PAPERS ABOUT EARS,NOSE AND THROAT

Composed for the fulfiment task english courses

Adviser: Rachma Putri K, M.Pd

Arranged by:
Amala Lailatul A 171004
Bielly Figgy A 171011
Derizta Amillya 171029
Elsa Fajira 171041
Etha Teana A. D 171044

NURSING COURSES

POLYTECHNIC OF HEALTHdr. SOEPRAOENMALANG

SCHOOL YEAR 2019/20220

 CHAPTER I

INTRODUCTION

1.1. Background of the paper

Together with the eyes and skin, the ears, nose and speech organsn in the

throat are the principal means of perceiving and communicating with the outside

world. Your ears enable you to hear what goes on around you and, in another

important role, help you to maintain your balance. Your nese allows you to

perceive smells and is the gateway to the respiratory system. In addition to

passageways for food and air, you throat are contains the larynx and vocal cords,

which enable you to speak.

The structures within the ears, nose and throat are complex and delicate

and, because they are open to the outside world, vulnerable to a host of bacteria

and viruses. Just how vulnerable they are becomes apparent every time a

stuffed-up nose, anching ear or a sore throat makes your life miserable. In

addition to being open to infections, the digestive and respiratory systems-by a

network of interdependent passageways to travel quickly throughout the body.

In the days before antibiotics,a slight sore throat could trun into a

crippling case of rheumatic fever; an earache might lead to permanent hearing

loss or necessitate a mastoid operation, a procedure that was then performed

more frequently than a tonsillectomy. Today, thanks to antibiotics, infections of

the ears, nose and throat can be controlled and cured. Breakthroughs in this field

have not been limited to fighting infections. Otolaryngologist, or ear, nose and

throat specialists, can now rebuild a shattered nose, repair a torn eardrum, and
 even control excessive snoring with surgery. Perhaps most encouraging of all,

advances are being made in dealing with hearing loss, the most prevalent

physical disability of our noise-conscious and ageing society.

1 Formulation Of The Problem

1. what causes interference with hearing?

2. How is pathology of cataract and glaucoma can happen?

1.1 The Writing Of Purpose

Berdasarkanrumusanmasalahdiatas,

makatujuandaripenelitianiniadalahsebagaiberikut:

1. Memperolehdeskripsitentangbagaimana proses terjadinya pelangi.

2. Memperolehdeskripsitentangkaitan eksperimen pelangi dengan kognitif anak.

 CHAPTER 2

2.1 EARS

2.1.1 HEARING LOSS

I have read that loss of hearing is the single most common physical disability in

this country? Is it true?

It probably is, Although the total numbers are not known exactly,

complete or partial hearing loss is a major probelm in the community. Hearing

impairment accounts for a large proportion of handicapped people in both

Australia and New Zealand. The Autralian Bureau of Statistics figures indicate

that 7 per cent of people report some degree of hearning loss, ranging from 2 per

cent in people aged 15-24 years to 25 per cent in people over 65. In New

Zealand, it is estimated that there are 480.000 people with completed or partial

hearing loss (including 6000 who are totally deaf). Because our society is ageing

and also because we are all exposed to a great deal ofexcessive external noise,

hearing loss is on the rise in the Western world. Men are generally more affected

than women, due mainly to different occupational experience

Of particular concern is the number of children who suffer a degree of

temporary or permanent hearing loss before the age of ten, suffcient to be a

handicap to their development. Hearing loss occurring in a chlid during the

critical period of language acquisition may place the chlid at rizk of developing

a language problem and academic learning impairment. For this reason, more
 attention is now given to treating all hearing problems in children (see also

p.315).

2.1.2 EARWAY

Glands in the outer ear canal produce earwax (known technically as cerumen) in

quantities that very from person to person in most cases, excess esrwax causes no

problems it ysally rolls right out of the ear on its own, or it can be removed from

the outer ear with a face cloth.

Hearadened earwax can, however, become imbedded in the ear, causing pain

and interfering with hearing. If this happens, do not try to remove the impacted

earwax youself. Cotton wool buds, bobby pins, sticks,pencils or other

objectscommonly used to dislodge earwax may only drive the wax fuether into into

the ear the earwax may harm the ears. If wax is blocking your ears. See your

doctor. He will remove the excess earwax safely with a small probe or a syringe.

