Throat

SORE THROAT

A sore throat is a common but painful condition that can be caused by a variety of reasons. Most are the result of viral infections, but they can also be caused by bacterial infections, allergies, acid reflux, or strained vocal cords. Occasionally, a tumor within the mouth or throat can cause a sore throat. Proper evaluation by an otolaryngologist for sore throats lasting more than 2-3 weeks or not responding to standard medical therapy is crucial.

REFLUX

Gastroesophageal reflux disease (GERD), more commonly known as acid reflux, is a common condition affecting millions of Americans every year. It occurs when acidic stomach contents move backwards into the esophagus and can cause heartburn and indigestion. In more severe cases, these acidic contents can move all the way up into the back of the throat. This is something called laryngopharyngeal reflux disease (LPRD), or more commonly “silent reflux”. Silent reflux can be accompanied by voice changes, sore throat, or a feeling like something is stuck in the throat. Your physician will take a thorough medical history and perform a physical exam that may include a laryngoscopy. This is a specialized telescope that can view the throat and the vocal cords to evaluate for reflux or other throat disorders. Reflux is most commonly treated with medications and diet modifications.

CHRONIC COUGH

A chronic cough is one that has lasted for longer than eight weeks. This can be detrimental to your sleep, work, and quality of life. Chronic cough can be caused by several different factors including postnasal drip, asthma, acid reflux, allergies, chronic lung conditions, or voice box abnormalities. Diagnosis will usually consist of a physical exam including laryngoscopy, a specialized telescope than can view the voice box and throat. Treatment will depend on the cause but typically involve antihistamines, nasal sprays, antibiotics, acid reflux medication, or cough suppressants.

TONSILS AND ADENOIDS

The tonsils and adenoids are part of the immune system, protecting the body by preventing bacteria and germs from entering the mouth and nose. In certain cases, the tonsils and adenoids can get enlarged and cause issues with sleeping or breathing. They can also become infected, either chronically or repeatedly. Initially, antibiotics may be required to help resolve infections. For patients who have recurrent infections or are having issues with sleeping or breathing caused by enlargement of the tonsils and/or adenoids, surgery may be necessary. In younger children, recovery from surgery is relatively quick and may only last for seven days. In older children and adults, recovery may be longer and can last up to two weeks.

VOICE DISORDERS

Voice problems can be caused by a variety of reasons, most commonly from a viral infection of the throat. In certain cases, there may be a problem with the vocal cords themselves. For voice problems lasting more than four weeks, evaluation by an otolaryngologist is critical to be able to view the vocal cords to accurately diagnose your problem.

THYROID AND PARATHYROID

The thyroid gland is part of the endocrine system of your body and works to produce thyroid hormone. This hormone helps to regulate your metabolism among numerous other functions. When an abnormal collection in the thyroid is detected, also called a thyroid nodule, further investigation is needed. This may include an ultrasound of the thyroid and possibly a needle biopsy. For patients who require removal of the thyroid for cancerous and non-cancerous reasons, surgery is usually done through a well-hidden neck incision and under general anesthesia.

The parathyroid glands are four small glands located in the neck that help to regulate the calcium levels in your body. In cases where the calcium levels are elevated, a parathyroid gland may be abnormally producing too much of its hormone. In those cases, surgery may be necessary to remove the abnormal gland. Otolaryngologists are uniquely qualified to perform thyroid and parathyroid surgery as experts of neck anatomy.

POSTNASAL DRIP

When excess mucus is created in the nose or it is thicker than normal, it can become noticeable as it travels down the back of the throat. This postnasal drip can be quite bothersome and affect quality of life. This can be caused by viral infections, acid reflux, allergies, certain foods, fumes in the air, and abnormalities such as a deviated septum. Initial treatment will normally consist of nasal sprays, saltwater nasal rinses, mucus thinning medications such as Mucinex, or possibly antihistamines. Acid reflux symptoms can sometimes be confused for nasal symptoms; in those cases, acid blocking medication can be effective.

SALIVARY GLANDS

The salivary glands are responsible for producing saliva to keep your mouth moist and allow for appropriate chewing and swallowing. These glands can become swollen, inflamed, or develop blockages that can lead to infections. There are also tumors that can affect the salivary glands. Treatment will depend on the cause of the issue, but normally medical therapy is adequate for infections or mild to moderate inflammation. For those patients with frequent infections or salivary gland stones, surgery may be necessary. This can be performed in a minimally invasive fashion with sialendoscopy, a technique that uses very small telescopes to evaluate the salivary gland system to remove any obstructing stone or dilate any narrowing. In cases where a minimally invasive approach is not possible, surgery may be required to remove the affected gland.

SWALLOWING DISORDERS

Swallowing is a complex mechanism requiring many different muscles in the head and neck to work together. In patients having difficulty with swallowing, a thorough medical history and physical exam can help to find out the cause of the problem. This can be a structural issue such as a narrowing in the esophagus, or a functional issue such as loss of muscle tone due to age or debilitation. In many cases, a swallow test may be ordered to further evaluate the function and structure of the mouth and throat during swallowing. Treatment can vary and include swallow therapy with a speech language pathologist, medication, or surgery.

HEAD AND NECK MASSES

Lumps or bumps in the head and neck have several different causes. Most commonly, a neck mass is an enlarged lymph node from a current or recent infection. Benign neck masses and cysts can also be a relatively common cause. In other cases, a neck mass can be a sign of head and neck cancer. A thorough evaluation by an otolaryngologist will help to diagnose a neck mass that has been present for longer than two weeks. Imaging such as CT scans or MRIs can be helpful to accurately diagnose neck masses. In cases where cancer is suspected, a needle biopsy of the mass may be performed. Treatment will depend on the cause of the neck mass. Benign neck masses are typically removed surgically. Head and neck cancers are treated with a combination of radiation therapy, chemotherapy, and surgery, depending on the location and other factors

HEAD AND NECK CANCER

Head and neck cancer is the seventh most common cancer worldwide and consists of cancer found in the oral cavity, voice box, throat, salivary glands, or the nose. Most commonly, head and neck cancer is caused by tobacco and alcohol use; it can also be caused by human papillomavirus (HPV) or exposure to certain industrial toxins. Symptoms are often associated with other less serious conditions, but if they persist then evaluation with a physician is recommend. These symptoms include ear pain, difficulty swallowing, voice changes, sore throat, weight loss, lumps in the neck, or chronic cough. After a thorough medical history and physical exam, further imaging tests such as CT scans, MRIs or PET scans may be ordered. Biopsy is needed to confirm diagnosis of a head and neck cancer. Head and neck cancers are treated with a combination of radiation therapy, chemotherapy, and surgery, depending on the location and other factors