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December 14, 2016 By @ENTClinicSydney

What Are Grommets

Grommets are small plastic tubes that are inserted into a child’s eardrum (tympanic membrane). Grommets are often used for children who suffer from persistent middle ear infections (chronic otitis media) in order to limit complications and improve hearing.

Otitis Media and Glue Ear

The ear cavity is normally filled with air, a property that is important for hearing. In otitis media, the middle ear cavity becomes infected, filling with fluid and/or pus – affecting hearing and development. The pus and fluid also put pressure on the eardrum, which may cause it to rupture. It is normal for young children to occasionally have ear infections. If a child has three or more episodes of otitis media in a six-month period, a diagnosis of chronic acute otitis media is made and may be an indication for insertion of grommets.

Another type of otitis media is otitis media with effusion, or glue ear. In this type of infection, the collection of fluid that remains after a period of weeks or months will become thick. The thick, glue-like fluid can interfere with a child’s hearing. If glue ear does not respond to other treatments or persists for an extended period of time (three-six months), the insertion of grommets may help. Otitis media can affect a child’s hearing. Hearing loss in children can adversely affect social, emotional and intellectual development, and hence, the insertion of grommets may help to reduce the impacts of hearing loss on developmental delay.

What do grommets do?

Grommets help to drain the fluid which builds up in the middle ear cavity. By draining the pus and/or fluid, the pressure in the middle ear cavity is reduced, alleviating the strain on the ear drum and improving hearing.

What is involved in the procedure?

Grommets can be inserted under local or general anaesthesia. For young children, who most commonly require grommets, the procedure is commonly performed under a general anaesthetic. This is because the patient needs to remain still during the procedure, as there is a risk of damage if the patient moves suddenly.

In most cases, there isn’t a need for surgical removal of the grommet. Eventually, the grommet will fall out of its own accord at some point. Some grommets can last up to about 4 years, whereas others will fall out anywhere between six months and two years following the initial insertion. Generally, the ear drum will heal by itself and close the tiny hole left by the grommet.

Complications

One of the main problems which can occur after the grommet has fallen out is a persistent hole in the ear drum. If the ear drum does not heal properly, another operation may be necessary to repair the hole remaining in the ear drum. Sometimes the ear drum may be affected by scarring or be thinner than normal after grommets are inserted. In most cases, this doesn’t affect hearing but may mean that the ear drum is at an increased risk of perforation. As with all surgical procedures, there is a risk of developing infection after the operation. Bleeding may also occur after surgery.

If the grommets fall out too early and otitis media is still a problem, it may be necessary to undergo a second operation to re-insert the grommets. In some cases, there may be another cause for hearing problems in the child in the middle ear or elsewhere, and the grommets may not result in hearing improvement. Once the problem is identified, the appropriate management can be implemented.

If you have any questions about grommets talk to your local doctor who will arrange for you to see an ear nose throat specialist.

For more information see our article about ear grommets.

The post Grommets appeared first on ENT Clinic Sydney.

December 14, 2016 By @ThyroidClinic

When the Thyroid Gland Goes Wrong

The thyroid gland regulates some of the most important functions of the human body, and if it doesn’t work right, we can suffer a long list of problems. But what is it? And why does it matter so much to our health?

The first thing to know about this gland is how it fits into the human body. Generally speaking, there are eight main endocrine glands, of which the thyroid is one.

These glands, which produce hormones essential to the body, include the adrenal gland, which produces adrenaline and other stress hormones, the pituitary, which releases hormones regulating homeostasis, and the islets of Langerhans, cell clusters on the pancreas responsible for creating insulin. The thyroid gland, for its part, generates three main hormones: calcitonin, thyroxine and triiodothyronine.

Calcitonin is one of the hormones resposible for reducing calcium levels in the bloodstream. Thyroid hormones including thyroxine and triiodothyronine, regulate growth and functioning rates of bodily systems. Together, these hormones control the speed with which the body uses energy and produces proteins, as wells as the body’s sensitivity to other hormones.

