health care provider may look in your ear canal with a tool called an otoscope (OH-t-OH-scope) or other device to see if you have impacted earwax. If you do, you may be treated for the impaction at that time or you may be sent to another provider for treatment.

Impacted earwax can be treated in several ways. Some of the treatments can be done at home, but you may have certain medical or ear conditions that could make home options unsafe. You and your health care provider should discuss possible treatments and decide on the best treatment for you. Figure 2 may help with your discussion.5 Available treatments are:

Watchful waiting, or observation for a period of time. Earwax removal by the body is a natural process, and many impactions clear on their own. Your health care provider might offer the option to wait and see if the problem goes away or gets worse over time.

Irrigation, or ear syringing. This involves clearing the wax out of the ear canal by a stream of warm water. Self-irrigation can be done at home. Irrigation is not recommended for patients who get a lot of ear infections, have ear tubes, or have a hole in the eardrum. Home use of oral jet irrigators is not effective and is not recommended as they can lead to damage in the ear.

Wax softening agents (cerumenolytics). These are ear drops that soften or break up the wax to help in removal. These solutions can be used alone or together with irrigation or physical removal by a provider.

Physical removal of wax with special instruments or a suction device. Physical removal of earwax should only be performed by a health care provider or your ENT-Specialist

Do You Have Sleep Apnea? Read Here to Find Out!

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Woman Sleeping

Forty-five percent of normal adults snore occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight people and usually worsens with age. Snoring may be an indication of obstructed breathing and should not be taken lightly. An otolaryngologist can help you to determine where the source of your snoring may be, and offer solutions. 

WHAT CAUSES SNORING?

The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. This area is the collapsible part of the airway where the tongue and upper throat meet the soft palate and uvula. Snoring occurs when these structures strike each other and vibrate during breathing.

In children, snoring may be a sign of problems with the tonsils and adenoids. A chronically snoring child should be examined by an otolaryngologist, who may recommend a tonsillectomy and adenoidectomy to return the child to full health.

People who snore may have one or more of these issues:

1. Poor muscle tone in the tongue and throat: When muscles are too relaxed, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. 
2. Excessive bulkiness of throat tissue: Children with large tonsils and adenoids often snore. Overweight people may have excess soft tissue in the neck that can lead to airway narrowing. Cysts or tumors are rare causes of airway narrowing.
3. Long soft palate and/or uvula: A long palate narrows the opening from the nose into the throat. The excessive length of the soft palate and/or uvula acts as a noisy flutter valve during relaxed breathing.
4. Obstructed nasal airways: A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat that pulls together the floppy tissues of the throat, and snoring results. So snoring may only occur during the hay fever season or with a cold or sinus infection. Also, deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) can cause such an obstruction.

  • WHY IS SNORING SERIOUS?
    Snoring can make the snorer an object of ridicule and can cause the bed partner to experience sleepless nights and fatigue.
  • It disturbs sleeping patterns and deprives the snorer of adequate rest. It may be a sign of obstructive sleep apnea (OSA), which can lead to serious, long-term health problems.

WHAT IS OBSTRUCTIVE SLEEP APNEA?

Snoring may be a sign of a more serious condition known as obstructive sleep apnea (OSA). OSA is characterized by multiple episodes of breathing pauses greater than 10 seconds at a time, due to upper airway narrowing or collapse. This results in lower amounts of oxygen in the blood, which causes the heart to work harder. It also causes disruption of the natural sleep cycle, which makes people feel poorly rested despite adequate time in bed. Apnea patients may experience 30 to 300 such events per night.

The immediate effect of sleep apnea is that the snorer must sleep lightly and keep the throat muscles tense in order to keep airflow to the lungs. Because the snorer does not get a good rest, he or she may be sleepy during the day, which impairs job performance and makes him or her a hazardous driver or equipment operator. Untreated obstructive sleep apnea increases the risk of developing heart attacks, strokes, diabetes, and many other medical problems.

HOW IS HEAVY SNORING EVALUATED?

Heavy snorers should seek medical advice to ensure that sleep apnea is not a problem. An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck, often using a fiberoptic scope. An examination can reveal if the snoring is caused by nasal allergy, infection, nasal obstruction, or enlargement of tonsils and adenoids. A sleep study in a laboratory or at home may be necessary to determine if snoring is due to OSA.

