Text B. Tonsillar Cellulitis and Abscess

 

Cellulitis (inflammation of cells) around the tonsils may occur with or without quinsy ab­scess in the area around the tonsils). It's usually caused by a streptococcal infection but can be caused by other bacterial infections. Abscess is rare in children but more common in young adults.

Swallowing causes severe pain. A person feels ill, has a fever, and typically tilts the head toward the side of the abscess to reduce pain. Spasms of the chewing muscles make opening the mouth difficult. The abscess pushes the tonsil forward and the soft palate at the back of the throat is red and swollen. The uvula (the small, soft projection that hangs down at the back of the throat) is swollen and pushed to the side opposite the abscess

Penicillin is given intravenously. If no abscess is present, the penicillin usually starts to clear the infection in 24 to 48 hours. If an abscess doesn't rupture and drain spontaneously, a doctor must cut into it and drain it or insert a needle in it to draw out the pus. Treatment with penicillin is continued by mouth. The abscess tends to recur; therefore, the tonsils are usually removed 6 weeks, after the infection has subsided or earlier if the infection is controlled with antibiotics.

 

Notes:

tilt наклон, угловое смещение

soft palate мягкое нёбо

Text C. Cancer of the Nasopharynx and of the Tonsil

Part I.

Cancer of the upper part of the pharynx (na­sopharynx) may occur in children and young adults. Although rare in North America, it's one of the most common cancers in the Orient. It's also more common in Chinese who have immi­grated to North America than in other Americans and slightly less common in American-born Chi­nese than in their immigrant parents.

The Epstein-Barr virus, which causes infectious mononucleosis, also plays a role in the development of nasopharyngeal cancer.

Often, the first symptom is persistent blockage of the nose or eustachian tubes. If a eustachian tube is blocked, fluid may accumulate in the mid­dle ear. A person may have a discharge of pus and blood from the nose and nosebleeds. Rarely, part of the face becomes paralyzed. The cancer may spread to lymph nodes in the neck.

A doctor diagnoses the cancer by performing a biopsy (removal of a small tissue sample for examination under a microscope) of the tumor. The tumor is treated with radiation therapy. If the tumor is large or persists, surgery may be needed. Overall, 35 percent of the people survive for at least 5 years after diagnosis.

Part II.

Cancer of the tonsil occurs predominantly in men and is strongly linked to smoking and alcohol consumption.

Usually, a sore throat is the first symptom. Pain often radiates to the ear on the same side as the affected tonsil. Sometimes, however, a lump in the neck resulting from the cancer's spread to a lymph node (metastasis) may be noticed before any other symptoms. A doctor diagnoses the can­cer by performing a biopsy of the tonsil. Because smoking and alcohol con­sumption may also be linked to other cancers, laryngoscopy, bronchoscopy, and esophagoscopy also are performed.

Treatment includes both radiation therapy and surgery. Surgery may involve removal of the tumor, lymph nodes in the neck, and part of the jaw. About 50 percent of the people survive for at least 5 years after diagnosis.

Notes:

consumption потребление

lump комок, образование, припухлость

jaw челюсть

 

Head and Neck Cancers

 

The average age of people who have head and neck cancers—excluding cancers of the brain, eyes, and spine—is 59 years. Generally, cancers of the salivary glands, thyroid gland, or si­nuses affect people under 59, and cancers of the mouth, throat (pharynx), or voice box (larynx) affect those over 59.

Usually, cancers of the head and neck spread to nearby lymph nodes first. These cancers usu­ally don't spread (metastasize) to other parts of the body for 6 months to 3 years. Metastases (can­cer that has spread from the original site to other parts of the body) usually come from large or persistent tumors and are more likely to develop in people whose immune system is suppressed.

Causes

About 85 percent of the people who have head or neck cancer are former or current users of alcohol and cigarettes. Mouth (oral) cancer may also result from poor oral hygiene, ill-fitting den­tures, and use of snuff or chewing tobacco; in India, chewing betel nut is a major cause. The Epstein-Barr virus, which causes infectious mononucleosis, plays a role in the development of cancer in the upper part of the pharynx (na­sopharynx).

People who were treated 20 or more years ago with small doses of radiation therapy for acne, excess facial hair, an enlarged thymus gland, or enlarged tonsils and adenoids have a higher risk of developing thyroid and salivary gland cancer. Radiation therapy isn't used for such purposes today.

Staging and Prognosis

Staging is a method of determining the spread of a cancer to help guide therapy and assess prognosis. Head and neck cancers are staged accord­ing to the size and location of the original tumor, the number and size of metastases to the lymph nodes in the neck, and evidence of metastases in distant parts of the body. Stage I is the least ad­vanced and stage IV the most advanced.

Tumors that bulge outward tend to respond to treatment better than those that grow into the surrounding structures, form ulcers, or are hard. If the tumor has invaded muscle, bone, or carti­lage, a cure is less likely. For people who have metastases, the chance of surviving more than 2 years is poor. A cancer that spreads along the path of a nerve, causing pain, paralysis, or numb­ness, is likely to be highly aggressive and hard to treat.