What does my doctor mean when he tells me that i have sensorineural hearing

impairment? Are there different kinds?

Broadly speaking, there are two types of hearing impairment: nerve loss

medically known as sensorineural hearing impairment and conduction loss. More

than 90 per cent of people with hearing problems suffer from nerves of the inner ear

have been partially or even fully destroyed. The 30.000 nerve fibres in the inner ear

suffer damage from a varety of causes a blow to the head overexposure to loud

noise or music, including sudden loud “impluse’ noise age related degeneration or a

tumour on the auditory nerve, whic connects the ear to the brain. Such tumours are

frequently benign, however, and if caught early enaough can be removed without
further loss. Unfortunately, one the nerve is damaged nothing can be done to restore

it, whatever the cuse

Nevertheless, hearing aids can help by amplifying sounds for transmission by

functioning nerve fibres. In fact, most hearing aid wearers are people who suffer

from sensorineural loss. For more information on research in the filed, contact the

national acoustic laboratories or the adlut deaf society in your capital city if you

live in australia if you live in new zealandconctac either the audio logy clinic at a

publi hospital or the local branch of the hearing association

A conduction loss means that sound saves are blocked in either the outer or the

middle ear, and thus cannot be transmitted to the inner ear. The simplest form of

conduction loss is caused by wax or a foreign body lodged in the outer ear canal. A

doctor can usually remove such obstructions easily and restore normal hearing. A

perforated eardrum can also reduce hearing abilities but with today’s microsurgical

techniques most eardrum perforations can be repaired Another common form of

conduction loss is known as otoselerosis. Whic involves bone growth in the middle

ear. This condition can be recified with a stapedectomy, a delicate operation with a

success rate of about 80 per cent, in which the surgeon removes the diseased bone

and substitutes a prosthetic replacement. If succesful the other ear may then be

operated on It is also possible to have mixed hearing loss, inolving both conductive

and sensorincural deficits and affecting both the middle and inner ears

My parents began to lose their hearing in their mid-fifties does this mean iwil be

affected in the same way ?

 Deafness can be hereditary so you run some risk of developing hearing problems

similar to your parents a recessive gene is frequently implicated in inner ear

deafness or sensorineural hearing loss otosclerosis a from of conduction hearing

loss (see above) also appers to run in families about 20 per cent of deafness in

children is considered to be genetic in origin and another 40 per cent of unknown

origin some possibly patterns so the approach for you might be to talk to a

specialist in genetic disirders

My husband is beginning to endure a small hearing loss, and has trouble

hearing words with the sounds s,f,sh,ch and h in them why?

All the consonants you mention are in the high-frequency range and as we get

older we lose our ability to distinguish sounds in these frequencies the condition

known as senile deafness can in fact occur from the age of 50 onwards young

children can often hear high-pitched sounds that older people do not pick up men’s

voices are frequently more audible than the voices of women and children

What symptoms of progressive loss of hearing should i be on the lookout for?

If you can’t hear people talking to you from another room or who are not facing

you directly, you may have a hearing problem. If you can’t hear soft noises such as

the drip of a tap, or if you hear voices more clearly over the telephone than in

person, or if you hear distorted sounds from a television set or in a movie theatre,

then it’s probably a good idea to have your ears checked.

2.1.3 HEARING TESTS

 The simplest hearing tests are whisper and voice tests—the doctor, sitting

about 6 metres away from you, whispers numbers and then repeats them in a

normal voice, while you cover one ear at a time. In the ticking watch test, he tests

each ear to determine the distance at which you can hear a watch ticking, A tuning

fork may also be used to test your ability to hear tones conducted by air and by the

bones of your head

A more precise way to evaluate hearing is by means of an audiometer, a device that

produces pure tones of known pitch and volume in the first part of the test, which

measures the ability to hear air conducted sounds, you listen through earphones to

tones of different pitch and volume or to repeat the words you heard to measure

your ability to hear bone conducted tones, an oscillating device may be placed on

the bone behind each ear and you will be asked to indicate as soon as you hear a

tone

My father in law is getting hard of hearing, yet he sometimes complains that loud

sounds bother him. Why is this ?

Your father in law may have what doctors call presbyacusis or age related hearing

loss. It is caused by gradual wear and tear of the receptor cells of the inner ear

although age related changes in the brain have also been implicated in this type of

impairment.

