Bird Families

Don't climb inside! The Barnaul doctor honestly told what was wrong with our ear-throat-nose


Catfish - cuckoo (or multi-spotted synodontis) is a unique aquarium fish. It differs from other inhabitants of the reservoir by its unusual color and behavior during spawning. Although the cuckoo catfish has recently appeared in pet stores, it has already become popular among many aquarists.

- The main children's problem is frequent colds, constant coughing and sneezing. How can ENT help?

- Of course, everyone knows that children have reduced immunity. But not everyone knows that it is excessive, and for this reason, children also often get sick. That is, they react to every draft with an increase in temperature, coughing and sneezing. On the one hand, it's good - the body learns to cope with diseases. But for mom, this is a source of endless experiences.

With excess immunity in a child, protective tissue grows in a larger than necessary volume. We call this enlargement of the adenoids and tonsils. And then the mothers say: "Three days healthy - two weeks sick." And so for years. Colds in childhood should be two to three times a year, not twice a month.

The easiest way to fix this is to trim the enlarged adenoids and tonsils to their normal size.

- Many adults remember tonsil surgery as the worst hospital nightmare from childhood.

- Now operations on ENT organs are performed for both children and adults. The operation in most clinics is performed under general anesthesia, the patient does not remember anything, after a few days he is completely happy and discharged home and forgets about the runny nose and sore throats.

In Soviet times, there was a low quality of anesthesia, after which many complications could appear, overlapping, in fact, the positive effect of anesthesia. So then the children underwent surgery on the adenoids and tonsils, as the doctors joked, “under screaming,” that is, without anesthesia, the children were really shouting.

Now there are modern high-quality drugs for general anesthesia. The only disadvantage is that they are expensive. For this reason, they are often not used in many hospitals.

The main thing is that adenoids and tonsils cannot be removed by everyone, there are clear medical indications for this. At one time in the United States, in order to prevent other diseases, they began to do such operations to everyone and received a huge number of complications. For example, completely removed the tonsils in a healthy person, the infection is not retained by the lymphoid tissue in the pharynx and flies straight to the lungs - the person earns chronic bronchitis.

The decision about surgery should be made only by ENT according to medical indications.

- Let's say the doctor decided to remove the tonsils, and the mother says: "No, I won't let the child cut!"

- There are a lot of such mothers. We cannot order, but then we must prepare for the fact that the child will continue to get sick often and a lot, snore and breathe with an open mouth. Any orthodontist will tell you that large adenoids and tonsils are one of the reasons that permanent teeth begin to grow crooked.

So by adolescence, a child's teeth will literally fan out or crawl over each other, and it will take a lot of money and years to correct this scourge.

- What else do adenoids affect?

- There are other childhood problems associated with adenoids. For example, otitis media: when enlarged adenoids simply block the auditory tubes from the inside, the ears become inflamed, even through holes can form - perforations in the eardrum. Or sore throats: with large tonsils, food particles fall into their lacunae, they become inflamed and suppurate.

In fact, mothers themselves often "help" their children to get sick longer and more often. For example, rinsing the nose with strong jets of salt water or pharmacy sprays with sea water.

They, contrary to the general belief, do not flush germs from the nose, but on the contrary - everything that gets into the nasal cavity during inhalation, including viruses, bacteria, dust, is driven into the ethmoid, maxillary, frontal sinuses and even through the auditory tubes into the ears. And then, after diligently washing the nose, mothers take the children to the ENT doctor with otitis media and sinusitis.

No matter how television advertisements for flushing devices show that all the microbes from the nose disappear somewhere, they do not go anywhere, but go through natural holes - fistulas - straight into the paranasal sinuses, causing inflammation there.

- But what about the famous cuckoo procedure? It is still used today.

- This is a Soviet invention. Back then, many doctors did not understand how the nose worked at all. They thought that with the help of an electric pump it was possible to somehow remove the pus from the sinuses. This technique is still really used, but I am against: what is the point in moving the infection from one sinus to all the others? The healing effect is minimal, and the inflammatory process spreads.

