March, 2017

What is Vertigo? What can cause it?

Posted in Uncategorized on March 28th, 2017 with No Comments

Feeling dizzy is a very common complaint in medicine. Dizziness can be described in several ways, including being lightheaded, unsteady, or woozy. On some occasions, patients will experience a specific type of dizziness called vertigo. Vertigo is the sensation of whirling, often described as a “room spinning ” feeling. Unlike most types of dizziness, vertigo is typically caused by disorders of the inner ear (labyrinth). Three of the most common causes of vertigo include BPPV, Meniere’s Disease, and Labyrinthitis.

BPPV, or benign paroxysmal positional vertigo, is characterized by acute vertigo lasting approximately 30 seconds. Episodes are triggered by positional changes of the head, such as rolling over in bed, looking up, or stooping over. BPPV is thought to be caused by loose particles (otoliths) in the inner ear. It can be identified by an easy in-office test called the Dix-Hallpike test. In most cases, the patient’s dizziness improves when keeping the head steady. If the dizziness persists, at-home exercises called the Brandt-Daroff exercises can be performed which often improves the condition. Sometimes a patient will require a repositioning maneuver known as an Epley procedure to help resolve the positional vertigo.

Labyrinthitis is another common cause of acute vertigo. Unlike BPPV, patients with labyrinthitis experience constant vertigo, lasting several hours, sometimes days. Associated symptoms may include nausea, vomiting, headaches, hearing loss, and ringing in the ears. Symptoms begin acutely and gradually improve. Sometimes patients will experience residual symptoms lasting up to a month before completely resolving. Labyrinthitis is caused by inflammation of the vestibular nerve, thought to be caused by a viral infection. It is not uncommon for patients to experience labyrinthitis in the setting of an upper respiratory tract infection or cold. Although there are no definitive cures for labyrinthitis, certain medications such as Meclizine can be provided that help calm the vestibular system of the inner ear. If symptoms persist after an extended period of time, physical therapy can also be performed.

Patients with Meniere’s Disease experience episodic vertigo – lasting minutes to hours, ringing in the ears, and fluctuating hearing loss. Although the cause of Meniere’s Disease is not well understood, it is thought to be related to a fluid imbalance in the inner ear(endolymph) . Meniere’s Disease can sometimes become a chronic condition , and may affect a patient for many years after onset. Coping with Meniere’s can be challenging, as attacks are unpredictable. In many cases, first line treatments such as a low-salt diet and a diuretic can be helpful to control or eliminate symptoms.

If you are experiencing symptoms of vertigo, it is helpful to be seen by an Ear Nose and Throat specialist (Otolaryngologist) to rule out inner ear disorders. During the visit, your physician may recommend obtaining a comprehensive audiogram (hearing test). Many conditions associated with vertigo are also associated with hearing loss. In certain circumstances, your physician may also recommend obtaining a specialized balance test called an electronystagmography (ENG). ENGs can be performed in the office and measure the normal eye movement and involuntary eye movement (nystagmus) following exposure to various stimuli. The test can be helpful for identifying the potential cause of a patient’s vertigo/dizziness.

If you or family members have concerns regarding dizziness, please do not hesitate to contact Colden and Seymour Ear, Nose, Throat, and Allergy to set up an appointment. Opinions expressed here are those of Daryl Colden, MD, FACS, and Christopher Jayne, BA. These opinions are not a substitute for a medical evaluation performed by a medical provider.

It is Head and Neck Cancer Awareness Month

Posted in Uncategorized on March 2nd, 2017 with No Comments
Head and neck cancers usually begin in the cells that line the moist, mucosal surfaces inside the head and neck. These surfaces include the mouth, the nose, and the throat, although can include other structures like the salivary glands, thyroid gland, lymph nodes, and skin. Head and neck cancers account for approximately 3% of cancers in the U.S. each year. Risk factors for head and neck cancer include: History of smoking or excessive alcohol use. Smoking cigarettes, cigars, or pipes; chewing tobacco are the largest risk factors for head and neck cancer. Roughly 85% of head and neck cancers are linked to tobacco use. Individuals who drink two alcoholic beverages per day increase their risk twenty times. A newly recognized risk factor is exposure to Human Papilloma Virus (HPV). HPV, which is sexually transmitted, has been linked with the development of head and neck cancers particularly in the tonsil region and base of tongue. This same virus is also a causative factor in certain types of cervical cancer in women . Signs and symptoms of Head & Neck Cancer MAY include a sore in the mouth or throat that does not heal, persistent pain, red or white patches in the mouth, changes in voice, pain around teeth as well as loosening of teeth. Other common symptoms include trouble swallowing or abnormal bleeding. It is not unusual for these types of cancer to present as a painless lump in the neck or throat. Symptoms tend to differ depending on location and advanced stage of disease. If a patient has any of these symptoms or perhaps has identified risk factors, you should consider an evaluation with a trained medical professional .Evaluation often includes a thorough evaluation in the office of an Ear Nose Throat Specialist, imaging (CT or MRI), lab testing, and biopsy .Early detection of these cancers can lead to a high cure rate for many patients. Treatment options for patients with head and cancer will vary, and depend on many factors, such as the disease location, cancer type, size, and any local spread to lymph nodes or more distant spread to other body regions such as the lung. All our Head and Neck Cancer patients are first evaluated in our multi-disciplinary cancer center affiliated with Beth Israel and Dana Farber so that patients have the most up to date and comprehensive testing and treatment available. Many head and neck cancers that are diagnosed early and are localized to a specific area may be treated with surgery and/or radiation therapy. For cancers that are larger or have spread to other regions, chemotherapy may be used in combination with other treatment options . If you, a family member, or friend have any concerning signs or symptoms in the head & neck, please contact our office for an appointment.
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