Q & A

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I have had Parotitis (mumps) for almost a month. I have a huge lump on my left side of face/neck and it is extremely painful especially at night.

Question: I have had Parotitis (Mumps) for almost a month. I have a huge lump on my left side of face/neck and it is extremely painful especially at night. I have finished taking antibiotics for 10 days and the lump has not gotten any smaller. Is surgery the only thing left to do to get rid of the remaining parotid gland swelling?

Answer: Mumps is generally a childhood illness that causes swelling in salivary glands, especially the parotid gland (parotitis). It can occur at any age. Mumps is caused by the mumps virus and would not respond to antibiotics. Today, because of the mumps vaccine, it is unusual in the United States. Mumps generally is self limited and will last for a week to ten days. There are many other possible causes of parotid gland swelling (parotitis)- including other viral infections. Parotitis for a month unlikely to be uncomplicated mumps.

More common today than mumps are bacterial infections of the parotid gland. One can have swelling from bacterial infections of the parotid gland- from stones, blocking the drainage of the gland, as well as from a small abscess around an area of infection. Additionally, unfortunately, one can have tumors- most often benign, of the salivary gland that cause a persistent swelling in the gland.

It seems unlikely that you have mumps causing your persistent problem.

I would suggest an evaluation by an otolaryngologist- if you’re in the NY area, we would be happy to help you-

Robert Pincus MD

Asssociate Professor Otolaryngology

NY Medical College

NY Sinus Center

Q & A

Causes (And Treatments) For Your Baby’s Hoarse Voice

Unfortunately, even though infants don’t possess fully developed vocal skills, they’re not immune to the hoarseness and vocal problems that can plague adults. If you notice that your infant has a raspy voice, there are a number of simple causes and solutions for that hoarse baby voice.

Common Causes of Hoarse Baby Voice

Prolonged crying. Although all infants cry, some do so more frequently, especially when suffering from colic. Excessive crying can lead to swollen vocal cords and a raspy voice. Once infants rest their voices, the hoarseness can diminish. Many infants outgrow phases of heavy crying on their own.
Acid reflux. Gastroesophageal disease, or acid reflux, is common in babies, and severe or frequent attacks can lead to a raspy voice. Although the condition occurs in many infants, it’s important to visit a doctor if you suspect acid reflux in your infant; the child’s eating and sleeping patterns also can be disrupted. Diet changes and medication often offer relief.
Vocal cord nodules. When the voice is used excessively, including from long crying spells, callous-like nodules can grow on the vocal cords and prevent them from functioning effectively. Vocal rest is usually recommended for these nodules, meaning that treatment can be difficult in infants, who cannot directly comprehend medical instructions. Check with a doctor if hoarseness persists – though in this condition, many infants must outgrow their crying before finding ease.
Allergies. Symptoms of allergies, including post-nasal drip, can lead to vocal-cord irritation and swelling. Hoarseness and other complications can result, so it’s especially important to consult a doctor to determine the cause of any allergic reactions.

Any general illness – even a cold – can be linked to hoarseness if it means your infant is suffering from congestion and a post-nasal drip. The accompanying raspy voice and discomfort should both pass once the illness does.

If your infant is experiencing vocal trouble, including signs of hoarseness, then feel free to contact our office anytime for personalized advice.

Sources:

http://www.livestrong.com/article/244436-causes-of-hoarseness-in-infants/

http://heartburn.about.com/od/infantschildrenandreflux/a/refluxininfants.htm

Q & A

Revision Sinus Surgery – Is It Necessary?

Choosing to have sinus surgery can be a difficult decision. Despite all of the advances in medical technology, there will still be some pain and swelling. Plus, getting surgery is just plain scary…we understand that. What can be even more disheartening, however, is having sinus surgery and still suffering repeated bouts of sinusitis. The good news is, in most cases, revision surgery isn’t necessary.

As mentioned in a previous blog post (link), the post-surgery recurrent congestion or pain could be due to:

Allergies
Nasal polyps
Acid reflux
Headaches
Immuno-deficiencies

Treating these underlying conditions may clear the congestion and the pain, without the need for revision sinus surgery.