Malfunction of the thyroid gland can lead to a number of disorders. The two most common problems are hyperthyroidism, or over-production of these hormones, and hypothyroidism, underproduction. Each of these can lead to numerous physical symptoms and problems with energy, weight fluctuations and cognitive function.

The most common cause of hyperthyroidism is Graves’ disease, an autoimmune condition in which rogue antibodies force the thyroid to create too much of its hormones. Neck goitres, heart palpitations, excessive sweating, weight loss, bulging eyes, irritability, muscle weakness, diarrhoea, sleep problems, heat sensitivity and increased appetite are all symptoms.

A number of causes can lead to hypothyroidism, from autoimmune disorders and iodine deficiencies to congenital problems and removal of the thyroid during surgery. Stress is a common factor. Weight gain, baldness, memory problems, cold sensitivity, slowed heart rate and fatigue are common symptoms.

Both these conditions are commonly misdiagnosed as clinical depression. The weight fluctuations, fatigue, irritability, memory deficits and sleep disturbances common to thyroid disorders all mirror symptoms of major depressive disorder.

Cancer can also cause dysfunction of the thyroid. Though it usually presents without many symptoms, a nodule in the neck may appear, and vocal changes and neck pain may develop later in the cancer’s progression.

A simple check of the thyroid gland can help detect these problems if you think you’re showing symptoms. Tilt your head back, swallow some water and watch your throat in the mirror, particularly the area between your Adam’s apple and collarbone. If you notice any protrusions, bulges or other unusual signs, alert your doctor.

If you have questions or concerns about thyroid problems see your local doctor who will arrange for you to see a thyroid surgeon.

The post When the Thyroid Gland Goes Wrong appeared first on Thyroid Clinic Sydney.

October 20, 2016 By Rhinoplasty Clinic Sydney

Rhinoplasty summary

This gentleman requested several changes to his nose. The before and after pictures are displayed in the slideshow.

Patient concerns

Appearance

Nasal bump
Nasal length too long
Drooping nasal tip

Function

Breathing problems
Nasal congestion and obstruction

Surgical technique

To address his concerns this gentleman underwent open structure rhinoplasty, nasal septal reconstruction and bilateral inferior turbinoplasties.

After rhinoplasty surgery

The concerns in terms of appearance and function are addressed. After rhinoplasty the bump is removed. The tip is deprojected and uprotated. The columella retraction was addressed. Overall the nose has a natural appearance in keeping with the facial features. The nasal airway is improved and breathing is easier.

The post Grant Before and After Pics appeared first on Rhinoplasty Clinic Sydney.

October 20, 2016 By @ENTClinicSydney

Preparing in advance for a smooth recovery will help you to recover after tonsillectomy surgery. A tonsillectomy is one of the more painful surgeries with a recovery process that can take a week or two. So its better to manage your recovery proactively, rather than try to downplay the pain of recovery associated with this surgery.

When tonsils become infected or inflamed, they must be removed; however, many patients find the pain of recovery to be uncomfortable. There are some helpful tips, however, that can help ease pain and speed recovery time. If you’ve just gone through a tonsillectomy, here are five tips for a smooth recovery.

Tips for Tonsillectomy Recovery

1. Enlist the Help of a Friend or Family Member

First, it’s very important to enlist the help of a friend or family member during your recovery period. The combination of intense pain and numbing pain medications will likely render you incapacitated for the first few days after surgery. An acting nurse can help keep your ice cup full, keep you comfortable and ensure that you have what you need to recover.

2. Chew Ice Constantly

Ice is one of the best things to have during a tonsillectomy recovery. Ice keeps the incision site moist during recovery and this is very important for speedy healing. The cold temperature of ice also helps to numb pain and reduce swelling. Because a swelling uvula can be a dangerous side effect of a tonsillectomy, chewing ice is an absolute necessity. Keep a cup filled with ice chips on hand at all times.

3. Ice Cream!

Eating ice cream is one of the most reliable ways to help you during a tonsillectomy recovery. While many people feel absolutely incapable of eating food after surgery, keeping energy levels high is an important part of the recovery period. Choose foods that are soft and creamy such as yogurt and ice cream, or consume nutrient-rich broths and sugary beverages for energy.

