Earwax Blockage - Everything You Should Know

Earwax, medically known as cerumen, is a waxy oil that is produced by earwax glands. This is to protect the inner parts of the ears, from the microorganisms, dust, and foreign objects. After the secretion, this oil gets hardened and finds its way out of the ears naturally.

What Causes Earwax Buildup?

Earwax buildup occurs when there is excessive secretion of cerumen than what’s necessary and also when the hardened oil fails to find its way out. Both the cases can lead to earwax buildup, ear block, and temporary hearing loss, eventually. Sometimes people who are cleaning might accidentally push the wax further deep causing the blockage.

Signs and Symptoms of Earwax Blockages

Buzzing or ringing sound in the ear is a common sign of earwax blockage. You might lose hearing ability temporarily based on the percentage of the block.

Becoming aware of the inner voice when you talk, a sense of fullness in the ear, and sometimes earache are the other signs of it.

Earwax Buildup in Children

Earaches are associated with infants and children more than the adults. In children, you can find earwax buildup by checking for the darker brown substance inside the ear walls. Using ear swabs, however sensitive they are, can damage ear canal linings, and eardrums in extreme cases.  Consulting an ENT specialist and seeking assistance is a sensible thing to do.

Earwax and the Infection -

Earwax blockage will become an infection only when the buildup stays inside the ear walls for too long. Ear infections can cause excruciating pain and such an ear infection in children can become a nightmare to live for both the child and to the parents.

This pain could not be subsidised, and a discharge from the ear also could be observed in the case of infections caused by earwax buildup. Other symptoms include fever, coughing, and giddiness.

Treatment for Earwax Blockage and Infection -

Followed by the initial diagnosis at the ENT hospital, the ear specialist uses an otoscope that helps them to see the inner ear.

Certain oils or hydrogen peroxide to soften the earwax block. Then the ear doctor may use irrigation, a technique where water is sent like a stream, inside the ear to clean the block. Curette, a curved instrument, is also used to clean earwax blockage.

Earwax removal is a simple process. Once the block is cleared, it is important to follow the after-care instructions by your doctor. Ear irrigation kits are also available as the over-the-counter kits. You can practice as instructed by your ENT specialist.

Softening and irrigation techniques should work. However, sometimes the softeners could only melt the outer layer of the wax and force removing might cause damage. If your condition is not improving, consult your doctor.

How to Avoid Earwax Blockages

Generally self-care and hygiene are the remedies for earwax blockages. But it is essential to see your ENT specialist periodically to maintain ear hygiene. It becomes imperative if your ear glands produce more cerumen.

It is common to see people using ear swabs to remove the earwax buildup. Using a soft and sensitive ear swab once or twice a week might help you keep your ears clean but in order to remove a blockage, you should reach out to an ENT clinic.

If you feel there is a block inside your ear and you could not hear properly, do not try to insert any swab, paper rolls or any other item. They will only cause more damage.

Even though earache, ear discharge, and the sense of fullness are the symptoms of earwax blockage, there are other conditions that show the similar symptoms.

The Takeaways -

Earwax buildup is a common issue in people who secrete more cerumen. This can happen in both children and adults. If you know how to use the irrigation method, try it periodically based on your doctor’s recommendation. In children, consult your ENT doctor to get the wax removed.

Earwax is useful for your ears. It keeps them clean, and protects in many ways. Once the work is done, the wax gets washed away by the body. And, all this happens naturally. Follow your doctor’s recommendation to keep your ears clean.

Things to know about Nosebleeds

Nosebleeds are normally frightening and can last for a few seconds to about fifteen minutes or more. During a nosebleed, blood can flow out from one or both nostrils and the flow may be either heavy or light. It occurs due to the breakage of blood vessels in the septum(wall between the nostrils).This rupture can happen due to blowing of dry air, injury to the nose or scratching of nostrils with sharp fingernails. Nose bleeds are also called as epistaxis.

Single or rare short episodes of nosebleeds are usually not dangerous. However, if they last for more than twenty minutes or occur after an injury, medical intervention is recommended.

Types of Nosebleeds

• Anterior Nosebleeds-This type of nosebleed occurs when the blood vessels in the front region of the nose break.
• Posterior Nosebleeds-These nosebleeds occur from the back or the deep inner part of the nose causing blood to flow back down the throat. This type of nosebleed is likely to be more dangerous than anterior nosebleeds.