In some cases, however, an additional revision sinus surgery may be necessary. The goal of sinus surgery is generally to enlarge the natural ostium, or opening, of the sinus. If a surgeon misses the natural opening by so much as a millimeter, he or she will make an opening in the wrong place in the sinus. In these cases, the patient may have problems with the mucus recirculating—going out of one opening, and coming right back in the other opening.

In these situations, additional surgery may be required. Fortunately, this revision surgery should be much simpler than the original surgery, as it entails solely shaving down the tiny bridge of tissue that separates the openings. This is typically extremely straightforward, and can sometimes be done as an office procedure.

Revision surgery is one of our specialties. If you have any questions about it, please contact us today. You can breathe easier, and we can help.

Q & A

How To Treat Puffy Eyes From Sinusitis

Congestion, a sore throat and a headache might plague you when you’re fighting a sinus infection. But your appearance can reveal your health problems, too. Puffy, swollen eyes can accompany sinusitis – and when you’re trying to fight the impression that you’ve been crying all night, there are a few simple swollen eye treatment remedies to get your eyes back in shape.

Swelling from Sinusitis

Why does a sinus infection lead to eye swelling? The sinuses, positioned just beneath the eyes, become inflamed and infected during a sinusitis attack. As a result, you might notice extra pressure and puffiness in the eye area.

When you’re fighting sinus-related eye swelling, consider these swollen eye treatment for relief.

Take a decongestant. An over-the-counter medication can fight mucus buildup in the sinuses – and help reduce eye puffiness in the process.
Drink extra water. Staying properly hydrated can prevent your body from hording extra liquids in all the wrong places.
Try a simple massage. With your eyes closed, gently move your ring finger in a half-circle from the inside to outside corner of your eye area. Complete the motion 10 to 15 times and repeat on the other side.
Turn to tea bags. Steep two tea bags in hot water for about five minutes, then let the bags cool until they’re comfortable to touch. While lying down with your eyes closed, place one tea bag over each eye area, and lay a soft cloth on top. Black or green tea can help constrict blood vessels, and herbal teas can sooth inflammation and redness. Take your pick!

Whether you’re fighting eye swelling or another symptom of sinusitis, a doctor’s help can make your trouble seem more bearable. Especially when sinusitis becomes a chronic problem, longer-term medical solutions can help you cope.

For a consultation or advice specific to your symptoms, please contact us anytime. And as always, check with a doctor to be sure these (and any) at-home solutions are right for you.

Q & A

My Nose Has Been Congested For 6 Months

Question:
I have been congested (stuffy nose) for over 6 months now. At first I thought I was getting a cold but when my cold meds weren’t working, I figured it was just allergies. After trying Claritin, nasal sprays, and the neti pot, I was realized nothing was working. My doctor also suggested that it was allergies, but I know that it is something more than that. I have chronic congestion, and it is keeping me awake at night, and its taking a toll on my life! I’ve tried online research but am not having any luck. Can you plase suggest some chronic congestion relief?

Answer:
Thanks for your note- It seems unlikely that your symptoms are from allergies, alone. Usually with allergies, a patient will have at least temporary relief of congestion with antihistamines. We certainly are proponents of using a neti pot- but if your congestion is persisting for 6 months, you should have a more thorough evaluation than your primary care physician can offer. Your chronic congestion may well be a sign of a low grade sinus infection, nasal polyps or other treatable problem. Sometimes, medications taken for other problems can cause nasal congestion as a side effect.

I would suggest that you have a thorough ENT evaluation which includes a complete history, but also looking at your nasal airway with a lighted telescope. This is an office procedure which will allow a doctor to find the cause of your problem and a treatment specifically for chronic congestion relief.

Robert Pincus MD
Co-director NY Sinus Center

Q & A

Atrophic Rhinitis

Question:
I live in Denver, CO which is very dry, and I have had chronic colds since last November. I was recently diagnosed with atrophic rhinitis. My allergist recommended a daily Atrophic Rhinitis treatment of a sinus wash daily (NeilMed or a neti pot). He also wants me to swab my sinuses with olive oil twice a day. My doctor didn’t seem alarmed by what I have, but I researched this disease on the Internet and it seems more serious than he made it out to be. My doctor told me that if I follow these directives, I shouldn’t have as many colds next winter. He never recommended an antibiotic or antibiotic ointment. What do you think?

