Healthy Aging Month reminds us to take care of ourselves. It’s the time to take inventory of our daily routine to ensure we age healthfully and comfortably. Read on to learn how to get back on track.
Shelby Stockton: (00:00)
Thank you for tuning into the Texas ENT Audio Blog. My name is Shelby Stockton, and September is Healthy Aging Month. To celebrate, I sat down with otolaryngologist Dr. Michael Briscoe to discuss how aging affects the ears, nose, and throat. He tells us how these areas of our bodies sometimes decline as we get older and what could be done to help. Loss of hearing is a popular topic here, but Dr. Briscoe also educates us on how our nose and vocal cords can atrophy as we mature. Take a listen.
Shelby Stockton: (00:30)
Dr. Briscoe , welcome to the Audio Blog.
Dr. Michael Briscoe: (00:33)
Good morning, how are you?
Shelby Stockton: (00:35)
I'm great. I just want to talk to you about a few things, because September is Healthy Aging Month and we're here to discuss how aging affects the functions of the ear, nose, and throat. So having had said that Dr. Briscoe, as we age, what happens to these areas of our body?
Dr. Michael Briscoe: (00:51)
So the most common issue that I see is hearing. So the hearing does decline as we age, but also there can be ringing or tinnitus that shows up. With aging, the hearing, usually it's the higher frequencies that lose more of the hearing first, and this can cause problems such as being able to hear people but not understand them completely, having trouble when you're in crowded areas or restaurants. A lot of times patients will come in because their family members are concerned about their hearing, that they are always asking them to repeat themselves or they're mishearing what their family members are saying. So that's probably the number one issue that I see as far as the years go. Second to that would be ringing in the ear and we can see ringing in the ear at any age, but definitely I see it a lot more in the aging population and that can also be attributed to hearing loss.
Dr. Michael Briscoe: (02:03)
There are some things that certainly contribute to ringing in the ear, having a previous job where you were exposed to noise or going to loud concerts, riding motorcycles, using firearms or hunting, those are things that can contribute to ringing in the ear. In addition to that, stress, lack of sleep, caffeine and alcohol intake also affect ringing in the ear. And a lot of people do have sleep issues as they age where they wake up a lot earlier than they normally would or they have trouble falling asleep or staying asleep. So after hearing problems, I would say the most common issue that I see in the aging population would have to do with their nose. So several conditions can happen where they can have maybe decreased smell, they can have a chronic runny nose or they can have postnasal drip, which can lead to a chronic cough.
Dr. Michael Briscoe: (03:06)
As far as the, I guess we call it chronic rhinitis, is when you have congestion in the nose and drainage, several conditions can affect that. One is just run of the mill allergies, and this is something that they may have had allergies their whole life or they may have developed them later in life. In addition to allergies, there's also something called non-allergic rhinitis, which basically is very similar to allergies. Except when we do allergy testing, they don't respond to any of the allergens. In addition to that, there's something called vasomotor rhinitis and that's where the nose just kind of runs all day, and it can run because the temperature has changed. It could run because there is wind blowing on the face. It could run because of strong perfumes or chemical irritants. And the last one that I see relatively frequently is something called gustatory rhinitis.
Dr. Michael Briscoe: (04:02)
And that occurs with basically every time they eat or drink anything, their nose just starts to run. And we certainly have ways of treating all of those different types of rhinitis. The last problem that I typically see in the aging population is issues with their swallowing and their voice. So it could be that they were able to eat most things and not have to drink water or liquids to kind of help push them down or they were able to take multiple pills at once, but as they get a little bit older, they do have to take their time. They have to chew their food a little bit more, make sure that they're taking pills one at a time and with liquids. With the voice, their voice sometimes can get softer. They can develop hoarseness, they can develop raspiness. And it has to do with the muscles of the vocal cords getting a little ... they just lose a little muscle tone. And there's certainly ways that we can help with that, diagnose that and get treatment for that as well.
Shelby Stockton: (05:11)
Are these issues inevitable or is everyone just kind of different?
Dr. Michael Briscoe: (05:17)
The hearing, it's really interesting because I have some people who have excellent hearing all the way until their nineties and I have other people who they may just be in their early fifties and have hearing loss. So some of it is genetic, some of it is related to occupational or recreational noise exposure. The main thing is if you feel like you're having any hearing loss or ringing in the ears, come in and seeing us, we can certainly do a hearing test, and it could be a baseline hearing test or it could be a comparative hearing test to see if there has been some hearing loss. And hearing loss can be because of nerve damage or there's other conditions that we see such as ear wax impaction or fluid in the ear. And those are things that can be addressed and treated. And those are more of the reversible types of hearing loss or as the nerve hearing loss really does require amplification. So we'd be looking at potentially doing hearing aids or something like that.
Shelby Stockton: (06:25)
So are there any surgical procedures that can help with any of these issues?
Dr. Michael Briscoe: (06:29)
So for hearing, it really does depend on if this is a nerve hearing problem or if there's a blockage. And there are a lot of people that I see who have something called eustachian tube dysfunction and it's basically they have negative pressure on their ear and it definitely affects their hearing and it can fluctuate. It can be when they travel to elevation or when they're on a plane and their ear can just get stopped up for days. And we do have procedures that can treat that. So for eustachian tube problems, we can either do a eustachian tube dilatation or we can do a myringotomy tube, which is basically making an incision in the eardrum and placing a tube so that the ear can equalize pressure. For the chronic nasal drainage, there's medications that can be used and it just depends on if it's the allergic rhinitis, the non-allergic rhinitis or the vasomotor rhinitis. The typical medications would be the allergy medications, so your nasal steroids and antihistamines.
Dr. Michael Briscoe: (07:39)
There's also a medication called ipratropium bromide, which works very well for the gustatory and vasomotor rhinitis. But we also do have surgical procedures that can be done. The main procedures we have work on the posterior nasal nerve, which causes a lot of that drainage, and the procedures are either ClariFix or RhinAer. And what they do is they calm that nerve down so that you're not having as much drainage and mucus production. So it can help a lot with that postnasal drip and cough and chronic clearing. With issues with swallowing and the voice, a lot of times we do need to do with something called a flexible laryngoscope where we actually look at the airway and we look at that initial opening to the esophagus. And that's how we can see if there's any problems with the tone to the muscles of the vocal cords, or if there's any masses that could potentially be blocking or interfering with swallowing or with the voice. And if we do find any pathology there, there are times where we can do surgeries to remove vocal cord polyps or any other masses that may be present.
Dr. Michael Briscoe: (08:57)
There are times where if the vocal cords, they just need a little bit of a workout, we could recommend some speech therapy to help out with that, but there are other pathologies that we would have an intervention performed by a laryngologist. On the swallowing side, we work very closely with the speech pathologist and they can help us out as well.
Shelby Stockton: (09:23)
So there's hope. Growing older doesn't have to be completely bad. There are things we can do.
Dr. Michael Briscoe: (09:28)
Yeah, I would definitely say come in, let us know what your problems are so we can do a full evaluation and assessment. And if there's any other further tests that we need to do, whether it's a hearing test or it's actually looking at the nasal mucosa or looking at the larynx or the voice box and the throat, we can do all of that. And if there's any other testing or any procedures that would be helpful, we can certainly recommend those. If there's any medications that can help out also, we would try to those first.
Shelby Stockton: (10:00)
Great. Dr. Briscoe, thank you so much. I really appreciate your time.
Dr. Michael Briscoe: (10:05)
Thank you. Thank you. Thank you. I certainly appreciate being here and being a resource to all the patients.