And adults come with the same problem, because they start treating any cold with this harmful nasal rinse. And if earlier we believed that sinusitis as a complication from acute respiratory infections can join on the seventh day, or maybe not at all, now, after intensive rinsing of the nose, it can occur on the second or third day and significantly worsen the course of the disease.

I'll tell you where the nasal rinsing came from. In the early 1980s, there were such recommendations for workers in coal mines. If a person's respirator is broken and he works without protection, then after the change it was necessary to irrigate his nose with water and blow his nose, and it became easier for the person to breathe.

But everyone else does not need to do this, we do not have coal deposits in our nose.

But selling all kinds of nasal flushing devices is a great business: selling slightly salty water for the price of cognac.

- So, let everything flow out of the nose by itself?

- Why did you decide that the nose needs to be rinsed at all? A person has an excellent mechanism for self-cleaning of the nose: everything inside is covered with a thin layer of mucus, dust and infection that have gotten on inhalation adhere to it, then special microcilia are pushed into the throat, and the person unnoticed it swallows it, and the stomach digests it all.

The stomach is a rather aggressive environment, it digests everything except a few infections. Cholera cannot be digested, but most staphylococci, streptococci, viruses are easy.

New, clean mucus is produced in the nose again, and the process is repeated. Small children, sharply sniffing air and swallowing, help this process of clearing the nose, and adults are able to blow out some of the mucus.

Nasal mucus contains ingredients that prevent inflammation. It is as natural a secret as saliva or tears. When we cry, tears also enter our nose and throat, and we swallow them. So the nose is an endless self-cleaning filter.

- Let's get into the ears. Do I need to take care of them somehow hygienically?

- We also have an ear protection mechanism - the production of sulfur. It is a special anti-inflammatory substance that covers the ear canal around it. And any microbe or virus that enters the ear with water, dust and dirt sticks to the sulfur.

Then the sulfur dries up and at night, while you sleep, it just spills out of your ear. It's so small - tenths of a gram - that you can't even see these micro-flakes. The key point is that the sulfur must dry. And if a person washes his ears vigorously, then the sulfur will accumulate and in a year or two it will completely plug the ear in the form of a cork. I will say more: sulfur is hydrophobic, it is not washed off with water, so this procedure is doubly meaningless.

If a person is concerned about hygiene and joyfully shuffles in his ears with cotton swabs, he erases this protective sulfur film. In contrast, the body begins to produce this substance much more intensively, and again we have an excess of sulfur and ear plugs.

In addition, cotton swabs are not sterile, they are intended for external use. Using them to clean your ear leads to inflammation.

- Growing up, what ENT problems does a person acquire?

- By older people, due to problems with the nose in the eardrum, permanent perforation may form. Chronic otitis media will develop. And then the ear will become inflamed and fester all life when water gets in or with a runny nose.

Such people undergo hearing restoration operations. This is high-tech assistance, there are quotas for it. Ossicular prostheses can be placed. And the "holes" are closed with their own, specially processed living tissues from the temporal muscle membrane or the cartilage of the auricle. In this way, the eardrum and therefore hearing can be completely restored.

As for the nose, the big problem is breathing recovery. Many young people like to show strength, and the blows are often missed, so that the nasal septum bends, and a badly breathing nose leads to frequent inflammations - sinusitis and frontal sinusitis. Prompt restoration of nasal breathing is one of the most common operations in ENT departments.

Chronic tonsillitis is another common "adult" problem. In the stage of exacerbation, it manifests itself as angina. Now it is perfectly treated with the Tonsillor apparatus using low-frequency ultrasound. The throat then does not become inflamed for a long time, sore throats stop, and the person feels good throughout the year. Unfortunately, this procedure is not paid for under the compulsory medical insurance policy and is carried out only for a fee.

