ear

Description

Sound is a form of energy that moves through air, water, and other matter, in waves of  pressure. Sound is the means of auditory communication. The ear changes sound pressure waves from the outside world into a signal of nerve impulses sent to the brain.

Although the ear is the vertebrate sense organ that recognizes sound, it is the brain and central nervous system that "hears".

The ear consists of three basic parts

-    The outer ear.

-    The middle ear .

-    The inner ear.

Each part of the ear serves a specific purpose in the task of detecting and interpreting sound.
The outer ear serves to collect and channel sound to the middle ear. That sound pressure is amplified through the middle portion which serves to transform these vibrations into a compressed wave in the inner ear. The inner ear serves to transform the energy of a compressed wave within the inner ear fluid into nerve impulses that can be transmitted to the brain.

The outer ear consists of an earflap and an approximately 2-cm long ear canal. The earflap provides protection for the middle ear in order to prevent damage to the eardrum. Because of the length of the ear canal, it is capable of amplifying sounds with frequencies of approximately 3000 Hz. the sound is still in the form of a pressure wave, with an alternating pattern of high and low pressure regions.

The middle ear is an air-filled cavity that consists of an eardrum and three tiny, interconnected bones - the hammer, anvil, and stirrup. The eardrum is a very durable and tightly stretched membrane that vibrates as the incoming pressure waves reach it. ( the energy of the mechanical wave becomes converted into vibrations of the inner bone structure of the ear).

The inner ear is hollow, embedded in the temporal bone, the densest bone of the body. It consists of a cochlea, the semicircular canals, and the auditory nerve. The cochlea and the semicircular canals are filled with a water-like fluid. The cochlea is a snail-shaped organ that would stretch to approximately 3 cm. In addition to being filled with fluid, the inner surface of the cochlea is lined with over 20 000 hair-like nerve cells that perform one of the most critical roles in our ability to hear.  The microscopic "hairs" of these cells are structural protein filaments that project out into the fluid. The hair cells are mechanoreceptors that release a chemical neurotransmitter when stimulated. Sound waves moving through fluid push the filaments; if the filaments bend over enough it causes the hair cells to fire. In this way sound waves are transformed into nerve impulses.
Each hair cell has a natural sensitivity to a particular frequency of vibration. When the frequency of the compressional wave matches the natural frequency of the nerve cell, that nerve cell will resonate with a larger amplitude of vibration. This increased vibrational amplitude induces the cell to release an electrical impulse that passes along the auditory nerve towards the brain.

sinuses

Description

Sinuses  are referred to those hollow , air-filled cavities that are in the skull and connected to the nasal airway by a narrow hole in the bone (ostium). 

 Humans have four pair of these cavities which are often described as a unit and termed the "paranasal sinuses" .

These  four pair of sinuses are  named according to the bones within which the sinuses lie:

1. frontal sinus (in forehead) in the frontal bone .
2. maxillary sinus (behind cheeks) 

         also called the maxillary antra .It's the largest of the paranasal sinuses,  in the  maxillary bones,.

    3. ethmoid sinus (between the eyes) formed from several discrete air cells within the ethmoid bone.

    4. sphenoid sinus (deep behind the ethmoids) in the sphenoid bone at the center of the skull base under the pituitary gland.

The paranasal air sinuses are lined with mucus-secreting cells, epithelial cells and some cells that are part of the immune system (macrophages, lymphocytes, and eosinophils).


Functions of the sinuses

• Decreasing the relative weight of the front of the skull, and especially the bones of the face.
• Increasing resonance of the voice.
• Providing a buffer againt facial trauma.
• Insulation of sensitive structures like dental roots , nerves and eyes from rapid temperature fluctuations in the nasal cavity.
• Humidifying and heating of inhaled air because of slow air turnover in this region.