4. Create a Pain Medication Schedule

The biggest mistake that one can make during a tonsillectomy recovery is to skip a dose of pain medication. To prevent this from happening, it’s a good idea to create a pain medication schedule. This will help you keep on top of your medication and prevent pain from spiralling out of control.

5. Gather Entertainment for the Recovery

The tonsillectomy recovery process is lengthy and frustrating, so be sure to have some entertainment laid by for the recovery period. Video games, movies, great books, soothing music and puzzles are great ways to keep your mind off the pain.

Tonsillectomies can pose a difficult recovery for patients, but the pain will pass faster with the right management. These helpful tips can get you through the worst of the recovery period.

If you have questions about snoring, tonsillitis or tonsillectomy, contact your local doctor who will arrange for you to see an ear nose and throat surgeon.

The post 5 Helpful Tips for Tonsillectomy Recovery appeared first on ENT Clinic Sydney.

October 20, 2016 By @ThyroidClinic

What Are the Parathyroid Glands?

Peppered throughout the human body are small organs known as glands. These organs have a complex and important job without which we couldn’t survive. They produce hormones that keep the body functioning properly.

Among the most critical are the endocrine glands. These include the pituitary gland, which secretes hormones regulating growth, pain relief and sex function, among others, and the adrenal glands, which produce stress hormones. Another key member of this group is the thyroid gland, which regulates the body’s use of energy, creation of proteins and sensitivity to other hormones.

About the Parathyroid Glands

The parathyroid glands are attached to the thyroid, but despite the similar names, they play a different role. The parathyroids are usually located on the back surface of the thyroid, in the portion of the neck between the Adam’s apple and the collarbone. There are typically four of them.

These small glands release a substance known as parathyroid hormone, or PTH. Its primary purpose is to regulate the body’s blood calcium levels, a task it shares with the thyroid. It also has an effect on the body’s absorption of phosphate. See the picture below for thyroid and parathyroid gland anatomy.

The thyroid gland produces a hormone called calcitonin that limits the level of calcium in the blood. PTH works as an antagonist to this hormone and together they keep calcium levels within a very narrow range. PTH also increases phosphate absorption by activating vitamin D in the kidney.

The parathyroid glands, like the thyroid, come with their own set of disorders. Overproduction of hormones by the thyroid can lead to the well-known conditions hypothyroidism and hyperthyroidism. Less well-known are the conditions hypoparathyroidism and hyperparathyroidism.

Underactive Parathyroid

Hypoparathyroidism occurs when the parathyroids produce too little PTH. This results in low blood calcium levels, which in turn results in symptoms including cramping, involuntary muscle spasms and unpleasant tingling. Headaches, insomnia, abdominal pain, fatigue and bone pain are also possible.

Hypoparathyroidism is a serious condition and it can cause medical emergencies, including seizures, irregular heartbeats and respiratory failure. There are a number of possible causes, such as removal of the parathyroid glands during surgery, autoimmune disorders, hemochromatosis and magnesium deficiency, among others. It can also be inherited.

Overactive Parathyroid

Hyperparathyroidism, meanwhile, results from an overproduction of PTH. Primary hyperparathyroidism occurs when the glands actually malfunction. This can be caused by hyperplasia (increased cell production), adenoma (a benign tumour) or, in extremely rare cases, carcinoma (cancer) of the parathyroids. Patients with bipolar disorder who take lithium long-term are also at greater risk for primary hyperparathyroidism, since that drug can lower calcium levels, leading to stimulated production of PTH.

Secondary hyperparathyroidism is caused by any medical condition that leads to lowered calcium levels in the blood. Chronic kidney failure and vitamin D deficiency are the most common factors leading to this disorder.

About half of all patients with hyperparathyroidism are identified by medical tests before they show any signs. Low calcium rarely causes overt distress though depression, bone pain, osteoporosis, nausea, decreased appetite and kidney stones are among the possible symptoms. Bone loss is possible.

If you have questions or concerns about thyroid problems see your local doctor who will arrange for you to see a thyroid surgeon.

For more information about the parathyroid glands click here.

The post What Are the Parathyroid Glands? appeared first on Thyroid Clinic Sydney.