MultiCare Health System

Welcome to our March E-Health Connect web chat.

Today's topic is Allergies and Ear, Nose & Throat issues.  Dr. Ronald Benveniste can provide advice on what you can do to enjoy Spring, both indoors and out, without having the sniffles.

To ask a question, simply enter your name and email address, click join, then ask your question in the message box. Please note your email address will not be used for any other purpose than to contact you if needed about the chat.

In the spring I get ringing in my ears. What can cause something like that?

Ringing in the ears is a very non-specific symptom and many factors can trigger this. If there is an accompanying worsening of hearing this could reflect the congestion of the eustachian tubes secondary to allergic nasal congestion.

What treatment options exist for excessive snoring?

There have been many treatment options advocated for snoring. It is important to first determine whether or not the snoring is a part of a sleep apnea picture, as this may require more aggressive treatment. An overnight sleep study is the best way to determine what is underlying the snoring. Depending on the sleep study results the appropriate treatment can be selected. If the snoring is accompanied by nasal obstruction, then treatment for that is usually one of the first treatment options.

Here is a question that came in via email: What are ear tubes and why are they so common in children?

Ear tubes are small plastic or metal tubes that are inserted into the eardrums to allow for ventilation of the middle ear space and drainage of the fluid that may have accumulated there. Children are more prone to develop fluid in their middle ear space because of having anatomically much narrower eustachian tubes, thereby blocking easily with simple nasal congestion or respiratory infections. Not all children need to have tubes placed as many times the fluid can resolve on its own or with medication. The tubes should only be considered after a failure of medication regimen.

I have heard that breastfeeeding your baby can significantly reduce his/her chances of developing allergies later in life. Is that true?

Allergies usually can run in families. The mother may have already developed some immune response to allergies and can thereby pass it through breastfeeding. There is no conclusive evidence that breast milk offers definite protection against allergies.

I've been chronically congested for 6+ months now and have ruled out environmental and food allergies. What else might possibly be causing this?

I can assume you do not smoke, as this is the  most common reason for chronic congestion. There are possible nasal congestion side effects from certain medications such as blood pressure medications, which can cause these symptoms. One can still develop environmental allergies and may be unaware of the amount of exposure to the allergens. Not all allergies are pollen/hay fever.

My sinuses always feel "full" even though I can breath somewhat through my nose. Is this common?

Not all that is facial pressure or headache is necessarily a sinus problem. The sinuses usually reflect the quality of the nasal airway. If one can breathe through the nose well then that usually will aerate the sinuses well also. Frequently people notice a feeling of facial pressure or headache that they attribute to sinuses but this may be referral discomfort from other sources, such as migraine or tension. The nerve supply of the head usually radiates pain forward to the area where one would assume there are sinuses.

How can you tell if children have allergies or just cold/flu symptoms. It seems to me many of the symptoms are the same.

The symptoms are similar, though a child with flu is usually quite ill with possible fever. A cold should only occur once or twice a year for most people and if the congestion is a more frequent occurence, then one can suspect possible inhalant allergies. Allergic children and adults are much more prone to respiratory infections.

What is laryngitis?  How can you treat it?

Laryngitis is inflammation of the larynx. Many times hoarseness or voice difficulties are not true laryngitis, and can be seen with improper use of voice, as is frequently seen in public speakers and professional singers. True laryngitis can usually be diagnosed on physical examination. The treatment depends on the underlying problem resulting in the voice abnormality or throat discomfort.

My son has a chronic cough but never seems to be congested. Can you have allergies without a stuffy nose?

Yes. Inhalant allergies can, in some people, create more bronchial problems than nasal symptoms. Some individuals are extremely bothered by asthma-like symptoms, but are not as bothered by nasal symptoms.

Can you recommend an over-the-counter allergy medicine?

There are obviously OTC allergy medications and many of these were recently prescription medications and are beneficial to many people. Most of these are extremely safe and can be tried to see if they alleviate your specific symptoms. If you find they are not effective, then newer prescription medications may be a better option. The choice of the medication is usually a personal preference as to what works.

When do you need to treat a deviated septum?

Surgical treatment is usually only needed if there is significant obstruction where there is no accompanying congestion. Almost everyone has a deviated septum, which can possibly even be from birth trauma, but not everyone needs to have this repaired if the nasal airway is adequate. A deviated septum may also be repaired if it is creating a cosmetic deformity or crooked nose.

Can allergies go away as you age? I've had hayfever my entire life but for the past couple years I haven't experienced any symptoms. I'm wondering if there is any chance I don't have that allergy anymore.

Many people report changes in the nature of their allergy, sometimes even with moving to a different house or area. The tendency for allergy is usually there all of one's life and can be tested at any time, and the test response would usually still be the same. Many people also become used to accepting their allergies. If you are not having symptoms, there is no need to be concerned at this time.

How long do ear tubes remain in kids ears? How early is too early for ear tubes?

Most tubes used in children are in for about six months, though some may stay in for as long as two years. Some children may require a repeat set of tubes and if this is required on several occasions, then there is consideration made for using longer-lasting tubes that may last about three years. I am reluctant to recommend long-lasting tubes in children as this may lead to possible persistent hole in the drum that may necessitate surgical closure at a later time.

There is some controversy as to how early a child should have tubes inserted, but this can be done prior to the age of one. The risk of performing this too early is probably that of anesthesia risk.

Thanks for participating in today's chat.

For more information about Dr. Benveniste and the MultiCare Ears-Nose-Throat (ENT) Specialists visit http://www.multicare.org/home/ear-nose-throat