Upper respiratory tract infections due to cold weather can occur anytime during the winter months. It occurs more frequently from November to March.
So what does it mean to have a cold?
Being cold actually means rapid heat loss. Heat, humidity and pollution in the air play an important role in the emergence of diseases. Cold works in two ways. The former reduces resistance by affecting circulation in the respiratory epithelium, and the latter causes reflex contraction of the respiratory epithelium. This in particular causes sinus constriction, impairing air circulation. Thus, it helps the reproduction of microbes that come with airborne droplet infection. The ideal amount of humidity in the air we breathe should be around 45%. In heated places, the amount of humidity in the air decreases to 15%.
This draws the water in the respiratory epithelium and allows it to dry out and also allows microbes to reproduce more easily. On the contrary, it prevents evaporation in the tissues in the nose and causes nasal congestion in the tissues. All these factors lead to colds or, in other words, upper respiratory tract infections called colds. This is the mechanism of formation of the disease, which is popularly called “I have a cold”.
Ear, Nose and Throat in Winter
In Istanbul, an increase in upper respiratory tract diseases is observed with the cold weather in winter months. The patient, whose complaints started, first comes to the ENT doctor. There are complaints such as nasal congestion, discharge, sore throat, pain, fever, malaise. If treatment is started as soon as the symptoms begin, the patient will recover within a few days, not too many. Most of the time, there is no need to use antibiotics. Resting as much as possible and avoiding bad habits such as smoking helps and accelerates recovery.
Well, what happens if this microbe that infects the ENT area cannot be treated on time or if the patient has diseases such as deviation chronic tonsils that will cause the disease to progress? In this case, the disease usually progresses locally and spreads primarily to spaces such as sinuses, causing acute sinusitis. When sinusitis develops, the inflammatory fluids that fill the sinus cavities intensify with excessive secretion of the mucous membranes here and stay there for a long time, causing chronic sinusitis.
The other reason for this is that the thickened mucous layers block the openings of the sinuses into the nose. Istanbul weather creates an ideal environment for this disease. The cold and humid weather in winter contributes extra to swelling in the tissues lining the nose and sinuses. On top of that, when the infection caused by viruses or bacteria circulating in the moisture droplets in the air by settling here is added, upper respiratory tract diseases easily occur.
Crowded environments are the factors that increase the frequency of infection due to the density of people in public transport. Especially in the cases we encounter very frequently, in families with children, the infection from school friends is brought home or, on the contrary, the sick child transmits it to other friends at school. Therefore, a mucosal infection occurring in the ENT area should be treated immediately at the initial stage and these potential problems should be prevented.
Ear Infection in Children with Cold Weather
With the cold weather, children who have to spend more time in closed environments such as school have an increase in upper respiratory tract infections such as upper cold sinusitis. If the child has a tissue that obstructs the nasal cavity, such as adenoid, this is almost always accompanied by otitis media.
The most important reason for this is that the nasal tubes of the ear, which we call the tuba eustachian, which provides ventilation of the middle ear, are short and anatomically flatter than adults. Thus, microbes that settle in the nose easily reach the middle ear and cause infection there. If the child has adenoid problem, this area becomes more suitable for infection. When such complaints begin, a slight runny nose, cough, mild fever and ear pain are seen. When these complaints occur, you should show your child to an ENT specialist as soon as possible. Because when fluid accumulation starts in the middle ear, it may follow a silent course.
Even if the child’s complaints regress, mild hearing loss will be seen due to the fluid in the middle ear. You can understand this best when they start to turn up the volume of the television and do not react when you call.
Does Snow Kill Germs?
The words that my patients who come with complaints such as colds and sinusitis usually say “even if it snows and the microbes die, look, we got the cure”…
So is this really true?
Do the germs, viruses or bacteria that cause colds, flu and sinusitis really die with snowfall? This statement is partly true and partly false. Istanbul has an air that even the north winds cannot clean due to the very dirty and wrong urbanization. This humid air contains a large amount of harmful substances, particles and microbes. Indeed, when it snows, snowflakes pick up these harmful microbes and substances and bring them down to the ground. They clean the air of these harmful substances, but they also stick all the dirt to the earth. That’s why the snow in the city is quite dirty. Snowflakes really clean the air, but not the earth.