 Sinusitis

It's the inflammation of one or more of the paranasal sinuses and nasal passages.
 This is may be due to :
.  A pathogenic organism (virus, bacterium, or a fungus) grows within a sinus .
The sinuses contain defenses against foreign bacteria (germs). If a disruption occurs that affects the normal host defenses inside the sinuses, those defenses may allow bacteria, which are normally present in the nasal passages, to enter any of the sinuses. Once there, the bacteria may stick to the lining cells and cause a sinus infection.
.  Allergy and irritation of the sinuses such as with hay fever.
.  Irritants, such as chemicals .
. The use and/or abuse of over-the-counter (OTC) nasal sprays.
.  Illegal substances that may be snorted through the nose.

these factors cause intermittent blockage of the sinus ostium (a small orifices joined to the nasal cavity).
 If this happens, normal drainage of mucus within the sinuses is disrupted. Drainage of mucus and pus often occur when the blockage is relieved. The drainage usually goes from the nasal passages to the throat or out the nostrils.


Symptoms of sinusitis

      .   headache.
     .   facial tenderness.
     .   pressure or pain in the eyes, nose, cheek area, or on one side of the head.
     .    fever (25% of patients may have fever associated with acute sinus infection).

• cloudy, discolored , thick nasal drainage .
  .
• a feeling of nasal stuffiness
• sore throat
• cough.

Some people notice an increased sensitivity or headache when they lean forward because of the additional pressure placed on the sinuses. Others may experience tooth or ear pain, fatigue, or bad breath.

 In noninfectious sinusitis, other associated allergy symptoms of itching eyes and sneezing may be common. Nasal drainage is usually clear or whitish-colored in people with noninfectious sinusitis.


 Sinusitis is categorized as :

1. Acute sinusitis  (sudden onset) usually lasts less than 8 weeks or occurs no more than 3 times per year with each episode lasting no longer than 10 days. Medications are usually effective against acute sinusitis. Successful treatment counteracts damage done to the mucous lining of the sinuses and surrounding bone of the skull.

2. Chronic sinusitis (long term, the most common type) lasts longer than 8 weeks or occurs more than 4 times per year with symptoms usually lasting more than 20 days.



Treatment of sinusitis

.   For sinusitis caused by virus infection, no antibiotic treatment is required.
.   For sinusitis caused by bacterial infection ,Antibiotics are not helpful for patients with mild-to-moderate symptoms, so they should not be prescribed for at least the first 7 days.

 If the symptoms lasts for more than 7 days amoxicillin-clavulanate (Augmentin) is the first-line drug for treatment of a suspected bacterial sinus infection .
-(The five most common bacteria causing sinus infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Streptococcus pyogenes).
-In the penicillin allergic individual, cefaclor (Ceclor), loracarbef (Lorabid), clarithromycin (Biaxin), azithromycin (Zithromax), sulfamethoxazole (Gantanol), trimethoprim (Bactrim, Septra).
An effective antibiotic needs to be continued for a minimum of 10-14 days.

.   Saline nasal irrigation is often needed on an ongoing basis.

.  Decongestants as  pseudoephedrine.

.  Mucolytics as guaifenesin and  expectorants.

.   Antihistamines should be avoided unless it is felt that the sinusitis sinus infection is due to allergy, such as  from pollens, dander, or other environmental causes.

.  Topical nasal steroid spray  such as prednisone will help reduce swelling in the allergic individual without the drying that is caused by using antihistamines although both are occasionally used.

In many people, allergic sinusitis develops first, and later, bacterial infection occurs. For these individuals, early treatment of allergic sinusitis may prevent development of secondary bacterial sinusitis.

If the condition dramatically improves after 1 - 2 months, antibiotics are stopped. The patient should continue with both the steroid and saline nasal solutions. If there is no improvement after this time, surgery may be considered. For some people with chronic sinusitis, however, the condition is not curable, and the goal of treatment is to improve the quality of life.

 Home remedies

.  Drinking plenty of fluids and getting lots of rest when needed is still the best bit of advice to ease the discomforts of the common cold. Water is the best fluid and helps lubricate the mucus membranes.

·  Chicken soup does, indeed, help congestion and ache.  The studies have reported that , the ingredients in the soup may have anti-inflammatory effects. In fact, any hot beverage may have similar soothing effects from steam.

·  Ginger tea, fruit juice, and hot tea with honey and lemon may all be helpful.

·  Spicy foods that contain hot peppers or horseradish may help clear sinuses.

