General ENT

GeneralENTMedical problems of the ear nose and throat represent a vast array of conditions across multiple organ systems. From hearing loss to voice loss, these problems can cause recurrent or chronic disease that impacts quality of life. At GNO Snoring and Sinus, we offer treatment for the full range of ear nose and throat disease for adults and children alike.

 

 

Recurrent Ear InfectionsPersistant Aural CongestionHearing Loss

It is not uncommon for adult and pediatric patients to experience occasional ear infections that require antibiotic therapy. However, for those patients that suffer from recurrent or chronic infections that require multiple courses of antibiotics, impair hearing, or lead to significant pain and discomfort, a proper ENT examination is recommended.

Often times placing tubes in the ears is an effective remedy for such recurrent ear infections and can provide increased quality of life and hearing.

Most every adult has experienced temporary aural congestion during changes in altitude. Whether it is a result of a recent airflight or trip to the mountains, the feeling of pressure in the ears usually resolves in a short period of time. This pressure sensation is a result of pressure differentials between the outside environment and the middle ear space. For certain individuals, this feeling is quite persistent and can cause hearing difficulty and discomfort. In this case, further ENT examination is recommended.

Simple in office maneuvers can be performed to help “pop” the ears. If these are unsuccessful, an office myringotomy is performed to provide further relief.

Hearing loss affects adults and pediatric patients at all stages of life. Young children most often experience hearing loss as a result of recurrent or chronic ear infections that create fluid in the middle ear space. In both young children and adolescents, asymmetric hearing loss associated with chronic ear infections can be suspicious for benign tumors(i.e. cholesteatoma) in the ear that can severely damage hearing if left untreated. Sudden hearing loss can result from trauma that creates ear drum perforations or viral infections. Progressively worsen hearing loss in older patients is more likely a result of age related hearing loss associated with chronic noise exposure.

Accurate diagnosis is the key to proper treatment, and this begins with a thorough ENT examination.

Recurrent Sore ThroatsChronic HoarsenessDifficulty SwallowingChronic Cough

Adult and pediatric patients often suffer with recurrent sore throats. In most cases these are treated with over the counter medications, however, in certain cases they require multiple courses of antibiotics. In these instances, patients should be assessed for recurrent or chronic tonsillitis. This is treated with a tonsillectomy and can markedly improve a patient’s quality of life and time missed from work or school.

A change in voice quality is not uncommon during periods of excessive voice usage, or upper respiratory infections. However, for patients that frequently experience bouts of hoarseness or chronic hoarseness that does not improve, ENT examination is recommended to directly visualize the larynx.

Patients that are motivational speakers, educators, preachers, or others who use their voice quite frequently, often suffer from vocal cord nodules. This creates a level of hoarseness that is most often treated with conservative therapy. In patients with a history of tobacco abuse and worsening hoarseness, the suspicion for vocal cord cancer is high and proper ENT examination is required to rule out any worrisome pathology.

Other reasons for hoarseness can exist as well, all of which can be properly diagnosed and treated with a thorough ENT examination.

Difficulty swallowing (dysphagia) is a common medical problem that can be associated with multiple symptoms. These include coughing, regurgitation, pain, heartburn, and weight loss among others.

As the sequence of events that contributes to swallowing is quite specific and complex, any single disruption in that mechanism can lead to dysphagia. Common causes include reflux, cerebrovascular disease(stroke), head and neck tumors, or a Zenker’s diverticulum.

Episodes of dysphagia that frequently recur or increase in severity warrant further ENT examination. In office laryngoscopy and swallowing studies are performed to characterize your swallow and determine the exact level of dysfunction, providing enhanced information to arrive at an accurate diagnosis

It is not uncommon to experience a cough during an upper respiratory infection. However, in certain cases the cough can be prolonged for months after the initial infection resolves. This can create a sense of discomfort and a decreased quality of life for the patient suffering from the cough.

Common explanations for such a prolonged cough can include a post nasal drip, reflux, asthma, or vocal cord tumor. In these situations, proper ENT examination is required to rule out worrisome pathology such as a vocal cord tumor.

Head and Neck TumorsSwollen Lymph NodesThyroid DiseaseSkin Lesions

Tumors of the head and neck occupy a broad range of disorders, including benign and malignant tumors of the salivary glands, larynx, oral cavity, pharynx, and sinuses. These are often associated with tobacco and alcohol abuse, however, recent studies have shown that patients without a history of tobacco and alcohol use are at risk due to the human papilloma virus. Increasing numbers of head and neck cancers are being attributed to this virus, requiring all individuals to have a heightened sense of awareness.