This is true for external environments. But we city people spend most of our time indoors. While there is air that has been cleaned by snowfall outside but has stuck the dirt in the air to the surface, there is polluted air inside that makes it easy for us to get sick and infect each other. Especially workplaces where many people work together, public transportation vehicles and cafes create risky environments. This, in contrast to the above claim, leads to more frequent infections such as colds and sinusitis in the upper respiratory tract. It is snowing and the air is clear, but we are hesitant to go outside, what should we do?
First of all, we have to break our hesitation and decide to go out. However, we should never eat the falling snow while breathing the cleaned air. Especially we should not feed it to our children and pets. Going out will break the resistance created by closed, low and stuffy environments and will bring us dynamism. If we have to stay indoors, we should ventilate the environment frequently despite the cold. Thus, although it is not very true in practice, we continued the myth of ‘it snowed and the microbes died’. Despite the bad weather, we could get rid of being stuck inside and maybe play snowballs with the children, increasing our energy and helping our immune system to work more effectively.
What is the common cold?
With the cold weather in the winter months, an increase in upper respiratory tract diseases is observed. The patient, whose complaints started, first comes to the ENT doctor. There are complaints such as nasal congestion, discharge, sore throat, pain, fever, malaise. If treatment is started as soon as the symptoms begin, the patient will recover within a few days, not too many. Most of the time, there is no need to use antibiotics. Resting as much as possible and avoiding bad habits such as smoking helps and accelerates recovery.
Well, what happens if this microbe that infects the ENT area cannot be treated on time or if the patient has diseases such as deviation chronic tonsils that will cause the disease to progress? In this case, the disease usually progresses locally and spreads primarily to spaces such as sinuses, causing acute sinusitis. When sinusitis develops, the inflammatory fluids that fill the sinus cavities intensify with excessive secretion of the mucous membranes here and stay there for a long time, causing chronic sinusitis. The other reason for this is that the thickened mucous layers block the openings of the sinuses into the nose.
Winter weather creates an ideal environment for this disease. The cold and humid weather in winter contributes extra to swelling in the tissues lining the nose and sinuses. On top of that, when the infection caused by viruses or bacteria circulating in the moisture droplets in the air by settling here is added, upper respiratory tract diseases easily occur.
Crowded environments are the factors that increase the frequency of infection due to the density of people in public transport. Especially in the cases we encounter very frequently, in families with children, the infection from school friends is brought home or, on the contrary, the sick child transmits it to other friends at school. Therefore, a mucosal infection occurring in the ENT area should be treated immediately at the initial stage and these potential problems should be prevented.
Allergic Catarrh and Nose Surgery
Our patients with allergic rhinitis generally think that nasal surgery will not benefit the treatment of their diseases. Yes, surgery does not cure allergies, but it helps to reduce allergy disease, although not directly. Allergy, as we all know, is a disease characterized by the excessive reaction of the tissues in our nose and upper respiratory tract to substances such as dust and pollen in the external environment.
When the allergen comes to the tissue lined with respiratory epithelium, such as the nose, a severe counter-response develops against it. The tissue swells and produces too much secretions, responding too much to remove the substance and disproportionate to the amount of incoming substance. This causes complaints such as nasal congestion, discharge, sneezing, redness around the eyes and tearing in the eyes, which we call nasal allergy. If the patient also has nasal division curvature, these complaints double. If it is not treated in time, it causes the epithelium filling the nose and sinuses to overgrow, regional obstructions and even the formation of polyp tissues such as grape bunches in the nose.
So where does nose surgery benefit from?
Surgery does not cure allergies. In patients with mild or severe allergic rhinitis, surgery is required if there is nasal division curvature and sinusitis. Since the operation is not aimed at allergies, the nasal airway passage is opened and breathing is relieved, the sinus holes are widened and the connections with the intranasal are increased, providing advanced relief for the patients.
In addition, an even more beneficial result is obtained if the nasal concha, which is the surface where allergies are most common, is reduced. As we asked before, what is the benefit of this for allergies? The answer is actually simple and functional. In the epithelium lining the upper respiratory tract, such as the inside of the nose, the surface that encounters the allergen has decreased. This physical benefit causes less allergen retention and less complaints thanks to a healthy functioning epithelium. Patients use less allergy medication after surgery and patients’ complaints about the disease come to a level that does not cause much discomfort.
It should also be noted that if the allergy is stopped in the upper respiratory tract, the disease will not occur in the lungs and lower airways.