Someone with presbyacusis may be able to hear general sounds but may not beable

to discern speech. Your father in law’s sensitivity to loud noises a condition known
as recruitment is probably a result of the degeneration of his inner ear receptor

cells.

Presbyacusis generally doesnt become noticeable until after the age of 60, and in

some people not until much later in fact, presbyacusis is not an inevitable part of

ageing. The ability to hear higherpitched sounds begins to decline after the age of

30 but this gradual loss may continuewithout ever producing a handicap

I have been feeling mildly dizzy lately. Could this be related to my hearing

problems?

It could, depending in the type of dizziness you are experiencing. Most doctors

distinguish between lightheadedness, in which the patient feels faint or wozzy, and

vertigo, in which the patient feels that the room is spinning around him. The causes

of lightheadedness can range from psychosomatic factors to a minor fluctuation in

the brain’s blood supply to severe cardiovascular problems. Vertigo, on the other

hand, os often related to problems in the inner ear, where the balance centres are

located. A viral infection, for example, can cause vertigo and impair hearing if not

treated promptly. Vertigo and also occur as a side effect of some medications. In

any case, you should consult your doctor about the dizziness you have been

experiencing.

Persistent attacks of severe vertigo, which may strike without warning, can be a

symptom of meniere’s disease, a condition in which excessive fluid plugs the inner

ear, destroying the sense of balance. Attacks of this disease can be alarming: in

addition to losing one’s balance one may be overcome by nausea and vomiting,
 break out in a sweet, hear loud, rumbling noises inside the hide, and experience

fluctuating hearing loss. This lass symptom may persist between episodes and

become worse in time. Attatcks very in intensity, duration and frequency. A variety

of drugs and, if necessary, surgical techniques are used to treat meniere’s disease.

I can hear a fint ringing noise in my ears. Is this and early sign of hearing loss?

You may be afflicted with what is known as tinnitus, a condition thet affects

thausands of people. It involves a ringing noise in the ears which may or may not

be accompanied by hearing los. If however, you have been taking medication such

aaspirin, your tinnitus may be nothing more than and transient side effect. If you are

to be on long-term therapy, a basic hearing test (see p.310) may be advisable at the

start.

2.1.4 TINNITUS

Tinnitus may be caused by a variety of disorders in all three parts of the ear as

well as in the auditory nerve and brain. Among the problems associated with tinnitus

are wax build-up and other obstructions in the outer ear; a ruptured eardrum, fluid

build-up, excess bone growth (otosclerosis) or infection in the middle ear; such inner

ear problems as presbyacusis (age related hearing loss), meniere’s disease, the side

effects of drugs, and noise damage; and tumours and other diseases effecting the

auditory nerve or the brain.

Hear perfectly well, others experience such loud ringing in their ears that other

sounds are virtually blocked out. There are number of reasons why you might be

suffering from tinnitus, including overexposure to loud noises, a build-up of earwax,

an attack of flu, high or low blood pressure or diabetes. Unfortunatel, except for

controlling and treating such underlying causes, there is as yet no cure for tinnitus.

There are, however, ways to alleviate the problem. These include medications

such as nicotinic acid, wich enhances the absorpotion of inner ear fluid, and

biofeedback techniques (see p.239), wich can be useful in reducing stress. Because

beckground noise can help to mask tinnitus, a divice known as a sound masker, worn

like a hearing aid, has been developed. For those with tinnitus and hearing problems,

there is something called a tinnitus instrument, wich combines a sound masker and a

hearing aid.

Is it true that some of the drugs used in cancer chemotherapy can bring on hearing

loss?

Certain potent anticancer, can indeed damage hearing. If you receive any of

these drugs, be sure that your hearing is carefully monitored throughout treatment I

order to detect and reduce damaging side effects. Certain antibiotics, blood pressure

medications and diuretics may also harm the nerves of the inner ear of certain patients.

In addition, if you experience hearing loss or balance problems when taking any

medication, so that that he can change or modify the medication.

Is a low-fat helpful in preventing hearing loss?

Possibly, but the connection is purely circumstantial. A theroscclerosis,or the

build-up of fatty deposits in the blood vassels (see p.161), is a contributing factor in

age-related hearing loss.thus a low-fat diet that lowers the risks of developing

atgerosclerosis cloud retard hearing loss, and could even improve hearing.
I suffer from profound deafness caused by the destruction of the nerves of my inner

ear. My doctor has suggested a cochlear implant. It this a good idea?

