Snoring

As many as forty-five percent of adults report occasional snoring, but over twenty-five percent snore every night. Snoring occurs when there is an obstruction in air flow in the back of the mouth and nose. The sound we hear is the result of the tongue and upper throat vibrating against the soft palate and uvula during breathing.
Snoring most commonly occurs in males and/or people who are overweight, and it usually worsens with age. Chronic snoring can be caused by poor muscle strength in the tongue and throat, resulting in the tongue falling backward and obstructing the throat, excessive throat tissue or soft tissue in the neck or a long soft palate and/or uvula. Snoring can also be caused by stuffy nose from sinus infection, hay fever or a cold; this type of snoring should go away after recovery from the illness.

When children have chronic snoring, it usually indicates enlarged tonsils or adenoids. Children are especially prone to infections of the tonsils or adenoids, which causes swelling, blockage and trouble breathing. Congenital abnormalities and enlargement of these glands, which would require surgery, may also cause chronic snoring in both children and adults.

Snoring can be the symptom of a more serious condition, such as sleep apnea. When snoring is interrupted by pausing, choking or gasping, sleep apnea is a high probability. Obstructive sleep apnea (OSA) is characterized by episodes of breathing pauses that last longer than ten seconds that are caused by collapse of the upper airway. OSA prevents adequate oxygen from entering the bloodstream, leading to an overworked heart.

Head & Neck Masses

Masses of the head and neck can be malignant or benign. It is important to have masses evaluated right away so that if they are dangerous, treatment can start early. There are three major categories of head and neck masses: congenital, inflammatory and neoplastic.
Congenital masses are most common in children, but can be present in adults. These are commonly cysts, thymic rests or dermoids. They are typically benign, slow-growing and painless. Congenital masses generally require surgery for removal.

Bacterial and viral infections can cause neck masses – swollen lymph nodes being the most common form. These are benign and will go away on their own. Other infections like tuberculosis can cause neck masses, which may require antibiotics and other medicines to treat.

Neoplastic masses can be benign, such as lipomas, hemangiomas, neuromas and fibromas. These are non-invasive and do not usually affect sensory or motor skills. Thyroid cancer, mucosal cancer and metastatic disease are all examples of malignant masses; these are very serious and require immediate treatment. Your doctor will likely choose to surgically remove all neoplastic masses to eliminate risk of cancer or infection.

Neck masses can originate from lymph nodes, the thyroid or salivary glands. Rarely they can arise from bone, cartilage, muscles, veins or nerves. The location and size of the mass as well as the health and age of the patient can help the doctor identify the mass’s origin. If a physical exam does not provide an obvious answer, an MRI or biopsy may be necessary.

Throat Cancer

There are two types of throat cancer: pharyngeal and laryngeal. Pharyngeal cancer forms on your pharynx (breathing and digestive tube) and laryngeal cancer forms on your larynx (voice box). Symptoms of throat cancer include coughing up blood, trouble swallowing and lumps on the throat felt outside the skin. There are several treatment options, depending on the size and prevalence of cancerous tumors. Surgery can be performed to remove small tumors. Radiation therapy can be used alone or after surgery to destroy malignant cancer cells. For large tumors or tumors that have spread to other organs and tissues, chemotherapy is the best treatment option.

Reflux

Acid reflux, or gastroesophageal reflux disease (GERD), is a chronic digestive condition that causes painful heartburn and regurgitation for millions of Americans every year. It occurs when the contents of the stomach seep backwards into the esophagus.

Symptoms & Causes

Normally, following a meal, a valve on your esophagus – the sphincter – closes, preventing hydrochloric acid produced in the digestive process from backing up (refluxing) into the esophagus. When reflux occurs, this valve fails to seal properly, and the stomach contents flow freely into the throat and esophagus. This damages the esophageal lining and causes a variety of painful symptoms.

Heartburn is most commonly associated with GERD. Also known as acid indigestion, this burning pain radiates from the stomach to the abdomen and chest and may last for up to two hours after a meal. It is frequently accompanied by regurgitation, a sour taste in the mouth, and dyspepsia, or general stomach discomfort. Other symptoms often include belching, bloating, coughing, wheezing, hoarseness and nausea.

Symptoms occur most frequently after eating, when lying down or when bending over. They are most common at night.

Some patients have small amount of reflux without heartburn, which can affect the throat, resulting in mild sore throat, hoarseness, feeling something stuck in the throat, having excess mucus in the throat or difficulty swallowing. This condition is called laryngopharyngeal reflux (LPR) and can occur with or without GERD.

Reflux Treatments

An effective way to treat acid reflux is to avoid the triggers that cause painful heartburn and other symptoms. Stay away from those foods and beverages that are likely to cause a negative reaction. Change your eating habits; stick with smaller, more frequent meals, and avoid eating too closely to bedtime. Quit smoking, and ask your doctor if the medications you are taking might be responsible for your symptoms. If you are overweight, start exercising.

