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Throat & Voice Disorders

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Sore Throat:

 

There are multiple reasons for a sore an irritated throat, ranging from post nasal drainage, to infections, to reflux issues.   Evaluation with a nasolaryngoscope (lighted telescope to view the nose and throat) by the Otolaryngologist can determine any problems within the connected system from the nose down to the throat.   Proper therapy can then be initiated based on this objective test.

Sore throats can be an indication for an infection, bacterial or viral in nature, leading to painful swallowing and difficulty swallowing.   Additional issues may include allergies and sinus infections with post nasal drainage that can cause a sore throat. There may be an indication of evaluation by an Otolaryngologist for a sore throat lasting longer than five to seven days.  Hydration is still important, with salt water gargles, and OTC pain medications.   Appropriate antibiotic and anti-inflammatory treatment may be added.

Causes:

  • Viral infections may include the flu, colds, measles, chicken pox, whooping cough, or croup.   Another type of viral infection may include mononucleosis (Epstein Barr Virus), with associated massive enlargement of the tonsils, with white plaques on the tonsillar surface.   There may also be some associated soreness and lymph node enlargement in the armpits, groin, with fever, chills, and headache.

  • Bacterial infections commonly include Strep throat that has potential to damage the heart valves (rheumatic fever) and kidneys (nephritis), scarlet fever, pneumonia, sinusitis, and ear infections if left untreated.

    • Epiglottitis, infection/swelling of a portion of the larynx (voice box), leading to closing of the airway and choking sensation.   This is more emergent in nature, and should be evaluated with a nasolaryngoscopy (small lighted telescope that easily slips in the nose and down the throat to view the voice box) for appropriate management, including IV antibiotics or airway control in the hospital.

    • Tonsillitis is the general inflammation and infection of the pharyngeal tonsils, those glands in the back of the throat on either side of the uvular (punching bag in the throat).   With chronic recurrent or persistent infections, despite medical/antibiotic therapies, it is likely that the tonsils need to be removed by a procedure known as a tonsillectomy (typically an outpatient procedure).

  • Reflux, or contents from the stomach and esophagus regurgitates up into the throat, may cause throat irritation and pain, typically when in a reclined position.

  • Tumors of the throat, tongue, and larynx (voice box) can also cause a sore throat, sometimes with referred pains to the ear.   There can be associated hoarseness, lump sensation in the neck, weight loss, or spitting up blood in the mucous.

 

Tonsillitis:

 

Tonsils are filtering glands for infections in the back of the throat, on either side of the uvula.   There are tendencies for the gland to become overcome with bacteria, and chronically become infected.   This leads to chronic sore throat/infections, and may become enlarged and obstructive, leading to snoring/sleep apnea issues.

When the tonsils are more problematic than functional, a tonsillectomy is sometimes indicated.   The physicians at Sonoran Ear Nose and Throat may recommend a tonsillectomy, as an outpatient procedure to relieve the patient of recurrent infections and obstructive tonsils.

Sonoran ENTA does not perform tonsillectomies and would refer out for these services.

Voice Disorders:

 

Hoarseness is a common malady that has social repercussions, and occupational issues.   There are multiple causes to this, ranging from allergies/post nasal drainage, to intrinsic vocal cord masses or dysfunction.   The physicians at Sonoran Ear Nose and Throat have the ability to appropriately diagnose organic vocal cord disease versus functional problems with use of a nasolaryngoscope.   There are a multitude of medical regimens to consider, in addition to surgical intervention of the vocal cords. These include:

  • Suspended Direct Microlaryngoscopy with Biopsy – This is a procedure performed under general anesthesia to visualize the voice box and surrounding structures to biopsy any lesions of concern to the Otolaryngologist.   This is an important step if the concern is a malignancy in the throat.

  • Vocal Cord Medialization – Vocal cord paralysis, weakness, or bowing/laxity are issues of different causes, that lead to breathy voices, and breathlessness and fatigue.   A procedure that utilizes injections to push the vocal cord to a more correct midline position can strengthen the voice.

Swallowing Disorders:

 

Dysphagia is the formal term for problematic swallowing.   This may be due to either obstructive or physiologic issues that can be initially evaluated by your Otolaryngologist with a nasolaryngoscope.   There are multiple objective tests beyond this to consider, with both medical and surgical options to review.

Treatment:

  • Swallow Testing

  • -Swallow Therapy

  • MBS, Modified Barium Swallow Study