Risk Factors

Nosebleeds are most likely to affect-

• Children aged between two and ten years
• Elderly persons
• Pregnant ladies
• People who regularly take medicines like anticoagulants and aspirin
• Patients who have blood clotting disorders like haemophilia

Causes of Nosebleeds

• Dryness of the nasal membranes
• Dry air leading to crusting, itching and irritation
• Medicines like antihistamines and decongestants for colds, allergies and sinus problems
• Frequent blowing of the  nose
• Deviated nasal septum
• Sinusitis
• Presence of foreign objects which tend to get stuck in the nose
• Harmful chemical irritants
• Reactions due to allergies
• Trauma/injury to the nose
• Repeated episodes of sneezing
• Intentional picking of the nose
• High dosage of drugs like aspirin
• Infection in the Upper Respiratory Tract(URT)
• Blowing of cold air
• Health conditions like high blood pressure, bleeding/blood clotting disorders and cancer

Diagnosis of Nosebleeds

The following tests may be done to investigate the cause of nosebleeds-

• Complete Blood Count (CBC)
• Partial Thromboplastin Time(PTT) which a test to determine blood clotting time
• Nasal CT Scan
• Endoscopy of the nose
• Facial and nasal x-ray

Treatment of Nosebleeds

Normally, anterior nosebleeds may be treated at home. For this, the soft portion of the nose must be squeezed while sitting in the upright position. The nostrils may be closed for about ten minutes after leaning forward slightly and breathing through the mouth. It is important not to lie down the duration of the nosebleed as it can lead to swallowing of the blood causing stomach irritation. The nostrils must be released after about ten minutes to check if the bleeding has stopped. If not,these steps may be repeated a couple of times if there is continuous bleeding.

Other alternative treatments include-

• Giving cold compression over the nose bridge
• Using nasal decongestant sprays for closing the small blood vessels

If the bleeding does not stop with these options, it is necessary to seek medical intervention as there may be a posterior nosebleed.

• Foreign objects causing nosebleeds are removed by ent doctors.
• Frequent or persistent nosebleeds are treated by a clinical process called cauterization. In the process, the blood vessels in the nose are burnt by using a heating element or compound like silver nitrate that removes the tissue. Subsequently, the nose is packed with cotton, gauze or foam. Balloon catheters may also be used to put pressure on the blood vessels and stop the bleeding.

Prevention of Nosebleeds

• People residing in dry areas can use a humidifier at home to keep the surrounding air moist.
• Picking the nose often especially with sharp nails should be avoided.
• Adults and seniors should cautiously limit the dosage of drugs like aspirin as it dilutes the blood and results in nosebleeds.
• Medicines like antihistamines and nasal decongestants must be used in moderation as they are likely to create dryness in the nose.
• Nasal passages may be kept moist by using safe nasal sprays and gels.

Summary

Nosebleeds are rarely serious and may be treated easily. Posterior nosebleeds are more dangerous than anterior nosebleeds. But, if there are periodic occurrences or heavy bleeding, it is essential to seek clinical attention to avoid health problems like anemia. Hence, it is best recommended that persistent or more serious cases are handled by ENT (Ear, Nose and Throat) specialists.

How to deal with Sleep Apnea?

Sleep apnea is a common but serious sleep disorder characterized by interruption of normal breathing due to blockage of throat airways. It is usually accompanied by lethargy during the daytime. Many people underestimate the problem and merely consider it as loud snoring. Most patients with sleep apnea are likely to witness such short breathing pauses multiple times during night though they may not be aware of it.

The predominant effects of sleep apnea include a decline in mental alertness, energy levels and productivity compared to the normal thresholds during the day. Chronic sleep deprivation caused by this disorder leads to excessive daytime sleepiness, poor reflexes, impaired concentration and increased risk of accidents. It can also result in mood swings, irritability and depression. In the long run, this condition causes dangerous consequences on physical health including obesity, diabetes, cardiovascular disease and liver problems.
Symptoms of Sleep Apnea

• Repeated episodes of acute loud snoring every night
• Incidences of choking, snorting and gasping
• Frequent breathing pauses
• Sudden awakening with shortness of breath
• Drowsiness and exhaustion during the day despite long hours of sleep

Less common signs include morning headaches, mouth dryness, restless sleep, unusual irritability, memory issues and frequent visits to bathrooms during the night. It is important to note that sleep apnea affects the quality of sleep resulting in extreme fatigue and sleepiness, unlike normal snoring.

