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Drooling can be embarrassing for children and adults when it occurs, as it is something usually associated with babies. Therefore, most people will avoid talking about it, even if it is becoming a problem. But what are the causes?

Drooling is something everyone does occasionally, particularly when sleeping when swallowing doesn’t occur as frequently. Therea re many possible causes to consider. The best treatment can depend on what the cause of the problem is.

• Treat sinus problems – Stuffy noses cause people to breathe out of their mouth, thus creating more saliva and making it easier for that saliva to escape. Getting this treated may eliminate your problem.
• Botox injections – This may sound extreme, but injecting Botox into the salivary glands using ultrasound imaging will paralyze the muscles in that area, preventing the saliva forming. This is used to treat people with neurological conditions, and the effects last around 6 months before needing to be repeated.
• Medication – This may be recommended by a doctor for patients with neurological conditions and is called scopolamine. It works by intercepting nerve impulses, and is usually a patch placed behind the ear, each one lasting for 72 hours. Glycopyrrolate is another medication used, but the side effects tend to be more extreme.
• Oral appliances – This is a device placed in the mouth to help with tongue positioning and lip closure, which in turn help with swallowing, meaning a person would drool less.
• Surgery – A last resort, usually only used in patients with an underlying neurological condition when other treatments have failed to work. This will involve removal of the salivary glands.

Finally, there are some less common conditions such as cerebral palsy where drooling is more common because the muscles in the mouth and neck are less tight and more floppy, as well as the position of the head being a little more bent forwards in many cases. This makes it easier for the saliva to flow forwards out of the mouth rather than back into the throat and oesophagus (food pipe).

Sinus Headaches – The Facts

Sinus Headaches are very common and usually follow an infection or allergy. We have four pairs of sinuses which are situated above the eyes, in between the eyes at the bridge of the nose and over the cheeks. A sinus headache can be felt along any of these areas and can also affect either one or both sides of the face. Treatment usually involves tackling the initial cause.

Symptoms

If someone has an infection or allergy, this can cause the sinus membrane to swell up, resulting in a feeling of pressure and/or pain over the face and the beginnings of a headache. The pain will be in the cheeks or above the eyes or nose and these areas may appear swollen.

Sinusitis is an infection that can trigger sinus headaches. A sufferer may have a fever, a blocked nose, green or yellow mucus from either the nose or down the back of the throat (catarrh or postnasal drip) and a lowered sense of smell. The pain may increase after sneezing, coughing or bending down. The severity of the symptoms depends on whether the infection is caused by a virus (such as after a common cold) or bacteria, and how long it has been building for.

Treatment

Medication – If the sinus headache is mild it can be treated at home by simply drinking plenty of fluid and taking painkillers. If the pain is more severe then the sufferer will need to see a doctor. Decongestants may be issued for treatment and antibiotics could be prescribed to tackle the infection.  If allergies are the cause, then you may be given a nasal spray containing steroids or antihistamines.

Surgery – If the sinus headaches are persistent over a few months then you may be referred to an ear nose and throat specialist who will go through your symptoms and medical history, undertake a careful examination of the nose and sinuses with a nasal endoscope, and perhaps arrange a CT scan of the sinuses. Some patients may need surgery to widen the sinuses. In many cases this can be done in a relatively straightforward and minimally invasive way using surgical balloons to treat the problem (balloon sinuplasty).

Home Remedies – You could try breathing in steam to open the sinuses which can relieve pressure. Put your face over a bowl of boiled water, cover your head with a towel and slowly breath through your nose. You can use plain steam or add a few drops of menthol or eucalyptus. You can also use a salt water solution to clean your nasal passage, which can help to drain the mucus from the sinuses. A warm wash cloth placed against the sinus areas for a few minutes three times a day can also be soothing.

A nosebleed (Epistaxis) is usually caused by a broken blood vessel in the nose or sinuses. Nasal bleeding, particularly when blowing it, is very common and usually not a cause for worry.

As many as 60% of people experience nosebleeds but only around 6% need medical attention. It can be difficult to know what causes broken blood vessels in the nose. There are several things that can contribute to this.

