Ear, Nose, Throat

What will happen during laboratory sleep testing?

DEAR DOCTOR K: My doctor thinks I may have sleep apnea, and he wants me to go to a sleep lab to be tested. What will happen during the testing?

DEAR READER: Sleep apnea is a serious health condition in which breathing stops or becomes shallower. In the most common form, obstructive sleep apnea, the tongue or throat tissues temporarily and repeatedly block the flow of air in and out of your lungs. This can happen hundreds of times each night. Laboratory sleep tests are the most reliable way to diagnose this problem.

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What can I do to get relief from a sinus infection without antibiotics?

DEAR DOCTOR K: My doctor won't give me an antibiotic for my sinus infection. So what can I do to feel better?

DEAR READER: Most cases of sinusitis are caused by viral infections. Viruses are bulletproof to antibiotics. All antibiotics can do in this case is cause side effects. So, the best course of action for occasional sinusitis is to use self-care steps to ease symptoms while the body clears the infection.

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What can I do to prevent ear pain on planes?

DEAR DOCTOR K: I get pain in my ears every time I fly and the plane descends for landing. A friend says that chewing gum works for him, but it doesn't work for me. What can I do?

DEAR READER: The ear pain you experience -- barotrauma of the ear -- is the most common medical problem reported by air travelers. "Barotrauma" refers to injuries caused by increased air pressure.

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What will happen during my hearing test?

DEAR DOCTOR K: My hearing is going. Before I get a hearing aid, I'm told I need a hearing test. How will the test help?

DEAR READER: The hearing test (formally called an "audiological evaluation") identifies how bad your hearing loss is in each ear. It also determines where the problem is worst. Is it with high-pitched sounds? Is it in distinguishing a particular sound -- like someone speaking to you -- in a noisy place? This is what the audiologist (a health professional specializing in hearing testing and hearing aids) needs to know in order to tell if you could benefit from a hearing aid and, if so, which style and type would help the most.

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Are cochlear implants a type of hearing aid?

DEAR DOCTOR K: I'm hard of hearing and want to learn more about cochlear implants. Are they a type of hearing aid?

DEAR READER: A cochlear implant involves several small electronic devices that are surgically implanted in the ear. It can provide sound to people who are severely hard of hearing or deaf. It is not a type of hearing aid. In fact, to be eligible for a cochlear implant, a person must have hearing loss in both ears that is so extreme that even the best hearing aid has little or no effect.

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My toddler gets frequent ear infections. Should we consider surgery?

DEAR DOCTOR K: My toddler gets frequent ear infections. His doctor wants me to consider surgery, but that seems much too aggressive to me. Am I wrong?

DEAR READER: I'm not sure what kind of surgery your pediatrician is recommending, but I'll bet it involves putting in ear tubes. I'll explain that below. Ear infections are very common and can make children miserable. Most go away and don't cause problems, even without treatment. But a few can lead to complications, including more serious infections of the bone near the ear or even the brain.

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What can I do about my dry mouth?

DEAR DOCTOR K: My mouth and throat are always very dry. As a result, I am constantly sipping water. It's annoying and uncomfortable. Is this normal? Is there anything I can do?

DEAR READER: Dry mouth is not as common as dry eyes (something I have), but it's not uncommon. The medical term for dry mouth is xerostomia (pronounced ZE-ro-STOME-ee-uh), but I'll avoid doctor-speak and call it dry mouth. Usually, dry mouth is mild enough to be an annoyance, as it is with you. However, severe cases can cause complications. Dry mouth can rob you of your sense of taste and can make chewing slow and swallowing difficult. Also, since saliva is important for dental health, dry mouth can contribute to tooth decay and periodontal disease.

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I’ve noticed that my sense of taste has dulled. What could be happening?

DEAR DOCTOR K: Over the past year or so I've noticed that my sense of taste isn't as sharp as it used to be. What could be happening?

DEAR READER: Taste buds line your tongue, throat and the back of the roof of your mouth. When food or drink stimulates them, they send a message to your brain allowing you to identify the taste as sweet, sour, bitter, salty or savory. In addition, thousands of nerve endings on the moist surfaces of the eyes, nose, mouth and throat help you experience the food you're eating. They convey sensations such as heat, cold and texture.

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How do you treat tinnitus?

DEAR DOCTOR K: I have a constant ringing or buzzing sound in my ears. It's been going on for months. What can I do? It's driving me crazy.

DEAR READER: You probably have a condition called tinnitus. It's pretty common. Many of my patients have it. Occasionally, I have it. It doesn't usually affect your hearing. But it can be really annoying and distracting, enough so that it affects people's level of function.

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How strep throat is diagnosed.

DEAR READERS: In yesterday's column, I responded to a reader's question about acute pharyngitis -- inflammation of the throat caused by infection with bacteria or viruses. I was taught that diagnosing and treating a patient with a sore throat was not complicated: The sore throat was caused either by Group A streptococcus ("strep," a kind of bacteria) or by a virus. If a throat culture showed strep, you treated it with penicillin. Simple. But in my view (some colleagues disagree), it's not that simple. The risk from an untreated infection with Group A strep is much lower today in the United States than it was 70 years ago. That means that the value of treatment is reduced. But the chance of side effects from the treatment -- antibiotics -- is not reduced.

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