Sleep Apnea Treatment

Though the diagnosis of sleep apnea could be slightly difficult, it is a treatable condition. The cure for snoring in less severe cases can be done by adopting simple lifestyle changes –

• Losing weight- Losing weight can be beneficial for people who are overweight. They are likely to have extra tissue at the back of the throat which blocks the airways and prevents proper breathing.
• Quitting smoking-It is advisable to stop smoking as this habit increases inflammation and fluid retention in the throat region and the upper airways.
• Exercising regularly – Apart from aiding weight loss, physical activities and exercises can positively impact the quality and amount of sleep in individuals.
• Avoiding certain substances-Drinks like alcohol and certain drugs like sedatives and other sleeping pills taken before bedtime can interfere with the breathing process as they tend to relax the throat muscles. Likewise, heavy meals and caffeine products must be avoided before sleeping.
• Maintaining sleep schedules-It is important to maintain and follow a regular schedule as it provides better mental relaxation and promotes good quality sleep. People who have adequate sleep have lower attacks of sleep apnea.

However, for severe symptoms, medical evaluation and treatment for snoring are essential. The options include-

• Breathing Devices - Several clinical devices are available to overcome the blockage of airways. One of the most common ones is the Continuous Positive Airflow Pressure (CPAP) device which is essentially a mask that covers the mouth and nose.  It provides a continuous supply of air to keep the air passages open while sleeping. A saline nasal spray may also be used if there is a nasal block that inhibits breathing. Other assistive breathing devices include Expiratory Positive Airway Pressure (EPAP), Bi-level Positive Airway Pressure (BPAP) and Adaptive Servo-Ventilation (ASV) devices.
• Oral Appliances - Customized oral appliances are available for treating sleep apnea. These are gaining popularity as they are highly portable, comfortable and quieter compared to breathing devices. Some examples of oral appliances include mandibular advancement device and tongue retaining device.
• Surgical Route - Surgery for snoring is aimed at increasing the airway size to reduce the number of sleep apnea episodes. For this, the ENT surgeon may remove tonsils, adenoids or excessive tissue in the throat, do a jaw reconstruction surgery or make a plastic rod implantation in the palates. Laser surgery for snoring is a safe intervention today which fosters quick recovery of the patients. The latest advancements include pacemaker implants for opening airways through muscular stimulation.

Sleep Apnea treatment India offers promising results to patients with innovative healthcare technologies and affordable rates. For more information please contact this ENT hospital in Coimbatore.

The Connection Between Nose, Throat and Ears - How Exactly It Works?

The interconnectedness of the ear, nose and throat is probably the 5th grade science and still knowing about the world of these three intricately connected organs will never fail to amuse us.

Even though our entire body obeys the butterfly effect in the theory of chaos, no other organs in our system can relate to each other as much as the nose, throat and ears do.

The love to share with each other -

Even though all organs in our body are directly or indirectly connected or interdependent, nose, throat and ears share a special bond that goes beyond just sharing and supporting. These organs almost work like one system and when there is a disturbance in one organ, the others will follow it.

This is the very reason why whenever there is an ailment such as congestion, infection, and swelling in any of the lot, the other organs reflect it without fail. For example, it is almost impossible for someone with a nose problem to dodge the illness in the throat or in the ear.

The connection between these three is so strong that even in the medical world, there are no separate specialists for nose, ear or throat and any issue related to any of these organs will be treated by the ENT specialists.

What drives the connection between nose, throat and ears to work the way it works?

The science behind the way this connection works is a simple math! The nose, ear and throat are connected with a tube-like structure, medically known as pharyngotympanic tube. This makes an easy passage for the bacteria and viruses to travel in between.

As the interconnectedness is all about the structure of these three organs, let’s have a look into the structural parts of each organ for a better understanding.

