Robin Leblanc

Hello. Thank you for reaching out. This looks like a swollen parotid gland, or perhaps a mass in the parotid gland. Massage, warm packs, and eating or drinking sips of sour substances (lemon, grapefruit (if you don’t have medications that preclude this), sour sugar free candies), and hydration are key. This should settle down within a few days. If it gets more swollen, painful, and / or red, or hot to touch, it may be infected and may require antibiotic treatment. If it does not become inflamed but it does not go away, there could be a mass. MOST parotid masses are benign, but a small percentage can be cancerous, and the only way to know is with a biopsy, done by your doctor.

I hope this helps. Good luck.

Hi! The middle ear is the space behind your usually intact and waterproof eardrum. There is a little ventilation shaft inside this space that connects to the very back your nose called the Euatachian tube. It usually helps equalize pressure in the middle ear with pressure outside the eardrum; when you swallow, chew, and even speak, the valve opens and the pressure between the two spaces equalize. It is like holding the opening of a balloon: if the balloon is full of air and you release that valve a little, some of the extra pressure in that balloon will equalize and let some air out. If the pressure inside and outside the balloon is the same (empty balloon) then no air has to flow.

The pain comes when that valve cannot open. In children it is usually due to immature anatomy and small openings, along with obstructive tissues in the area blocking the opening (the adenoids aka the nasal tonsils). In adults, some people have small midface anatomy or small valves and do not equalize well.

Ear tubes are little plastic port holes we use after we have generated a little incision into the eardrum to create an alternative equalization opening. The tube is there to help prevent the incision from healing. The difference in how this works compared to normal anatomy is that a healthy Eustachian tube opens as needed and with certain actions but is otherwise closed by default, while an ear tube is always open and allowing constant equalization.

Tubes can be placed in kids and adults alike.

Have a good summer!

Dr. LeBlanc

Over-the-counter decongestant sprays (xylometazoline, oxymetazoline) can cause changes in the nasal linings that promote dependence. That means that using the same amount over time causes less effect. Over the course of a few weeks, using two puffs of one of these sprays a few times a day causes less relief, and people end up needing to use more puffs to accomplish the same effect.

Nasal steroids do not cause dependence. They work differently in the nasal linings. Using a nasal steroid will often lead to improvement in nasal symptoms, and usually will not lose their effectiveness over time (though if someone gets sick, their allergies kick in or are exposed to a new irritant, they may not feel it is as effective). However, if they have a chronic nasal condition like allergies, or they smoke and they stop their nasal steroid after a time, their symptoms will often recur. This is not failure of the medication to fix the problem.

In general, I would advise someone with nasal congestion with a cold to try a nasal decongestant for a few days to get through their symptoms and stop after five days. If they are experiencing daily nasal symptoms longer than a few weeks, then they need to be checked and possibly prescribed a nasal steroid spray. Nasal steroid sprays are the safer long-term option, as long as there are no contraindications to using them.

Good luck!

Hi there!

The good news is that you do not have to do anything. A baby’s ear canals are so small that there is not much water that can get in. The only reason I would worry about water in the ears is if there is mucous or pus draining out the canal (meaning an ear infection), and adding water can slow down the recovery. Otherwise, your baby can bathe quite comfortably.

I hope that helps!

Dr. LeBlanc

Hi. Your sense of “flavour” is tied to both smell and taste. A sinus infection or any cold that affects your nose and sense of smell will very likely affect your perception of a food’s flavour. You should still be able to discern tastes like salty versus sour or bitter. Once the sense of smell improves so should flavour. Think “pinch your nose before taking that old cough syrup” - that’s why people do that. Hope that helps!

Infants typically have immature drainage passages from the middle ears to the back of the throat. However, while their ears might be uncomfortable during descent on a flight trying to ventilate, most kids recover well. If they have fluid in their middle ears before the flight from a previous infection, the fluid in the middle ear actually protects them from pain, as the pressure cannot compress a liquid as opposed to an air filled space.

There is really nothing you can or should give an infant for flying. If you bottle or breast feed your child during descent, the swallowing action will be their best bet to stay out of trouble with their ears.

Good luck!

Hi - if the blow was not enough to cause you to lose consciousness or to cause a nose bleed, it probably was not enough to cause a significant nasal bone fracture. The blow would have to have been directed to the centre of the nose in an upwards direction (or downwards and subsequently slighted flatten the bridge) to fracture a previously straight nasal septum. And again, a septal fracture usually causes bleeding. If there was blood afterwards then it is possible either the nasal bone fractured inward and narrowed a passage or the septum deviated to a side by buckling and is causing obstruction. Swelling of the nose might be from soft tissue injury from there the ball hit your nose, or in response to a fracture if it broke.

Hi! I am sorry to hear about your uncle!

In general, I would say it is unlikely that his sinonasal cancer originated from the use of a plastic steamer. The two most common risk factors are smoking and alcohol use, especially together. Male gender and older age also predispose him towards this type of cancer. Exposure to HPV increases the risk as well. There is an association with inhaled substances, such as various dusts (nickel, flour, wood (drywall, wood sanding), chromium), glue fumes and fumes from various furniture polishes and varnishes. This last one may be what his doctors may have thought was the risk. I suppose it depends the type of plastic of which the steamer was made and whether it is stable under heat. As long as there is water in it and he was not inhaling the air when it went dry and therefore the temperature of the plastic went up, it should be ok. If the plastic in the steamer appears melted that is possible.

