CORONA FACE MASK

On a current occasion: Do you have any complaints from using the mouth-nose mask / Corona face mask?

The Corona pandemic is forcing humanity worldwide and probably permanently to wear masks in public and in daily life. Whether in restaurants, on public transport or at work, wearing a mask determines our everyday life and is now almost unthinkable without it. Often, mask wearers complain of complaints such as shortness of breath, irritation of the respiratory tract, mucus build-up, a lumpy feeling in the throat and headaches, loss of concentration, as well as tiredness and fatigue. However, this does not have to be the case. Such symptoms are often easily treatable.

Do you also complain about discomfort? Below you will find the most important problem areas at a glance:

1. General information about the respirator:

Most people observe shortness of breath in themselves and in other people during exertion, but also at rest while wearing a mouth-nose covering or a mouth-nose protection. Depending on the shape of the mask and the choice of material, there may be significant restrictions on the individual's gas exchange. The vast majority of the population wears either textile masks or simple paper masks. These have a pore size that varies depending on the material. The masks are not tight-fitting, so that air can flow in and out through the mask material, but also to all sides of the mask. This results in a slight increase in airway resistance at best. However, there is already an increase in the amount of carbon dioxide from the exhaled air that is breathed back in. The pore size is not specifically prescribed by the respective governmental authorities. The wording only states that a suitable covering of the mouth and nose must be worn. This form of masking improves external protection, but not self-protection.

Because of the increased exposure to airborne particles or pathogens, medical personnel must wear masks with a suitable pore size that ensure filtration of the particles from the inhaled air. There is a medical device directive and a European standard for this. There are masks that have different quality designations depending on the country of origin or country of use. In Europe, FFP 2 (Filtering Face Piece) and FFP3 masks are the most commonly used corona masks. These are designed to filter particles the size of SARS Covid-19 viruses to 95% or almost 100% respectively. The denser the filter, the higher the airway resistance. This can be up to 60 Pa/cm2. Medical staff have to wear these masks continuously for practically the entire working day. This takes many mask wearers to the limit of reasonable exposure.

2. Problem area respiratory tract: shortness of breath, oxygen desaturations, nasal pain and headaches

Everyone who wears these masks has noticed the very specific, not always pleasant smell of these masks, which is caused by the material used (meltblown fleece) or the adhesive. Many complain that this provokes an irritation of the nose, which results in a watery runny nose. However, the continuous putting on and taking off of the mask for blowing is not desirable for epidemic protection and hygienic aspects, as otherwise a virus contamination is likely.

People with pre-existing respiratory conditions, especially asthmatics, allergy sufferers, people with gas exchange disorders, chronic obstructive pulmonary disease, people with anaemia, i.e. too little haemoglobin, which transports oxygen in the blood, or people with anxiety, i.e. phobias, experience a significant reduction in their quality of life by wearing the masks. A pre-existing nasal breathing obstruction and/or people suffering from obstructive sleep apnoea experience additional airway resistance from the Corona mask, which eventually forces mouth breathing. However, mouth breathing damages the body in the long run. The nose as a personal air conditioner is virtually disconnected from the respiratory flow. The filtration, warming and humidification of the air we breathe cannot be guaranteed by mouth breathing. As a result, the mucous membranes of the mouth and throat, as well as the trachea and bronchi, can dry out. The result is an irritated cough and an annoying lumpy feeling in the throat. Pre-existing respiratory problems are thus aggravated.

People with sleep apnoea suffer doubly. Night sleep is already not restful and oxygen desaturations disturb the sleep architecture. The restful REM sleep and deep sleep are often no longer achieved. The recurring adrenaline releases triggered by the pauses in breathing have a massive effect on the cardiovascular situation. Daytime fatigue and a drop in performance occur almost regularly. With this preload, a further increase in airway resistance and an increase in carbon dioxide due to the exhaled air in the mask while wearing it during the day has an even more fatal effect.
The reduction of oxygen and the increase of carbon dioxide in the inhaled air usually lead to headaches and concentration problems.
With some anatomical variations in the shape of the external nose, wearing a mask can either be painful, as pressure points and possibly also pimples develop at the contact points of the mask due to skin contamination. In some cases, on the other hand, the necessary seal may not be guaranteed.

A thorough ENT examination can help to identify any longstanding airway resistance and to assess its effect on the organism. In addition to medications and equipment, there are a number of surgical options to return the airways to a normal state.

3. problem area ears: Hearing comprehension and earache

Hearing-impaired people who either wear a hearing aid or still have a certain level of speech comprehension by lip-reading or checking the mouth image and therefore do not yet need a hearing aid, although they are on the borderline of needing a hearing aid, are suddenly no longer clear when their surroundings and their conversation partners are masked. At this point at the latest, an individual ORL check with a hearing test is sensible and necessary.

However, earache and hearing loss can also result from reduced tube ventilation due to blockage of the nasal airways.

The elastic straps of the mouth-nose masks are held in place by the auricle. After wearing the mask for a long time, most people experience localised pressure pain with and without simultaneous deformation of the auricle. This often results in grotesque deformations of the pinna, which are often disfiguring enough, while also causing the rubber reins to slip off the now deformed cartilaginous pinna. People who wear hearing aids in addition to their glasses then find it difficult to put on or take off one of the three aids. Health insurance companies are now accustomed to having to provide more replacements for hearing aids, because even people with good manual dexterity lose them more often in the process. If manual dexterity or arm lifting is limited due to neurological or orthopaedic diseases, those affected often feel overwhelmed.
Permanently deformed auricles can be restored to an attractive condition by corrective auricle plasty.

4. problem area of voice and communication:

People with communication disorders, hoarseness or stuttering experience additional stress due to the muffling of the speech sound that the Corona mask exerts. They need to speak louder depending on the environment they are in, but often cannot. The voice "tilts", hoarseness or stuttering increases. The person(s) they are talking to do not understand or lose interest in communication. The consequence is social withdrawal, which can often enough result in depression.

Communication professions such as teachers, managers, speakers, singers and many others who make their living from speaking notice that much more effort is required when the Corona mask is worn than when video conferences are held online and the mouth-nose mask is not worn. Vocal fatigue is the result, which often enough does not have to result directly in hoarseness, but can also manifest itself as a lumpy or cramped feeling in the throat, or be felt in the larynx area. In order to counteract the drying out of the mucous membranes, they try to secrete more mucus, which is felt by the affected person as massive mucus with or without the need to clear the throat.

However, it is not possible for all professions to go "online". Often enough, the person or the business model is dependent on personal contact.

Here, a targeted ORL diagnosis of the anatomical conditions of the larynx and the individual vocal load can provide information about the respective load tolerance. In the case of conspicuous findings, targeted voice strengthening training geared to individual needs can lead to a significant improvement in performance and thus to personal satisfaction.

Do you also have mask complaints?

We will be happy to advise you. Simply make an appointment under the following telephone number: +41 44 250 43 43

Stay healthy

Your Dr. Schwab