Common Causes:

• Dry nasal cavities
• Nasal injury
• Nose picking
• Blowing too hard or too often
• Infection or allergies
• Dry cavities or sinuses
• Exposure to dry or cold air
• Antibiotic medications
• Blood thinning medications
• Changes in humidity
• High altitude
• Septum issues

Less common causes:

• Nasal, sinus, face, or eye surgery
• Nasal tumors
• Inflammatory conditions
• High blood pressure
• Holes in the septum
• Blood disorders
• Leukemia
• Liver or kidney issues
• Severe vitamin C deficiency
• Cocaine use
• Chemotherapy
• Exposure to toxic chemicals

Treatment

Often, a nosebleed will stop after a few minutes without treatment. If not, you can try the following:

• Gently pinching the nose over the soft lower part that can be squeezed between thumb and finger (not the bony part at the top)
• Relax and breathe orally
• Tilting your head slightly back
• Avoid touching or picking the nose
• Nasal packing
• Local haemostatic agents
• Antiseptic creams and antibiotics
• Blood vessel surgery
• Clotting medicines

Prevention

• Be gentle when blowing your nose
• Avoid picking
• Avoid exposure to cold air
• Treat allergies with sprays or pills
• Use nasal lubricants or saline for dryness
• Avoid exposure to toxic chemicals
• Do not use cocaine

When to seek advice

If nosebleeds are chronic or repetitive then you should seek medical advice. If your nosebleeds are accompanied by any of the following you should also see your doctor:

• The nosebleed does not stop after 20 minutes
• The nosebleed does not slow down or stop when you apply pressure and tilt your head
• Eye pain
• Persistent stuffy nose
• Excess mucus in the throat
• Vision changes
• Swollen neck glands
• The appearance of the nose changes
• Pus
• Facial numbness
• Headache
• Persistent watery eyes
• Loss or reduction in sense of smell
• Ear pain or pressure
• Loss of hearing
• Tooth pain or looseness
• Trouble opening the mouth

New research may have found a way of screening low risk patients for lung cancer, a way that is less costly and less invasive. This procedure is said to be able detect if lung lesions are malignant. Lung lesions (also known as solitary pulmonary nodules) are little growths that are detected on the lungs, usually when the patient has an x-ray for other health related reasons. More often than not, these growths are benign, but cancer is naturally a real concern. In fact, it is thought that in as many as 95% of cases, these lesions are found to be benign. To determine this, many patients undergo invasive surgery to achieve a biopsy on the lung. This new research shows there is a method that can find the answer with a simple nasal swab.

Scientists examined nasal epithelial brushings of patients that were have lung lesions assessed. They examined patients that have formerly been or are currently smokers. The nasal epithelium is made up of a complex layer of cellular tissue that protects and encloses the nasal cavity. The research showed cancer related gene expressions were altered the same way across the two airway sites. This suggests that the nasal airway epithelial field in smokers extends to the nose therefore the brushings could be a lung cancer bio marker. Simply put, a cancer associated airway field that can be measured in the nasal epithelium can provide information about the presence of cancer. This could allow professionals to rule out cancer early on without the need for invasive surgery, just by testing for molecular changes in this field of injury. At present this is a research tool only and is not in mainstream clinical practice although with further research the technique could be introduced into patient care to speed up the diagnosis of lung cancer in a relatively non-invasive way.

A recent study has investigated how obstructive sleep apnea in children can impact memory consolidation. Over the years we are finding out more secrets about sleep and the way it can alter many day to day things. It seems that a broken sleep pattern could be more harmful to our memory function than first thought. One of the many things that sleep plays a part in is memory consolidation. Rapid eye movement (REM) has always been deemed important, but science has revealed that non-REM is also of interest. If sleep helps to firm up our memories then broken sleep is not going to have a good result.

It is thought that as many as 1 in 10 children suffer from Sleep Disordered Breathing (SDB). This refers to symptoms including degrees of airway collapse, such as sleep apnea and snoring. Obstructive sleep apnea (OSA) is the most severe and can stop the sufferer from breathing for as long as 20-40 seconds many times a night. This causes blood oxygen levels to decrease. Fragmented sleep has been proven to have a negative result on adult memory consolidation but there have been very few studies on children.