For you own protection, you should consider getting a second opinion on the

advisability of undergoing a cochlear implant. The operation is a recent development,

one the remains on the frontier of otolaryngology, and one that should be considered

only as a last resort. You should be aware of the limitations of this particular

procedure, although these may be modified as research I the field continues.In the

operation, electrodes are implanted in the inner ear and used to stimulate the nerves

leading to the brain. Only in rare cases, however, have patients been able to hear

human speech after a cochlear implant ; the thechnique is at present too primitive for

this. The results are most satisfactory in people who have had normal facility

previously. The operation does enable deaf people to hear certain sound: wather

running, for evample, or an engine turning over. These homely sounds help to give a

hearing-implaired person some encouragement and a sense of the outside world.

I cannot distinguish speech at a distance of more than one or two metres, and I have

trouble fllowing conversations in groups. Will a hearing aid help me?

A hearing aid amplifies sounds and, if adjusted specifically to do so, can also

help in hearing high-pitched sounds. With a hearing aid you may indeed feel that you

have recovered your hearing, although the tone and quality of the sound your hear are

different. It is important to remember, however, that a hearing aid can do noting about

distorted sounds; that is, it dosen’t clarify sounds, it merely increases their loundness.

A hearing aid also connot amplify selectively; all sounds will go up in volume. Those
 who hear normally can, to some degree, focus on specific sounds; a hearing aid dose

not have this capacity.

Who is the best person to go to for advice about hearing aids?

Once you have made the decision to get an aid, your doctor shound refer you to

an audiologist, or hearing aid specialist, who will test your hearing disability. He will

then direct you to the most effective type of hearing aid for your problems. There are

essentially five varieties of hearing aids. The least obstusive model is placed inside ear

canal and is destigned for people with a mid hearing disability. For those with mild to

moderate loss, there is an aid that fist in the opening of the ear. Hearing disabilities in

the moderate to severe range can be helped by aids placed behind the ear, fitted into

eyeglass frames, or encased in ‘body'boxes that can be attached to clothing. You must

be prepared to be patient and to spend time adjusting your aid to meet your needs. If

the device doesn’t fit perfectly an isn’t turned correctly, you may be overwhelmed bye

extraneous noises.

I have been told I need a doctor’s prescription to get a hearing aid. Is that true?

No. hearing aids can be purchased through a large number of private agencies

without a doctor’s prescription. This is not, however, a recommended course of action,

as hearing loss can be caused by an underlying medical problem such as diabetes, an

underactive thyroid gland or an operable tumour on the hearing nerve. Consequently, it

is always a good idea to undergo a complete physical examination as well as an

examination for hearing loss by a specialist before purchasing an aid. In Australia, the

National Acoustic Laboratories provide hearing aids free of charge for all people under
21 and for pensioner an repatriation patients. Other patients are means tested. For New

Zealanders, a free hearing-deficiency testing service is available at the audiology clinic

of public hospitals. Free hearing aid are provide for school-children; other patients

receive a Health Department subsidy. For those with special needs, additional costs are

often met by the Social Welfare Department.

I have heard that hearing aids can be insecured against loss. Is this worth doing?

You can, and it’s good idea, especially for children who wear aids. A hearing

aid costs anywhere from $500 to $1000 and custom-made aids can cost even more.

Most insurance companies provide cover for hearing aids, sometimes through a

homeowner’s policy; check the requirements of individual companies. The supplier pf

the hearing aid may also be able to give you some guidance.

Also, I understand there are now ‘hearing ear’ dogs? Is this really the case

This is a fairly recent development. There are specially trained dogs who can

make a hearing-impaired person’s everyday life easier, more pleasant and safer. The

dogs are taught to respon to and alert their owners to a great variety of sounds: a door

bell, a baby’ cry, and even to an owner’s individual requirements.

I have a lot trouble hearing on the telephone. Is there anything that I or Telecom can do

to overcome the problem?