• Nose - Compared to the other three in the system, the nose takes a plethora of illnesses. Structurally, it is divided into 2 major parts known as anterior nose, also known as the visible part of the nose, and the posterior nose. The posterior nose directly connected to the throat by the pharyngotympanic tube.
• Throat - Throat could be divided into 3 parts. Nasopharynx which is located right behind the posterior part of the nose, the 2nd part known as oropharynx which is behind the mouth, and the 3rd part known as the laryngopharynx which hosts the voice box.
• Ears - Each ear is segregated into 3 parts. Outer, middle and inner ear. Middle ear and the throat are connected by the same tube that completes the cycle of interconnection.

This entire system is housed in the skull cavities called sinuses. This whole system determines our sensory capabilities such as smell and taste. Additionally, it plays a defining role in the way we breathe.

In fact, there is no denying that this whole system determines a person’s quality of living which makes it essential for us to take good care of it.

Treatment for various conditions of nose, throat and ears -

An infection in the ear could be passed onto the throat and a congestion in the nose could lead to ear ailments. As listing down all the infections is a mammoth task considering they are plentiful, here are a few ENT conditions that are common and you might want to look out for.

• Nose conditions - Nasal conditions affect the ability of smell, breathe and even sleep. The conditions include common cold, chronic sinusitis, sleep disorders, and deviated septum.
• Throat conditions - Common cold can lead to sore and strep throat. Other common throat conditions would be reflexes, strep throat, adenoids and tonsillitis can cause issues in the ears leading to reduced hearing and ear pain.
• Ear conditions - Ear infections can lead to pressure and balance related issues, dizziness, pain and allergies. If left untreated, these conditions may lead to hearing impairments.

If you are facing any of the above health conditions, consult your nearest ENT specialist for medical help.

Each ENT issue will have a significant impact on our day to day life. Considering this, it is imperative to seek medical help at the earliest.

Step by Step Instructions to Use Nasal Spray

Nasal sprays are common in any household as over the counter medicine. And, they are widely used for many reasons. Starting from the nasal congestion to clearing the sore throat, nasal sprays could treat issues associated with nose and sinuses.

In addition to that, various types of medications through the nose using them. Knowing how to use nasal sprays prior, helps people in maintaining the correct dosage, passage of medicine and also the absorption of it by the body. 

This blog helps you in understanding nasal sprays better, the types of them, how to prepare and step by step instructions on using nasal sprays.

Why do you need to use nasal sprays sensibly?

As nasal sprays, mostly, are over the counter medicines, it is important to know the general usage guidelines that are safe. Overusing these sprays can cause irritation or cause the nose to stop its reaction to the sprays.

There are other side effects such as rebound effect that may eventually lead to chronic sinus infections. Using any type of medicine sensibly as instructed by the doctor is important and nasal sprays are not an exemption.

What you need to know about nasal sprays?

Generally you will get 2 types of nasal sprays - regular spray and pump spray. Doctors prescribe the suitable type of spray based on the nose condition.

Once applied as directed, nasal sprays start working by shrinking the blood vessels that are swollen due to sinus issues, allergies and cold.

People may think using nasal spray is easy and this could lead to serious nasal issues. Here is a step-by-step guide for you to understand the nasal spray usage better and avoid the side effects.

How to use nasal spray?

If you are an adult, you could self-administer nasal sprays but if you are a child or an elderly person, you need a caregiver. Before administering the medicine, you need to wash your hands with a soap or hand sanitizer, keep the nasal spray and tissue ready.

Step by step guide to use nasal spray -

The preparation remains the same for both types of nasal sprays. If you have been prescribed the regular nasal spray, follow these steps to use it in a correct sense.

1. Using the regular nasal spray -

• Sit upright with your head in a straight and relaxed position. Use tissue to clear the nose and uncap the spray.
• Hold the container using your thumb and point finger and close the nostril that is not being sprayed with the other hand.
• Insert the tip of the nasal spray inside the nostril and gently press the container. Ensure the pressure is not releasing more than a single drop from the spray.
• Remove the spray from the nostril and gently sniff. Give it a 5-10 second gap before you spray the next drop. Remain in the position for at least 30 seconds before you relax.
• Follow the same steps for the other nostril if it’s been recommended. The frequency and dosage may vary based on the nasal issue.

2. Using the pump nasal spray -

• Wash your hands and sit in a relaxed position. Place the spray tip between the index and middle finger with your thumb finger supporting the base of the container.
• Spray once or twice in air so that you know how much pressure needs to be applied. Close the other nostril and insert the tip in another.
• Gently apply the pressure, spray once or twice as directed and remove. Sniff slowly once or twice. And use the same directions for the other nostril if that was the instruction. 

