Common Ear, Nose and Throat Problems

There are several common ear, nose, and throat (ENT) problems. They range from ear infections and allergies to various cancers.

A primary care provider can diagnose many common ENT conditions, such as ear infections and strep throat. However, they will likely refer patients to ENT specialists for more complex conditions, such as those that require surgical intervention or cancer.

Common Ear Conditions

Several ENT conditions affect the ear. Some of the most common ones include:

• Middle ear infections
• Swimmer's ear
• Hearing loss
  

Middle Ear Infections

Ear infections are one of the most common ENT disorders. They occur when germs become trapped inside the middle ear.

The Eustachian tube, a tiny canal that originates in the ear and drains into the back of the throat, usually keeps unwanted germs out. If this tube is too small, swollen by swelling, or clogged by fluid and mucus, bacteria and other microbes can enter the ear and cause an infection.​

Symptoms: There are several signs and symptoms of an ear infection including:

• Pain and pressure
• Fever
• Loss of balance
• Difficulty hearing
• Nausea and vomiting
• Fluid discharge

Ear infections are more common in children than adults and most common in infants and toddlers. If a young child has an ear infection, you may see the child:

• Pulling or tugging on the ears
• Experiencing increased fussiness, especially at bedtime (the pressure change with laying down can cause pain)
• Not responding to their name (decreased hearing)
• Eating or drinking abnormally

Treatment: Not all ear infections require antibiotics. However, if you or your child has a fever and isn't getting better after a couple of days, a provider may prescribe oral antibiotics or antibiotic ear drops.

Over-the-counter pain relievers and decongestants can also help. Discuss safe dosing for kids with a healthcare provider.

Swimmer's Ear

Swimmer's ear is also known as otitis externa. It affects the skin of the outer ear and the skin inside of the ear canal.

Excess moisture in the ear canal is the main cause of swimmer's ear. The condition is most commonly associated with swimming and other activities that allow opportunities for water to enter the ear.

Children with injuries from improper ear cleaning, eczema, and seborrheic dermatitis may be more likely to develop the condition.

Symptoms: In mild cases, a child may complain about their ear itching or feeling full. A younger or nonverbal child may scratch or tug at their ear.

In severe cases, there is increased pain and pressure. You may see swelling of the ear canal and pus or drainage. A younger or nonverbal child may be fussy and irritable, hold their hand over their ear, and cry while chewing (the movement can feel painful).

Treatment: A healthcare provider may prescribe prescription ear drops to treat swimmer's ear. If the ear canal is too swollen for drops to be effective, a healthcare provider may place a wick in the ear canal. Rarely are prescription oral antibiotics needed to clear the infection.

Hearing Loss

There are several reasons an individual may experience hearing loss. In adults, hearing loss can be due to natural aging, earwax buildup, an ear infection, or more serious causes such as a stroke or brain tumor.

One of the most common causes of hearing loss in kids is fluid buildup in the middle ear from congestion due to a cold or ear infection. This type of hearing loss typically goes away once the illness resolves.

Other causes of hearing loss in kids include wax buildup, structural issues with the ear, or nerve damage.

Symptoms: Symptoms can vary widely depending on the cause of the hearing loss. An individual may not notice hearing loss, especially if it happens gradually. In children, hearing loss may be identified if a child is not turning towards noises or experiences delays in speech.

In adults, an individual may ask people to repeat themselves frequently or gradually need to turn up the volume on their devices.

Treatment: Treatment varies depending on the reason for the hearing loss. For example, hearing loss caused by a temporary condition such as a cold, congestion, or ear infection should resolve once symptoms subside.

Sometimes, children have problems with their Eustachian tubes and experience excessive ear infections or fluid retention in the middle ear that can cause difficulty with hearing. In these cases, a primary care provider may refer the child to an ENT to have special tubes placed in the ear to help with drainage.

For more permanent causes of hearing loss, devices such as cochlear implants and hearing aids may restore some hearing.

