Ear, Nose & Throat Health

SALLY DUFFINBSc Nutr.Med, MBANT, FHFI

www.nutritioninyork.co.uk

Aims of Webinar

• Look closer at the structure and detail of the ear, nose and throat passages and how they are interconnected

• Highlight common ENT disorders• Discuss key nutrients and practises for

supporting ENT health

Ear, nose & throat

• 1st line of defence against airborne microbes• Lined with sensitive mucous membranes to

trap and filter airborne particles• Otology, Rhinology, Laryngology

EarEar is divided into 3 parts: - External ear: Auricle (Pinna)External acoustic meatus (ear canal)Tympanic membrane (ear drum)

- Middle ear:Oval windowMalleusIncusStapesRound window

- Inner ear:CochleaSemicircular canals

Physiology of hearing

• External and Middle ear relate to hearing, Inner ear relates to hearing AND balance

• Hearing and sight are our 2 most dominant senses

• Our ears pick up tiny vibrations in the air = sound energy

• We developed the ability to hear 210 million years ago!

Physiology of hearing• The pinna concentrates and

directs sound waves into ear canal

• Eardrum vibrates• Vibrations transmitted by the

ossicles (malleus, incus, stapes)

• Fluid in the inner ear moves stimulating neuroepithelial cells to generate nerve impulses along 8th cranial nerve to the brain

Physiology of balance

• Inner ear part of balance regulation• A change in head position causes the lymph to

move which stimulates nerve endings.• Nerve impulses passed to cerebellum area in the

brain which also receives impulses from eyes, muscles, joints.

• These impulses re co-ordinated and efferent impulses sent to muscles to alter or maintain body position

What can go wrong?

• Ear infections – external and internal– Staphylococcus aureus– Bacteria– Fungi– Allergic reaction

• Otitis media• Menieres• Labyrinthitis – flu, chickenpox, rubella, mumps• Tinnitus

NoseExternal nose; bones and cartilage

Nasal cavity; nostrils septumLined with ciliated columnar epithelium containing goblet cells that secrete mucous

Nasal lining extends into the pharynx

Sinuses; frontal sphenoidal maxillaryOlfactory region – our sense of smell

Physiology of nose

• Breathing! Remains open when we eat• Warms and humidifies air coming into the

lungs• Defence against microbes and airborne

particles• Smell• Speech

What can go wrong?

• Sinusitis – pre-disposing condition, fungal infection, infected tooth

• Allergies, hayfever• Rhinitis• Post-nasal drip• Loss of sense of smell• Epistaxis – risk factors include trauma, dry

membranes, medications, hypertension, alcohol abuse, clotting disorders.

ThroatPharynx; - common opening of both the digestive and respiratory systems - Connects to the respiratory system at the larynx and the digestive tract at the oesophagus3 sections - Nasopharynx contains openings from 2 auditory tubes from the middle ear and the pharyngeal tonsil (adenoid) - Oropharynx contains palatine and lingual tonsils - LaryngopharynxLarynx; - extends from the base of the tongue to the trachea (windpipe) - thyroid and cricoid cartilages

Physiology of the throat

• Begins as a common passageway for air and food

• Prevents us swallowing food into our lungs

• Vocal chords - speech

What can go wrong?

• General sore throat• Tonsillitis• Laryngitis• Throat infections• Diphtheria - vaccine• Sleep apnoea – muscle function in throat

Supporting ENT Health

• Inflammation• Infection• Pre-disposing

conditions• Part of a larger picture

of dis-ease

Key Nutrients

• Antioxidant nutrients– Vit C– Vit A and beta carotene– Vit E– Zinc– Selenium

• Vit C, vit e, beta carotene shown to reduce cold symptoms & duration by 20%

Key Nutrients

• How?– Anti viral– Supporting health of mucous membranes– Antioxidant– Supporting Natural Killer Cell function– Supporting T-cell maturation– Closely linked with.........

Key Nutrients

• Beneficial gut bacteria–Repress rotaviruses, inhibit pathogen growth –Modulate T-cell activity to influence

inflammatory cascade–Essential to counterbalance commonly

prescribed ENT antibiotics–Supplement with good quality, carefully

processed probiotics

Key Nutrients

• Hop alpha acids–Natural pain relief–Anti-inflammatory via selection of COX-

2 enzymes–Reduces the need for NSAIDs–No sedative or oestrogenic effects

Key Nutrients

• Vit DKey vitamin D metabolizing enzymes are

expressed by the immune system. Modulates the adaptive immune system

through its effects on T-cell activation and antigen-presenting cells.

Enhances clearance of bacteria by immune cells.

Key Nutrients

Aloe Vera• Correctly processed whole leaf preparations are rich

in polysaccharides• Enhances bioavailability of vitamins C and E• Encourages growth and proliferation of probiotic

bacteria• Anti viral• Anti inflammatory• Use as mouthwash or gargle

Key NutrientsOmega 3• Powerful anti-inflammatory and immunomodulatory

effects• Regulates eicosanoid production• Eicosanoids from arachidonic acid on the omega-6

pathway have pro-inflammatory activity; omega-3 pathway eicosanoids balance this with anti-inflammatory actions.

• Krill oil provides omega-3 fats in highly bioavailable phospholipid form as opposed to triglyceride form

• Useful for chronic ENT conditions

Supportive Holistic techniques

• Steaming• Oil pulling with coconut oil• Warm facial compresses

• Facial massage

Summary

ENT conditions can be bacterial, viral, fungal or auto-immune and involve symptoms of inflammation, pain and excess mucous

Key nutrients can be used to support anti-inflammatory pathways, pain relief

Practical techniques can also be used

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References

• Seeley R. et al (2008) Anatomy & Physiology Eighth Edition McGraw-Hill, New York

• http://www.medterms.com/script/main/art.asp?articlekey=3290 accessed online 13/03/2013

• Sleep apnoea http://www.patient.co.uk/health/obstructive-sleep-apnoea

Accessed online 12/03/13• http://en.wikipedia.org/wiki/Thyroid accessed online 13/03/13• http://journals.cambridge.org/action/displayAbstract?fromPag

e=online&aid=7948498 accessed online 14/03/13

• Micronutrients and Innate Immunity http://jid.oxfordjournals.org/content/182/Supplement_1/S5.short accessed online 14/03/13

References• Vitamin C Promotes Maturation of T-Cells.

http://www.ncbi.nlm.nih.gov/pubmed/23249337 accessed online 14/03/13

• Dietary and commensal derived nutrients: shaping mucosal and systemic immunity. http://www.ncbi.nlm.nih.gov/pubmed/22857854 accessed online 14/03/13

• Murray M.T. (1996) Encyclopaedia of Nutritional Supplements Three Rivers Press, New York

• Functional and Morphological Pathology of Chronic Sinusitis Mucous Membranehttp://informahealthcare.com/doi/abs/10.3109/00016488309105584

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