ENT Knowledge Base

Diagnosis

Throat

Foreign Body Ingestion

Swallowing of an object commonly happens in adults with mental health problems such as those affected by drugs and alcohol. Examination with tongue depressor and laryngeal mirror should reveal the foreign body. If the foreign body is suspected to be at lower place, a nasoendoscope is performed.

Aphthous Ulcer

Diagnosis & Treatment:

Sores inside the mouth e.g. on the inside of your lips and cheeks, or on your gums or tongue are referred to as Aphthous Ulcers. They are painful but not harmful. In most cases, they will resolve in 2 weeks. The causes are unknown yet, it is believed stress or infection or some irritating food like chips may give rise to the oral ulcers.

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Aphthous ulcers

Torus Palatini

Torus (plural ‘tori’) is a harmless growth of bone which usually grows on the roof of mouth, the inside of the lower jaw and the cheek of mouth. Tori are slow-growing and vary in size, but most do not interfere with eating or speech. Many people have tori without knowing it.

Surgical treatment is advised only if the growths cause complications or interfere with daily life

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Aphthous ulcers

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Torus palatini

Tonsillith

Tonsillith means a tiny stone in the tonsils (sides of the throat) which is caused by chronic tonsillitis.

Differential diagnosis of tonsilloliths includes foreign body, calcified granuloma, cancer.

Surgical Removal of stones is the treatment to severe cases. Preventive methods include gargling with salt water. Cider vinegar or a non-sugar-based mouth washes.

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Left tonsillolith

Pharyngitis

Pharyngitis refers to the inflammation of pharynx (throat). Sore throat is the result. It can be caused by both bacterial or viral infection.

Patients may experience:

  • sore throat

  • strep throat maybe accompanied fever, headache and swollen lymph node

  • Viral one may be associated with running nose and postnasal drip

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Acute pharyngitis

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granular pharyngitis

Peritonsillar abscess

Quinsy is the abscess between the back of tonsils and the wall of the throat and if untreated, it may develop into acute tonsillitis.

Patients often have a history of sore throat with pain that may be more prominent on one side. There may be fatigue, fever, chills and ear pain.

With the symptoms of Quinsy, they should see a physician on an emergency basis. If Quinsy is suspected, the physician usually attempts to draw out the pus from the tonsillar abscess using a needle. Needle aspiration is usually the best way to diagnose Quinsy, and will also initiate the patient’s recovery. The aspirated material can then be sent to the laboratory for bacterial culture.

Laryngitis

Laryngitis is an inflammation of the voice box, or larynx that causes your voice to become raspy or hoarse.

Laryngitis can be caused by Cold or Flu, bacterial infection, fungal infection, overuse of voice, and irritation such as allergy and alcohol consumption.

The main symptom of laryngitis is hoarseness. Your voice may sound raspy, be deeper than normal, or break now and then. You may lose your voice completely. Other symptoms may include a dry or sore throat, coughing, and trouble swallowing.

You may need surgery if your vocal cords have been damaged, such as by sores or polyps.

Vocal Cord Polyp / Nodules

A vocal cord nodule/ polyp is a nodule or mass of tissue that grows on the vocal cords. Typically this mass will appear on the anterior one-third of the vocal fold, where contact is most forceful.

Symptoms include hoarseness of speech, painful speech production, frequent vocal breaks and reduced vocal range.

These conditions are best diagnosed by having an ENT examine your vocal cords using a flexible endoscope. There is also An additional strobe light examination (video stroboscopy) can also illustrate the vocal cords movement because it shows them opening and closing in what looks like in slow motion.

Treatment, or voice rehabilitation, usually involves vocal training (speech therapy), and, occasionally, vocal rest. In rare cases, surgery may be required.

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Vocal cord polyp

Vocal Cord Paralysis

Vocal cord paralysis is the inability to move the muscles that control the vocal cords. Vocal cord paralysis may affect speaking, breathing, and swallowing. Paralysis may allow food and fluids to be inhaled into the windpipe (trachea) and lungs. If only one side is paralyzed, an operation can be done to move the paralyzed vocal cord to the best position for more normal speech. When both sides are paralyzed, keeping the airway open adequately is difficult. A tracheotomy (surgery to create an opening into the trachea through the neck) may be needed.

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Right vocal cord polyp and palsy

Leukoplakia

Leukoplakia is a common disease of the mouth. People with Leukoplakia usually have a white patch on their tongue or cheek, which cannot be rubbed off. The Leukoplakia patches usually clear up a few weeks to months after the source of irritation has been taken away. Very rarely though, they may develop into mouth cancer and for this reasons any areas of Leukoplakia should be reviewed on a regular basis by your medical professionals.

The presence of white or gray colored patches on your tongue, gums, roof of your mouth, or the inside of the cheeks of your mouth may be a sign of Leukoplakia , however, a biopsy will likely be taken to rule out other causes, such as oral cancer

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left tongue leukoplakia

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left tongue leukoplakia

Laryngeal Cancer

It occurs when there is cancer cells appear on the tissue of the larynx or voice box.

A person may experience:

  • Hoarseness or change on his or her voice

  • Difficult swallowing

  • Shortness of breath

  • Wight Loss

  • Prolonged headache

Patients will be examined with a flexible endoscope to see your larynx. If there was suspicious lesion in the larynx, biopsy will be suggested. This is the only way to diagnosis cancer.

Tonsillar Cancer

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Carcinoma of larynx

Cancer of the tonsils occurs predominantly in men. It is strongly linked to smoking and alcohol consumption. Recent evidence suggests that human papillomavirus (HPV) is associated with tonsil cancer as well.

Patients will be examined with a flexible endoscope to see your larynx. If there was suspicious lesion in the larynx, biopsy will be suggested. This is the only way to diagnosis cancer.

Tongue Cancer

There are two types of tongue cancer: Cancer of the Oral tongue and the Cancer of the base of the tongue

  1. A lump on the side of the tongue

  2. The lump often looks like an ulcer and is grayish-pink to red in color

  3. The lump bleeds easily if bitten or touched

Symptoms of Oral Tongue Cancer:

  1. The tumor is often difficult to see in the early stages so it is usually diagnosed when it is larger

  2. There are few symptoms in the early stages.

Symptoms of base of the tongue cancer:

In later stages, the cancer may cause pain, a sense of fullness in the throat, difficult swallowing.

Several tests are used to aid in diagnosis. These include:

  1. PET scan

  2. CT scan

Risk factors include:

  1. smoking, drinking alcohol

  2. HPV 16 and HPV 18 carrier (a sexually transmitted disease)

Treatment options:

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Throat carcinoma of tongue