Other Conditions Affecting the Ears

Several additional common ENT problems can affect the ears. For example, an individual may experience:

• Tinnitus: This is ringing in the ears and can have several causes.
• Vertigo: This is dizziness and a sensation of spinning. Middle ear conditions often contribute to vertigo.
• Cholesteatoma: This is a cyst that occurs in the middle of the ear.
• Ruptured eardrum: Several situations can cause your eardrum to rupture, such as a bad ear infection, extreme pressure changes, foreign objects in the ear, a sudden loud noise, or head trauma.
• Meniere's Disease: This inner ear disorder can cause dizziness.

Common Nose Conditions

Common ENT problems affecting the nose include conditions that increase nasal discharge and stuffiness, such as sinusitis, allergies, and rhinitis. Nosebleeds, a deviated septum, nasal growths, and loss of smell are additional common issues.

Sinusitis

Sinusitis occurs when a germ multiplies in the hollow recesses of the skull that surrounds your eyes and nose. The infection can become trapped, causing inflammation, pressure, and pain.

Acute sinusitis is often secondary to a common cold and typically clears within several weeks. Chronic sinusitis, where symptoms persist for over 12 weeks, may occur due to an untreated allergy or a chronic condition such as bronchial asthma.

Symptoms: There are several symptoms of sinusitis, including:

• Headache
• Cough
• Nasal discharge
• Congestion
• Fever
• Fatigue
• Toothache (mainly of the molars)

Treatment: Treatment for sinusitis is typically supportive. Since viruses cause most sinus infections, antibiotics won't work. However, healthcare providers occasionally prescribe antibiotics if they believe the cause is bacterial or a bacterial infection has developed.

At-home treatments include:

• Warm compresses over the sinuses
• Decongestant or saline spray
• Breathing steam from a hot shower
• Over-the-counter (OTC) decongestants and pain medication

For children, follow dosing information from a healthcare professional and speak to a healthcare professional before administering any cough or cold medications.

Allergies and Rhinitis

Rhinitis is inflammation of the nasal passages. Allergies are a common cause of rhinitis.

Symptoms: There are several symptoms of allergic rhinitis, including:

• Runny nose and nasal congestion
• Watery eyes
• Sneezing
• Itchy eyes and nose

If not treated effectively, additional symptoms can develop, such as headaches, sore throat, and puffiness around the eyes.

Treatment: There are several at-home treatments for allergic rhinitis, such as:

• Antihistamines
• Corticosteroid nasal sprays (several are available OTC)
• Decongestants
• Reducing allergen exposure as much as possible

Sometimes, OTC options aren't effective for everyone. Prescription treatment options are available.

Other Conditions Affecting the Nose

Several additional common ENT conditions affect the nose, such as:

Nosebleeds: This condition can have several causes, ranging from minor conditions such as nose picking or irritation from dry air to more serious conditions such as a bleeding disorder. Treatment and prevention depend on the cause.

For example, a nosebleed due to irritation from dry air is often effectively treated by sleeping with a humidifier at night.

Deviated septum: In individuals with a deviated septum, their septum (the cartilage that divides the nose into two nasal passages) is shifted. It can be caused during development or as the result of a trauma. Treatment is often surgical.

Nasal growths: These growths include conditions such as nasal polyps, warts, and tumors. Long-lasting inflammation in the nose can lead to nasal polyps. While most nasal polyps are benign, contact a healthcare provider for any new growths, as several forms of cancer can develop in the nose.

Loss of smell: There are several reasons why an individual may lose their sense of smell. Reasons include viruses (e.g., COVID-19), a head injury, recent nasal surgery, stuffy nose, or neurological conditions. Treatment will depend on the underlying cause.

Common Throat Conditions

Several conditions can affect the throat, ranging from sore throat to strep throat, tonsilitis, and other conditions. Most conditions affecting the throat are self-limiting and resolve with treatment. However, sometimes throat conditions are due to more serious causes, such as cancer.