Wash your hands after using the spray. Clean the tip with clean tissue and tight cap it. Store the spray in a place as directed by the doctor or as per the instructions on the container.

Even though it is a common and widely used medicine, using other’s nasal spray is strictly prohibited. Also, ensure the tip of the spray is not touched anything apart from the inside parts of the nose.

Do not increase the dose or start using frequently for effectiveness. It may lead to inner nose damage or cause infections. Consult your nearest allergy specialist or any ENT hospital if you are not feeling any relief after using the nasal spray.

All about Anosmia

The scent of roses, the aroma of food, the lingering odour of musk, all add charm to our living. What is life without them?- next to nothing. The strongest sensorial function for all is the capacity to smell. If a person lacks this faculty, he/she is then said to have ANOSMIA.

ANOSMIA

The total inability to smell is called Anosmia. It is commonly called "smell blindness". Anosmia can be either permanent or seasonal.

Temporary Anosmia - This is a temporary lack of the smelling perception due to common cold, sensitivity to dust, pollen, pet dander, etc. It can be regained with the treatment for anosmia by expert nasal physicians. The ENT hospital in Coimbatore has proficient otolaryngolists to treat anosmia capably.

Permanent Anosmia -  Here the ability to smell is permanently lost due to head injury, brain tumours, nerve damage, etc.

CAUSES OF ANOSMIA

The causes of Anosmia can be simple or complex. Some of the acute causes may be any one of the following.

• NASAL OBSTRUCTION - A blockage to the nose is called a nasal obstruction. It may be caused by tumours, enlarged nasal turbinates’ or bone deformities of the nose.
• ALLERGIC RHINITIS - This causes a continuously running nose and swollen nasal lining, along with anosmia. This allergy is also called Hay fever.
• NASAL POLYPS - The swelling mucus coating of the nose may cause nasal polyps. These are benign cyst-like tissue formed on the internal lining of the nose.
• DEVIATED NASAL SEPTUM - When the middle bone of the nose has shifted sideways, the nasal pathways gets narrowed. This may cause anosmia.

NASAL OBSTRUCTION

When the nose is blocked, the patient is said to have a nasal obstruction. This usually hinders the flow of air in and out of the nose. It may cause breathing difficulties or even anosmia. Nasal obstruction may be due to the following reasons.

• FOREIGN OBJECTS - Any foreign body present inside the nose like rubber, cotton sponge or wool may cause nasal obstruction. Sometimes food items like bens nuts or peas may also cause nasal obstruction.
• OVERSIZED ADENOIDS - Adenoids are the tissue found at the base of the nose and back of the throat. They are responsible for trapping microbes that cause infection. The adenoids get inflamed when an infection occurs. Due to chronic or repeated infections, adenoids may become enlarged and stay that way. These oversized adenoids may block the sense of smell, causing anosmia.
• NASAL ALLERGIES - The lining of the nose usually gets swollen due to nasal allergies causing anosmia
• CHOANAL ATRESIA - This is a congenital defect where the patient has a blocked nasal passage from birth causing anosmia.
• INFERIOR TURBINATE HYPERTROPHY -  The bony structures of the nose called turbinates may become swollen due to allergy and dust. causing anosmia.

Anosmia due to nasal obstruction may be treated effectively by an expert ENT specialist. Consult the expert ENT hospital in Coimbatore for best results.

ALLERGIC RHINITIS or HAY FEVER

Allergic rhinitis or hay fever is a nasal allergy caused due to dust, pollen, cigarette smoke, perfumes, fumes, etc. Although it is called hay fever, it does not cause a fever but heavy nasal congestion, itching of the nose, coughing and sneezing, runny nose, etc. It is one of the causes of temporary anosmia. Hay fever may be seasonal where it is caused only during windy or monsoon months. Or it can be perennially caused by hair, pet dander, dust mites, cockroaches, etc. Allergic rhinitis may have fatal effects like motor accidents, work injuries, etc.