Over-the-counter antacids taken immediately after meals will help neutralize stomach acids and can prevent heartburn from occurring or relieve the symptoms.

For serious cases that do not respond to medical treatment, surgery may be recommended.

Tonsils & Adenoids

The tonsils and adenoids are part of the lymphatic system and serve as defenders of the immune system, protecting your body by preventing germs and bacteria from entering through your mouth and nose. Occasionally, they will develop problems themselves, requiring the attention of an ENT specialist.

Tonsil & Adenoid Problems

The tonsils (located in the back of the throat) and adenoids (high in the throat, behind the nose and soft palate) work together to protect the body from illness – but sometimes fall prey themselves.

Tonsillitis is an infection of the tonsils that causes soreness and swelling. Affected tonsils appear red and may have white or yellow spots. Symptoms include sore throat, fever, bad breath, ear pain, swollen lymph nodes in the neck and difficulty swallowing. Surgical removal of the tonsils (tonsillectomy) was a common practice in the past, but now doctors prefer to treat the condition with antibiotics first. If a patient is subject to chronic tonsillitis, a tonsillectomy (and often an adenoidectomy, as well) may be recommended.

Enlarged tonsils and adenoids are another problem; they block the airways and cause soreness, ear infections and breathing difficulties. Side effects include runny nose, snoring and sleep apnea. Steroid treatment is sometimes helpful, but in many cases, enlarged tonsils and adenoids need to be removed surgically.

Recovering from Surgery

If surgery is required to remove the tonsils and adenoids, recovery usually takes 7 to 10 days for children but can take 14 days or longer for adults. The following steps are recommended to make it as painless and quick as possible:

  • Drink plenty of fluids
  • A soft diet is recommended initially
  • Increase activity slowly
  • Take pain medication as prescribed

Keep in mind that scabs will form where the tonsils and adenoids were removed. These should fall off 5 to 10 days after surgery. There should not be any bleeding other than a little spotting in the saliva. If bright red blood is seen, contact a physician immediately.

Thyroid/Parathyroid

The thyroid and parathyroid are endocrine glands near the throat that secrete hormones throughout the body. The thyroid is bowtie-shaped and rests in front of the trachea (windpipe). It uses iodine from food to regulate the body’s energy. The parathyroid is a cluster of smaller glands located on the back of the thyroid. Their role is to control the amount of calcium in the blood.
One common thyroid disease is hyperthyroidism. Hyperthyroidism is defined as an overproduction of thyroid hormones, and there are several ways it can present: Graves’ disease, which is the production of too much thyroid hormone; toxic adenomas, or small nodules that develop in the thyroid gland that also produce hormones, disrupting the body’s chemical balance; subacute thyroiditis, which is inflammation of the thyroid that causes the gland to “leak” excess hormones, lasting a few weeks to a few months; and hyperthyroidism developed from pituitary gland malfunctions or cancerous growths. Hypothyroidism, by contrast, is the underproduction of thyroid hormones and is much more common. It is caused by certain drugs, autoimmune disorders or removal of the thyroid. Hypothyroidism is more common as we age.

The primary disease of the parathyroid glands is overproduction of hormones. This is called hyperparathyroidism. The most common way this occurs is the development of benign tumors in one of the parathyroid glands. The tumors produce hormones too, which causes hormone imbalances in the body, resulting in abnormally high levels of calcium in the blood. Left untreated, this can result in kidney stones, kidney damage, abdominal pain and osteoporosis. The parathyroid glands can also grow cancerous tumors, but this is very rare. Another cause of hyperparathyroidism is enlargement of two or more of the parathyroid glands.

Vocal Cords

Vocal cords, sometimes referred to as vocal folds, play an important role in how we produce sounds. First there must be air in your lungs; this occurs through the act of inhaling. The air is then pushed through the lungs into your windpipe. At the top of the windpipe sits your vocal cords. The cords stay open when breathing and close when you produce sound. As the air gets pushed out of the windpipe, it passes between the vocal cords, causing them to vibrate. This vibration sounds like a buzzing. This sound is passed through the throat, nose and mouth, which all work together to change the buzzing into speech. Any disorder that affects the vocal cords will affect your speech.
Vocal cord paralysis can be bilateral or unilateral. Bilateral involves both cords becoming stuck half open and half closed. The cords are unable to move in either direction. Unilateral occurs when only one side is stuck or has very limited movement.

Hoarseness, inability to speak loudly and choking or coughing while eating are common signs of vocal cord paralysis. To make a diagnosis, your doctor will review your symptoms and complete a physical exam. An endoscope may be inserted down your nose or throat so your doctor can get a better look at your vocal cords. Once the vocal cords are in view, your doctor will ask you to speak in order to watch what happens.

If you are diagnosed with bilateral vocal cord paralysis, a tracheotomy may be needed. This procedure creates a hole in your trachea and a tube is inserted to help you breathe. Unilateral vocal cord paralysis may also require surgery to move the paralyzed vocal cord.