Cold, Flu and Air Travel
During airplane travel, we are most often disturbed by our ears and sinuses. The reason for this is the pressure difference in these spaces inside our head due to the pressure changes in the external environment. While going from high pressure to low pressure, the air in these cavities inside the head comes out of the anatomical holes and balances the pressure with the external environment. Likewise, when going from high to low, the rising pressure in the external environment with the opposite mechanism enters these anatomical regions naturally and equalizes the pressure. While most people have problems with landing and take-off with very little ear congestion, the situation can be quite difficult for sick people.
If there is an infection such as sinusitis in the nose and sinuses, severe pain may occur in the head and around the eyes, as the aeration of the sinuses will become difficult. Likewise, if the nasal area is clogged, the same pain is felt in the ear, since the ear tube cannot work comfortably this time.
So, what should we do if we are sick and have to travel by plane?
First of all, if we have the opportunity before the trip, it would be beneficial for us to see an ENT specialist and get their advice. If we do not have such an opportunity, some things we will do will help us. Chief among these is chewing gum. Since our jaw movements will be continuous while chewing gum, this helps the air circulation of the middle ear as it helps to open and close the ear tubes.
As the channel called Eustachian tube opens and closes every time we swallow, air passage is relaxed. Nasal opening drops are beneficial. Used before takeoff, and especially during landing, they help open up both the ear tube and sinus punctures. Pressure problems are most common during descents. The reason for this is that while high-pressure air comes out of the sinus or middle ear more easily due to the laws of physics, high-pressure air enters the low-pressure head cavities more difficult as it will collapse the tissues. That’s why we are most uncomfortable on landings.
Nasal clearing pills containing pseudoephedrine, which we will take before the trip, are also very useful. And we mustn’t forget the Valsalva maneuver that we all know by taking deep breaths and closing our nose and mouth and pressing air upwards into the ears.
ENT Problems During Air Travel
During the plane journey, our patients most frequently have complaints in the ear, nose and throat area. This is because the air pressure decreases with increasing altitude after the aircraft takes off. It is explained by Boyle’s Law, one of the most fundamental laws of physics. As you know, Boyle’s Law states, “The pressure and volume of gases at equal temperatures are inversely proportional”. In other words, as the altitude increases, the air pressure decreases and the gases that are equal to the sea level move towards the low pressure ground. There are air-filled areas divided into different anatomical regions in the ENT and head and neck regions. These are located in the sinuses within the bone in the middle ear. The reason why these air-filled spaces are like this is to make our head lighter in mass and to fulfill the normal physiological functions of the organs in which they are located.
In simple terms, just as the inside of the soccer ball is filled with air and is light, the function of other air-filled spaces such as the sinus in our head is the same. We can simply divide the organs with air-filled spaces in the head and neck into two: These are the ear and the sinuses.
For bone-walled body cavities such as the middle ear and sinuses, it means that the air pressure in these cavities must match the ambient pressure during flight. In other words, since the pressure will decrease as the plane gains altitude during the journey, the high pressure in these spaces can easily go out and become equal to the ambient pressure. For example, gases in a closed area at an altitude of 4000 meters expand approximately twice.
Today, cabin pressure is kept constant throughout the entire journey in modern airplanes. However, this is adjusted according to the pressure at an altitude of about 2500 meters, not at the atmospheric pressure at sea level. As the passengers travel 10 kilometers up during the journey, the pressure inside the aircraft is adjusted as the pressure above 2500 km. While the plane is climbing, the air remaining in the ear exits from the nasal region through the Eustachian tube, and the air in the sinuses exits through the openings of the sinuses into the nose.
In this case, we should not have a disease that will cause the holes that allow this air exchange to be blocked, both in our ears and inside the nose, and in our nasal region. If we get on a plane when we are mildly ill or have a disease that obstructs the upper respiratory tract, such as a cold or flu, we may have complaints such as severe pain as the pressure in these air spaces cannot be easily equalized.
Therefore, we may need to seek advice, treatment or medication from a specialist if we are going to travel while we have a condition in the ENT area.
Attention to ENT Problems as Spring Comes!
The end of the winter months and the warming of the weather cause an increase in diseases seen in the upper respiratory tract. With the approach of the summer months with the spring, the heat and humidity rates in the air that we have been accustomed to for a while change. In particular, the sudden increase in temperatures can cause us to sweat and lose heat due to the clothes we cannot change yet, or being deceived by the nice weather and walking around with light clothes can also cause us to catch a cold.
Heat, humidity and pollution in the air play an important role in the formation of such diseases. Although the pollution in the air decreases with the spring, it leaves its place to the pollen that causes allergic reactions. Ideal environmental conditions; Ideal humidity, air temperature that does not vary too much and clean air increase resistance to diseases.