Strep Throat

Strep is an abbreviation for a family of bacteria called Streptococci. Strep throat occurs when the throat and surrounding structures become infected with this germ. While strep throat is a common infection, many other infections have the same symptoms.

Symptoms: The symptoms are usually abrupt in onset and include:

• Sore throat
• Difficulty swallowing
• Enlarged tonsils
• Enlarged lymph nodes
• White patches on the tonsils or back of the throat
• Fever
• Body aches
• Fatigue

Notably absent in strep throat are a runny nose and cough. Children between the ages of 5 and 15 are most at risk of this infection.

Treatment: Treatment for strep throat includes antibiotics, supportive care (e.g., cold drinks), and pain management through over-the-counter pain medications (e.g., acetaminophen).

Tonsilitis

Unless you have had them removed, most kids and adults have two tonsils on either side of the throat. The adenoids are close to the tonsils and often grouped with them.

Together, the tonsils and adenoids are a part of your lymphatic system. Your lymphatic system drains extra fluid and helps protect you against illness.

Sometimes, your tonsils (and adenoids) become infected when exposed to a virus or bacteria. Viruses cause most cases of tonsilitis in very young kids and adults. In kids ages 5 years to 15 years, many instances of tonsilitis are due to a strep throat infection.

Symptoms: Tonsilitis has many similar symptoms as strep throat and can include:

• Severe sore throat
• Red and swollen tonsils
• Fever
• Bad breath
• Swollen lymph nodes
• Fever
• Pain and difficulty swallowing

Treatment: Viral tonsilitis is typically treated with supportive measures at home. Tonsilitis caused by a bacteria (e.g., strep throat) is treated with antibiotics. Supportive at-home measures include:

• Rest
• Fluids
• Salt water gargles
• Throat lozenges
• Humidifier use
• Pain relievers such as acetaminophen (e.g., Tylenol)

Throat Cancers

Several different throat cancers can affect different parts of your throat. Some of the risk factors for throat cancer include:

• Smoking and tobacco use
• Heavy drinking
• HPV infection in the throat

Symptoms: There are several symptoms of throat cancer, including, but not limited to:

• Persistent sore throat
• Throat lump
• Ringing in the ears
• Ear pain
• Difficulty with swallowing

Treatment: Several treatment options are available for those with throat cancer. Treatment specifics will depend on the type of cancer and whether or not the cancer has spread. It may include surgery, chemotherapy, immunotherapy, radiation, or a combination of treatment types.

Additional Throat Conditions

Several additional ENT problems can affect the throat. These include:

• Laryngitis (can cause hoarseness)
• Sore throat (often caused by a virus)
• Gastroesophageal reflux disease (stomach acid goes back up into the esophagus)

Other ENT Conditions

There are several additional common ENT problems, such as esophageal disorders, facial trauma, and certain infections.

Sleep apnea is another common ENT problem that affects the airway.

Sleep Apnea

"Apnea" is a medical term meaning to stop breathing. Sleep apnea is a disorder causing one to stop breathing for brief periods of time while sleeping. Symptoms include:

• Waking up frequently in the middle of the night
• Feeling unrefreshed upon awakening
• Daytime drowsiness
• Mood swings
• Depression
• Waking up with a dry, sore throat
• Morning headaches

In addition to these symptoms, many individuals with sleep apnea have been told by a spouse or family member that they snore, gasp, choke, or even stop breathing momentarily while sleeping. You are more likely to have sleep apnea if you are overweight, have enlarged tonsils, or take sedatives at bedtime.

If left untreated, sleep apnea can cause potentially serious health complications, including hypertension (high blood pressure), coronary artery disease, stroke, and heart failure.

Summary

Most people will experience one or more of these disorders affecting their ear, nose, or throat in their lifetime. Many conditions, such as ear infections and strep throat, can be treated by primary care providers. However, for more complex conditions, such as a child who needs ear tubes or throat cancer, your provider will refer you to an ENT specialist.