DO YOU RECOMMEND THE USE OF OVER-THE-COUNTER DEVICES?

There is no specific device recommended. More than 300 devices are registered in the U.S. Patent and Trademark Office as cures for snoring. Different methods include products that help a person avoid sleeping on their back, since snoring is often worse in that position. Some devices open nasal air passages; others have been designed to condition a person not to snore by producing unpleasant stimuli when snoring occurs. While a person may find a product that works for him or her, underlying poor sleep quality may remain.

SELF-HELP FOR THE LIGHT SNORER

Adults who suffer from mild or occasional snoring should try the following self-help remedies:

Adopt a healthy and athletic lifestyle to develop good muscle tone and lose weight.
Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
Avoid alcohol for at least four hours and heavy meals or snacks for three hours before retiring.
Establish regular sleeping patterns.
Sleep on your side rather than your back.
Elevate the head of your bed four inches.

What Is Sinusitis?

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Sinus Pain

Sinus infections are one of the common conditions with which adults may be diagnosed. Sinus infections affect millions of adults in the United States each year. The sinuses are a group of hollow spaces that surround the nose and are also found above and between the eyes. Sinus infections include cloudy or colored runny nose with nasal blockage or clogging, facial pain/pressure, or both. Other symptoms include fever, cough, loss of energy, lack of or reduced sense of smell, tooth pain, and ear fullness. The symptoms can be severe enough to disturb your quality of life or general well-being.

What Causes Sinus infections?

 Sinus infections can be caused by viruses, bacteria, or fungi. A viral sinus infection has similar symptoms as bacterial infections but improves within 10 days and does not get worse. A bacterial sinus infection is defined by how long the symptoms last. The 3 types are acute (short course), recurrent (repeated), or chronic (long lasting). An acute bacterial sinus infection is one that either fails to get better within 10 days or has suddenly gotten worse after an initial period of getting better. Acute bacterial sinus infection lasts less than 4 weeks. See Figure 1 for more information on acute sinus infections. Recurrent bacterial sinus infections are when an acute sinus infection occurs 4 or more times in a 1-year period. A chronic sinus infection is when 2 or more symptoms and swelling lasts for 12 weeks or longer. A fungal sinus infection is one that is linked with chronic symptoms. Fungal sinus infections usually occur with people who have weak immune systems. Fungal sinus infections can also occur with people who have used long-term antibiotics.

What Causes Adult Sinusitis?

A sinus infection is typically caused by a viral upper respiratory infection, like a cold. A viral infection does not get better from taking antibiotics. Acute bacterial sinus infections are caused by a bacterial infection. Some people with bacterial infections can benefit from the use of antibiotics, although antibiotics are not necessary for everyone.

What Can You Do About Sinusitis?

You should see a healthcare provider soon after symptoms occur. Early diagnosis may help avoid misdiagnosis or delayed treatment and worse results. There are several types of sinus infections, so it is important to get the correct diagnosis for proper treatment. Treatment options should be discussed with the healthcare provider after diagnosis. Antibiotics do not work for viral sinus infections. Antibiotics are not recommended for all types of bacterial infections.

How Is Sinusitis Diagnosed?

A healthcare provider can diagnose a sinus infection by reviewing the medical history and doing a physical exam. The exam should review and document the conditions in your medical record. A healthcare provider will take note of how long symptoms have been present.

The healthcare provider should decide between acute bacterial sinus infection from viral sinus infection or noninfectious conditions. Your healthcare provider should diagnose an acute bacterial sinus infection when (1) symptoms (facial pain-pressure-fullness, nasal blockage) or signs (cloudy or colored nasal drainage) or both continue without getting better for at least 10 days after the onset of upper respiratory symptoms like a cold or (2) symptoms or signs of a sinus infection worsen within 10 days after getting better (double worsening).

Other conditions can seem like a sinus infection. For instance, a headache alone may not mean a sinus infection. With a sinus infection, there is usually cloudy or colored nose drainage.

An acute sinus infection is diagnosed when there are up to 4 weeks of colored or cloudy runny nose with nasal blockage, facial pain-pressure-fullness, or both. A healthcare provider should decide between chronic and recurrent sinus infections from single-incident of acute bacterial sinus infections and other causes of sinonasal (nose and sinus) symptoms.

