Tonsils and Adenoids
The tonsils and adenoids are lymph glands made up of tissues, fibers and white blood cells from the body’s immune system. Tonsils are the two round lumps in the back of your throat that the doctor examines when he tells you to stick out your tongue. Tonsils are prone to swelling, infection and pain if they are infected. They can also develop an abscess, which can occur from a severe infection. Swollen tonsils can obstruct the throat and make swallowing, breathing and sleeping difficult.
Adenoids have the same function as tonsils, but they are located in the throat behind the nose and above the soft palate. Adenoids are prone to the same conditions as tonsils, but they can cause additional problems with the ear, because they are located near the Eustachian tubes. They may be associated with ear infections because they can block the Eustachian tube and prevent it from draining. Symptoms of adenoid and tonsil infections may include sore throat, stuffy nose, bad breath, earache, fever, swallowing difficulties and snoring.
Bacterial tonsil and adenoid infections are first treated with antibiotics, as is the case with most bacterial infections. However, chronic infections or other serious problems may require surgery. If your tonsils and adenoids make you chronically or recurrently sick and uncomfortable, you and your doctor may decide that removal is the best option. Surgery of the tonsils is called tonsillectomy. Surgery of the adenoids is called adenoidectomy.
Tonsillectomies and adenoidectomies are more commonly performed on children, but occasionally adults may require a tonsillectomy or adenoidectomy.
Head and Neck Masses
Tumors of the head and neck can be malignant or benign. If you notice an abnormal lump or bump in the head and neck region It is important to have it evaluated right away so that treatment can start early if necessary. There are three major categories of head and neck masses: congenital, inflammatory and neoplastic. Congenital masses are most common in children, but can be present in adults. They are typically benign, slow-growing and painless. Congenital masses generally require surgery for removal.
Bacterial and viral infections can cause neck masses – swollen lymph nodes being the most common form. These are benign and some may go away on their own or after treatment with antibiotics.
Lymph Node Excision
Lymph nodes are an important part of the immune system; they contain lymphocytes which fight against foreign bodies that cause sickness and infection. A lymph node excision, also called a lymphadenectomy, may be necessary if the lymph node is possibly cancerous or if it is prone to chronic infection. The procedure usually is done under general anesthesia. An incision is made in the skin and the lymph node is dissected from the surrounding tissues and removed. It usually is sent for pathologic examination to determine if it is malignant.
Parotidectomy
A parotidectomy is the surgical removal of one of the major salivary glands, the parotid gland. The parotid gland is located on the sides of the face, in front of the ear. It may need to be removed due to a growth or tumor, which usually is benign but could be cancerous. A patient undergoing a parotidectomy is given general anesthesia,.The surgeon makes an incision in front of the ear. The parotid gland is removed with care not to damage the facial nerve that travels through the gland.
Submandibular Gland Excision
The submandibular gland, another major salivary gland is located under the jaw. This gland may require removal if it becomes chronically infected or grows tumors. . This gland is more prone to getting salivary stones, which block the outflow of saliva. Antibiotics or surgical removal may be necessary because of recurrent salivary stones causing swelling and infection.
The excision is also done under general anesthesia. A small incision is made in the skin under the jaw and the submandibular gland is excised from the surrounding tissue.
Throat Cancer
There are several types of throat cancer, including cancer of the larynx, (voice box) or cancer of the pharynx (posterior portion of mouth and digestive tube). Symptoms of throat cancer include coughing up blood, changes in the voice, difficulty swallowing, throat pain, or persistent ear pain. There are several treatment options depending on the location and size of the tumor.
Swallowing Treatment
The process of swallowing consists of three phases, the oral phase, the pharyngeal phase, and the esophageal phase. The oral phase is where the food is manipulated and chewed to prepare to be propelled to the back of the throat by the tongue. The pharyngeal phase is the start of the swallowing reflex where the food is squeezed into the throat and the airway is closed to prevent choking. The final stage is the esophageal stage, when the food passes through the esophagus into the stomach.
