Dr. Denis Grillo, Ear, Nose & Throat, 10/02/12 - Pink Paper Day

Being pregnant can be a wonderful, yet curious period of time that can induce physiological changes in the body and nearly half of the women who become pregnant may see manifestations of this physiological change in their ear, nose and throat system.

+ Otosclerosis, which is a hearing loss problem that is characterized by buildup of bone in the middle ear normally occurs more frequently in women than men. During pregnancy it progresses even more rapidly in some cases. One out of two women who have a family history of otosclerosis or already have been diagnosed need to pay careful attention, as this may occur.

+ Bell’s palsy, or facial nerve paralysis, occurs three times more in pregnant women versus non-pregnant. It also seems to be most common in the last three months of the pregnancy.

+ Gastroesophageal reflux disease and laryngopharyngeal reflux, or commonly called heartburn, occurs frequently during pregnancy because of increased abdominal pressure, decreased stomach emptying, and a weakened stomach valve, allowing acids to flow up the esophagus into the throat.

Patients may have symptoms including sore throat, a sensation of something being in the back of the throat, a sensation of postnasal drip and maybe even a sour taste as fluids reflux into the throat area.

This type of heartburn is self-limiting, and when the pregnancy resolves it usually goes away and does not carry the long-term problems gastroesophageal reflux disease does. Usually, treatment with antacids work quite well.

+ Voice changes can occur with the hormonal changes seen during pregnancy and can be quite disturbing to the patient, but are relatively minor. Usually, you will see some swelling of the lining of the voice box, some dryness and maybe even some weakness of the vocal cords that bring about an unusual quality to one’s voice.

No treatment is required for this condition and it will resolve once the pregnancy is over.

+ “Pregnancy neoplasm” is a benign, non-cancerous growth of the oral cavity usually seen on the gums that can get red and purplish and bleed, which can be scary. But there is little chance of this growth becoming cancerous.

Once again, it usually will resolve when the pregnancy is completed. Sometimes it requires surgical intervention and removal if it is too uncomfortable or will not stop bleeding.

Other findings in the oral cavity include inflammatory changes usually seen on the first trimester. Usually, this is an increased reaction to local irritants and is also likely to go away on its own and require no treatment.

+ Nasal symptoms are probably the most common problem I see during pregnancy. The No. 1 complaint is usually nasal congestion, followed by nosebleeds with no prior history of nose bleeding. We know that the episodes occur as a result of increased estrogen causing increased blood supply, leading to swelling of the nasal membrane, and causing it to become irritated and bleed.

Usually, topical cautery is all that is needed to take care of this problem.

The more rare problem seen during pregnancy are nasal polyps, which will usually go away with topical steroid spray as well as completion of the pregnancy.

For the most part, ear, nose and throat problems during pregnancy are self-limiting and seldom ever over shadow the wonderful event that is occurring.

Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.