The healthcare provider cannot diagnose chronic sinus infection based on symptoms alone. The healthcare provider will also need to see nasal swelling or inflammation on exam. The healthcare provider may use tools such as cameras (an endoscope or rhinoscope). These types of tools can offer a better view of your sinuses. The healthcare provider may also order a special radiology test called a CT (CAT) scan to view sinonasal swelling. The CT scan may confirm a diagnosis of chronic sinus infections. For chronic sinus infections, the healthcare provider should confirm whether nasal polyps are present. Nasal polyps are harmless growths. Having nasal polyps will modify care of your symptoms.

Instead of prescribing antibiotics right away for your acute bacterial sinus infection, your healthcare provider may suggest a treatment option known as watchful waiting. This option usually includes a 7-day waiting period without antibiotics to see if you get better on your own.

You may be tested for allergies and immune function. This testing will help tell chronic or recurrent sinus infections from allergies.

What Treatments Are Available?

It is important to properly diagnose viral and bacterial sinusitis because antibiotics are not for a viral sinus infection. If you have heart, kidney, or liver disease, your healthcare provider may consider different treatment.

For a viral sinus infection: Talking with your healthcare provider can help you make decisions about the treatment of symptoms. To relieve symptoms, pain relievers, nasal steroid sprays, and/or nasal saline rinse (irrigation) may be recommended. Nasal saline rinse can be purchased or homemade. Nasal saline rinse involves using a bulb, squeeze bottle, or Neti pot with a mixture of water, baking soda, and a noniodized salt.

For an acute bacterial sinus infection: The healthcare provider should offer either watchful waiting without antibiotics or an antibiotic. If a decision is made to treat acute bacterial sinus infection with an antibiotic, amoxicillin will likely be prescribed. A combination of amoxicillin with clavulanate for 5 to 10 days may also be prescribed as a different treatment. If you feel worse or do not improve with the antibiotic treatment after 7 days, you should see your healthcare provider. The healthcare provider will review the diagnosis and will rule out other causes. The healthcare provider may also decide to change the antibiotic. To relieve your symptoms, your healthcare provider may recommend over-the-counter treatments. These treatments may include pain relievers, nasal steroid sprays, and/or nasal saline rinse. Nasal saline rinse can be purchased or homemade. Nasal saline rinse involves using a bulb, squeeze bottle, or Neti pot with a mixture of water, baking soda, and a noniodized salt.

For an apointment to see an ENT Specialists, click here or call 770-281-4487

What Causes Vertigo?

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Benign paroxysmal positional vertigo, abbreviated BPPV, is the most common inner ear problem and cause of vertigo (a false sense of spinning). It is more common in older people. Many of us will experience BPPV at some time in our lives.

BPPV is a specific diagnosis, and each word describes the condition:

What Causes BPPV?

Most cases of BPPV happen for no reason. It can sometimes be associated with trauma, migraine, other inner ear problems, diabetes, osteoporosis, and lying in bed for long periods of time.

We have crystals of calcium carbonate in our inner ear that help us with our balance and body motion. These tiny rocklike crystals, or “otoconia”, are settled in the center of the inner ear. BPPV is caused by the crystals becoming “unglued” from their normal place. As they float around, they can get stuck on sensors in the wrong part or the wrong canal of the inner ear. BPPV symptoms are caused by the crystals being out of position.

The most intense part of BPPV symptoms relate to how long it takes the crystals or sensors to settle down after you move or change your head or body position. As the crystals move and settle in your inner ear, your brain is getting these (false) messages telling you that you are spinning, when all you may have done is lie down or roll over in bed.  

What Are Common Symptoms of Vertigo?

Everyone will experience BPPV differently, but there are common symptoms:

  • Distinct triggered spells of vertigo or spinning sensations
  • Nausea (sometimes vomiting)
  • Severe feeling of disorientation in space or instability

These symptoms will be intense for seconds to minutes. In some people, especially seniors, BPPV can seem more like an isolated feeling of instability that happens when changing body or head position. Sitting up, looking up, bending over, and reaching can trigger this feeling. BPPV does not cause constant severe dizziness and is usually triggered by movement. BPPV does not affect your hearing or cause you to faint. The dizziness episodes related to BPPV can increase your risk of falling.

