Listen up! An ENT specialist fields common questions about your ears, nose and throat.
Here at Honeycombers, we’re big on getting readers involved in our stories. Previously, we got a dermatologist to ease your skincare concerns. Now, we’ve reached out to an ENT specialist with your questions surrounding your ears, nose and throat. Meet Dr Jeeve Kanagalingam. He’s a Consultant Ear, Nose and Throat Surgeon at The ENT Clinic at Mount Elizabeth Novena Hospital and Gleneagles Hospital with over 20 years of medical experience. He specialises in nose and sinus, snoring, children’s ENT, voice, thyroid and salivary gland conditions. Want an expert opinion? From cleaning ear wax on your own to sinus issues and easy ways to soothe an itchy throat, he has all the answers.
Questions answered by an ENT specialist
1. Is it normal to have a permanently blocked nose? How do you treat it?
A permanently blocked nose is abnormal. The nose is the main channel for breathing and mouth breathing is unhealthy. There are various causes for a blocked nose. If both your nasal passages are blocked it could be due to the enlargement of structures called turbinates in your nose. These turbinates are small swellings inside your nose meant to warm up and humidify the air you breathe. Patients with allergies can suffer from enlarged turbinates.
Other common causes of nasal blockage are nasal polyps (which often cause a loss of smell) or a deviated (bent) nasal septum. The nasal septum is a wall made up of cartilage and bone that divides your nasal cavity into a left and right passage. A hallmark of a deviated nasal septum is a blockage that is often one-sided.
The treatment for nasal blockage depends on the cause. We often use nasal steroid sprays, saltwater (saline) flushes or antihistamines. In some cases, surgery is necessary. Surgery to reduce the size of the turbinates is called a turbinoplasty whilst surgery to straighten a deviated or bent septum is called a septoplasty.
One common over the counter medication that people often resort to is nasal decongestant sprays such as Otrivine, Oxynase, Iliadin or Afrin. But these aren’t suitable for long-term use and can lead to a condition called rhinitis medicamentosa.
2. Is ear candling safe?
Despite its popularity, ear candling is neither effective nor safe. There’s a wealth of evidence that shows it doesn’t clear wax and carries the risk of burns or wax clogging the ear canal. If you think you have wax in your ear, it’s safest to consult your doctor. Wax softeners, syringing or ear suction by a specialist are both safe and effective.
3. Can you have eczema in your ears?
Yes, you can! The skin of the outer third of the ear canal is just like the skin elsewhere. Eczema of the ear canal skin presents as itchy and flaky. Sometimes the skin is broken and it bleeds. Damaged ear canal skin can lead to infections. If dead skin falls deeper into your ear canal, or if it’s pushed in using cotton buds, it can get trapped and become moist in our humid weather. This accumulation of moist dead skin can lead to troublesome fungal infections that cause intense itching, blockage or pain. They are difficult to eradicate. Antibiotic ear drops not only fail to treat fungal infections but can exacerbate them.
4. What’s the most effective natural way to relieve an itchy throat?
An itchy throat can be due to a variety of factors. The common causes are allergies or acid reflux. If you have a runny nose, back drip or sneezing, your itchy throat is likely allergy-related. Simple antihistamines (many of which can be purchased over the counter at the pharmacist) will help. If you don’t have any of these associated symptoms, acid reflux from your stomach may be the cause. In this case, diet modification, antacids or reflux medication from the doctor may help.
5. Which is a better solution for a deviated septum: septoplasty or nasal spray?
A deviated nasal septum is a structural problem. The cartilage and bone that makes up the septum are bent to one side. Nasal sprays cannot straighten a septum, so surgery is the better solution. That said, a deviated septum is actually very common. In fact, in the 1800s, a diligent ENT surgeon called Sir Morell Mackenzie studied over 2,000 skulls and found that almost 77% of people have a deviated nasal septum! Not all these patients will have a nasal blockage, so just because a septum is deviated doesn’t mean it ought to be straightened.
6. Does hay fever occur in Singapore? If so, what precautions should we take?
Hay fever is an allergy to pollen. In Singapore, we don’t have seasons, so the pollen counts remain low and stable throughout the year. We don’t have many hay fever sufferers, but we do have patients with allergies to grass and tree pollen. They should, if possible, avoid fields and wooded areas. Alternatively, take antihistamines when the weather is sunny and dry.
7. What’s the best way to remove ear wax at home? How deeply can I clean my ears without causing damage?
Ears are meant to be self-cleaning. You should only attempt to remove wax at the entrance of the ear canal with a soft damp cloth. Inserting cotton buds or q-tips into your ears can cause damage or simply push wax further into your ear canal. There are many wax softening drops that you can purchase over the counter.
Wax serves a purpose. It’s an antiseptic that protects the ear canal. Some wax is normal. It’s pointless to obsess over a small amount of wax at the entrance of your ear canal that causes no symptoms!
8. How do you deal with excessive ear wax?
A few people develop excessive amounts of wax in their ear canals. They may also have narrow ear canals so a small amount of wax causes blockage. It’s best to seek medical advice if this is the case. Simple methods such as syringing by your GP can be effective. In some cases, ear suction done with a microscope gives the best results. This is a common procedure done by all ENT specialists.
9. Any natural home remedies for sinus issues?
Sinusitis causes nasal congestion and a runny nose. One effective home remedy is the use of saltwater sprays or flushes. Humidification with steam inhalation can ease the sense of congestion. A good dose of vitamin C is also helpful. There are a variety of other remedies such as the use of garlic, colloidal silver and essential oils that are popular but lack sound evidence.
10. Why does ringing in the ear happen? Should I be concerned?
Ringing in the ears is called tinnitus. It’s extremely common. Most people experience tinnitus at some point in their lives. In most cases, tinnitus is short-lived but in a minority of patients, tinnitus can be persistent and highly intrusive. It’s often worse at night when there’s silence.
Tinnitus is due to abnormal electrical activity in the nerves that detect sound (the auditory neural pathway). If tinnitus is persistent, one-sided or pulsatile in nature, you should seek medical help. Tinnitus may be due to simple earwax impaction or a more serious underlying problem such as sudden hearing loss.
11. What causes nosebleeds and how can I prevent them?
Nose bleeds are common and often affect children. The vessels in the front part of the nose are fragile and can rupture, leading to nose bleeds. These vessels are arteries and therefore bleed profusely. Allergies contribute to the increased fragility of these vessels. Nose picking and rubbing due to allergies can trigger nose bleeds. Dry conditions can also cause nose bleeds. Addressing underlying allergies will prevent them or reduce their frequency. Antihistamines can be helpful, too.
We hope we’ve covered all your ear, nose and throat woes; ultimately, it’s always wise to see an ENT specialist if your symptoms persist.