Answer:
Atrophic rhinitis can be quite a problem and can vary greatly in its severity- from a little dryness, to foul smelling crusting and infection. It can be caused by chronic infection or chronic irritation, aggressive surgery or at times we don’t know the cause. The nose works as a filter. The mucous in the nose traps particles- including bacteria, viruses, allergens and others and pushes them down into the stomach where stomach acid can destroy them. The nose also is a humidifier and temperature regulator. By the time inhaled air reaches the back of the throat, it is both 100 per cent humidified and brought to body temperature. With atrophic rhinitis, one or all of these functions are reduced or eliminated.

First, one should try to find the cause of the problem. Unusual infections such as rhinoscleroma, or inflammations such as sarcoidosis can be treated. Symptomatic treatment for atrophic rhinitis aims at replacing or reinforcing the lost functions. Hypertonic saline (extra-salty) nasal rinses are aimed at helping the nose clean itself of the particles discussed above. Topical application of ointment once or twice a day to the anterior part of the nose will help trap particles and moisturize the nasal cavity. Theoretically, these should be water soluble- such as rhinaris nasal gel- but others such as petroleum based triple antibiotic ointments like bacitracin have been used. A room humidifier, kept clean, will help in the heating months.

When there is an infection, we use appropriate antibiotics as an Atrophic Rhinitis treatment, preferably based on culture. For brief periods one may need oral antibiotics, but generally we rely on antibiotic ointments- such as bactroban, or appropriate antibiotic washes- I don’t recommend continuing on antibiotics topically or using oral antibiotics persistently without another indication. It may lead to getting infections that are resistant to antibiotics.

Robert L. Pincus MD

NY Sinus Center

Q & A

Is Post Nasal Drip Curable?

Question: Is there a post nasal drip cure? Can you get antibiotics for it? Aside from sinus infections, what are the other causes for it?

Answer:

The short answer is yes, post nasal drip is curable once one finds the cause. Post nasal drip is one of the more common symptoms people complain about to their Ear Nose and Throat doctor. Much of the time doctors consider this a diagnosis. It is not a diagnosis, but a symptom with many causes. The actual post nasal drip cure starts with understanding the sinuses and the causes of post nasal drip.

We make mucous in the nose and sinus cavities, about a quart a day. It serves as a lubricant, think motor oil, that traps particles in the nose- dust, virus, contaminants, bacteria- and is swept back by cilia into the back of the nose and then down the throat into the stomach. The stomach acid then destroys or inactivates these contaminants. The mucous is usually a thin lubricating layer.

However, sometimes we make the wrong consistency of mucous- think thick old motor oil- and there are multiple causes that should be able to be diagnosed by your ENT or sinus doctor.

One of the more common causes of post nasal drip is gastric reflux. If acid comes up as high as the nose or throat, the membranes make extra mucous, trying to delicate nasal lining tissues from the acid. Patients often feel the need to clear the throat with this.

A sinus infection can cause post nasal drip. In this case the examiner can see pus coming out of the sinus openings, being swept down the throat.

Allergies can cause post nasal drip by making “the wrong kind of mucous”. Typically with allergic nasal conditions one may make excess watery- or at other times overly thick- mucous that one feels in the throat.

Mucous can become thick from drying and cause a post nasal drip. This can occur with dry air- such as heated air in cold weather or often from drying medication such as a diuretic (water pill).

Any individual can have one or more of these problems simultaneously. Appropriate treatment, when aimed at the cause or causes, should be able to help alleviate your post nasal drip.

Robert Pincus MD
NY Sinus Center

ENT Doctor Archives - Page 5 of 5 - The New York Otolaryngology Group

I have had Parotitis (mumps) for almost a month. I have a huge lump on my left side of face/neck and it is extremely painful especially at night.

Causes (And Treatments) For Your Baby’s Hoarse Voice

Common Causes of Hoarse Baby Voice

Revision Sinus Surgery – Is It Necessary?

How To Treat Puffy Eyes From Sinusitis

Swelling from Sinusitis

My Nose Has Been Congested For 6 Months

Atrophic Rhinitis

Is Post Nasal Drip Curable?