If you have a serious hearing problem, you will certainly have trouble hearing

on the telephone. Fortunately, there are some devices thatmights be helpful. For

example, you can buy a hearing aid with telecoil switch. This device boosts the
sensivity of the aid by allowing it to pick up and amplify your telephone’s

electromagnetic waves (make sure that your telephone is hearing aid compatible). You

may encounter some feedback and disitortion with the telecoil, and so you should try it

before investing in one. Another device is a coupler, which can be attached to the

telephone receiver to amplify sound. In addition, Telecom wil provide you with a

handset amplifier that you can plug in yourself. All these devices, while helpful, do

have their limits. Many of them can be used only on your own phone, and none of them

will make it possible for you to use the phone as casually as a hearing person can.

If you can’t hear or speak on the phone, you might consider investing in a

telephone typewriter service or TTY, a special telecommunications device for the deaf.

This equipment enables you to send or receive printes messages over the phone. You

can communicate directly with other TTY owners or send your messages to a special

operator who will read them over the phone to a hearing person. A TTY is extremely

useful for someone who wants to keep in touch with a hearing-impaired family member.

In Australia, check with the Deaf Society in your capital city; TTY services are listed

under Deaf Society in your local telephone directory. In New Zealand, the audiology

clinic at a public hospital will advise you on where to obtain a telephone typewriter or

any of the other telephone listening devices available.

2.1.5 Childhood problem

What should I do if my child pushes something into his ear?

The first thing you should do is resist the temptation to try to remove the object

yourself. If you do, you may well push the item farther into the ear, and damage the
eardrum. Instead, see you doctor, who will remove the object with a special spoon-

shaped instrument or small forceps designed just for such situations.

Why are children so prone to ear infections?

A child’s Eustachian tube, the link between the back of the nose and the middle

ear, is not only shorter and wider than an adult’s but is also positioned at less of an

angle. This makes it easier for infections to spread from the nose to the middle ear. A

cold, flu or allergy can thus reach and inflame the middle ear with relative ease,

possibly blocking the Eustachian tube and causing fluid to build up. About two-thirds of

all preschool children have at least one infected-ear episode; more than one-third will

have three or more episodes.

How long should I wait before calling the doctor if my child has an earache?

If there is no fever, you can wait a couple of days, but if your child also has a

temperature, call your doctor at once. It is also important to call the doctor of the

earache is accompanied bye dizziness, facial paralysis or diarrhea.

Our little boy has constant earaches, and the doctor wants to insert a tube into his ear

to drain it. Is this a helpful procedure?

If your child’s earaches are caused by fluid build up in his middle ear, the doctor

may try to relieve the problem by cutting a small slit in the eardrum-the procedure is

called a myringotonomy, after the medical term for the eardrum-and inserting a

temporary tube to connect the middle ear to the outer ear canal, and allow air to enter

and dry out the middle ear. (The slit in the eardrum heals over once the tube is
removed). Sometimes the operation works well, but there are times when the tube

doesn’t drain properly or falls out prematurely. In addition, some specialist believe that

such tubes lead to thickening of the eardrum. This is a matter for you and your doctor to

discuss.

HOW TO RECOGNIZE HEARING PROBLEMS IN YOUR CHILD

For the first six months after birth the best way to monitor your child’s hearing is to
note his reaction to sounds. A newborn will be startled by loud noises, while the
sounds of people speaking in normal tones should have a soothing effect. A three-to
six month-old baby, on the other hand, should begin looking around to locate the
source of noises; it will, for instance, turn towards a voice.

All infants-even deaf ones-babble. At about six months, however, a totally deaf
child will stop babbling while normal child should be following simple commands.
At three years he ought to be using some verbs and pronouns, and at five years he
should be able to carry on uncomplicated conversations. If your child diverges in
any significant manner from this pattern, he may have some degree of hearing loss.
If you think this is the case, see your doctor immediately. A hearing-impaired child
should be examined child should be examined and start special training as soon as
possible.

My son has large, protruding ears. Is there anything that can be done about them?

A minor operation on the skin at the back of the cars should take care of your

son’s problem. It will probably be carried out after he is five years old. A strip of skin is

removed and the incision sewn together; a fold in the skin will almost totally hide the

scar. The operation is usually perfomed by a plastic surgeon or an ear specialist, but

your son should see the latter first for consultation.

Why are some babies born with a hearing loss?

