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Neck, Throat & Thyroid

Laryngoscopies

Laryngoscopy is an examination that lets your doctor look at the back of your throat, your voice box, and vocal cords with a scope. It is performed to diagnose throat pain, bleeding, hoarseness, check for inflammation, discover a possible blockage of the throat, remove foreign objects, visualize or biopsy a mass or tumor in the throat or on the vocal cords, diagnose voice problems, such as weak voice, hoarse voice, or no voice.

GERD/LPR Diagnosis & Treatment

Gastroesophageal reflux disease, or GERD, is a chronic digestive condition in which acids in your stomach flow backwards up your throat, causing a burning sensation beneath your breastbone , but in some cases, called " silent reflux", there is no burning , but other symptoms such as throat clearing. . When you eat, the sphincter valve on your esophagus opens and closes, allowing food and liquids to pass from your throat to your stomach. When reflux occurs, this valve fails to close completely, and hydrochloric acids produced during the digestive process flow into your throat and esophagus, producing painful symptoms. GERD can be caused by Hiatal hernia – a condition in which the sphincter valve and upper portion of the stomach move around above the diaphragm. Reflux occurs most often immediately following a meal, when you are lying down, or bending over. Risk factors include eating spicy, fatty, or fried foods, or those containing citrus, tomato, chocolate, mint, onions, and garlic; drinking beverages that contain alcohol, caffeine, or carbonation; eating close to bedtime, or lying down following a meal. Avoiding the triggers that cause GERD is the most effective way of preventing it from occurring. Avoid foods and beverages that cause acid reflux, eat smaller meals, and resist late-night snacks. Quit smoking, and lose excess weight. We often see patients with chronic cough or throat clearing, which can be caused by silent reflux or LPR, which does not have the typical symptom of heartburn.

Woman with throat pain

Dysphagia

Dysphagia is when you regularly have difficulty swallowing. It is usually a sign of a problem with your throat or esophagus. Having a dry mouth can make dysphagia worse because you may not have enough saliva to help move food out of your mouth and through your esophagus. Reflux is often a cause of dysphagia as well.


Hoarseness

Hoarseness usually arises from overuse or abuse of vocal cords. Most people suffering from hoarseness have suffered from irritation or injury to the voice box or larynx. When we speak or sing the vocal cords that usually vibrate freely can become restricted. Other causes can include stomach reflux, allergies, smoking, thyroid problems or cancer of the larynx. Symptoms can be a sore throat and abnormal voice that is raspy or cracks often. The best treatment for worn-out vocal cords is patience. With time and vocal rest your immune system will repair the damage done to the larynx and return your voice to normal. Avoid singing, talking loudly or whispering while you rest your voice.


Patient getting check with a breathing machine

Sleep Apnea

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea usually is a chronic condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep. Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member might be the first to notice signs of sleep apnea. Sleep apnea can cause serious long term heart or lung problems if left untreated.

Woman trying to sleep with a snoring partner.

Snoring

When the airway passages are narrow the vibration can create the sounds associated with snoring. Other causes can include being overweight, consuming alcohol, problems with the nasal cavity or sleep apnea. Other symptoms arising from a night of heavy snoring can include sore throat, high blood pressure, poor concentration and drowsiness. Your doctor may perform a physical evaluation and could order a CT scan to look for obstructions of your airway. Some doctors may recommend a sleep study which can now be done at home. Depending upon the results from the evaluations various treatment options are available. Home remedies include sleeping on your side, avoiding meals, snacks or alcohol a few hours before bed and losing weight to open up airway restriction. If these solutions are not working your doctor might suggest looking at surgical options. Dental mouthpieces, pressurized masks and traditional surgeries like tonsillectomy or somnoplasty might be solutions.


Tonsillitis/Tonsil Stones

Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat. Symptoms of tonsillitis include sore throat, difficulty swallowing, scratchy voice, bad breath, fever, chills, earaches, stomachaches, headaches, a stiff neck, jaw and neck tenderness, red or swollen tonsils, and white or yellow spots on your tonsils. Your doctor may do a physical examination and also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection.Treatments for severe cases of tonsillitis may include antibiotics or a tonsillectomy, surgery to remove the tonsils.

Vocal Cord Nodules or Polyps

Vocal cord Nodules also know as "calluses of the vocal fold." They appear on both side of the cords usually midpoint facing one another. These calluses usually diminishes or disappear when over usage of the cords are stopped. Vocal polyps typically occur only on one side of the vocal cord and can occur in a variety of shapes and sizes. Depending upon the nature of the polyp, it can cause a wide range of voice disturbances. If you continue to have problems with vocal cord nodules or polyps there is a possibility the otolaryngologist may request a Micro direct laryngoscopy with biopsy which is usually done in an outpatient facility under general anesthesia.