How Is Vertigo Diagnosed?

Health care providers diagnose BPPV through a physical examination and review of your medical history. Normal medical imaging, such as scans and x-rays, or medical laboratory testing cannot confirm BPPV. Your health care provider or examiner will complete simple bedside testing to help to confirm your diagnosis. The bedside testing requires the examiner to move your head into a position that makes the crystals move, and it will make you dizzy. The testing may include hanging your head a little off the edge of the bed or rolling your head left and right while lying in bed. The examiner will be watching you for a certain eye movement to confirm your diagnosis.

How Do You Treat for Vertigo?

Medications may be used for the relief of immediate distress, such as nausea, but not for BPPV itself. Most BPPV cases can be corrected with repositioning procedures that will be performed bedside by your provider. These treatments usually take only a few minutes to complete. They have high success rates (around 80%), although sometimes the treatment needs to be repeated a few times.

These repositioning treatments (referred to as “maneuvers”) are designed to guide the crystals back to their original location in your inner ear. You may be treated during the same office visit when the diagnosis testing is performed. You might be sent to a health professional (medical provider, audiologist, or physical therapist) who can perform these maneuvers, especially if any of the following apply:

  • You have severe disabling symptoms.
  • You are a senior with history of past falls or fear of falling.
  • You have difficulty moving around, such as joint stiffness (especially in your neck and back) and/or weakness.

You can also be taught to perform these maneuvers by yourself with supervision, which is called “self-repositioning.” Discuss learning these maneuvers with your health care provider.

Does Vertigo Go Away on Its Own?here is evidence that if BPPV is left untreated, it can go away within weeks. The natural course of BPPV is to become less severe over time. People will often report that their very first BPPV spinning episode was the worst and the following episodes were not as bad. However, remember that while the crystal is out of place, in addition to feeling sick and sensitive to motion, your unsteadiness can increase your risk for falling. You will need to take precautions not to fall. You are at a higher risk for injury if you are a senior or have another balance issue. Seniors are encouraged to seek professional help quickly to resolve symptoms.

How Long Will It Take before I Feel Better?

During the BPPV treatment, you may experience brief distress from vertigo, nausea, and feelings of disorientation. After treatment, some people report that their symptoms start to clear right away. Others report that they have continuing motion sickness–type symptoms and mild instability. You can still feel a little bit sensitive to movement even after successful treatments for BPPV. These symptoms can take a few days to a few weeks to slowly go away. Once your symptoms are slowly going away, it is important to return to normal activities that you can do safely. Exposure to motion and movement will help to speed your healing. You should discuss these activities with your provider. Seniors with a history of falls or fear of falling may need further exercises or balance therapy to clear BPPV completely.

Can Vertigo Come Back? Can I Prevent It?

Unfortunately, BPPV is a condition that can sometimes return. Your risk for BPPV returning can shift from low risk (few experiences in your lifetime) to a higher risk, which is often caused by some other factor, such as trauma (physical injury), other inner ear or medical conditions, or aging. Medical research has not found any way to stop BPPV from coming back, but it can be treated with a high rate of success. It is very important to follow-up with your health care provider if you continue to have symptoms. You may be sent for further testing to confirm your diagnosis and/or discuss other treatment o

Do You Think You Have Swimmer’s Ear?

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Understanding Swimmer’s Ear

A condition that often occurs in the summer months is Swimmer’s Ear (also called: acute otitis externa). It is a painful condition resulting from inflammation, irritation, or infection of the outer ear.

Doctor with Pediatric PatientSwimmer’s ear happens when bacteria grows in the ear canal. The ear canal is a passageway to the eardrum, so this can impact you in many ways. In that canal, there is delicate skin that is protected by a thin coating of earwax. Most of the time, water can run in and out of the ear canal without causing a problem. Usually, you don’t get swimmer’s ear from taking baths or showers.

Bacteria can grow when water stays in the ear canal. A lot of swimming can lead to these wet conditions in the ear canal. If bacteria grows, the ear canal gets red and swollen. Sometimes people can get an infection in the ear canal even if they haven’t been swimming. A scratch or other irritation to the ear canal can also lead to swimmer’s ear.