 The cause may be genetic (see p.209), or it may involve a nongenetic factor-for

example, the child’s mother may have had rubella, or German measles, during her

pregnancy (see p.522). It was once thought that hearing would be damaged only if the

mother had German measles during the first three months of pregnancy, but recent

research indicates that the foetus may still be vulnerable later. Blood type

incompatibility can also jeopardise a child’s hearing. An Rh-negative mother should

discuss this problem with obstetrician if in previous pregnanices she carried an Rh-

positive foetus (see p.538). There is also birth trauma can be produce a loss of hearing.

Babies in these categories are 14 times more likely to have hearing loss.

There is no way to reverse presbyacusis the abiliy to lip read and in some cases a well

fitted hearing aid can be of help. (if the distortion of incoming sound is severe, however,

a hearing aid may make matters worse) your father in law should also undergo a

comp;ete physical examination to rule out other possible and perhaps treatable causes of

his hearing loss.

My neighbour tells me that her daughter is prelingually deaf. What does this mean?

Any baby born with hearing loss or who becomes hearing-impaired before learning to
speak iscalled prelingually deaf. One baby in about a thousand is either born deafor
losesits hearing in the first years of its life. Hearing loss in very young children may be
the result of aviral infection suchas mumps or measles; even the flu can infect a child’s
inner ear and destroy nerva cells essential to hearing in the cochlea. A neglected case of
middle ear infection. Of otitis media (seep. 304), can also cause damage to a child’s
hearing capabilities.

How soon a doctor tell if a child is deaf?

By applying special tesis, a doctor can tell almost from birth whether or not a baby has a
hearing defect. As a child grows, other tesis can be performed: by the age of four
months a baby should respond in the human voice. And by eight months it should react
to sounds coming from various directions. If you detect a lack of response in your child,
report it to your doctor at once.

Our boy was diagnosed as being almost totally deaf. But now, aged two, hre seems to be
responding to noises. Should we have him retesied?

Yes, of course. Testing a child’s hearing is a tricky business. During the first test, your
son may have been in an uncooperative mood, he might even have been responding to
your own apprehensions. A second test makes good sense.

Our son, who is one year old, was diagnosed at birth as having a substantial hearing
loss. How can we help him?

Perhaps the single most important factor in the growth and development of a deaf child
is the attitude of the parents. Hearing-impaired children live in a completely isolated
world, unaware even that sounds exist. A hearing baby will gurgle to itself and
eventually turn such sounds into speech; a deaf child begins by gurgling but, hearing
nothing, soon stops. The parents of such a child must have great patience and learn a
whole new approach to communication. Many organisations offer assistance, both
locally and nationally. The national Acoustic Laboratories or the Deaf Society in your
capital city if you live in Australia, or the Hearing Association in New Zealand, can
guide you to such organisations.

Our daughter is only one year old, but we have been advised to get her a hearing aid.
Isn’t this a little early?

Not really. Experts believe that it is vital for children to learn to connect sounds with the
environment, and hence they urge that children be fitted with hearing aids as soon as
hearing loss is diagnosed. It there is any residual hearing, then the aid will form an all
important bridge with the outside world. Furthermore, your daughter will grow
accustomed to wearing a hearing aid. Another device sometimes recommended is a
baby buzzer, a vibrator that enables a profoundly deaf child to feel sounds. The device
consist of a patch worn over the breastbone and a micro phone and electronic circuitry
connected to the patch. The rhythm and intensity of sounds are picked up by the
microphone and translated into vibrations the child can feed. Considerable research has
been done on these device, and the results have been highly encouraging. They can
provide a deaf child with a sence of environmental sounds, such as the ringing of a
telephone or the reverberations of a car engine. The devices have also proved to be
valuable aids in teaching deaf children to enunciate sounds.

Our child is partially hearing-impaired. Should we, her parent, consider going to a
speech therapist too?
Yes, it might be a good idea. The strain on parent with a hearing-impaired child is great,
anything that makes it easier for you to communicate is advisable.

2.2 THE NOSE; ITS FUNCTIONS AND DISORDERS

I know that I breathe through my nose and smell with it, but what other functions does
this organ have?

The nose is the body’s air conditioner as well as a gateway to the respiratory system.
The air breathe enters the nose through the nostrils, two openings separated by a thin
wall of cartilage called the septum. Protective hairs in the nostrils begin the job of
filtering out particles of dirt from the incoming air. From the nostrils, the air continues
on to the mucus-lined nasal passages. Here, the warm, convoluted surfaces heat up the
air before it reaches the lungs while the sticky lining traps dust and bacteria and helps to
moisten the air. Covering the lining are tiny, hair-like projections called cilia; these
sweep back and forth, moving dirt, bacteria and excess mucus to the troath or to the
front of the nose.