·  Inhaling steam 2 - 4 times a day is extremely helpful. 

 The patient should sit comfortably and lean over a bowl of boiling hot water (no one should ever inhale steam from water as it boils) while covering the head and the bowl with a towel so the steam remains under the cloth. The steam should be inhaled continuously for 10 minutes. A mentholated or other aromatic preparation may be added to the water. Long, steamy showers, vaporizers, and facial saunas are alternatives.

Rhinitis

Rhinitis  ( Nasal allergy)

An allergy is a hypersensitivity to a foreign substance that is usually harmless but produces a violent reaction in the allergy sufferer. Allergies are generally the body's effort to eliminate something it considers unsuitable.

Allergens are some of the most common allergens include pollens, dust, dust mites, fungi, bacteria, insects, mold spores, and animal dander.

Rhinitis is a chronic or acute inflammation of the mucous membrane of the nose due to viruses, bacteria or irritants. The inflammation results in the generating of excessive amounts of mucus, commonly producing the aforementioned runny nose, as well as nasal congestion and post-nasal drip.

Types of rhinitis

1. Allergic rhinitis

Allergic rhinitis is a collection of symptoms, mostly in the nose and eyes, which occur when you breathe in something you are allergic to, such as dust, dander, or pollen.

This article focuses on allergic rhinitis due to outdoor triggers, such as plant pollen. This type of allergic rhinitis is commonly called hay fever.

Causes

Hay fever involves an allergic reaction to pollen. (A similar reaction occurs with allergy to mold, animal dander, dust, and similar inhaled allergens.)

The pollens that cause hay fever vary from person to person and from region to region. Tiny, hard to see pollens more often cause hay fever. Examples of plants commonly responsible for hay fever include:

• Trees (deciduous and evergreen)
• Grasses
• Ragweed

The amount of pollen in the air can play a role in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.


Symptoms

In many ways, the symptoms of allergic rhinitis (which is another name for nasal allergies) are close to those of the common cold. However, a cold usually goes away after a few days, while allergy symptoms do not. They may last for days or weeks at a time, or may even persist year-round, depending on what your allergy triggers are.

Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:

• Itchy nose, mouth, eyes, throat, skin, or any area
• Problems with smell
• Runny nose
• Sneezing
• Tearing eyes
• A hallmark sign of nasal allergies in children is what is known as the "allergic salute" This occurs when children push up on their noses with the palm of their hand in order to stop the itching or sniffles.

Symptoms that may develop later include:

• Stuffy nose (nasal congestion)
• Coughing
• Clogged ears and decreased sense of smell
• Sore throat
• Dark circles under the eyes"shiners"
• Puffiness under the eyes
• Fatigue and irritability
• Headache
• Memory problems and slowed thinking

 Nasal allergy weakens the immune system in the nasal passage because of continuous releasing of mucus and sneezing. Mucus is the defender of the nasal organ. Continuous sneezing could injure the nasal tissue and cause it becomes easily infected by bacteria or viruses. Infection of the bacteria causes the sinusitis; whereas, infection of viruses causes flu. That why, nasal allergy patients easily catch flu and have sinusitis.

Treatment

-The best treatment is to avoid what causes your allergic symptoms in the first place.
-For mild allergic rhinitis , a nasal wash can be helpful for removing mucus from the nose You can purchase a saline solution at a drug store or make one at home using one cup of warm water , half a teaspoon of salt , and pinch of baking soda.

Treatments for allergic rhinitis include:

1. ANTIHISTAMINES
. Antihistamines work well for treating allergy symptoms , especially when symptoms do not happen very often or do not last very long.

.  Antihistamines taken by mouth can relieve mild to moderate symptoms, but many can cause sleepiness.   
 Some may be bought over the counter, without a prescription. Talk to your doctor before giving these medicines to a child, as they may affect learning.

.  Newer antihistamines cause little or no sleepiness. Some are available over the counter. They usually do not interfere with learning. These medications include loratidine (Claritin) and cetirizine (Zyrtec). Other antihistamines are available by prescription.

.  Azelastine (Astelin) is a antihistamine nasal spray that is used to treat allergic rhinitis.

