Thursday, December 24, 2020

How to disclose pin hole perforation in a discharging ear through valsal...

A person presents to you with a discharging ear but on otoscopic examination, No perforation is found despite meticulous suction cleaning. In such cases, applying Valsalva Maneuver (Forced expiration against closed Nose and mouth helps to pop middle ear with air), helps to disclose very tiny perforation ( like a pin hole). This technique is useful as this help us to distinguish Outer ear infection from middle ear infection and changes the whole scenario in diagnosis. Even in normal cases, seeing the ear drum moving outward in response to Valsalva maneuver help to establish normal Eustachian tube function Eustachian tube connects back of the nose to middle ear and that's how it equilibrizes middle ear pressure with atmospheric pressure. sometimes infection in middle ear lead to high pressure. Pus formation under pressure needs and outlet to come out of ear. This pus make very tiny temporary perforation which comes out only when middle ear pressure is high that typically happens during mid night. This tiny perforation or pin hole perforation closes as soon as pressure in middle down comes down. ENT Surgeon is in dilemna to distinguish between suppurative middle ear infection or Otomycosis of outer ear canal alone though both conditions may exist. If there is no middle ear infection, then treatment is lot easier and can only be managed with ear drops only. Middle ear infection means antibiotics and nose opening drops have to be continued for long. #Pinholeperforation #discharging ear #CSOM #ASOM #Valsalva Maneuvre #Suppurative otitis media Dr Ajay Jain, MS (PGI Chd), DNB ENT and Head & Neck Surgery ENT Clinic: Shop No:1,2,3 DDA Market-1, G-block, Preet Vihar, Delhi-92. Landmark: Enter G-block opposite Metro pillar 102 Appointments: 9871166370. Website: Map: Https:// Other Videos Care of discharging ears (CSOM)-बहते हुए कानों की देखभाल Must see video before ear surgery -कान के ऑपरेशन से पहले कम से कम एक बार इस वीडियो को देखें

Sunday, December 20, 2020

Which Ear drop should I put in ear? कान में कौन सी बूंदें डालनी चाहिए

Ear drops are often purchased without prescription to use in various condition of the ear like pain, infection, wax and fungus. कान की बूंदों को अक्सर कान की विभिन्न स्थिति जैसे दर्द, संक्रमण, मोम और कवक में उपयोग करने के लिए पर्चे के बिना खरीदा जाता है। This is not right way to approach. Ideally, it should be seen by Ear, Nose, Throat specialist and then prescribed. Still, If you don't have access to ENT doctor, then few ear drops can really help. Then how to choose ear drops? Dr. Ajay Jain, who is a senior ENT Surgeon practicing at New Delhi, India for last 20 years, explains about rational behind using ear drops in simple Hindi language. Wax is often the case for sudden ear blockage where person don't have any issue for long and especially develops after taking bath, swimming or after using ear buds or Q tips. It is essential in these cases to soften the wax first so that it can easily be removed by ENT specialist. In such cases over the counter drops which often has some kind of `wax` mentioned in trade name is the best. When water going from outside is an issue and there have not been any history of ear discharge or cold, then most likely, fungus in the ear or Otomycosis is an issue. then Clotrimazole based ear drops work best. If there is an issue with recurrent ear discharge, then combination of antibiotics, anti fungals and steroid based ear drops work best but the choice of antibiotics is tricky and few antibiotic ear drops can also cause Ototoxicity with decreased hearing.

Friday, December 4, 2020

What are those bumps behind tongue? जीभ के पीछे वे लाल दाने क्या हैं ?

People often visit ENT Doctors worrying about red bumps behind tongue? वे जीभ के पीछे लाल दाने की उत्पत्ति के बारे में पूछते हैं ? I wish to tell them the bumps lined in form of V shape are circumvallate papillae that is normal taste buds. They are useful normal thing. sometimes these buds become swollen because of local irritation from tongue cleaner or food allergy or smoking. The area behind these bumps is base of tongue which is blind area to most physician and only ENT doctors can see and reassure patients that there is nothing to fear about over tongue.

Wednesday, December 2, 2020

Ringing Sensation In Ear during Coronavirus Pandemic

It has been reported that tinnitus incidence has increased during Coronovirus pandemic ( read during lockdown or covid infections). This is true as we see tinnitus or ringing sounds in ear are felt more during silence. With more machine silent during Covid, more people are coming with these complaints. Most of the cases have some hearing loss at some of the frequencies and an audiometry test is must for work up of cases. High frequency hearing loss is often seen because of noise pollution.

Message from Dr Ajay Jain

Dear Friends, I hope this message finds you in good health and high spirits. Welcome to my blog, a space dedicated to educating my patients ...