- How many times should a person have a sore throat? Is there some limit after which a patient can be considered a "chronicle"?

- Five sore throats a year are already "chronicles", and people get sick 8-10 times. In principle, a person may not be very worried about this, but chronic tonsillitis then can lead to rheumatism (a systemic disease of connective tissue, localized mainly in the membranes of the heart), polyarthritis (inflammation of several joints at once), glomerulonephritis (immune inflammation in the kidneys).

So chronic tonsillitis must be treated without fail. And with the ineffectiveness of conservative treatment and complications, remove the tonsils.

In addition to inflammatory processes, otorhinolaryngologists also deal with other problems of the larynx. For example, tumors. And it's good if they are benign. The person has a hoarse and hoarse voice, and many think that he smokes a lot.

Although most often it is - neoplasms grow just in smokers. It happens that a person is sincerely surprised: “Where did the tumor come from? Well, think about it, I've been smoking two packs a day for 40 years already. "

Small benign tumors can be removed with special instruments or a laser, and the voice is restored. It is more difficult with malignant tumors. They are either burned out by radiation, poisoned with chemotherapy, and if this does not work, then they are removed entirely along with the larynx, a small hole on the neck with a breathing tube remains, and there will be no voice. And this is not the worst option yet.

So if the voice has changed, you must immediately go to the ENT doctor, otherwise you can grow a large, very large tumor, and the person cannot be saved.

- How to understand what is needed specifically to the ENT, and not to another doctor?

- By order of the Ministry of Health since 1974, therapists and pediatricians should deal with all colds, sore throats, bronchitis, tracheitis, laryngitis and acute rhinitis. The ENT doctor deals with complications after these processes.

Any ARI should pass in a week. If not, then, most likely, it has begun, for example, sinusitis or otitis media, then it's time to go to ENT. But often people think: "Well, for the second day I have been sneezing, I will go to the lore." This is not true. See a therapist for you.

- In our city, we still have to try to get an appointment with an ENT, since there are not so many doctors.

- This is not a prestigious specialty, compared to many a low-paid one. There are not enough doctors.

In addition, in order to simplify the statistics, at one time they made two categories: ear diseases and upper respiratory tract diseases. So, ordinary cough and complex sinusitis fall into the latter category, only one disease is treated by a therapist, and the second is treated by ENT.

Based on these statistics, the required number of doctors is calculated. And it seems that more therapists are needed if we have a lot of upper respiratory tract diseases. And how many ENT doctors are needed is difficult to determine.

There is also a danger of getting to a doctor, in whose office there is no necessary equipment. In 2012, a standard for equipping an ENT office was developed and approved in Russia. It should have a workplace and endoscopic equipment that allows you to view organs with magnification on the screen and even record it on video.

But eight years have passed, and this equipment is not available in all ENT offices of polyclinics. Doctors have to look at the patient with just an eye and small mirrors, and they are far from seeing everything, especially in the internal cavities. And there is a great chance of simply not seeing serious illnesses.

- It is known that a person does not really like to go to the clinic: I'd rather go to the pharmacy and ask "some nasal drops."

- Did the pharmacy look into your nose? Why do you think that the right medicine will be recommended for you?

A runny nose can be a symptom of anything. These are allergies, nasal polyps, sinusitis - each disease has its own treatment. A pharmacist is not a doctor, but a seller; it is more profitable for him to sell you expensive drugs. And you think that the more expensive, the more effective.

Let's take the most ordinary aspirin and take it across the floor of the globe by plane - the cost will increase tenfold, but this will not stop it being an ordinary aspirin and will not acquire magical properties. But, if you put it in a beautiful bag and advertise it, you can sell it hundreds of times more expensive.

- What are the consequences of self-medication?

- There are, for example, medicines for the treatment of certain ear diseases, containing so-called ototoxic antibiotics. They help in healing the skin of the ear canal. But if there is a hole in the eardrum, they will get on the auditory nerve and cause complete deafness.