Overall, 65 percent of the people who have can­cer that hasn't spread survive for at least 5 years, compared with fewer than 30 percent of those who have cancer that has spread to the lymph nodes or beyond. People over age 70 often have longer disease-free intervals (remissions) and better survival rates than younger people.

Treatment

Treatment depends on the stage of the cancer. Stage I cancers, regardless of their location in the head or neck, respond similarly to surgery and to radiation therapy. Usually, radiation is aimed not only at the cancer but also at the lymph nodes on both sides of the neck because more than 20 per­cent of these cancers spread to the lymph nodes.

Some tumors, including those with a diameter of more than three fourths of an inch and those that have invaded bone or cartilage, are removed by surgery. If cancer is found or suspected in the lymph nodes, surgery is generally followed by ra­diation therapy. Alternatively, in certain cases, ra­diation therapy with or without chemotherapy (treatment with anticancer drugs) may be used, resulting in fair survival rates; if the cancer recurs, surgery can usually be performed later. For can­cer in an advanced stage, a combination of sur­gery and radiation therapy usually offers a better prognosis than either treatment alone.

Chemotherapy kills cancer cells at the original site, in the lymph nodes, and throughout the body. Whether combining chemotherapy with surgery or radiation therapy improves the cure rate isn't known, but combined therapy does pro­long remission. If the cancer is too advanced for surgery or radiation therapy, chemotherapy can help reduce the pain and the size of the tumor.

Treatment almost always has some adverse ef­fects. Surgery often affects swallowing and speak­ing; in such cases, rehabilitation is necessary. Radiation may cause skin changes (such as in­flammation, itching, and loss of hair), scarring, loss of taste, and dry mouth, and rarely, it de­stroys normal tissues. Chemotherapy can cause nausea and vomiting, temporary hair loss, and inflammation of the lining of the stomach and in­testines (gastroenteritis); it also can reduce the numbers of red and white blood cells and tem­porarily impair the immune system.

Notes:

salivary glands слюнные железы

ill-fitting неподходящий

denture зубной протез

 

EXERCISES

 

Exercise 1. Make up sentences of your own using the following words and phrases from the text “Hearing Loss and Deafness”.

 

may be caused by, hearing loss, to be distinguished by, inner ear, middle ear, hearing tests, to indicate a problem, the hearing apparatus, occasionally, discrimination, a type of audiometry, to be commonly used, to transmit sounds through, in response to, the acoustic reflex, magnetic resonance imaging (MRI), auditory brain stem, to depend on.

 

Exercise 2. Study the texts from the chapter “Outer Ear Disorders” and say whether these statements are right or wrong. Correct them if they are wrong.

 

1. The outer ear consists of the three parts, namely the external part of the ear, the ear canal and the eardrum.

2. Cerumen may block the ear canal and cause itching, pain, and a temporary loss of hearing.

3. When the eardrum is perforated, water can enter the inner ear and possibly worsen a chronic infection.

4. Children may put all kinds of foreign objects info the ear canal.

5. External otitis is most common during the winter season.

6. A variety of bacteria and fungi can cause generalized external otitis.

7. Accumulated debris and earwax tend to trap water that gets info the ear canal during a shower.

8. Hematoma can provide the blood supply to the cartilage, leading to a deformed ear.

9. Tumors of the ear may be benign or malignant.

10. Malignant tumors may develop in the ear canal, blocking it and causing a buildup of earwax and hearing loss.

11. More advanced cancers may require surgical removal of a larger area of the external ear.

12. When the cancer has invaded the cartilage of the ear radiation therapy is more effective than surgery.

 

Exercise 3. Summarize the text “Earache” using the following introductory phrases.

 

This text is related to the subject/problem of…

In connection with…I’d like to say that…

In this context I’d like to add that…

It’s quite evident that…

Summing up…

It should be stressed that…

The text clearly shows that…

It may be concluded that…

 

Exercise 4. Discuss the meanings of the following special terms.

 

audiometry, discrimination, tympanometry, eardrum, ossicle, otitis media, sinuses, epistaxis, rhinitis, sinusitis, pharyngitis, tonsillitis, laryngitis, acoustic trauma (reflex), remission, anosmia, tonsil.

 

Exercise 5. Learn the definition of the following special terms.

 

atrophy – a progressive, acquired decrease in the size of a normally developed cell, tissue, or organ. Atrophy may result from a decrease in cell size, number of cells, or both.

 

hematoma – a mass of blood in the tissue as a result of trauma or other factors that cause the rupture of blood vessels.

 

malaise – a general feeling of discomfort or uneasiness, often the first indication of an infection or other disease.

 

polyp – a smooth, pedunculated growth from a mucous surface such as from the nose, bladder, or rectum.

