Throat Surgery and ENT Treatments
From an ENT perspective, the throat consists of the oral cavity, the neck, the voice box (larynx), the breathing tube (trachea), and the swallowing tube (esophagus). The lips form the opening to the oral cavity that contains the tongue, tonsils, teeth, and the roof of mouth (palate). Furthermore, the mouth is lined with a thin barrier called the mucosa. The mucosa contains thousands of "minor salivary glands" that produce salt and water (saliva) to keep the mouth moist. The neck contains blood vessels, nerves, glands, lymph nodes, and muscles. Like in the mouth, some of the glands produce saliva. However, these salivary glands are much larger and are called the "major salivary glands". The names and locations of the major salivary glands are: two parotid glands located in front of the ears, two submandibular glands located beneath the jawbone (mandible), and one sublingual gland located under the tongue.
Hypothyroidism Symptoms
Common symptoms due to low thyroid or hypothyroidism are:
- Fatigue and weakness
- Low basal temperature (cold intolerance)
- Dry and coarse skin
- Hair loss
- Cold hands and feet
- Weight gain
- Insomnia
- Constipation
- Depression
- Poor memory, forgetfulness, dementia
- Nervousness and tremors
- Immune system problems
- Heavy menstrual periods
The neck also contains glands that secrete hormones into the blood and are therefore called "endocrine" glands. One of the endocrine glands in the neck is called the thyroid and the others are called parathyroid glands (usually four). The thyroid is a butterfly shaped gland that is located between the thyroid cartilage and the upper chest. The thyroid cartilage is often prominent in men and referred to as the "Adam's apple." The thyroid gland controls how quickly the body burns energy, makes proteins, and the sensitivity of the body to other hormones. The parathyroid glands are located beneath the corners of the wings of the butterfly shaped thyroid gland. Parathyroid glands control the amount of calcium in the blood and in the bones. Lymph nodes are organs that are located around the major muscles and blood vessels in the neck. They are made up of many types of cells and act as filters to trap foreign particles including viruses and bacteria. The lymph nodes are important to the proper functioning of the immune system.
Lymph nodes become inflamed or enlarged in response to infection or cancer. When the infection resolves, the lymph nodes usually shrink to their original size. However, when cancer is present, they do not shrink and tend to become larger and harder. The larynx is located in the upper middle portion of the neck and is involved with preventing food and other particles from entering the trachea (airway protection) and sound production. The trachea is the breathing tube that extends from the upper neck in to the chest cavity where it divides to provide airflow to the right and left lungs. Finally, the esophagus is a muscular tube that allows food to pass from the back of the throat (pharynx) to the stomach.
Every day, millions of people suffer from throat problems that can be relieved by medical or surgical treatment. We can help you get relief if you are having:
Oral cavity problems:
A. Symptoms: sore throat, pain or difficulty swallowing, swollen tonsils, bumps, masses or sores in the mouth/tongue, discoloration of the lining of the mouth, snoring/restless sleep due to excessive tissue in the mouth or an enlarged tongue, articulation disorders (trouble pronouncing words), and trouble with feeding (infants).
B. Causes: cancer, bacterial infection, viral infection, tongue tie, salivary gland dysfunction, trauma, burns, inflammation or inflammatory diseases (Lupus, Sjorgens Syndrome, Wegener's Granulomatosis), smoking or tobacco use.
Hyperthyroidism Symptoms
Common symptoms due to low thyroid or hyperthyroidism are:
- Fatigue and weakness
- Heat intolerance
- Dry and coarse skin, clammy skin
- Hair loss
- Warm hands and feet
- Weight loss
- Insomnia
- Depression
- Poor memory, forgetfulness
- Nervousness and tremors
- Immune system problems
- Light menstrual periods
- Frequent defecation
Larynx (voice box) problems:
A. Symptoms: hoarse or raspy voice, frequent throat clearing, neck pain, lump in the throat, loss of voice, sore throat, frequent pneumonia, irregular speech pattern, coughing (dry, mucous, or blood)
B. Causes: cancer, smoking or tobacco use, vocal cord polyps or nodules, paralyzed vocal cord(s), swallowing a foreign object (i.e. chicken bone, toy, coin), infection, voice trauma, vocal cord spasm (spasmodic dysphonia)
Thyroid problems:
A. Patients most commonly are referred to the ENT doctor for thyroid problems because they have a lump in their neck or a nodule found on a thyroid ultrasound.
B. Causes: cancer, over-active nodule, non-functioning nodule, immune system problems (autoimmune disorders), developmental problems (i.e. thyroglossal duct cyst), genetic condition.
Salivary gland problems:
A. Symptoms: dry mouth, swelling of the involved gland that gets worse with eating, pain, facial paralysis, and enlarged lymph nodes.
