General Otolaryngology

Symptoms of an ear infection include hearing problems, drainage, a full sensation, dizziness, nausea, fever and pain that may be constant or come and go.

Ear infections in children are often due to eustachian tube dysfunction. Inside your ear you have something called an eustachian tube that equalizes pressure behind the ear drum and naturally clears middle-ear secretions. When the eustachian tube becomes blocked due to a cold, allergy, upper respiratory infection (URI), bacteria or a virus, negative pressure can develop and mucus can collect behind the eardrum causing pain, swelling and redness.

In adults, common causes of earaches include otitis externa, or swimmer’s ear, and otomycosis, a fungal infection of the ear canal.

Often, antibiotics will be prescribed to fight the infection. Other medications that your doctor may prescribe include an antihistamine (for allergies), a decongestant (especially with a cold) or both. Sometimes the doctor may recommend a medication to reduce fever and/or pain. Special ear drops can also help ease the pain.

Ear tubes may be surgically placed to address recurrent ear infections.

A common ear canal obstruction occurs when a patient has wax blockage against the eardrum. This is often because the ear has been probed with such things as cotton-tipped swabs, bobby pins or twisted napkin corners. These objects only push the wax in deeper in the ear canal. Otomycosis is a fungal infection of the ear canal. There can also be bacterial infections of the ear canal. Symptoms of an obstruction or an infection include pain, itching and decreased hearing.

Your doctor will often clean the ear and may prescribe medications to treat an infection.

A mass may be a sign of an infection, or it may indicate a serious medical condition. It does not necessarily mean you have cancer, but it does mean you may need additional evaluation to receive an accurate diagnosis. See your doctor or otolaryngologist if the mass lasts longer than 2 to 3 weeks.

Injuries to the ear, nose or throat are called trauma. This includes bruising, swelling, broken bones and blockages. Treatment will vary but may include surgical procedures.

Head and neck pain can be caused by many things: arthritis, infection, muscle strain, poor posture, temporomandibular joint (TMJ) syndrome, migraine, sinusitis  and more. If you have repeated episodes of sinus pain and pressure, a nasal endoscopy (a pencil-size scope used to see inside the nose and sinuses) or imaging such as an MRI or CT scan can determine if sinus pain or pressure is due to a sinus infection or other sinus pathology. A normal sinus CT scan while you have symptoms could help rule out sinusitis, and determine if migraines, headaches or other causes of facial pain and pressure are causing the symptoms.

Skin cancers of the head and neck usually present as abnormal growth on the skin. Treatments vary depending on the type and placement of the skin cancer, but generally involves removing the growth.

Hearing loss is more common with age, although growing older isn’t the only reason that people experience a loss in hearing. Three million children under the age of 18 have some kind of hearing loss.

There are several kinds of hearing loss. Sensorineural comes about from damage to the inner ear from a variety of factors but most commonly from the aging process or loud noise damage. Conductive hearing loss is caused by a physical blockage, such as a buildup of ear wax, a punctured ear drum or fluid in the middle ear.

For temporary hearing loss, sometimes a visit to your doctor to remove earwax, perform an outpatient ear tube placement or other medical treatment can correct the hearing loss.

For permanent hearing loss, hearing aids, bone anchored hearing aids, FM systems and/or cochlear implants may be recommended depending on the type and severity of hearing loss.

A foreign body is any object that does not belong in an ear or nose, such as a bead, marble, insect or hearing aid part. Do not poke at the object as that could push it further in. Your doctor may use special instruments, suction or even surgical procedures to remove the object.

A nasal infection, or sinusitis, usually has symptoms like nasal discharge, facial pain, headache, postnasal drip, cough, sore throat, reduced smell and/or taste and others. A nasal injury may include nosebleeds, difficulty breathing, swelling and bruising. See a doctor promptly if you think your nose may be broken.

When it feels like you can’t breathe through one or both nostrils, you may have a nasal obstruction. It could be due to a deviated septum, polyps, inflammation from an infection or allergies and more. Treatment will vary depending on the cause of the nasal obstruction. It could include antibiotics, antihistamines, decongestants, steroids or surgery.

See your doctor as soon as possible if you’re experiencing double vision, facial numbness or a fever that lasts more than a few days.

Some of the most frequently suffered fracture injuries involve trauma to the nose and/or midface. While not all nasal or midface fractures require reconstructive surgery, the procedure can correct impaired function of the nasal structure and/or improve or restore its appearance.

