- Mr Vafa, first of all, we would like to know what are the causes and symptoms of ear infection?

- The ear consists of 3 parts: external, middle and internal. Depending on the anatomical structure of the ear, the causes and ways of spreading infection are different. So, an ear infection can spread in 5 ways:

• Through the external ear path (transmeatal route). The tympanic membrane, located between the outer and middle ear, acts as a boundary. When the integrity of the eardrum is compromised, the infection can spread from the outer ear to the middle ear because of the perforated eardrum.
• From the nasopharynx through the auditory tube (rhino-tubal pathway). The middle ear is connected to the nasopharynx through the Eustachian tube. In most cases, infection spreads to the ear through the nose. Causes of nasal origin include adenoids in children, inflammatory diseases of the paranasal sinuses (acute and chronic sinusitis), nasal polyps, curvature of the nasal septum, rhinitis, chronic tonsillitis and a number of other diseases.
• Through the infection in the blood (hematogenous way);
• Through an infection circulating in the lymph (lymphogenic way);
• Traumatically. Infection can spread to the ear during open and closed ear injuries and head injuries.

Doctor, what are the complications of nasal breathing difficulties?

• Anatomically, the nose consists of 3 parts: external nose, nasal cavity and additional pockets of the nose (paranasal pockets of sinuses). The nose and nasal accessory pockets are located at the beginning of the upper respiratory tract. Phylogenetically, the nose has 3 functions: breathing, smelling and protecting. Airflow entering the nasal cavity is divided into three directions: upper, middle and lower. Air entering the nasal cavity under pressure is delayed in the nasal cavity according to anatomical features. The air entering the nose is heated and moistened. Thus, the air, the composition of which is regulated, is directed from the nose to the pharynx and then to the larynx, trachea, bronchi and lungs. Difficulty in nasal breathing can cause a number of complications:

• Inflammatory diseases of the sinuses (sinusitis);
• Diseases of the nose and ears (rhinitis);
• Nasal polyposis;
• Throat diseases;
• Diseases of tonsils (tonsilitis);
• Diseases of the larynx, trachea and bronchi (laryngo-trachea-bronchitis);
• Disease of the auditory tube (eustachian, tubo-otitis);

When is adenoid surgery decided?

• Most people, by mistake, think that the adenoid is located in the nasal cavity. The pharyngeal tonsil (lll tonsil) or adenoid is located in the upper part of the pharynx, in the nasopharynx. Adenoid hypertrophy (growth) occurs in 4 degrees. Depending on the degree of growth, complications in the upper respiratory tract increase. Firstly, nasal breathing becomes difficult, but then complete obstruction is observed. The reason for this is the obstruction of the auditory tube opening to the nasopharynx by adenoid vegetation. Adenoid growth can cause inflammation of the ear, called acute otitis media in many cases. Adenoid vegetation disrupts nasal breathing and causes deformation of the teeth and jaw in school-age children, thus causing a violation of the bite. As the inflammatory process develops, it can cause complications such as chronic bronchitis in the internal organs. In adults, inflammatory diseases of the sinuses called sinusitis are observed. In the last century, adenoid was considered a disease-specific to children. Recently, adenoids have been observed in people over 30 and even 40 years old.

Adenoid vegetation of the 1st degree causes difficulty in nasal breathing and has a slight effect on other organs. The 2nd degree of adenoid growth, causes difficulty in nasal breathing and is more apparent at night. 3rd degree hypertrophy can cause difficulty breathing and other serious complications. As for 4th degree, nasal breathing is completely obstructed, and diseases are observed in the surrounding organs.

Thus, adenoid vegetation of the 1st and 2nd degrees is subject to conservative treatment. Grades 3 and 4 do not respond to conservative treatment and can only be treated surgically. The surgical treatment of adenoid vegetation is called an adenotomy operation.

What is the reason for frequent nosebleeds?

• In the front part of the septum of the nose, approximately 1 cm behind the entrance, there is a capsule called Kisselbach. In this case, the junction of 5 arteries is noted: the anterior clavicle, the posterior clavicle, the palatine-pharyngeal, the big palate and the upper lip arteries. The listed vessels are thin and superficially located under the mucous membrane and in 90% of cases, bleeding is observed right here.

There are several common causes of nosebleeds:

• Hypertension disease;
• A number of blood diseases;
• Diabetes;
• Chronic kidney failure;
• Pregnancy;
• Various nasal traumas;
• Angiopathy of capillaries;

What can cause the ear ringing (tinnitus)?

• The ear is the human organ of hearing and balance. All data is transmitted from this organ to the brain by the Vlll pair of nerves. There are two types of hearing impairment depending on the impairment of the apparatus that transmits or receives the sound. Conductive type – sound transmission and sensorineural is a pathology of the sound-receiving apparatus.

Starting from the inner ear and ending in the nuclei of the cerebral cortex, the hearing aid has a complex anatomical structure. Thus, the sound wave reaches the inner ear by moving the sound-conducting apparatus and the function of sound reception is involved in the process.

As a result of the disruption of this complex process, noise is formed in the ears, along with hearing loss. They are in the form of various sounds and are observed during a number of diseases. These ringing sounds are also found in diseases of the sound-transmitting and sound-receiving apparatus:

• Sensorineural hearing loss and deafness;
• Meniere’s disease;
• Otosclerosis;
• Adhesive otitis and tympanosclerosis;
• Exudative otitis;
• Acute otitis media;
• Earplugs

It is important to note that additional sounds are observed during other pathologies besides ear diseases. For instance, in hypertension, during osteochondrosis of the cervical vertebrae, benign and malignant diseases of the brain, after head injuries. The cause of tinnitus during the listed diseases is a violation of innervation and blood supply.