We are often told that the sense of smell is the least developed of all our sense. Is the
true?

Problaly. The human sense of smell is certainly very primitive compared to that of a
dog or most other animals.

Our sense of smell is based on a chemical reaction in the body. The process begins in
the back of the nasal cavity, where hair-like receptor cells are stimulated by molecules
of gas released by, say, a spring flower or burning food. These cells then transmit
chemical messages directly to the olfactory, or smell, centre of the brain.

Exactly how the molecules produce a response in the receptor cells is not yet fully
understood and neither is the mechanism that enables us to distinguish between
different smells. It is known, however, that the sense of taste, and that it fatigues
quickly.

Why do we sneeze?

Sneezing is a means of keeping dirt, dust and other irritants out of the nose. When the
sensitive nerve endings that line the nose are irritated, the brain sends a message to the
lungs to draw in air and prepare for a sneeze. Proprlled by the chest muscles, the air is
ejected through the nose and mouth at great speed. The processis involuntary, which is
why it is so difficult to stop a sneeze once it starts.

Why does my nose run on a cold day even when I don’t have a cold?

The cold air moving up your nostrils stimulates certain nerve endings in your nose to
secrete excess mucus, which then gathers and forms large drops. These, in turn, flow
downwards and cause your noseto drip. For some reason, any rapid change of
temperature seems to trigger such an accumulation of fluid.

I have often heard the term postnasal drip. Is this a real medical condition?

Yes, it is. Normally, most excess mucus from the nasal passages is expelled by blowing
the nose. Small amounts of mucus, however, may drain behind the nose and drip down
the back of the trotat, usually without your being aware of it. When this back of the
throat drain age becomes excessive and irritating, you have what is known as postnasal
drip. The condition is usually caused by something that clogs up the nose such as a cold,
allergies, dust, noxious fumes or other irritants, overuse of nasal sprays or drops and,
often by sinusitis (see p.321). Persistent postnasal drip may lead to throat irritation and,
in some cases, bronchitis (see p.177).

Most cases of postnasal drip are cleared Up by eliminating the underlying cause.
Because dry, overheated air tend to congestnasal passages and prevent normal mucus
drainage, many doctors recommend using a vaporiser or room humidifier to minimise
postnasal drip. Sleeping with the head propped up by pillows and even blowing the nose
more frequently also seem to help. If you are bothered by postnasal drip that isn’t
caused by a cold, allergy or some other obsious factor, consult your doctor.

Every so often (usually in winter) my nose bleeds. Is his a serious problem?

Probably not. Most nosebleeds are of the harmless type-doctors refer to them as
anterior-in which blood vessels in the front portion of the nose rupture, perhaps because
of a blow to the nose, or because you blew your nose too vigorously. This type of
nosebleed often occurs in winter, when dry air causes the nasal membrans to crack,
crust over and bleed. You can avoid wintertime nosebleeds by applying petroleum jelly
around and just inside the nostrils and, when indoors, by using a humidifier.

The best way to treat a simple nosebleed is to pinch the nostrils together for about five
to ten minutes. When the bleeding stops, don’t blow your nose for several hours and be
careful not to pick at any cruted places in your nostrils.

A less common but more serious type of nosebleed is called a posterior nosebleed:blood
blood flows from the back of the nose and down the throat. Such a nosebleed may be
harmless and stop spontaneously; if it persists, however, you may lose a lot of blood.
This can be a symptom pressure, jaundice or alcoholism.

If either type of nosebleed persists, see your doctor. He may treat an anterior nosebleed
by packing the nostrils with gauze. A posterior nosebleeds requires careful diagnosis,
complicated packing or even cauterisation of blood vessels.

What should i do if one of my children pushes a button or bean up his nose?

Children do indeed have a habit of pushing various objects up their noses. A sign that a
foreign body is stuck in the nasal passages may involve a discharger of pus or the
appearance of blood in a nostril, Don’t attempt to remove the object yourself; instead
take your child to your doctor. After applying nose drops to constrict the blood vessels,
the doctor will remove the foreign body with a blunt hook. If the child strugggles, this
may be performed under a general anaesthetic.

