Travel Reference
In-Depth Information
CHAPTER 16
EAR, NOSE, THROAT, AND DENTAL DISORDERS
James A. Wilkerson, M.D.
Principal Contributor s
Diseases of the ears, nose, and throat, the most common of all disorders if the common cold
isincluded,areusuallyinconvenientratherthandisablingand,exceptforallergies,areofre-
latively short duration. However, all diseases of these organs, even colds, carry some threat
of significant complications and must be respected and treated carefully, particularly in the
wilderness.
DISORDERS OF THE NOSE
Common Cold
A number of viruses cause upper respiratory infections (colds). (Some generalized viral
infections, particularly measles, often mimic a cold during their initial stages.) The viruses
are spread by personal contact. Chilling may play a role in contracting the disease by in-
creasing susceptibility to infection, but in the absence of the causative viruses, cold expos-
ure alone cannot produce infection. Secondary bacterial infections and allergy to the virus
or bacteria cause many of the symptoms of a cold.
A sense of dryness, scratchiness, or tickling in the throat or back of the nose usually ap-
pearsfirst,althoughataltitudethesesymptomsaresometimesencounteredandarenotsigns
ofacold.Suchearlysymptomsarefollowedinafewhoursbynasalstuffiness,sneezing,and
a thin, watery nasal discharge. After forty-eight hours, when the disease is fully developed,
the eyes are often red and watery, the voice husky, and the nose obstructed. An abundant
nasaldischargeispresent,andtasteandsmellarediminished.Acoughiscommonlypresent
andtypicallyisdryatfirst.Lateramoderateamountofmucoidmaterialmaybecoughedup.
The individual characteristically is uncomfortable but not seriously ill. Fever is usually ab-
sent but may be as high as 102°F (39°C). The throat may be sore, but exudates (white spots)
are not present (see “ Streptococcal Pharyngitis ), and the lymph nodes around the neck and
jaw usually are not enlarged.
No effective treatment for a cold has been developed, although some measures to allevi-
ate the symptoms are available. The disease usually lasts seven to ten days. Strenuous activ-
ity during the first few days when symptoms are most severe should probably be avoided,
particularlyathigheraltitudes,toreducetheprobabilityofcomplicationssuchassinusitisor
bronchopneumonia. Moderate exercise at low altitudes and limited work at higher altitudes
fortheadditional threetosixdaysrequiredforcomplete recoveryareusuallywelltolerated.
A decongestant nasal spray may be used to reduce nasal congestion and obstruction.
However, symptoms may be worse after the decongestant wears off, particularly after short-
 
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