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Swallowing Difficulty (Dysphagia): Causes, Warning Signs and When to See an ENT Specialist

  Swallowing Difficulty (Dysphagia): What Causes It and When Should You Be Concerned? Most people swallow hundreds of times every day without noticing. When swallowing becomes uncomfortable, difficult or feels abnormal, it can quickly affect eating, drinking and quality of life. Some patients describe food “sticking” in the throat, while others notice coughing during meals, discomfort swallowing tablets or a persistent sensation of tightness in the throat. The medical term for swallowing difficulty is dysphagia . Swallowing problems can range from mild irritation to more significant conditions requiring specialist investigation. This article explains common causes of dysphagia, symptoms to look out for and when to seek ENT assessment. What is dysphagia? Dysphagia means difficulty swallowing. It may involve problems with: Swallowing solids Swallowing liquids Initiating a swallow Sensation of food sticking Pain during swallowing Coughing or choking while eating Symptoms ...

Intratympanic Injections

 



Who will need intratympanic injections?

ENT specialists offer intratympanic injections as a part of treatment for Menier's disease, sudden hearing loss, autoimmune hearing loss or before a skull base inner ear surgery.



What does intratympanic injection mean?

In simple terms, it means that an ENT specialist is placing a medication in the middle ear with the help of a fine needle.


What happens on the day of the intratympanic injection procedure?

Before you leave for your appointment, have a painkiller medication. It would be best if you asked your family or a friend to drive you to the appointment. The doctor will go through the consent process and numb the ear canal with spray or cream when you arrive. Numbing medication is left in the ear canal for 30 to 45 minutes. Once the ear is numb, the cream and spray are cleaned, and a small needle is passed through the eardrum to inject medication in the middle ear space. The doctor will ask you to lie flat for 45min to one hour, allowing the medication to be absorbed into the inner ear.


What are the complications of intratympanic injections?


  • Ear pain is due to the buffer used in the steroid medication; it can sting when injected. It should only last for few minutes. It is advisable to have some painkillers before coming to your appointment.


  • Hearing loss: When the medication is injected into the middle ear, it can lead to muffled hearing for few days. Using gentamicin injections for Ménière's disease or skull base surgery can affect your hearing.


  • Hole in the eardrum: A hole in the drum made by a fine needle heals within few days. In a rare instance, it can lead to permanent perforation, which may need surgical repair.


  • Dizziness: Mild imbalance is usual after an injection. If you have injections before skull base surgery, this imbalance helps in post-op rehabilitation after a skull base surgery.


  • Ear infection and bleeding: these complications are exceedingly rare. While you have your treatment, you should avoid water getting into your ear by using a cotton ball with vaseline and an ear shower cap if you need to wash your hair.


How does an intra-tympanic steroid injection work?

The exact mechanism of action is not known. The medication injected into the middle ear helps in decreasing inner ear inflammation. There is strong evidence to suggest that intratympanic injections tend to work better in Meniere's patients in some cases.


Why did my Menière's disease not respond to intratympanic injections?

  • The patient has poorly defined Meniere's symptoms, associated vestibular migraine or bilateral Meniere's
  • The medication did not stay in the middle ear for a long time due to a wide eustachian tube and adhesions in it.
  • Vertigo due to a non-ear condition needing a review of diagnosis



 
Consultant ENT surgeon


Helping patients with specialist expertise and kindness



entsurgeonclinic@gmail.com

07494914140

Disclaimer: 
For general information only, 
always seek medical advice from your treating consultant



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