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Most of us experience periodic sore throats that often resolve on their own. However, sometimes there are other reasons for sore throats that may be an indication of a more serious problem that warrants seeing your doctor or ENT specialist.
Strep throat is treated with antibiotics and usually resolves in three to seven days, although the healing time can take a couple of weeks. It is important to diagnose a Strep infection and begin treatment as soon as possible to avoid complications and prevent its spread to others. Keep in mind that a “Rapid Strep Test” is a throat culture that is only testing for a specific and common type called “Strep Group A”. A negative result does not necessarily mean there is no infection, it just means it’s not Strep A.
One of the main indications for a tonsillectomy is having recurrent infections several times a year. If you are frequently sick and plagued by throat infections, you should meet with Dr. King and discuss whether tonsillectomy is right for you.
Tonsils & Adenoid Infections
Antibiotics are generally prescribed to treat the inflammation caused by bacteria like Strep, but many infections are caused by viruses that resolve in four to seven days. Chronic cases of repeated tonsillitis may require surgical removal of the tonsils and/or adenoids (tonsillectomy and adenoidectomy). An adenoidectomy may also be recommended for children experiencing chronic ear infections (see Otitis Media).
Laryngitis from viral infections usually resolves by itself within one to two weeks with the help of voice rest and staying well hydrated. Because there are many possible causes of hoarseness, persistent symptoms should prompt further evaluation with your doctor. Dr. King specializes in diseases of the larynx and has specialized equipment that can help determine the root cause.
This patient has hoarseness due to a viral infection around the vocal folds resulting in swelling and poor vibration.
Snoring & Sleep Apnea
Snoring can also be a sign of a more serious problem, known as obstructive sleep apnea. Sleep apnea occurs when the tongue and muscle in the back of the throat completely obstruct the airway and breathing momentarily is halted. Patients with sleep apnea typically stop breathing many times a night before the brain prompts them to wake up and start breathing again. Most patients don’t fully awaken or realize this is occurring all night long, but they wake up feeling unrested and tired through the day. Daytime fatigue causes decreased alertness and productivity, not to mention the dangers of falling asleep while driving or performing other important tasks. Left untreated, long-term complications of sleep apnea include high blood pressure, heart attacks, stroke, heart failure, anxiety and depression.
Sleep apnea is diagnosed through a physical examination with particular emphasis on weight, blood pressure and airway constriction in the nose, throat and lungs. In many cases, a sleep test will be recommended at a sleep laboratory. The sleep study monitors several functions while you sleep and can help identify the exact cause and severity of the sleep apnea.
Conservative measures for alleviating mild apnea include sleeping on your side (not on your back) and avoiding alcohol or sedatives before bedtime. In mild cases, treatment may consist of nasal decongestants, inhaled steroid preparations or oral mouth devices that force the jaw forward and prevent the tongue from falling back and obstructing the throat. For more severe cases, your doctor may prescribe Continuous Positive Airway Pressure (CPAP). This device straps onto your face and generates pressurized air, and helps keep the airway open during sleep. CPAP can often cure sleep apnea. Sometimes surgery can decrease the severity of sleep apnea, but rarely results in a cure. The most common procedures to treat sleep apnea or snoring include a tonsillectomy, adenoidectomy, deviated septum repair (septoplasty), or surgery on the palate and uvula.
Thyroid and Parathyroid Disease
The thyroid is a butterfly-shaped gland that resides at the base of the neck and produces hormones that regulate important bodily functions such as temperature and metabolism. Thyroid hormone is normally tightly regulated, but abnormal levels of thyroid hormone result in thyroid disease: overproduction (hyperthyroidism) and underproduction (hypothyroidism).
There are typically four parathyroid glands in the neck closely associated with the thyroid that control calcium levels in the body. Abnormal levels of parathyroid hormone (PTH) lead to a number of problems, and symptoms can be mild or sometimes severe. Depending on the source of the problem, treatment may require surgical and/or medical therapy.
Thyroid Nodules & Goiter
Symptoms typically include recurrent kidney stones, stomach pains, mental confusion or depression, and achy joints and bones. Even one abnormal parathyroid gland (adenoma) can cause calcium and PTH levels to be out of balance and lead to the above problems. Most parathyroid and calcium disorders are complex and may require the expertise of endocrinology specialists. When a parathyroid adenoma is detected, the treatment is surgical excision of that gland.
Head & Neck Cancer
Cancers in the head and neck are relatively uncommon, and most are highly associated with tobacco use and alcohol consumption. Head and neck cancers overall are more common in men than women. Like many cancers, they are also generally curable if caught early. Symptoms to watch out for include painful swallowing, difficulty breathing, persistent hoarseness, ear pain, a lump in the neck that lasts longer than two weeks, sores in the mouth that don’t heal or bleeding from the mouth, nose or throat. Below is a brief description of some of the head and neck cancers.
Depending on the site of origin, treatment of pharyngeal cancers may require multiple modalities including surgery, radiation and/or chemotherapy treatment.
Dr. King specializes in diseases of the larynx and pharynx. Our state of the art endoscopic equipment can often detect small cancers or even pre-cancerous lesions. With early detection, some patients are candidates for minimally invasive laser procedures that can be done in the office. Dr. King is the only ENT in Colorado performing these in-office laser procedures.
Throat Cancer (Cancer of the Vocal Cords or Larynx)
Throat cancer can affect different areas. In this video, the cancer is eroding the left vocal cord entirely, causing a very hoarse voice and a left vocal cord paralysis.
Throat Cancer 2 (Cancer of the Vocal Cords or Larynx)
This video shows a smaller cancer starting on the patient’s right vocal cord. She has a hoarse voice, but the the cancer is confined to the edge of the vocal cord and there is no paralysis of the cord on that side.
Oral & Tongue Cancer
Other Head & Neck Cancers
- Sinus & Nasopharyngeal Cancers usually present with nasal breathing obstruction, facial pain or headaches and frequent nose bleeds. These are rare cancers, but need to be differentiated from chronic sinusitis.
- Salivary Gland Tumors can develop in the mouth, lips, palate, under the tongue or jaw, or in the cheek in front of the ear. Fortunately, most salivary gland tumors are benign. However, some types of benign tumors can turn malignant over time, and it is generally recommended to remove them early.
- Skin Cancers can develop anywhere on the face. More common locations include the nose and ears because they are more exposed to sun. Suspicious moles that change color or lesions that look like an ulcer, bleed or don’t heal on their own should be checked out by your dermatologist or ENT.
- Lymphomas sometimes present in the head and neck. There are two broad categories called Hodgkin’s and Non-Hodgkin’s Lymphomas. The typical signs and symptoms are painless, enlarging neck masses (lymph nodes), unexplained weight loss, fatigue and fevers. Dr. King can perform lymph node biopsies to help make the diagnosis.
- Skull Base Tumors arise from the sinuses, back of the nose or high in the neck at the base of the skull. Fortunately, these are relatively rare cancers, but they are often serious and early detection is can be difficult.