Suppuration with otitis media may disappear, but the auditory nerve may be damaged, and after a while it will be impossible to restore hearing. So should you trust a pharmacy?

There is also the concept of medication rhinitis. It happens from the uncontrolled use of vasoconstrictor drugs. During the first four to six hours, there is indeed an effect. And then sometimes up to two weeks without instillation, the nose breathes badly. So the coryza "lengthens".

Without these drugs, you can recover much earlier. Having instilled vasoconstrictor drops into the nose, you can get a runny nose lasting from two weeks to the end of life. Millions of people in the world cannot live without vasoconstrictor drops, addiction arises. Today, WHO has already singled out rhinitis medication as a separate disease.

It is better to use the so-called topical nasal steroids instead of vasoconstrictor drops and sprays, there are also a lot of these drugs. They will slowly but surely help restore nasal breathing. Swelling in the nose can be relieved by taking antihistamines. And this is quite enough to quickly recover from mild colds. And complex, long-term diseases still need to be consulted by an ENT doctor.

What is known about Yevgeny Timoshensky

Otolaryngologist of the highest category, candidate of medical sciences. He began his medical practice in 1985.He worked in the medical unit "Transmash", the Regional Clinical Hospital, the Regional TB Dispensary, the Special Polyclinic No. 2, the Regional Oncological Dispensary, and was in charge of the ENT department of Russian Railways in Barnaul. Chief otorhinolaryngologist of the Altai Territory (1990-2002, 2006-2019). Laureate of the International Prize in Healthcare. N.I. Pirogova.


The body of the fish is elongated and dense. In an aquarium, an animal can grow up to 17 cm in length. The head is elongated, on the sides there are large eyes, the mouth is below. Three pairs of whiskers grow around it, with the help of which the catfish orientates itself in the reservoir.

The dorsal fin, which has the shape of an acute-angled triangle, has spiny spines. The pectoral fin is wide and large. With its help, fish are able to move quickly in the water. The caudal fin is wedge-shaped with long rays at the end.

The color of the scales of the multi-spotted synodontis can vary from cream to brown. All over the body of the fish there are black or dark blue spots, with a diameter of 1 to 3 cm. Their size is determined by the individual characteristics of the animal. The fins of the fish are transparent, they also have specks.

The life span of the cuckoo catfish varies from 13 to 18 years.

Living in nature

The birthplace and only home of the multi-spotted synodontis is Lake Tanganyika, which is located in four countries at once: Tanzania, Burundi, DR Congo and Zambia. The cuckoo catfish is endemic to this reservoir, therefore it is impossible to meet it in other lakes.

Here fish live at a depth of about 30-40 meters, where a small amount of sunlight reaches and where the composition of the water practically does not change over time. Animals prefer places with little vegetation, where sandy soil alternates with stone.

Keeping in the aquarium

These fish cannot be called demanding on the conditions of detention. However, in any case, some rules should be followed to make the life of animals as comfortable as possible.

Aquarium volume

Since the average body length of a cuckoo catfish is approximately 13 cm, the aquarium should be selected with a volume of at least 100 liters to accommodate 3-4 individuals. Filtering should be effective, but not overly powerful. Aeration is required.

Water parameters

For a multi-spotted synodontis, the following water parameters will be comfortable:

  • Acidity - 6.8 - 7.8 pH,
  • Hardness - 20 - 30 °,
  • Temperature - 25 - 28 ° С.


Lighting should be diffused and dim. This is due to the fact that in their natural habitat, fish are predominantly nocturnal, and therefore they will hide in shelters from too bright light. A good option would be to use low wattage lamps or place the aquarium in a room that is on the shady side of an apartment or house.

Water change intervals

Catfish - cuckoos are demanding on water quality. Therefore, its replacement must be carried out strictly every week, updating 30% of the total volume.


Sand or fine gravel works well as a substrate. Before placing in a reservoir, it should be thoroughly rinsed, disinfected and laid on the bottom with a layer 5 - 7 cm thick.