DEVIATED NASAL SEPTUM

The nasal septum is the bone dividing the 2 nostrils. Sometimes, a congenital defect or an accidental injury might cause the nasal septum to be displaced. This causes the narrowing of the nasal passage which in turn results in breathing difficulty and anosmia. A deviated nasal septum is a cause for acute concern as it might not stop with just anosmia but cause nosebleeds and sleep apnea as well. Patients with a deviated nasal septum must seek immediate treatment with an expert ENT specialist. Experienced otolaryngologists at the ENT hospital in Coimbatore can correct the deviated nasal septum effectively by septoplasty, septal reconstruction or submucous resection of the septum.

Anosmia can alter your life drastically depriving you of the feeling of fragrances. Get it treated by expert otolaryngologists at the ENT hospital in Coimbatore to get lasting relief and results.

Adenoiditis and Adenoid Hypertrophy

Infections of the nose and the throat are quite common in young children. These infections are often accompanied by adenoiditis which is nothing but the inflammation of the adenoids. Treatment of adenoiditis should be done immediately in order to avoid further complications like otitis media which may cause even hearing loss.  The patient must consult an expert ENT specialist without delay like the ones at the reputed ENT hospital in Coimbatore.

What is adenoiditis?

Adenoids are lumps of tissue located above the tonsils at the back of the nose. They are basically a bunch of lymph nodes which include the tonsils. they are situated at the Waldeyer's ring at the back of the throat. Adenoids contain lymphocytes which are used to infection. Sometimes during ear, nose or throat infections, the adenoids get affected and inflamed causing adenoiditis Adenoiditis can be troublesome as it may cause nasal congestion, sinusitis, tonsillitis, otitis media, etc.

Treatment of adenoiditis includes oral administration of antibiotics by a professional ENT specialist after diagnosis. If this proves ineffective, the adenoidectomy is done where the adenoids are removed.

Symptoms of adenoiditis

Adenoiditis is characterized by the following symptoms like

• Stuffy nose due to nasal congestion
• Sore throat
• Sinusitis- Inflammation of the sinuses
• Tonsillitis - Enlargement of the tonsils
• Snoring
• Sleep Apnea- breathing is paused intermittently during sleeping
• Earache
• Glue ear - this is called otitis media and is caused by the accumulation of fluids in the middle ear.

Adenoiditis should never be ignored as it may lead to frequent ear infections which may result in even hearing loss or speech delays. Consult the expert ENT hospital in Coimbatore immediately to get permanent and lasting relief from adenoiditis.

What is adenoid hypertrophy?

During childhood, the adenoids may swell up due to nose or throat infections. But adenoids usually shrink when children get to the age of puberty. But for some children, the adenoids continue to be enlarged causing adenoid hypertrophy. This condition results in blocking of the nasal passage making it difficult for the child to breathe. This causes snoring, sleep apnea, etc. Due to adenoid hypertrophy, fluids may get collected in the middle ear causing otitis media. 

Adenoid hypertrophy may result due to chronic or repetitive bacterial and viral infections which make the adenoids stay enlarged even up to adulthood. Infection by the Epstein-Barr virus may also cause adenoid hypertrophy in adults.

The only way to treat adenoid hypertrophy is to get the adenoids removed and this should be done only under expert care at premier health centres like the ENT hospital in Coimbatore.

What is adenoidectomy?

Adenoidectomy is the treatment for adenoiditis or adenoid hypertrophy where the adenoids are removed by a surgical procedure. It is performed by a skilled ENT specialist. The patient is administered general anaesthesia and operated upon to remove the adenoids. The adenoids may be normally removed along with the tonsils during a tonsillectomy. Laser treatment or endoscopic ablation is also done to quicken the process and get lasting relief with less pain at top health clinics like the ENT hospital in Coimbatore. Within 3-4 hours after the surgery, the patient is discharged safely along with the doctor's instructions.

Following the surgery, the patient may suffer from sore throat, mild fever pain etc for a few days. White scabs may also be formed in the mouth and these fall off within a couple of days. 

Feed the patient only soft foods after surgery for a week. Avoid dairy products immediately after surgery. After 24 hours, even ice cream can be consumed.

When is adenoidectomy a must?

Adenoidectomy is a must when the adenoids stay enlarged even after puberty and get frequently infected. It has to be definitely done when the middle ear gets frequently infected with fluid accumulation causing otitis media as this may cause deafness. 

Adenoiditis and adenoid hypertrophy should not be carelessly ignored. Consult experts at the ENT hospital in Coimbatore to get the right treatment and lasting remedy for adenoids.