B. Causes: cancer, benign tumors, obstruction of the ducts leading from the glands, bacterial infection, viral infection (i.e. "the mumps")
Lymph node problems:
A. Symptoms: enlarged lymph nodes with our without associated pain and tenderness, neck abscess
B. Causes: cancer, bacterial infection, viral infection.
Parathyroid problems:
A. Symptoms: Since parathyroid disease (hyper-parathyroid disease) was first discovered in 1925, the symptoms have become known as "moans, groans, stones, and bones with psychic overtones.” Patients often simply do not feel well, have loss of energy, feel old, cannot concentrate, have loss of sex drive, often have kidney stones, are often depressed, are irritable, may have heart palpitations, thinning hair, hurting bones, acid reflux, or recurrent headaches. Blood tests can reveal an abnormally high calcium level. Hypo-parathyroid disease is rare and almost always caused by surgery to remove the thyroid or parathyroid glands. The symptoms are usually numbness, tingling, cramps, and irregular heart beat. Patients are most commonly referred to the ENT doctor for parathyroid problems because of a lab test that shows abnormal blood calcium and abnormal blood parathyroid hormone level.
B. Causes: Surgery (99%), inability of the kidneys and bones to respond to parathyroid hormone (extremely rare), and inability of parathyroid gland to make active form of hormone (extremely rare).
Problems with nerves and blood vessels:
There are many important nerves in the face and throat that are treated by ENT physicians. These nerves have very interesting names but can best be remembered by the symptoms they cause: damage to the facial nerve causes the muscles of the face to become weak (often called Bell's Palsy), weakness of the laryngeal nerve causes a hoarse voice, problems with the hypoglossal nerve results in decreased tongue movement, weakness of the spinal accessory nerve makes it difficult to lift the shoulder, damage to the lingual or corda-tympani nerves will alter the way food tastes, damage to the olfactory nerve will cause an impairment in the ability to smell and taste.
The blood vessels in the neck and ear can develop non-cancerous tumors called "Paragangliomas." The symptoms associated with these tumors include neck swelling and nerve weakness as described above. When the tumor forms in the ear, patients will often complain of hearing a pulse or heartbeat in the ear. Tumors that arise in the blood vessels of the head and neck are rare but serious and need immediate medical attention.
An irritated throat can be annoying when symptoms continue to linger or become a recurrent problem. A carefully selected diagnostic procedure and an inclusive treatment plan can provide permanent benefits for an ENT patient suffering from chronic sore throat, hoarseness or glandular maladies. If you are not getting relief from over-the-counter medications, you might be surprised at the relief the right prescription medicine can offer. An ENT doctor can determine what is going on in your throat and which treatments are best suited to manage or eliminate the throat problems you’re experiencing:
- Chronic Dry or Sore Throat - When the flow of saliva is insufficient, the patient’s mouth feels dry. Dry mouth and dry throat often lead to hoarseness and a sore throat. The two major causes of dry mouth (non-cancer or non-chemotherapy) are disorders that: (1) cause the saliva glands to fail to produce an adequate amount of saliva; or (2) salivary gland swelling that limits the production of saliva. If this is a recurrent problem for you or a member of your family, you should see an ENT specialist. There are numerous diseases, medications, foods and stress-related disorders that can cause or contribute to dry mouth.
- Pediatric ENT – Dr. Greene always works closely with a younger patient’s primary care physician to provide the best solution for the pediatric ENT problem. We also work closely with parents to educate them as to the cause of the problem and what they can do to help their infant or child. If Dr. Greene believes a young patient might just outgrow their problem, then he will outline interim treatments and other options can be revisited over time. Jacksonville ENT Surgery always seeks to provide the best solution for speech disorders, chronic throat infections and other pediatric ENT problems.
- Sleep Apnea and Surgery – If you or a member of your family has a history of suddenly waking from your sleep choking and gasping for air, you may suffer from sleep apnea, a serious ENT disorder that should be discussed with an ear, nose and throat doctor. Obstructive sleep apnea is a serious ENT problem and causes dangerous health risks for patients who are tormented by the disorder. Sleep apnea in pediatric patients has been linked to aggressive behavior at school and at home. Corrective ENT surgery for pediatric sleep apnea aims to surgically remove inflamed tonsils (tonsillectomy) and remove the adenoids (adenoidectomy), eliminating a lot of the soft tissue that was restricting the airway. Dr. Greene can recommend the best treatment, sleep apnea therapy or corrective ENT surgery.
- Tonsillectomy and Adenoid Surgery – The best treatment for a sore throat depends upon the cause of the sore throat. Most of the time, you can use a home remedy like gargling with warm salty water to obtain relief. The only throat surgery most of us will ever experience is a tonsillectomy and/or an adenoidectomy. These throat and palette surgeries are often the only way an Ear, Nose and Throat doctor can control a patient’s ENT health. The tonsils and adenoids are removed to open the patient’s airway while reducing the patient’s tendency for chronic sore throat and throat infections.
Everyone experiences a sore throat from time to time. Although sore throats can be painful and annoying, most sore throats are caused by misuse or minor illness and go away without additional medical attention. In this area, an ENT doctor is well trained in treating throat disease, throat infections, throat obstructions, throat trauma, throat cancer and upper neck maladies with medications, minor throat surgery and major corrective throat surgery. Additionally, an Ear, Nose & Throat specialist must have expertise in managing diseases of the larynx and upper tract of the esophagus. These can cause patients to have trouble with breathing, swallowing or speaking. If you have throat issues, contact Dr. Greene for an appointment to discuss your specific throat problem.