This recent study tested 36 children aged 5-9 and, as expected, those who suffered from OSA had impaired memory consolidation. Although this was a relatively small study, it was fairly in depth and this is evidence that even mild levels of SDB and OSA can interrupt the memory process in children. Treatment for mild OSA is recommended in order to ensure your child has minimal interference with their memory consolidation. Children that have this issue for many years with out treatment are running the risk of it harming their learning and making academic life more of a struggle.

Recent studies have suggested that parents are unaware of the health issue associated with persistent snoring in children, and how it can be harmful to their quality of life. The research says that many children who snore occasionally will not suffer any harm, but more frequent snoring could be different, particularly in children with sleep apnea. This is because when snoring is persistent the quality of sleep is affected meaning the child can become sleepy in the day time, lack concentration, find learning difficult, wet the bed and even have delayed growth.

Sleep apnea is where breathing becomes shallow or pauses and is a common condition. When this occurs, you will drift from deep to light sleep. Obstructive sleep apnea is the most common type, and this is where the airway becomes blocked or collapses during sleep. The recent research showed that only a third of parents of children with these symptoms went on to seek medical advice, proving that awareness is low. Many parents do not know the implications of sleep apnea and persistent snoring in children.

The most common cause for excessive snoring in children shows to be enlarged adenoids or tonsils, suggesting this issue could be treated with surgery. Parents need to be provided with the facts, so they know when to seek help to ensure their children do not suffer in their day to day life.

Further research shows that teenagers that have sleep issues find it harder to cope with stress. This can have a negative impact on their health and education, leading to falling behind with school work and even depression. This is more evidence that any sleep issue, no matter how small, should always be reviewed by a professional as it is likely something that can be easily treated early on to prevent poor health in the future.

The tongue is an important muscular organ. We use it for speaking, eating and swallowing. If you have a sore tongue it is unlikely to be something to worry about, usually it will be a minor problem that is easy to fix. Here we look at some possible causes of a painful tongue.

• Oral thrush – Candida is a fungus present in the mouth and throat. If this overgrows it can cause a fungal infection. This is most common in newborns and people with low immune systems. Oral thrush causes painful white or yellow patches to form in the mouth and on the tongue. Antifungal medications can treat this.
• Biting or injuring your tongue – Accidentally biting your tongue when eating is very unpleasant and can cause a sharp pain. You can also injure your tongue by having it clamped down upon by your teeth in a fall or accident. Some illnesses that cause seizures may also lead to your tongue being bitten. It will usually take a few days and sometimes a week for your tongue to heal from this kind of injury. Gargling with warm salt water can help.
• Sores – Ulcers and cold sores are common and very irritating. These sores can be caused by a number of things such as stress, hormonal changes, spicy foods, or being run down with a cold or virus. Cold sores are a form of the herpes virus and can be very contagious.
• Glossitis – There are a number of types of Glossitis, almost all of which cause a painful tongue. Glossitis means inflammation of the tongue and treatment can vary depending on the person and the cause.
• Burning mouth syndrome – This is a painful condition that causes a burning, tingling or numb sensation on the tongue. The mouth will not show physical symptoms, but the pain can last a long time. It is thought burning mouth syndrome could be caused by allergic reactions, acid reflux, thyroid issues, dry mouth and diabetes. Treatment depends on the medical history of the individual.

Some of these issues are unavoidable, but practicing good oral hygiene is very important. Brushing and flossing your teeth and seeing your dentist regularly can go a long way.

If your symptoms have been persistent despite adhering to good oral hygiene, it would be worth consulting with your GP for a detailed examination. You may need some blood tests to rule out any vitamin deficiencies, and possibly  also a specialist referral in some cases.

We have all experienced a sore, red nose after a bad cold, the flu or an allergy. In these situations, the skin on your nose will be red due to persistent wiping. There are, however, some other causes of a red nose. Here we look at those causes and possible treatment.

