Ask a Ear Nose Throat (ENT) Specialist: Dr Lynne Lim from Mount Elizabeth Orchard Hospital Singapore

dr. Lynne Lim replied 2 years ago

Dizziness can be due to many factors, not just the ear. So it is important that your mother seeks a clinic consult with the ENT doctor, as she needs to be examined in person. Possible reasons include middle or inner ear infections or fluid or nose infections which can be treated with medications. Dizziness could be due to medication, blood pressure, sugar levels, heart or stroke like problems too. Thus, if ear or nose condition is excluded after the consult, the ENT doctor needs to do other tests or refer your mother for further evaluation. Take care!

dr. Lynne Lim replied 2 years ago

Hi, ringing of the ears can be due to many factors. Amongst them, 30% to 50% are due to ear hearing, ear infection or imbalances in biochemistry, antibodies or vitamins in the blood system. Occasionally, there can also be growths pressing on the ear nerve or brain. Other common causes could be medications, thyroid, blood pressure problems. It is best to have your ENT doctor check it out as tinnitus, like giddiness, is not an easy problem to diagnose via teleconsult.

dr. Lynne Lim replied 2 years ago

Hi, the “wax” that is coming out of the ear may be sticky fluid or crusted ear discharge from infection sometimes. It is unusual to have wax coming out of the ear when he coughs. It will be good to let your family doctor or ENT doctor take a look to exclude a chronic middle ear infection too. If there really is wax coming out each time he coughs, there may be a lot of wax build up in the ear canal, and the doctor can help to remove the wax.

dr. Lynne Lim replied 2 years ago

Hi, ringing of the ears can be due to many factors. Amongst them, 30% to 50% are due to ear hearing, ear infection or imbalances in biochemistry, antibodies or vitamins in the blood system. Occasionally, there can also be growths pressing on the ear nerve or brain. Other common causes could be medications, thyroid, blood pressure problems. It is best to have your ENT doctor check it out as tinnitus, like giddiness, is not an easy problem to diagnose via teleconsult.

dr. Lynne Lim replied 2 years ago

Ringing or buzzing of the ears can be a result of many factors, and is thus challenging to manage. The most important would be to get an accurate diagnosis to exclude any worrying conditions first. Tinnitus could be due to ear problems, but it could also be due to deranged biochemistries, hormonal imbalances, medications, blood pressure, blood circulation, thyroid or autoimmune factors. After follow up with some hearing and ear pressure tests, blood tests and even radiology scans may be needed. If it is due to a ear problem, sometimes, dedicated tinnitus maskers or hearing aids may be needed. It is important to let your ENT see you in person to get a good diagnosis first. Tinnitus can be rehabilitated in many cases if there is a specific cause found.

dr. Lynne Lim replied 2 years ago

Hi, ringing of the ears can be due to many factors. Amongst them, 30% to 50% are due to ear hearing, ear infection or imbalances in biochemistry, antibodies or vitamins in the blood system. Occasionally, there can also be growths pressing on the ear nerve or brain. Other common causes could be medications, thyroid, blood pressure problems. It is best to have your ENT doctor check it out as tinnitus, like giddiness, is not an easy problem to diagnose via teleconsult.

dr. Lynne Lim replied 2 years ago

Mucus discharging from the nose and mouth may be due to infection, either bacteria or viral usually. If it is for a month already, it is important to see your ENT doctor so that the doctor can examine in person, take a swab to determine to offending organism that is causing the infection, and that will guide the correct medication and treatment. Sometimes, your doctor may need to do a nose scope to see if there is polyps or sinusitis problem. If there is a cough for a month, a chest xray may be needed. If it is not an infection, it may be due to allergies which can lead to increased production of mucus from the nose that backdrips into the throat too. Please see your doctor, a family doctor if there is no ENT doctor available to you.

dr. Lynne Lim replied 2 years ago

Hi, there can be many causes of hoarseness of the voice. Your condition warrants a consult with your ENT doctor. Your ENT doctor can visualise the voice box vocal cords well with a simple in clinic flexible nasopharyngoscopy. It is painless. Sometimes, the voice cords are not moving well due to previous infections, injury or nerve damage. Sometimes, there are nodules or polyps on the voice cords that prevent the cords from closing fully. Rarely, but important to exclude, are cancers of the voice cord. It is very important to see your ENT first as the medication or treatment will be different depending on what the diagnosis is. Please do not delay as it has been for 3 years already.

dr. Lynne Lim replied 2 years ago

Itchy ears can usually be due to low grade chronic fungal infection, bacteria infection, trauma to ear canals from repeated digging of the ear, allergy related conditions. Depending on the diagnosis after seeing your doctor, the doctor can clean out the ear, then prescribe ear drops or cream to treat the inflammation. Sometimes allergy tests are carried out. Do not dig your ears.

