VERTIGO
Derived from the verb "turning" in Latin, vertigo roughly means dizziness and loss of the sense of movement. Vertigo is not a disease; it is the symptom of an underlying condition. It is very common in society. It may have a very broad clinical presentation from mild dizziness and a feeling of unbalance to a very intense feeling that prevents the patient from getting up from bed. The patient may feel drunk and as though they are not able to stand still, and they are about to faint. These feelings may cause helplessness, fear in the long term and depression in the patient. Vertigo is a condition that requires attention. It requires urgent consultation with a doctor. In such cases, an ear-nose-throat or neurology specialist should be consulted.
Benign Paroxysmal Positional Vertigo (BPPV) is known as the slipping of crystals in the internal ear. It is the most frequent cause of vertigo (dizziness). The probability for each human to experience BPPV at least once in their lifetime is 10%. These are dizziness episodes that manifest with a move of the head or of the body (while hanging curtains, maneuvering backwards in the car, laying down on a certain side, etc.). When vertigo does not occur, mild unbalance may appear while walking. It is a dizziness that manifests when crystal particles located on the balance organ within the semicircle channels in the internal ear fall and circle in the channels when we move our head, causing sudden triggers. A videonystagmography (VNG) test may ensure the identification of the location of crystal particles and can treat the condition with maneuver therapy that will differ based on their location.
What are the symptoms of vertigo?
Dizziness is described differently by each patient. Descriptions such as "everything is turning, the ground beneath my feet is slipping, I am slipping towards one side, my head empties, I blackout" are frequent. All of these are called dizziness. Patients who have dizziness may experience other symptoms based on different causes. Doctors may also determine dizziness caused by ear conditions may be accompanied by tinnitus (ringing of the ear), decreased hearing, feeling of pressure in the ear, nausea-vomiting, itching of the ear and abnormal movements in the eyes (nystagmus). Dizziness associated with neurological conditions may be accompanied with headache, numbness, paralysis and anomalies in eye movements.
How is it treated?
The treatment of vertigo is targeted (based on the cause). However, since usually the cause cannot be determined, a generic treatment is applied. This treatment is as follows:
- Removal of triggering factors (stress, alcohol, smoking, caffeine, salt)
- Avoiding triggering positions
- Drug treatment
- Surgical treatment
Ringing in the Ears (Tinnitus)
Tinnitus is the name given to the monotone sound heard by the patient in one or both ears in the absence of any external sound. The sound may be low, deep (such as the sound of the wind) or it may be a high-pitched (such as a ring). We all experience occasional ringing that manifests from time to time and that does not endure. However, constant tinnitus heard and accentuated in silent spaces can challenge the patient's everyday life.
Depression, anxiety, sleep disorders, difficulty concentrating are long-term results of tinnitus.
Patients experiencing tinnitus usually have a history of exposure to loud noise (acoustic trauma). Gun shots, loud music, loud heavy-duty equipment may affect patients negatively.
How is tinnitus treated?
Most cases do not have a specific treatment. If the underlying loss of hearing can be fixed, the ringing in your ear can also be eradicated. Some x-ray images and balance tests maybe needed to find the cause of the ringing. Despite these methods, the real cause of tinnitus is sometimes impossible to find. In some cases, medications will help even if the real cause has not been determined. There are many medications used for the treatment of tinnitus. The patient is usually recommended one or several of these and is asked whether they get a result.
ALLERGIC RHINITIS
Allergic rhinitis is an allergic disease manifesting in the nose or one of the respiratory tract organs. Nowadays allergy is defined as an abnormal, extreme sensitivity towards a substance that most people's bodies have no problem accepting. The allergic profile of a person is linked to genetic and environmental factors. Someone who has a strong allergic family history is more likely to develop allergies compared with someone who has none.
Classification of allergic rhinitis is based on the duration and severity of symptoms. If symptoms manifest less than 4 days a week or less than 4 consecutive weeks a year, they correspond to "intermittent" allergic rhinitis (these are non-consecutive, seasonal, and more widely known as hay fever), if symptoms manifest more than 4 days a week and more than 4 weeks consecutively per year, they correspond to "persistent" allergic rhinitis. If people encounter problems during sleep, daily activities, at work or at school and these are accompanied by unpleasant symptoms, the condition is defined as "moderate-severe", if sleep is normal and no problems are encountered during daily activities, at work, at school and are not accompanied by unpleasant symptoms, then the condition is qualified as "mild".
What are the symptoms of allergic rhinitis?
Main symptoms in patients suffering from allergic rhinitis are sneezing, itching of the nose and eyes, runny nose and nasal congestion. Less frequent symptoms are coughing, decrease in smell and taste and hoarseness.
While patients with allergic rhinitis usually experience these symptoms during springtime due to pollen, the causes of persistent allergic rhinitis are usually house dust mites also known as acari, mold fungi, and the hair of pets.
Why is allergic rhinitis important?
Allergic rhinitis causes significant social, clinic and economic damages. The symptoms may affect the quality of life of patients. They may cause issues during sleep, daily activities, at work or at school in some patients. Furthermore, it may be accompanied by conditions such as asthma, sinusitis, otitis media, food allergies, allergic skin diseases.
How is allergic rhinitis diagnosed?
Investigating and examining the age of patients, their environment, the time of the year during which their symptoms increase, the presence of other conditions, the presence of other individuals with allergies in their family are important in the diagnosis of allergic rhinitis. Following questions and examination, allergy tests may be conducted if needed. These tests may be applied on the skin or via blood sampling.
How is allergic rhinitis treated?
Treatment of allergic rhinitis can be considered under 3 main titles:
- Preventive measures: Avoiding the substance causing allergy.
- Pharmacological treatment: Drug treatment plays an important role in the treatment of allergic rhinitis. Some of the medication groups used in the treatment are oral antihistamines, steroid nasal sprays, oral leukotriene receptor antagonists and decongestant nasal sprays. Patients experiencing symptoms such as lacrimation, redness, itching may use eye drops to stop them.
- Immunotherapy (vaccination): Another treatment option is vaccination. In this method, substances to which patients are allergic to are administered at low doses at first and gradually increased to ensure that the body's sensitivity to the substance decreases.