Plants and decor

In natural habitat, catfish practically do not collide with plants and are absolutely indifferent to them. Therefore, a neutral flora should be chosen as a decoration for the aquarium:

  • All types of echinodorus,
  • Cryptocoryne,
  • Duckweed (will diffuse lighting),
  • Anubias,
  • Vallisneria,
  • Limnobium,
  • Hornwort.

Since multi-spotted synodontis are nocturnal animals, hiding is extremely important for these fish. Therefore, in the aquarium, it is imperative to place through grottoes, caves, houses, driftwood and pots in such an amount that they are enough for each individual.

Compatibility and behavior

Due to its peaceful nature and calm disposition, catfish can become a good neighbor for most fish species. Cichlids, whose homeland are the lakes of Africa, are ideally combined with it. Other fish of similar size and behavior will do well as well.

It is not recommended to add fish to the synodontis, the size of which is much smaller than his. Such inhabitants of the aquarium will either suffer from a lack of food, or they themselves will be perceived as live food.


Catfish - the cuckoo is considered not only an omnivorous fish, but also an aquarium cleaner. He gladly eats algae from the walls of the aquarium, worms, snails and in some cases even carrion.

For the full development of the fish and the further maintenance of its health, the animal's diet should consist of 70% protein food:

  • Worms,
  • Koretra,
  • Insects.

The rest of the menu is occupied by vegetable and dry food.

Dry food should only be purchased at pet stores. They must be specifically designed for catfish. The serving size and composition are indicated on the package.

Multi-spotted synodontis are prone to overeating, and as a result, obesity. You need to feed the fish once a day in the late afternoon (1 - 2 hours before the end of daylight hours). Serving size is determined by the amount that the flock can eat in 4 to 5 minutes. Further, the remaining feed is caught and removed.

Sex differences

You can distinguish a female from a male by several signs:

  1. By the time she reaches puberty, the female becomes fuller.
  2. The dorsal fin of the male is sharper.
  3. The genital nipples of females are more rounded than those of males.

Breeding and reproduction

Catfish become sexually mature by the age of two. When breeding, these fish use nest parasitism, throwing their eggs to other fish, like cuckoos. They often choose African cichlids as temporary parents.

Before spawning, multi-spotted synodontis eat eggs of other fish, replacing it with their own. Thus, cichlids place catfish eggs in their mouths and begin incubation.

Diseases and their prevention

By their nature, cuckoo catfish do not have a predisposition to any specific diseases. Therefore, all health problems come from improper care and carelessness in the maintenance.

Due to the fact that the fish lives mainly in the lower layers of water, it can develop fin rot, which is characterized by the formation of outgrowths and ulcers on the scales. In this case, the sick animal is given baths with the use of medicines.

The main symptoms of diseases:

  • A change in behavior towards apathy or hyperactivity (characteristic of almost all diseases),
  • Change in appetite
  • Discharge of mucus or blood from the eyes, mouth, anus, etc.,
  • Changes in the color or composition of the scales,
  • Rotting fins
  • Falling scales.

If any of these symptoms are found, it is urgent to deposit the fish in a separate tank and begin treatment with baths.

Compliance with the rules of care and attentiveness in the maintenance are the key to the health and comfort of the fish. Therefore, in order to avoid the occurrence of any diseases, preventive measures should be followed:

  1. The water parameters in the aquarium should correspond to the values ​​that are comfortable for the fish.
  2. The soil should be purchased only in special stores, and not collected on your own on the banks of natural reservoirs.
  3. If a sick fish is found, it should be immediately deposited in a separate container, and in the general aquarium, completely change the water and disinfect all the decorations.
  4. Fish food should also be purchased from specialty stores.
  5. The amount of food should not be in excess.

Catfish - a cuckoo is a real find for any aquarist. This unusual and attractive fish will diversify any body of water and decorate it with its presence.