dr. Lynne Lim replied 2 years ago

When there are a few symptoms occurring together like ringing of ears, fullness of ears, and ear pain, you need to see your family doctor or ENT doctor. The common reasons are ear infection of the ear canal or middle ear, which can be treated by cleaning of the ear by the doctor, and correct antibiotics, antifungal or anti-inflammatory medications. Do not continue digging your ears yourself or putting your own over the counter medication drops. Sometimes, the problem can be due to an inner ear problem, which would require a hearing test to help with diagnosis. Blood tests may be needed to exclude blood conditions that can contribute ot the fullness and ear ringing. There may be a hearing loss which has been missed, and in some cases, an MRI scan of the brain may also be needed if the problem persists and no cause is found.

dr. Lynne Lim replied 2 years ago

Dear Sir, you may want to seek a 2nd opinion from another ENT, to see if surgery is needed. You should also ask the doctor to explain to you fully what is the exact problem and what the "something" that is being reduced is. There are many structures in the nose that can be blocking the nose. For example, turbinate tissues, polyps, nose bone deviation, tumors. So it is important you find out first what is the "something", and ask what would happen if you leave it alone and what are the risks if you go for surgery. Bring your family members there so they can help you make a good decision.

dr. Lynne Lim replied 2 years ago

If your headache is due to sinusitis, your doctor will usually prescribe oral anthistamine medication, together with a steroid nasal spray. In very acute painful stages, your doctor may add oral or topical nasal decongestant medications, and even steroid tablets sometimes. If the symptoms persist, a nose swab is needed to see what the pathogen causing the sinusitis is, so that the correct antibiotics can be used. The doctor will also do a nose scope to exclude polyps and growths and see if the nose anatomy is normal. Sometimes, a CT scan is needed to determine next steps of treatment.

dr. Lynne Lim replied 2 years ago

Hi, it is important that you see a respiratory doctor in person, so that the doctor can check your lungs to see if there is lung infection. You may also need a chest X Ray, culture of the sputum and blood tests. You should not continue to self-medicate or use over the counter medication.

dr. Lynne Lim replied 2 years ago

If you have nose bleeds for a while now, with or without coughing, you must go and see your ENT doctor. Sometimes, a nose or sinus infection can have blood stained mucus or sputum. However, there can be more serious causes like abnormal blood vessels, ulcers, polyps, and benign or cancerous tumors that cause bleeding.

dr. Lynne Lim replied 2 years ago

Hi, your symptoms may be due to vasomotor rhinitis, where the nose and sinuses react to changes of humidity or temperature with runny and blocked nose. You may also have allergic rhino sinusitis, where you are allergic to allergens that are in the air in the room. For example, in bedrooms, there are house dust mite, cockroach, mould allergens. Or some homes have pet dander, grass or tree pollens. In such situations, the mucosa lining in the nose and sinuses swell and become congested, and this can cause headache. You should go to your doctor to have your nose examined. In certain cases, a flexible nasoendoscopy is needed at the ENT, to exclude anatomical problems like deviated nose septum and nose polyps. Allergy testing can also be done. Steroid nose sprays and antihistamine medications may help in simple cases.

dr. Lynne Lim replied 2 years ago

You may be digging your ears too much, such that there is a low grade infection in the ear canal, or the superficial layer of the skin in the ear canal is abraded or scrapped off. This results in loss of protective wax or oil in the ear canal, and increases the chance of infection. The more your dig your ears or put ear drops in your ear, the higher the risk of irritating the normal skin lining in the ear. Stop digging your ears. The ear wax do not usually result in hearing loss, so do get a hearing test if there is still hearing loss after the wax is out and infection is cleared.

dr. Lynne Lim replied 2 years ago

If your throat hurts during this time of Covid19, you should see a doctor in person to see if it is a bacterial infection, a viral infection, or if there are related conditions like nose infection or nose block, or gastroesophageal reflux that can cause throat dryness. The doctor can then prescribe the correct treatment if simple lozenges do not work. It is important if your symptoms persist for more than 3 days to see the doctor.

dr. Lynne Lim replied 2 years ago

There may have been some irritation to the skin of the ear canal due to the cotton bud. There could be some infection, either bacteria or fungal in nature. You may need the doctor to prescribe some medication ear drops for you after he/ she examines you and clean out any debris. The itch can also be because you dig your ears too much, thus the skin of the ear canal is not healthy. Avoid digging your ears with cotton bud as it becomes a hard habit to break. Our ears are self cleaning usually.