My doctor says that nasal polyps are causing the blockage in my nose. What are nasal
polyps, and how are they treated?

Despite their name, nasal polyps are not real polyps, since they do not conssist of new
or abnormal tissue. They are often formed of swollen sinus tissues that happen to bulge
into the nasal cavity. Nasal polyps may be caused by an allergy, such as hay fever, or by
some form of chronic infection of the sinuses.

Nasal polyps are usually benign, but they can block the nasal passages, make breathing
difficult and curtail the sense of smell. They may recede on their own, once the
underlying condition that is causing them is treated; or they can be removed surgically
under local anaesthetic. Unfortunately, they tend to recur.

I am not a drinker, but i have developed a bulbous nose. What can i do?

This affliction is know medically as rhinophyma and is actually a bacterial infection.

While alcoholism, it also occurs in people who, like you, don’t drink at all. It can be
aggravated by overeating, intestinal disturbances or a glandular imbalance. An operation
to remove the top layer of skin may help to restore the nose to its normal appearance.

I was born with a deviated septum, and as a result I am susceptible to sinusitis. Would
an operation help?

Virtually no one’s septum-the wall of cartilage that divides the two nostrils-is perfectly
straight. In some cases, however, the deviation is so severe that it can interfere with
breathing or lead to recurring attacks of sinusitis (see below). The operation to
straighten your septum and restore a normal flow of air to the lungs is a fairly simple
one, and it is often performed under a local anaesthetic. The operation would almost
certainly help in solving the problem of your being susceptible to sinusitis.

Could an operation to change the shape of my nose lead to complications?

In the hands of a reputable surgeon it shouldn’t. But as with any surgery, a rhinoplasty,
as this operation is called, does involve certain risks. Be sure to discuss them with your
doctor beforehand. A rhinoplasty is normally performed by a plastic surgeon or an
otolaryngologist. Dressings stay on for some seven days; you will probably emerge with
two large black eyes caused by the seepage of blood. Two weeks may elapse before all
signs of the operation disappear.

2.3 THE SINUSES

I have a friend who complains constantly of sinus attacks. What causes such problems?

Strictly speaking, a sinus is a hollow air space anywhere in the body, but when your
friend talks of a sinus attack she is referring to the four sets of air spaces grouped
around the nose, called the paranasal sinuses. Each of these sinuses opens into the nose
and shares a continuous mucous membrane with it. Because the nose and sinuses are so
closely connected, a viral or bacterial infection in the nose can spread easily into a
sinus. The resulting inflammation of the sinus mucous membrane is called sinusitis, or a
sinus attack. A cold, influenza, allergies, a tooth or throat infection, can all cause
sinusitis.

The symptoms of sinusitis include nasal blockage that becomes worse after a few days
instead of better, as with a common cold; a thick yellow and green discharge from the
nose; and depending on which sinuses are affected, pain in the forehead, cheeks or
around the eyes. Eventually the passages between the nose and the sinuses may become
completely blocked; this may reduce the discharge but makes the nose feel even more
stuffed up, and breathing has to be through the mouth.

I suffer from winter sinus headaches. Should i get my sinuses drained?

Perhaps, but only as a last resort. Many authorities suggest that before considering
draining you should try using a humidifier or vaporiser to offset the drying effects of
heated winter air. Applying hot wet compresses or heating pads to your nose and
forehead may also help. Don’t blow your nose with excessive force, avoid smoking and
alcohol, and take aspirin or paracetamol to your headache pain.

If these measures don’t work, consult your doctor. He may prescribe an antibiotic if an
infection is the causes of your sinusitis, or an antihistamine, if an allergy is the cause. Or
he may suggest nasal decongestant tablets, drops or sprays. If your condition persists,
draining may be indicated. This procedure, performed under a local anaesthetic,
involves creating a new passageway between the nose and the sinus, and either
irrigating the sinus or syringing out accumulated mucus with a vacuum device.

My son uses decongestants when his sinuses bother him. Is this a good idea?

It can be, but only if your son is using these decongestants in moderation and according
to his doctor’s recommendations. Limited use of decongestants, whether swallowed,
inhaled, sprayed or as nose drops, can help to shrink swollen nasal membranes and
provide temporary relief from sinus problems. Using decongestants too frequently,
however, may cause the nasal passages to bacome even more congested. Excessive use
may also cause postnasal drip (see p.319)