A swallowing disorder can occur at any of these phases.
Some symptoms of a swallowing disorder include coughing during or after eating or drinking, choking episodes during eating, or extra effort required to chew or swallow. Those with severe symptoms may be malnourished or chronically dehydrated, and at risk for choking or developing pneumonia.
There are many causes for swallowing disorders. They may be caused by damage to the nervous system such as from a stroke, spinal or brain injury, Parkinson’s disease, multiple sclerosis, ALS, cerebral palsy, muscular dystrophy or Alzheimer’s disease. They may also be caused by gastroesophageal reflux, cancer in the mouth or throat, injury or surgery of the head or neck and dental issues like decayed or missing teeth and poorly fitting dentures.
An evaluation by an otolaryngologist may be necessary as well as an evaluation by a speech pathologist. If a swallowing problem is diagnosed, therapy may consist of techniques and strategies taught by the speech pathologist to make swallowing easier. Specific foods may be recommended to improve the swallowing ability.
Acid Reflux
Acid reflux disease is a condition wherein the stomach contents travel back up the esophagus due to the lower esophageal sphincter (LES) not contracting over the stomach valve after swallowing. Common symptoms include tasting acid in the back of the mouth, heartburn, bad breath, a lump sensation in the throat, breathing problems and eroding teeth. Symptoms of acid reflux may be relieved by avoiding lying down for several hours after eating, avoiding certain foods, losing weight and quitting smoking. If symptoms still persist, medication or surgery may be necessary.
Dry Mouth/Throat
Our bodies produce saliva to moisten and cleanse our mouths, to fight infections and to help us digest food. When we don’t produce enough saliva, a common symptom is dry mouth and throat. Dry mouth is often caused by medication side effects, nerve damage, dehydration, infections, other diseases and tobacco use. Treating dry mouth may require evaluation from a doctor to first determine the underlying cause.
Burning Mouth
A burning, tickling or numbness in the mouth can have many causes including allergies to metals or foods, dry mouth, diabetes, neurological problems, certain medications (such as blood pressure medications), nutritional deficiencies, infection and acid reflux. Treatments for burning mouth include treating the underlying cause if one can be found, staying hydrated, changing medications, avoiding irritating substances and changing diet. Stress may make burning tongue or mouth worse and sometimes anti-anxiety medications are indicated. Talk to your doctor to determine the cause of your burning mouth and possible treatment options.
Zenker’s Diverticulum
Zenker’s diverticulum refers to an abnormal pouch or swelling of the mucus membrane of the pharynx. This can cause difficulty swallowing, regurgitation, cough, bad breath, infection and trap food and debris. Severe cases may necessitate neck surgery to correct the muscle’s position.
Voice
Hoarseness
Hoarseness is a general term that describes abnormal voice changes. The voice may sound breathy, raspy, strained or have changes of pitch. The changes in sound are usually due to disorders affecting the vocal cords. Sound is made by the vocal cords coming together and as air leave the lungs it passes through the cords causing the cords to vibrate. The vibration is what produces sound. The vocal cords then open to allow air to pass back into the lungs. There are many causes of hoarseness. Most are not serious and will go away on its own. The most common cause is usually from a cold or upper respiratory infection. Excessive voice use such as from screaming or yelling also can be a factor. More prolonged hoarseness can be from vocal cord nodules, polyps or possibly cancer. It is important to be evaluated by an otolaryngologist if hoarseness persists.
Chronic Cough
Chronic cough is defined as a cough that lasts at least eight weeks in adults or at least four weeks in children. This condition can interrupt sleep and cause vomiting, lightheadedness and even rib fractures. The most common causes of chronic cough are tobacco use, postnasal drip, asthma and acid reflux. Treating the underlying condition is the only way to completely eliminate chronic cough.