Shelby Stockton is joined by otolaryngologist Dr. Yamileth Nicolau. Dr. Nicolau talks about lifestyle changes we can incorporate to promote ear, nose and throat health, and how aging impacts nasal congestion and breathing difficulties.
Shelby Stockton (00:00)
Welcome to the Texas ENT Audio blog. I'm Shelby Stockton, and today I spoke with otolaryngologist Dr. Yamileth Nicolau about common ear, nose, and throat conditions that become more prevalent as we age. Dr. Nicolau talks about lifestyle changes we can incorporate to promote ear, nose and throat health, and how aging impacts nasal congestion and breathing difficulties. She also tells us how aging affects the voice and vocal cords and the treatments available to keep us in tip-top shape as we mature.
Dr. Nicolau, welcome to our audio blog. It's so great to see you again.
Dr. Nicolau (00:37):
Well, thank you Shelby, for having me today. It's great to be invited and enjoy some nice conversation.
Shelby Stockton (00:45):
Fantastic. I'm excited to get your insight. I want to talk to you about aging and your specialty. My first question is, what are the most common ear, nose, or throat conditions that become more likely as we age?
Dr. Nicolau (00:57):
That's a great question, Shelby. Starting with the ear, one of the most common complaints we have is actually hearing loss, which after the age of 65, gets even more common. Hearing loss that could be caused from noise exposure, genetics, the fact that we're getting older. The other one that's very common is actually tinnitus, which is that ringing in the ears and a lot of times it's associated with the hearing loss. A very, very common complaint that we hear about.
The other thing that sometimes gets to be a little bit more of a nuisance and a problem is actually ear wax, just very common ear wax, but it's something we can fix real quickly in the office, and we have a lot of different ways to manage. Certainly we recommend to avoid anything inside the ear canal and we can talk about that a little bit more, but that's very common for the ear.
Regarding the nose, a lot of people complain of more congestion, that drippy nose, drainage that goes to the throat. Trouble breathing through your nose, especially at night and we have a lot of patients that when they lay down at night, then they experience that blockage and it's very bothersome. Other things that are common is nose bleed. A lot of our patients that are older are on multiple medications. A lot of them need to take blood thinners, including aspirin. That can make it more common to manage that nose bleed. We call it epistaxis, but it's very important to manage. It can become very difficult.
The other thing that can happen as we get older, especially over 70, even 80, is changes in the sense of smell. Can have decreased sense of smell, and that can be associated with multiple things as we age. Those are the most common there.
Regarding the throat, of course, we get again the complaint of the drainage in the throat. A lot of patients as we age, our voice box changes so the voice changes as well. So all these changes in the voice can make them feel like they can't project their voice not as strong as it used to be, a little hoarseness. They used to sing in church and now it's getting more difficult. So we have these special scopes and cameras, we can check the voice box and see what can be done.
Other things are things like acid reflux that can affect certainly the voice box and you don't even know. You feel it like just drainage in your throat. Then the other thing that tends to be more common in general is the snoring, and some of our patients develop something called sleep apnea and we do manage that and then further test for sleep apnea.
So those are some I would say of the most common conditions we see as we age. Certainly allergies tend to be a little bit less, but for some people it gets worse. So we always take care of nasal allergies as well.
Shelby Stockton (04:29):
Oh gosh. Getting old is such a pain in the butt. But are there specific life changes that can promote overall ear, nose and throat health?
Dr. Nicolau (04:40):
Yeah, and I agree it's a difficult stage to manage, but certainly there are things we can start in our younger age, right? So getting old, you cannot prevent that. That's just going to happen. But there are things that we can do when we're younger to prevent those other things.
So what are those things? Well, one of the things, avoid loud noise. Avoid loud noise exposure, either workplace, or concerts or music. Now that we all wear headphones and have all this computer age, we just need to be careful of the volume that we listen to music and have our headphones.
We also recommend, in general, I think that would apply to anything, of course. Avoid smoking, tobacco use, certainly that affects everything from the nose all the way to the throat. Limit your alcohol intake, and we always say to protect yourself from the sun because we do see a lot of patients that may need to have what we call a Mohs procedure. So basically they get skin cancers and they need to be managed as well. So protect yourself from the sun.
The other thing, like we say, we manage people with sleep apnea. It tends to be more common in people that have trouble with their weight. If we can have an active lifestyle, good diet, avoid irritants to the throat and things like that.
Shelby Stockton (06:24):
How does aging impact nasal congestion and breathing difficulties?
Dr. Nicolau (06:30):
Interestingly, as we age, the anatomy and the support of the nose also gets a little bit more relaxed and that can also create some obstruction to the nose. So the nasal tip, the nasal valve is the sides of the nose that collapse a little bit sometimes. Those are all things that can make that nasal blockage obstruction worse as we age.
Also, swelling inside the nose. The lining of the nose changes as we age, that can be more swelling. A lot of our patients can have, like we discussed, a lot of that drainage, that congestion, the drippy nose. A lot of times as we age, the nerves that are going into the nose change the blood vessels in the nose and that creates congestion, that creates all that drainage, that creates the blockage. Because some patients have problems before but they didn't notice it as much as now when they're older. We certainly manage each and all of them. So basically nasal rinses, doing nasal steroid spray and a histamine spray.
For the drip, we use some things like a special nasal spray called ipratropium. We have multiple procedures that we can do in the office or in the operating room depending on what the patient needs that will really change this and improve their lives.
Shelby Stockton (08:11):
How does aging affect the voice and vocal chords?
Dr. Nicolau (08:15):
So that's an important one because of course, we use our voices for communication. As we age, a lot of the muscle, the lining of the throat also changes like it happens all over our nose and throat. The vocal cords themselves can become less strong, a little thinner. The mucus production changes, they get dry, less elastic, less strong. That can create that little bit of hoarseness, loss of projection, difficulty hitting some notes at the church, for example, at the choir.
Also, even sometimes patients at that point are retired, so their speaking engagements are not as common and you're not using your voice as often. So we do have patients that can undergo some lifestyle changes. Again, avoid irritants to the throat, drink lots of water, avoid too much tea, coffee, or things that irritates the throat.
Some of them need voice therapy, but there are procedures that we can do to improve their voice, including in office vocal cord injections that'll make those vocal cords a little more plump and they can project better. A lot of them have this and it really improves their lives.
Shelby Stockton (09:56):
So we're not completely lost. There is hope. There is ways to fix it.
Dr. Nicolau (10:00):
There is a lot of hope. Yes, and that's why it's important. Some people I understand, they say, well, it's been like this for a long time. But please visit your ear, nose, and throat doctor.
At Texas ENT, we have a lot of physicians that are very experienced with all these situations and there are things that we can do to help.
Shelby Stockton (10:26):
Well, you heard it here first, everybody. Doctor, thank you so much for your time. I really appreciate it and so does everybody who's listening right now.
Dr. Nicolau (10:35):
Well thank you for having me. Have a great day.
Shelby Stockton (10:38):
You as well.