Ear pain is the most common sign of swimmer’s ear. Swimmer’s ear may start with some itching, and then scratching can make the infection worse. Even touching or bumping the outside of the ear can hurt when it is infected. The infection also could make it harder to hear because of the swelling that happens in the ear canal.

It is very important to see an ENT if you think you have swimmer’s ear. The ENT can help you get rid of the infection. The doctor can prescribe ear drops that contain an antibiotic to kill the bacteria.

What is Rhinitis? How Can I Tell if I have This Sinus Problem?

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PollenRhinitis is an inflammation of the nasal membranes. It causes sneezing, nasal congestion and nasal itching in any combination.

Although allergic rhinitis itself is not life-threatening, it is difficult to go on throughout the day if you are suffering from this condition. People who are sufferning from this condition often seek medical care just to be able to feel better and breathe better. 

Here are the common signs and symptoms of allergic rhinitis:

  • Sneezing
  • Itching: Nose, eyes, ears
  • Postnasal drip
  • Nasal congestion
  • Headache
  • Earache
  • Tearing of the Eyes
  • Red eyes
  • Fatigue and Drowsiness

Complications of this allergic rhinitis include the following:

  • Acute or chronic sinusitis (swollen nose and sinuses)
  • Otitis media (ear ache)
  • Sleep disturbance or apnea (trouble sleeping)

Managing the symptoms of allergic rhinitis consists of three treatment strategies:

  1. Allergen avoidance: Minimize the exposure to allergens such as pollen, dust mites, and other triggers.
  2. Medicines: Patients can find successful treatment with oral antihistamines, decongestants, or both; regular use of an intranasal steroid spray may be more appropriate for patients with chronic symptoms.
  3. Immunotherapy: This treatment could be considered if conditions are found in addition to other diseases, poor response to other management options, and the presence deeper conditions or complications.

If you are suffering with any of the symptoms, call our ENT office for an appointment. 

Spirox Latera Offers Non-Surgical Methods for Better Breathing

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A new non-surgical way to alleviate nasal obstruction is here, by using the Spirox Latera™  an FDA approved implant. It’s only been in the United States market for a few months, but it is an excellent alternative to some surgical methods.

It’s a dissolvable implant that is easily inserted in the lateral wall of the nose without any cutting required. It is thinner than a pin and is about an inch in length.

It strengthens the walls of the nose to keep them from collapsing when inhaling. For patients needing rhinoplasty because of functional issues resulting from narrowing of their nose, it could improve their breathing.

Patients who have experienced temporary improvement in breathing from breathe rite strips could experience a more permanent solution with Spirox. Only in a few cases, patients could feel the implant after placement, but this issue resolved within three weeks of placement.

The placing of the device can be done in office setting with the patient asleep or awake. Another great benefit for the Spirox Latera implant is that there is no downtime from work or activity, after the implant placement.

The Spirox Latera™ implant is covered by most insurance companies and by Medicare.

To test whether the Spirox Latera™ implant might be an option for you, pull the cheek skin where the nose meets the face in the direction of the outside corner of the eye. If that significantly improves breathing, then Spirox Latera™ might be a nonsurgical option for you. Call your North Georgia Ent-Specialist to make an appointment.

Spirox Latera

What Causes a Post-Nasal Drip?

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Nasal AllergiesDoes your nose seem to run all the time? Glands in the nose and throat continually produce mucus. Sometimes it over-produces, and it’s a problem.

The normal production of mucus moistens and cleans the nasal membranes, clears inhaled foreign matter, and fights infection. The feeling of mucus accumulating in the throat or dripping from the back of your nose is called post-nasal drip. This is caused by increased secretions that can be thin or thick in consistency.

Increased mucus production can be due to colds and flu, allergies, cold temperatures, certain foods or spices, pregnancy, and other hormonal changes or abnormalities. These abnormalities might include a deviated or irregular nasal septum. An increase of thick secretions in the winter is often the result from dryness in heated buildings and homes. Sometimes food allergies, especially dairy products, can cause thickening of the mucous.

Another cause of post nasal drip can be blockages in the openings of the sinuses from swelling due to colds, flu, or allergies. This may lead to an acute sinus infection. If the secretions turn yellow or green, this is usually a sign of a sinus infection. A viral cold that persists for 7 days or more may have become a bacterial sinus infection and may increase post-nasal drip. A sinus infection needs antibiotic treatment by your doctor.