A neck mass is an abnormal lump in the neck. Neck lumps or masses can be any size—large enough to see and feel, or they can be very small. You may develop a neck mass due to a viral or bacterial infection. Ear or sinus infection, dental infection, strep throat, mumps or a goiter may cause a neck mass. If your neck mass is from an infection, it should go away completely when the infection goes away.

Your neck mass could also be caused by a noncancerous (benign) tumor or a cancerous (malignant) tumor. You are at a higher risk for cancer if the mass lasts longer than 2 to 3 weeks, your voice changes, you have trouble or pain while swallowing, there’s unexplained weight loss, have trouble breathing, cough up blood or have skin lesions on the face or scalp that are growing or changing color.

Your doctor may perform (or recommend) an endoscopy, which is a procedure that inserts a small tube with an attached camera through your nose to look inside your throat, voice box and the opening of your esophagus. In addition, they may order tests to help diagnose your neck mass, such as a CT, MRI, or PET (positron emission tomography) scan (if needed) to get a more detailed picture of the neck mass than normal X-rays can provide.

Treatments can include surgery, radiation therapy with or without chemotherapy or a combination of these treatments depending on the diagnosis and stage of the disease.

Nosebleeds (called epistaxis) are caused when tiny blood vessels in the nose break. There are 2 categories of nosebleeds. Anterior nosebleeds occur when the bleeding is coming from the front of the nose and posterior nosebleeds occur when the bleeding originates from further back in the nose, often where the source of bleeding cannot be seen without examination. Posterior nosebleeds are often more severe and almost always require a physician’s care. Treatment administered by a medical professional may include cautery (a technique in which the blood vessel is burned with an electric current, silver nitrate, a laser to stop the blood flow or nasal packing.)

Oral lesions can be canker sores, candida, geographic tongue, hairy tongue, cold sores, oral lichen planus and more. Treatments include corticosteroids, diet changes, antifungal and antiviral medications, special toothpastes or mouth rinses, biopsy and more.

The most common parathyroid disease is hyperparathyroidism, typically caused by a benign overgrowth of one of the parathyroid glands, called an adenoma. The most common symptoms of hyperparathyroidism are fatigue, brain fog and a general sense of not feeling well.

Doctors use bloodwork to see the parathyroid hormone (PTH) level and then will draw a metabolic panel with total calcium and vitamin D. If the bloodwork indicates parathyroid disease, they will order imaging, like an ultrasound or CT scan, to determine which parathyroid gland is affected.

Surgery, called a parathyroidectomy, is the mainstay of treatment for primary hypoparathyroidism, but it is not always needed if the condition is mild.

The way we maintain balance when we move about is by the complex interactions of both inner ears, the eyes, the muscles down your back and soles of the feet, and how all of these get processed in the brain. In the inner ear, we have balance canals that detect movement and balance organs that detect gravity. The gravity organs have tiny calcium carbonate crystals in them, which are often referred to as “rocks.”

With benign paroxysmal positional vertigo (BPPV), a rock or 2 gets dislodged from the organ and falls toward the balance canals. So, when you turn your head into those certain positions, the rock pushes on the canal, and the brain thinks you are whirling around. BPPV is the most common cause of vertigo. Vertigo is the unpleasant (often, very frightening) sensation of the world rotating, often associated with nausea and sometimes even with vomiting.

The treatment for BPPV involves moving those misplaced rocks, or crystals, from the active portion of the inner ear to the inactive portion of the inner ear, where they won’t cause dizziness. These treatments are office procedures called canalith repositioning procedures (CRP), an Epley maneuver or a Semont maneuver.

The salivary glands are found in and near your mouth, face and neck. These glands produce saliva, which helps moisten the mouth, initiates food digestion and helps protect teeth from decay. There are also many tiny, minor salivary glands located along the lips, inside the cheek, mouth and throat. You may experience symptoms like swelling and pain, difficulty eating or repeated infections if a saliva duct is blocked, if you have a tumor in a gland, if you’ve had a viral infection or if you have an autoimmune disease that attacks the salivary glands.

Medications and surgery can both be used to treat a salivary gland disorder.

Sinusitis is an infection or inflammation of the sinuses, the hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. Sinusitis can be acute or chronic. Symptoms include a stuffy nose, pain or pressure in the face, thick nasal drainage, long-lasting cold symptoms and loss of smell. Sinusitis is usually caused by a virus or bacteria. Antibiotics should only be used to treat sinusitis caused by bacterial infections. Other treatments include ibuprofen and steroid nasal sprays.