 

abscess – a localized accumulation of pus in a cavity formed by tissue disintegration.

 

tonsil – a rounded mass of tissue, usually of lymphoid nature.

 

laryngoscope – a hollow tube equipped with electrical lighting, used to examine or operate upon the interior of the larynx through the mouth.

 

Exercise 6. Answer the following questions to the text from the chapter “Disorders of the Nose and Sinuses”.

 

1. What does the upper part of the nose consist of?

2. What diseases does the nose affect?

3. What are the causes of nosebleeds?

4. What is usually done to control the nose bleeding?

5. What are the diseases causing the tendency to bleed?

6. What is nonallergic rhinitis?

7. What types of rhinitis do you know?

8. What does rhinitis result from?

9. What is sinusitis?

10. What are the symptoms of acute and chronic sinusitis?

11. What causes hearing loss and deafness?

12. How many types of hearing loss do you know?

13. How are middle (inner) ear disorders treated?

14. What are the most common symptoms of otitis?

15. What medicine is used to prevent nosebleeds?

16. What causes nosebleeds?

17. What may be done in case of nonallergic rhinitis?

 

Exercise 7. Choose the correct answer.

 

1. The eardrum is

a) the auricle b) the tympanic membrane

c) the cochlea d) fenestra vestibuly

 

2. The stirrup is

a) malleus b) incus

c) stapes d) saccule

 

3. The ear lobe is the

a) pinna b) ossicles

c) cochlea d) fenestra cochlea

 

4. The round window is the

a) fenestra cochlea b) fenestra vestibuli

c) malleus d) semicircular canal

 

5. The Eustachian tube allows our ear to

a) pop b) drain

c) bang d) close

 

6. Cerumen is known as

a) fluid b) hairs

c) paste d) wax

 

Exercise 8. Match the half-sentences in column A with the half-sentences in column B to make correct and complete sentences.

 

A

1. Hearing loss may be…

2. In childhood, the auditory nerve can…

3. Hearing loss can…

4. Some hearing tests can…

5. Earwax may…

6. Insects may…

7. The infection may…

8. An injury of the ear can…

9. The collected blood can…

10. Tumors of the ear may…

11. Inner ear disorders produce…

12. Viral otitis media is…

13. Signs of an impending complication include…

14. Earaches may…

15. Perforation of the eardrum can…

16. Bleeding usually can…

17. Acute rhinitis is…

18. Acute sinusitis may…

19. Pharyngitis can…

20. Cancer of the tonsil occurs…

 

B

a. …enter the ear canal.

b. …cut off the blood supply to the cartilage, leading to a deformed ear.

c. …block the ear canal and cause itching, pain and loss of hearing.

d. …result from inflammation caused by infections or from tumors in the outer or middle ear.

e. …the usual sign of a cold.

f. …be caused by a variety of bacteria and often developes after a viral infection of the upper airways.

g. …predominantly in men and is strongly linked to smoking and alcohol consumption.

h. …occur in viral infections such as the common cold, influenza and infectious mononucleosis.

i. …symptoms such as hearing loss, vertigo, tinnitus and congestion.

j. …usually followed by bacterial otitis media.

k. …be noncancerious or cancerious.

l. …affect the entire canal, or just one small area.

m. …be caused by acute otitis media.

n. …detect disorders in the auditory processing areas of the brain.

o. …caused by a mechanical problem in the ear canal or middle ear.

p. …be damaged by mumps, rubella and inner ear infections.

q. …cause bruising between the cartilage and perichondrium.

r. …indicate a problem in any part of the hearing apparatus.

s. …a headache, sudden profound hearing loss, chills and fever.

t. …be controlled by pinching the sides of the nose together.

 

Exercise 9. Underline the correct words or phrases to complete each sentence.

 

1. Symptoms, which include a sore throat and pain when swallowing, are

a) different in viral and bacterial pharyngitis; b) similar in viral and bacterial pharyngitis.

 

2. Antibiotics don’t help a) if the infection is viral; b) if the infection is bacterial.

 

3. Metastases usually come from a) benign tumors; b) large or persistent tumors.

 

a. Mouth cancer may result from a) poor oral hygiene, ill-fitting dentures and use of snuff or chewing tobacco; b) air pollution or allergic reactions.

 

4. If the tumor has invaded muscle, bone, or cartilage, a cure is a) less likely; b) more likely.

 

6. If cancer is found or suspected in the lymph nodes a) radiation therapy is generally followed by surgery; b) surgery is generally followed by radiation therapy.

 

Exercise 10. Speak on the following.

 

1. Diagnosis of Deafness.

2. Causes of Nosebleeds.

3. The Difference between Pharyngitis and Tonsillitis.

4. Head and Neck Cancers.

SECTION 9

EYE DISORDERS

Eyes and Vision

 

The structure and function of the eye are com­plex and fascinating. The eye constantly adjusts the amount of light it lets in, focuses on objects near and far, and produces continuous images that are instantly transmitted to the brain.