By- Dr. Arpit Sharma,(MS ENT), P.D. Hinduja Hospital, Mumbai
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that affects millions globally, including a staggering 55 million cases in India. Despite being the second leading cause of death and disability-adjusted life years (DALYs) in the country, COPD often goes underdiagnosed. Primarily caused by prolonged exposure to harmful irritants like tobacco smoke, air pollution, and occupational dust, COPD leads to airway damage, mucus build-up, and inflammation, impairing lung function over time. While its known effects include breathing difficulties, chronic coughing, and fatigue, its impact on the ear, nose, and throat (ENT) system remains underexplored. This lesser-known connection reveals the broader systemic impact of COPD beyond respiratory health. World COPD Day takes place on November 20th, with this year’s theme emphasising the importance of measuring lung function through spirometry.
How COPD affects the ENT system
While primarily a lung disease, COPD’s systemic nature can significantly affect ENT health.
Hearing loss: Oxygen deprivation caused by poor lung function affects the cochlea, the inner ear structure responsible for converting sound into neural signals. Chronic oxygen deficiency and inflammation can damage auditory cells, leading to gradual hearing loss.
Tinnitus and balance issues: Many COPD patients experience tinnitus, a persistent ringing in the ears, and dizziness, often stemming from impaired oxygen delivery to the vestibular system, which governs balance.
Recurrent ear infections: Poor mucus clearance and nasal congestion, common in COPD, can lead to middle ear infections, resulting in discomfort and temporary hearing problems.
Sinus problems: COPD-related inflammation often affects the nasal passages and sinuses, leading to chronic sinusitis, nasal congestion, and postnasal drip. These symptoms can exacerbate breathing issues and cause facial discomfort.
Voice changes: Chronic coughing and throat irritation in COPD patients can strain the vocal cords, resulting in hoarseness or voice fatigue.
Managing COPD’s ENT impacts
An integrated approach is vital to address the ENT complications arising from COPD.
Routine assessments: Regular check-ups with ENT specialists and pulmonologists can help detect and manage related issues early. Audiological tests, nasal endoscopy, and sinus evaluations are critical for comprehensive care.
Lifestyle modifications: Avoid smoking and reduce exposure to air pollution, both of which contribute to COPD and its ENT-related complications.
Proper medications: While treating COPD, monitor medications for potential ototoxicity. ENT-focused treatments, such as nasal sprays, antihistamines, or ear drops, can alleviate localised symptoms.
Hydration and humidification: Staying hydrated and using humidifiers can ease dryness in the throat and nasal passages, reducing irritation.
Pulmonary rehabilitation: Improving respiratory function through rehabilitation programmes indirectly supports ENT health by optimising oxygen flow and reducing inflammation.
Raising awareness
The growing COPD burden, particularly in India, highlights the need for a more holistic understanding of its systemic effects. With air pollution levels consistently breaching hazardous thresholds, especially in urban areas like Delhi-NCR, the risk of COPD and its ENT complications is rising. Public health initiatives must focus on early diagnosis using spirometry, lifestyle interventions, and preventive care to mitigate the disease’s far-reaching impacts.