A person with chronic sinusitis may develop polyps (growths in the nose) which is causes by persistent blockages, causing the lining of the sinuses to swell further. Patients with polyps tend to have irritating, persistent post-nasal drip.

Post-nasal drip often leads to a sore, irritated throat due to the tonsils and other tissues. The throat may swell when it is irritated and cause pain. This can cause a feeling that there is a lump in the throat. Successful treatment of the post-nasal drip will usually clear up these throat symptoms.

If you are experiencing any of these symptoms, it is important to have an exam by an otolaryngologist (ENT) to advise you of the causes of the symptoms and correctly assess the course of treatment. Call our office to make an appointment! 

Get Instant Sinus Relief with Balloon Sinuplasty

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Sinus problems and chronic sinusitis impact millions of Americans. Many people just try to live with the symptoms and never find any real relief. Some people rely on daily medications or shots to relieve the sinus pressure, headaches, or limited air flow. But there is a better way! If you, or someone you know, has been living with this type of sinus condition for years, we have great news for you!

Balloon Sinuplasty is a new procedure that is offering relief. It can help you breathe freely during your allergy season and all year long. Balloon Sinuplasty can open the nasal passages by creating room to breathe within the airways of the sinuses.

Balloon Sinuplasty opens your nasal passages using a tiny tube with a balloon at the end. The tube is inserted into the blocked nasal airway. The tiny balloon expands and opens the blocked sinuses. By creating the larger opening, it re-opens airways and restores normal (or better than normal) breathing.

This minor procedure offers quick healing and recovery, as it is minimally invasive. There is very little swelling, bruising or bleeding, and most people report being pain-free within a day. Most people can return to work or normal activities within 1 week.

At ENT-Specialists, we have performed this procedure on hundreds of patients and have many success stories that we can share! Make an appointment and see if you are a good candidate for this nasal procedure.

Call us today to see if Balloon Sinuplasty Right for You. 770-345-6600

Nasal Obstruction and Mouth Breathing

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child breathing with mouth openDoes your child breathe through his/her mouth? Does your child have difficulty sleeping at night? Is there a history of recurrent or constant sinus/upper respiratory infections?

Does any of this sound familiar to you?

I have a young toddler who used to snore and who was a very difficult sleeper. I remember waking up several times nightly in response to audible cries from his bedroom. It seemed as if we could not feed the child enough food to keep him asleep. As a result of poor sleep, he was irritable, tired, and frankly miserable during the day. He did not breathe through his nose, so he did not want to eat, as he struggled to eat and breathe simultaneously. If these things were not enough, he had constant congestion in his nose and required antibiotics for a sinus or ear infection every 4-6 weeks. After consultation with his pediatrician, a referral was made to an otolaryngologist for evaluation of possible adenoid enlargement.

I am an ENT doctor myself, but I do not consider myself to be my children’s doctor, rather I simply try to be a good father. I consulted with Dr. Van Tuyl who performed my son’s adenoidectomy. He had an outpatient procedure and was his normal, bouncing, boisterous self the very next day. He is now a much improved, healthier, and happier version of himself, and his parents are enjoying his new sleep habits as much as he is!

Adenoid tissue is the same type of tissue as the tonsils that line the back of the throat. The adenoid is located in the nasopharynx, the throat in the back of the nasal passages. The normal adenoid tissue is where the infection fighting capability of the immune system matures. This important tissue is found along the length of the respiratory and gastrointestinal tracts.

When the adenoid enlarges, the result is blockage of the nasal passages which can lead to mouth breathing, nasal congestion, sinusitis, snoring, sleep disturbances, and ear infections. The abnormal tissue can be identified by examining the nasopharynx with a mirror, endoscope, or an x-ray or CT scan. Once adenoid hypertrophy is diagnosed, it can be alleviated with a simple procedure known as an adenoidectomy. Fortunately there is redundant tissue throughout the body and the procedure does not lead to immune system deficiency. The procedure is typically performed through the oral cavity under general anesthesia in an outpatient setting. Typically, children can return to their normal diet and activities the day of surgery.

It is rare that I have the opportunity to report on a procedure as a surgeon and as a father. I am glad that I could share my experience with the community. Please come and have a discussion with us if we can be helpful to your child!

– Lawrence L. Robinson, Jr., MD