The ideal humidity in the air we breathe should be around 45%. Especially in winter months, the humidity in the air decreases to 15% in heated environments. In the spring, this rate increases. Even a light wind in a deceptively beautiful weather makes us feel the cold more. All these are factors that cause diseases in the upper respiratory tract.
In order to be protected, we should not be deceived by the beautiful weather, especially in spring, and pay attention to our clothes. We should prefer clothes that will keep us warm but not sweaty. If we think that the weather is hot outside and go out with light clothes, we may catch a cold, which leads to a decrease in our body resistance and to get sick. Or on the contrary, if we dress thickly and go out, we will sweat this time and this will cause us to lose heat and prepare the ground for the disease.
During these months, we should consume plenty of fluids and prefer fruits or fruit juices containing vitamin C. Avoid drinks containing caffeine such as cola and coffee. Smoking is especially dangerous because its smoke disrupts the self-cleaning mechanism of the mucous membranes of our upper respiratory tract and creates a suitable environment for diseases to settle. When we get sick, it prolongs our recovery time.
Ventilation is very important, especially in environments where a large number of people work. It is necessary to obtain the weather conditions mentioned above. Dirty and dusty rooms increase the possibility of transmission, if one person gets sick, others can easily be infected in such environments.
Ventilate your living and working environments frequently, and let the sun’s rays enter your room in sunny weather.
Benefits of Sea and Sun to Upper Respiratory Tracts
Sea water has many positive effects on our health. Studies show that sea water has many positive physical and psychological effects on people. Nearly 100 substances found in the human body are also found in sea water. Sea water has been used for healing purposes in many ages due to its ingredients such as calcium carbonate, sulfate, potassium chloride, magnesium chloride, magnesium sulfate, zinc and iodine. In this respect, seawater is a storehouse of mineral salts, amino acids and trace elements like blood plasma.
In particular, we can say that sea water is very effective in the treatment of asthma, allergic diseases and chronic sinusitis. Salt water cleans all the sinus tracts and ensures that the upper and lower respiratory tracts are completely discharged with the beneficial bacteria in its content.
In recent years, we recommend pure sea water, known as “ocean water”, to a large number of patients, from the treatment of infections in the nose after surgery to babies who have breathing difficulties for various reasons. In addition, swimming is a very effective physical therapy in terms of increasing the capacity of the lungs.
Thanks to the vitamin D we store in our body with the sun’s rays in the summer, our defense system is also strengthened. Sea air, loaded with negative ions that accelerate our absorption of oxygen, increases the amount of oxygen in the blood, increases thyroid activity, and helps us to be happy by fighting against stress. Before the end of the summer, I recommend you to meet the sea and the sun often.
External Ear Infection at Summer
The worst thing that can happen to us in the summer is severe ear pain that starts at midnight. Often we are at a summer residence or on vacation and we do not know what to do because we are unprepared. Especially since we are on holiday somewhere outside of our home, we do not have enough medicine or a health institution to go to. We often panic because we don’t understand what’s going on. In fact, the cause of severe ear pain that starts at night is usually external ear infections. Since this area is anatomically very narrow and formed together with cartilage tissue, the pain sensation is severe.
In our external ear canal, there is a layer of skin formed by sweat fat and hair follicles. This layer, together with the cartilage, lays this area like the layer covering the inside of a tube that reaches over the ear bone to the eardrum. The infection, which occurs as a result of the hair follicles or sebaceous glands getting infected here, puts pressure on the surrounding cartilage structure and bone structure. A lesion, such as a small pimple stuck in a narrow space, causes severe pain.
The best thing to do is to use a pain reliever if we have it with us and to reduce the pain with hot compress application. In a short time, it is necessary to go to an Otorhinolaryngologist, to clean this area with an aspirator, to apply solutions that will dry the infection, and to start using painkillers and antibiotics immediately.
Cleaning the external ear canal in infection is a painful but very useful method. It allows antibiotics or ear drops to take effect better and in a short time. The biggest reason for this disease to happen to us, especially in summer and holiday destinations, is the increased sweating in the summer months, the fact that our external ear canal is clogged with earwax, called a plug, and when we enter the water, such as a sea pool, the microbes coming from here find a suitable environment in this region and reproduce easily. Especially if we suspect earwax before going on vacation, having it cleaned will allow us to stay away from the disease that will poison our possible vacation.