Common signs worrisome for head and neck cancer include unilateral ear pain, chronic sore throat, hoarseness, and difficulty swallowing.

All treatment options are rooted in an accurate diagnosis and proper physical examination. As a fellowship trained head and neck cancer surgeon, Dr. Anand routinely cares for patients with advanced head and neck tumors. Whether you are seeking treatment for a primary diagnosis, recurrent cancer, or a second opinion, we are happy to provide personalized, compassionate care for all of your needs.

Lymph nodes of the head and neck are part of the body’s overall lymphatic system. This represents a network of drainage pathways for lymphatic fluid. For most patients, lymph nodes are swollen during bouts of infection and inflammation. This is most common in a sore throat or tonsil infection, when lymph nodes underneath the jaw become enlarged and tender. These lymph nodes will often improve as the infection resolves.

In certain cases, patients may appreciate lymph node swelling that continues to enlarge or is persistent. Common explanations include chronic infection, benign tumors, or cancer. In these cases, further ENT evaluation is recommended to determine the exact cause of such enlargement or persistence, and initiate a proper treatment plan.

Thyroid disease consists of a spectrum of disorders managed by internists, endocrinologists, and surgeons. The medical management of hypothyroid or hyperthyroid patients is usually the domain of internists and endocrinologists, whereas general surgeons and ENT surgeons specialize in the surgical removal of benign and malignant thyroid tumors. These commonly include benign thyroid nodules, goiters, and thyroid cancer.

All treatment options are rooted in an accurate diagnosis and proper physical examination. As a fellowship trained head and neck cancer surgeon, Dr. Anand routinely cares for patients with benign and malignant thyroid disease. Whether you are seeking treatment for a primary diagnosis, recurrent thyroid disease, or a second opinion, we are happy to provide care for all of your needs.

Skin lesions comprise a spectrum of disease that include both benign and malignant disorders. This range of disorders is well treated by many specialists, including dermatologists, ENT surgeons, and surgical oncologists.

In the head and neck region, these lesions can causes a significant aesthetic concern given the visible location of this region. Furthermore, given the high rate of sun exposure in the head and neck, there is always a concern for underlying skin cancer in lesions that are irregular and bleed with manipulation.

In the case of skin lesions that are long standing and provide an aesthetic or functional impairment, or in those cases where cancer is suspected, proper evaluation is recommended to guide further treatment. Most all treatment for local skin lesions is performed in our office surgical suite under local anesthesia

Facial TraumaFacial Paralysis

Trauma to the ENT region is unique in that it not only provides an aesthetic deformity but also a functional issue, as many vital structures reside in the head and neck. Nasal trauma can cause difficulty breathing, eye trauma can cause double vision, and mandible trauma can cause difficulty chewing.

It is important to see an ENT specialist within the first few days after head and neck trauma in order to have the injury assessed for repair. Often injuries are repaired soon after they are sustained to prevent the body from healing into a non favorable location – causing more problems down the road.

During your doctor’s visit, it is important for you to bring copies of your xrays if you have any, as we review all imaging prior to correction.

The facial nerve is a vital part of human expression and travels from the brain to various muscles in the face. The loss of facial expression from a sudden or progressive facial paralysis can be quite discomforting.

In cases of sudden facial paralysis, it is imperative to rule out a stroke. These are typically accompanied by other deficits, such as speech slurring and loss of motion in an extremity, among others. A thorough evaluation at an emergency facility is recommended in such cases.

In certain cases, an isolated sudden facial paralysis can indicate a viral disorder, known as Bell’s Palsy. Initial treatment with steroids and antivirals can facilitate improvement. It is important to follow up with an ophthalmologist or ENT physician in order to ensure that the eye is cared for, as the most worrisome initial concern in cases of Bell’s Palsy is damage to the cornea from ulcer formation.

Furthermore, in cases where the facial nerve does not fully resume function after a period of observation, an ENT physician can assist in the restoration of such function.

In cases of progressive facial paralysis, it is imperative to rule out a tumor. The facial nerve courses from the brain to the muscles of the face, therefore, a tumor can develop along any portion of this tract. During its progressive growth it may contribute to progressive facial paralysis. Proper ENT evaluation can assist in arriving at the correct diagnosis.

As the causes of facial nerve paralysis can consist of various entities, some more worrisome than others, it is important to seek immediate medical care once discovered.