I hope that helps, and good wishes for your uncle.

For the most part, a perceived loss of taste is actually a decrease in your ability to detect “flavour”. If you can still tell the difference between salty, sweet, sour and bitter then your taste is fine. The most common reason for decreased sense of flavour is due to decreased sense of smell. Those reasons could be congestion from allergy or head cold, polyps, or other causes.

Hi - that is a pretty broad question, so the short answer is maybe. Usually someone with recurrent sinus infections (for example, quarterly per year or with season transitions like fall to winter), or with other airway issues like asthma or allergies, that person is likely going to have long term issues with their sinuses. In those cases, the problem may be a combination of physical factor (deviated septum not letting enough air through, narrow drainage channels from the sinuses to the nasal passages, or even obstructive tissues like nasal polyps) and / or lining related problem like allergies or reactive airway tissues. The physical aspect often needs surgical intervention while lining related issues respond better to topical or systemic treatment.

Often people can get relief if they use treatment on a more proactive basis (whether it is avoidance, smoking cessation or topical therapy), rather than waiting until you are sick.

Hope that helps!

Hi there!

There are a few things this might represent.

1) Near the top corner of the nostril or at the bottom junction people can get little fissures. These are common in people with narrow nostrils, especially if they are blowing their nose a lot (colds, allergy season). These can be challenging to control. Protecting the area with an ointment and trying to reduce physical manipulation (not wiping or rubbing the nose) will help the fissure heal.

2) In the hair bearing skin just inside the nostril, people can get a folliculitis that can develop into little pustules or pimples, like an ingrown hair. These do not typically happen on the middle wall (the septum). Antibiotic creams, maybe with a little steroid like hydrocortisone if there is an element of dermatitis, can help this.

3) Cold sores can develop, usually along the bottom of the nostril and usually involve the skin outside the nostril extending toward the upper lip. These will pass after 7-10 days or sooner if you catch it with an antiviral agent when it first breaks out. These do not typically occur along the side nostril skin.

Hope that helps.

As a general rule, hydrogen peroxide is an irritant. After all, we are using it to kill bacterial cells. Some people have dry or sensitive skin in their ear canals. For that reason alone I would advise someone to avoid putting peroxide in their ears. Beyond that is the case where someone might have a ruptured eardrum. If peroxide were to enter the middle ear, it could cause at best a middle ear infection, and at worse may lead to inner ear damage. This would result in hearing loss and / or dizziness.

The good news is that ear wax is natural and for the most part does not need to be removed. Most people’s ears are self cleaning. People with hairy ear canals, narrow canals or with certain skin types are special cases, and I would not use peroxide in those ears either. Those people need a professional to remove their wax to prevent infections or damage.

Dr. LeBlanc

Hi there. Ear wax can have many different consistencies, ranging from a watery type of secretion all the way to a dry scaly type of debris. Ear canals are lined with skin that can also sweat a bit. Sometimes water from a shower, bath or pool can get into the ear and come out a little later. Those would be reasons for this to be happening on a regular basis.

If this is new and associated with other symptoms like hearing loss, ringing, dizziness or pain, then you should get it checked by a doctor to make sure your ear drum is intact. If you have a tube in your ear drum and it is leaking, you should likely see your doctor to make sure it does not need treatment.

Dr. LeBlanc

Hello.

Assuming there are no masses in, or “rashes” on the surface of your tongue, a burning sensation of your tongue is a common complaint. It can sometimes be due to the type of toothpaste you use. Tartar fighting pastes are usually more acidic, and sensitive tongues can become irritated from this exposure. An easy first step is to change your brand of toothpaste to a baking soda based toothpaste.

Dehydration and smoking will also aggravate this. Having nasal obstruction or congestion, enough to make you a mouth breather can also contribute to burning tongue. Having that addressed may help.

An acute fungal infection usually shows white spots or plaques in your mouth and throat. However sometimes a more chronic infection will leave you with what appears to be pink, bland areas that almost look like bald spots on the tongue. Usually an anti fungal rinse can help with this.

Most burning tongue conditions are benign in nature but can persist. If this is the case, it is best to be seen and followed by your dentist or your family physician.

Good luck!

Dr. LeBlanc

Hi - the bad taste in your mouth might be from tonsil stones (which is a common finding in people with or without Strep throat). If the Strep infection was bad enough to damage the superficial linings of the tonsil, that may also be a cause. Either way, the bad taste should improve over the course of a week or so after an infection is treated with appropriate course of antibiotics. Stay well hydrated, and if it gets worse, go back and see your physician.

Hi - The balloon sinuplasty will typically "squish" some linings aside to create a wider opening, if those linings were swollen or partially polyp-ridden, and can push some weak bone aside in some cases. However, the linings can become swollen again, and start causing obstruction and recurrence of your symptoms. Depending on the underlying issues, even people who get formal sinus surgery can end up with recurrence. The key is to continue with your medical management:

- nasal saline rinses
- nasal steroids if prescribed
- smoke avoidance (both tobacco and marijuana)
- antihistamines as suggested depending on allergies).

If that fails, then yes, you might need a repeat procedure, or if it has progressed, you might need formal surgery.

I hope that helps. Good luck!