Rosacea and Rhinophyma

Rosacea can start as a tendency to blush easily and the redness usually starts on the cheeks, spreading to the nose, chin, ears and other parts of the face and body. Some doctors believe that Rosacea occurs when blood vessels easily expand and dilate. Lifestyle factors can be a trigger, including stress, eating spicy food or using the wrong skin creams. Rosacea is treated by identifying factors that contribute to flare-ups of the condition and eliminating them. Some drugs that contain sulfur can help treat the symptoms and sun cream can ease the redness.

Rhinophyma is caused when Rosacea is untreated, making the oil-producing glands in the nose to thicken. This can make the nose appear hard and bumpy and blood vessels may be visible. The mite Demodex folliculorum is thought to be responsible. Contrary to common misconception, the condition is not related to excessive alcohol consumption.

Once this develops it is usually permanent and the condition cannot be reversed. However, you can ease the symptoms using the above Rosacea treatments.  There are also some surgical treatments available, including serial shave excisions and laser ablation.

Dry Skin

Conditions that make the skin on the nose dry such as eczema, can be a common cause of a red nose. The irritation makes the skin sore and any scratching or wiping will irritate this. This redness will usually be temporary but the underlying condition will continue to cause it to flare-up. If your nose is red due to your skin being dry then moisturising cream can help. If you have eczema then you need to use the correct cream that eithers treats and eases the condition or one that is mild and does not agitate it. Steroid creams are a common treatment for eczema and skin conditions.

Lupus

Lupus causes the body to attack cells, it is an autoimmune disease and many sufferers develop a butterfly shaped rash on their cheeks and nose. This is known as a malar rash and it makes the nose appear bumpy and red. There are medications that relieve the symptoms of Lupus related skin irritations and help to reduce the frequency of flare-ups. Also avoiding stress and being out in the sun too long can help.

Allergies

Hay fever, pet allergies and dust allergies can all cause the skin on the nose to become red and sore. Identifying the allergy is key and avoiding anything that causes irritation will reduce the risk of a flare-up. Nasal sprays and creams can also help.

Empty Nose Syndrome (ENS) , otherwise often referred to as Atrophic Rhinitis, is a disorder of the nose and nasal passage. Sufferers of this rare condition will have clear nasal passages that appear regular but they will have a range of symptoms. People who have had nasal surgery are most likely to suffer from ENS.

Causes

Multiple previous operations on the nose or nasal passage will increase your chances of developing ENS. People who have had a turbinectomy of any kind may suffer symptoms of ENS but it doesn’t mean that every turbinectomy will lead to it. A turbinectomy is a procedure that removes part or all of the turbinate structure in the wall of the nose, in order to make the nasal passages larger and make breathing easier. Historically, turbinectomy was undertaken rather more aggressively with removal of a large part of the inner nasal lining. Nowadays it is customary to preserve as much functioning mucosa as possible, thereby vastly reducing the risk of developing ENS.

Symptoms

• Nasal bleeding
• Dizziness
• Headaches
• Difficulty breathing
• Soreness and inflammation
• Weakened sense of smell and taste
• Sleep issues
• Inhaled air seeming too cold or dry

Treatment

Unfortunately, there is no quick fix or easy treatment for ENS. Temporary symptom relief is the main goal of most treatments. Saline drips and gels can help to relieve the dryness of the nose but they can also remove beneficial mucus meaning bacteria can spread to the nasal cavity more easily. Antibiotic nasal sprays are advised alongside saline treatments due to this risk.

There are some home remedies that can relieve the symptoms of ENS:

• Using a humidifier at night
• Using a CPAP machine to help with breathing
• Hot soups and hot liquids can ease symptoms
• Living somewhere warm and humid

ENS is often diagnosed once other conditions that can cause similar symptoms have been ruled out. A cotton test used to be performed by the doctor if they suspected ENS, which involved a small piece of wet cotton being held where the turbinate would be. If this gives relief than the person could be an ENS sufferer. This test is rarely performed nowadays as it is not sufficiently reliable.