Ear Pain. Only 50% of ear
pain comes from the ears. If
treated with multiple antibiotics and the eardrum is normal, look for other
causes such as TMJ pain or maxillary sinusitis.
Swimmer's ear or external otitis is often caused by pseudomonas. In the child, open the canal with a pope ear wick and use
ear drops. Do the same in the adult
but you may also want to use Cipro.
Itching ears are often caused by a fungus.
Lotrimin or Tinactin solution can be of help.
I prescribe it four drops four times a day for two weeks.
Ear pressure may be referred from the sinuses or nose much like an ice
cream headache. Ear fluid is
seldom present if the patient does not complain of hearing loss.
If pus is draining out of the external canal, always treat with oral
antibiotics AND ear drops. If an
ear tube is present 33% of these infections are pseudomonas, thus, ear drops are
Dizziness from the
Vertigois the sensation of motion, sometimes spinning.
Light-headedness is usually not from
Ear fluid rarely causes dizziness.
New advances in digital hearing aids are helping many patients with
sensorineural hearing loss.
If a patient has chronic nasal and facial complaints, obtain sinus films
they may show a sinusitis.
Severe and chronic headaches are usually not caused by sinusitis, a sinus
CT scan can rule out sinusitis as a cause.
Maxillary mucus retention cysts are common and most do not need
Do not use decongestants in patients with high blood pressure, especially
if on Beta Blockers.
Follow patients on nasal steroids to diagnosis mucosal atrophy early and
prevent a septal perforation.
The most common cause of hoarseness in the non-smoker is gastroesophageal
reflux, even if no heartburn symptoms are present.
The most common cause of food sticking in the lower throat is
gastroesophageal reflux, even if no heartburn symptoms are present
Persistent hoarseness needs a laryngeal exam to rule out a throat cancer
and other disorders.