 

2. CORTICOSTEROIDS

. Nasal corticosteroids sprays are the most effective treatment for allergic rhinitis.
. They work best when used nonstop , but they can also be helpful when used for shorter periods of time.
. Many brands are available. You will need a prescription from your doctor. They are safe for children and adults.

3. DECONGESTANTS

. Decongestants may also be helpful in reducing symptoms such as nasal congestion.
. Nasal spray decongestants should not be used for more than 3 days.
. Be careful when using over-the-counter saline nasal sprays that contain benzalkonium chloride. These may actually worsen symptoms and cause infection.

 

4. OTHER TREATMENTS

 

. The leukotriene inhibitor Singulair is a prescription medicine approved to help control asthma and to help relieve the symptoms of seasonal allergies.
. Specific illnesses that are caused by allergies (such as asthma and eczema ) may require other treatments.

 

5. ALLERGY SHOTS

. Allergy shots (immunotherapy ) are occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control . This includes regular injections of the allergen , given in increasing doses (each dose is slightly larger than the previous dose ) that may help the body adjust to the antigen.

                           

 Inflammation caused by nasal allergy and/or viral infection leads to obstruction, fluid accumulation, bacterial infection, and acute disease. If these diseases are unsuccessfully treated, a chronic state of inflammation, obstruction, and infection develops that can cause mucosal damage and, ultimately, chronic disease.

The chronic state of immunophlogosis and hyperreactivity is followed by some important sequelae as sinusitis, which is significantly associated with allergic rhinitis even during childhood and otitis media with effusion, that affects about half of children suffering from nasal allergy. Moreover, an early treatment of rhinitis can prevent the progression to asthma.



                                        
                       

2. Vasomotor rhinitis

Vasomotor rhinitis is a nonallergic condition that involves a constant runny nose, sneezing, and nasal congestion.

Causes

Vasomotor rhinitis is not caused by an infection or allergy. The exact cause is unknown. Symptoms are triggered by something that irritates the nose, such as a dry atmosphere, air pollution, spicy foods, alcohol, strong emotions, or certain medications.      Given that there are only two types of rhinitis--vasomotor and allergic--one might think that it would be easy to make a concrete diagnosis either way. However, given the need for slightly different treatment regimens and the differences in the pathology of the two kinds of rhinitis, it's important to identify your type correctly.

   If you first develop your symptoms when you're young and you're male, you're statistically more likely to have allergic rhinitis. If, on the other hand, you first develop symptoms as an adult and you're female, you're statistically more apt to have the vasomotor variety.

Symptoms

• Runny nose
• Nasal congestion (stuffy nose)
• Sneezing
• Watery nasal drainage (rhinorrhea)

Treatment

The primary treatment is simply avoiding the things that trigger your symptoms.
In some cases, decongestants or a nasal spray containing an antihistamine may help. Corticosteroid nasal sprays may be useful for some forms of vasomotor rhinitis.

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      Nasal allergy symptoms are something people with allergic asthma often have in addition to asthma symptoms. The combination can negatively affect your quality of life. Not only that, but when allergy symptoms go uncontrolled, asthma may actually get worse as well.




Home Remedies for Nasal Allergy:

1.  Make a solution of boiled minced grape fruit and lemon and add to it some honey, and drink it 2-3 times a day. This helps in curing hay fever.

2.  To get relief  from nasal congestion boil some chamomile and inhale the fumes.

3.  Eat a well balanced diet, include a lot of protein, vitamin B and C, this will help you strengthen your immune system.

4.  Ginger and garlic are among the best immunity builder so add them in your daily diet.

5.  Green tea with honey and thyme tea with a dosage of not more than 1-2 cups also helps in curing the nasal allergy.

6.  Avoid smoking cigarette, perfumes and make your home smoke free.

7.  Do not let your pet enter your bedroom.

8.  Vegetable juices (made of spinach and cabbage) taken on a daily basis for at least 10 days proves very beneficial.

9.  Cover your mattress, pillows etc. with plastic to protect it from dust mites and wash your bed covers, curtains and pillow covers in hot water.

10.  Practicing yoga is another natural way of curing it as it involves deep breathing. More people have turned to yoga to cure a variety of illness.