Sleep disorders are conditions that impair your sleep or prevent you from getting quality, restful sleep. That includes insomnia, narcolepsy, restless legs syndrome and sleep apnea. Sleep apnea is a general term for breathing problems that occur during sleep. Every time breathing is interrupted, the sleeper partially wakes so they can continue breathing.

Treating sleep apnea is important for your sleep quality and overall health. If you suffer from high blood pressure, diabetes, heart trouble or are overweight, treating your sleep apnea may improve these conditions while helping you feel better. Continuous positive airway pressure therapy (CPAP) is a common treatment for sleep apnea. Additional sleep apnea treatments include lifestyle changes, certain medications to treat the underlying cause of sleep apnea and sleep apnea surgery.

Infections from viruses or bacteria are the main cause of sore throats, but allergies and sinus infections can also contribute. Some sore throats are worse than others. If you have a sore throat that lasts for more than 5 to 10 days, you should see your doctor.

A mild sore throat associated with cold or flu symptoms can be made more comfortable with the following remedies: Increase your liquid intake, drink warm tea, use a humidifier, gargle with warm salt water several times daily and take over-the-counter pain relievers such as acetaminophen or ibuprofen.

For a more severe sore throat, your doctor may want to do a throat culture – swabbing the inside of your throat to see if there is a bacterial infection. If you have a bacterial infection your doctor will likely recommend an antibiotic that kills or impairs bacteria.

Speech disorders make it hard for someone to communicate. There are different types: fluency disorders (like stuttering), orofacial myofunctional disorders, speech sound disorders (like apraxia or dysarthria) and voice disorders (like laryngitis). Treatment will vary based on the specific disorder, but it is common to have a multidisciplinary team, such as an ENT and speech language pathologist working together to treat the patient.

Swallowing disorders can refer to any one of a number of conditions that affect swallowing ability. Dysphagia is a common one with more than 20% of people over 50 experiencing it. Symptoms of swallowing disorders include difficulty chewing, food or pills getting stuck, regurgitating food, coughing or choking while eating, recurrent lung infections and weight loss.

Diagnosis of a swallowing disorder can be done with many different methodologies, including X-rays, CT scans, endoscopies and more. There are also many treatment options from medications to BOTOX injections and muscle training to surgery.

Your thyroid is a small, butterfly-shaped gland in your neck that regulates your heart rate, metabolism, blood pressure and body temperature. Nodules are small lumps that may be either solid or fluid-filled and that develop on the thyroid gland. Most thyroid nodules do not cause symptoms and are not serious. A small percentage of thyroid nodules are cancerous. Some nodules can cause the thyroid to grow (called a goiter), some can be overactive and lead to hyperthyroidism, and some can be thyroid cancers.

Traditional treatments for problematic thyroid nodules or thyroid cancer are total thyroidectomy or hemithyroidectomy – surgical removal of all or part of the thyroid. Thyroid cancer may also be treated with radioactive iodine therapy. New minimally invasive endoscopic techniques have been developed for the management of thyroid nodules.

The lingual frenulum is the band of tissue that attaches the undersurface of your tongue to the bottom part of the mouth. Adequate tongue movement is necessary for swallowing and speech. When tongue movement is restricted, evaluation by an ENT specialist, or otolaryngologist, may be necessary to check for ankyloglossia or other conditions that can affect oral and tongue function.

The typical treatment of symptomatic ankyloglossia is a frenotomy, a surgery that involves cutting the band of tissue between the tongue and floor of mouth to release the tongue and help it move more freely.

If the tonsils are enlarged, it may be hard to breathe through the nose or cause difficulty while sleeping. Other signs of tonsil enlargement include snoring and pauses in breathing for a few seconds at night.

Tonsils may swell because of an infection or abscesses. The first step is usually to treat any bacterial infection of the tonsils with antibiotics. Tonsillectomy, or removal of the tonsils, can be an option when infections return frequently even after antibiotic therapy or there is difficulty breathing with the enlarged tonsils.

Tonsillitis, also described as pharyngitis, refers to inflammation of the pharyngeal tonsils, which are lymph glands located in the back of the throat that are visible through the mouth. Tonsillitis is often caused by viral or bacterial infection. Symptoms include fever, sore throat, bad breath, painful swallowing, tender lymph nodes, fatigue and white patches or redness of the tonsils.

Viral tonsillitis usually gets better without additional treatment. Hydration and pain control are important. Bacterial tonsillitis is usually treated with antibiotics, which helps prevent complications such as rheumatic fever. In certain situations determined by your ENT specialist, surgery may be recommended to remove the tonsils.