Non-surgical treatments such as behavioral therapy may be recommended by your doctor before surgery. This type of therapy will teach you how to breathe better and how to find the best body positon for you to produce strong speech.

Voice Disorders

Voice disorders can occur in the lungs, the larynx or the articulators of the mouth. Symptoms include quivering, hoarseness, choppiness, breathiness, unusual pitch and pain or discomfort around the throat when speaking. They can be caused by growths, inflammation, nerve problems or hormones. Treatment depends on the cause, but common treatments include lifestyle changes, speech therapy, medicines and surgeries.

Laryngitis/Laryngoscopy

Laryngitis is inflammation of the voice box due to vocal strain, irritation or infection. Symptoms of laryngitis include hoarseness, voice loss, rawness of the throat, sore or dry throat and cough. Acute laryngitis generally heals on its own or with at-home remedies like rest and drinking warm fluids. Chronic laryngitis is defined as symptoms that persist more than three weeks, which could point to a more serious condition. Seek immediate medical attention if you experience fever, trouble swallowing, trouble breathing, coughing up blood or excessive drooling.

Hoarseness

Hoarseness is an abnormally deep or harsh voice that may sound raspy, scratchy, breathy or strained. There may be changes in volume or pitch. It’s usually the result of irritation or injury to the vocal cords and can be caused by a number of different conditions.
When we speak, our vocal cords vibrate as air leaves the lungs, producing sound. Swelling or inflammation of the vocal cords affects the vibration, altering the quality of the voice. A variety of factors can cause this, but the most common is acute laryngitis. This swelling of the vocal cords is caused by a cold or viral infection. Attempting to use your voice while suffering from acute laryngitis can cause serious, irreparable harm to the vocal cords.

Misuse of the voice – yelling, whispering, excessive throat clearing, general overuse – can cause strained vocal cords. Other causes include benign vocal cord lesions, acid reflux, allergies, smoking, neurological disorders, vocal hemorrhage, thyroid diseases, trauma to the voice box and cancer.

Treatment for hoarseness will vary depending on the underlying cause. Your best course of action, regardless of the condition, is to rest your voice until symptoms recede. Vocal cord lesions (polyps, nodules and cysts) will require surgical removal.

To prevent hoarseness, be careful how you use your voice; avoid speaking too long or too loudly, and keep your vocal cords moist by drinking plenty of liquids. Avoid alcohol and caffeine, both of which dehydrate your body, and stay away from spicy foods. If you smoke, quit! Even secondhand cigarette smoke can cause problems.

Swallowing Disorders

Trouble swallowing, known medically as dysphagia, occurs when food feels like it is sticking in your throat or chest. It is usually the result of an improperly functioning esophagus and tends to affect the elderly more than any other age group.
Occasional difficulty swallowing affects almost everybody and isn’t cause for alarm; sometimes we simply eat too quickly or don’t chew our food thoroughly. Individuals with swallowing disorders experience persistent problems with chewing and swallowing. Normally, food and liquids are transported from the mouth to the stomach when we swallow, passing through the pharynx and esophagus before digestion takes place. When you suffer from a swallowing disorder, foods and liquids may become lodged in the throat, chest or sternum. This causes painful or difficult swallowing and may be accompanied by choking, coughing, gagging, regurgitation, drooling, hoarseness, chest pain, reflux, sore throat and weight loss.

Causes of dysphagia vary. They include aging, neuromuscular disorders, gastroesophageal reflux disease (GERD), hiatal hernias, scleroderma, esophageal webs that cause partial blockages and esophageal cancer.

A barium swallow study or fluoroscopy, in conjunction with x-rays, laryngoscopy and other diagnostic tests, can help determine what is causing your swallowing disorder. Treatment depends upon the diagnosis and may involve medications, surgery or swallowing exercises. When acid reflux is to blame, dietary changes – eliminating spicy foods, alcohol and caffeine, for instance – can be helpful in preventing dysphagia. Practice chewing your food slowly and thoroughly. In extreme cases, a feeding tube may be required to ensure the patient receives proper nutrition and maintains a healthy weight.

Pediatric Throat Services

When the tonsils become swollen, they cause pain and a variety of other symptoms. They will appear red and inflamed and may have white or yellow spots on them. Symptoms include sore throat, fever, hoarseness, difficulty swallowing, bad breath, headache, stomachache, swollen glands and a stiff neck. Younger children may experience drooling and exhibit marked irritability and a refusal to eat.
Home care is beneficial in relieving the symptoms of a tonsil infection and aiding in a speedier recovery. Make sure your child gets plenty of rest and liquids; warm broth, tea with honey and cold popsicles can all help soothe the throat. Gargling warm saltwater several times a day may also help. If your child is older than four, sucking on lozenges can help relieve a sore throat. Use a humidifier to moisten the air, or have your child sit in a steamy bathroom for a few minutes.

Snoring is another concern because a good night’s sleep is essential for your child’s growth and development. Daytime fatigue can lead to learning issues and has been associated with attention deficit disorders in some children. Children who snore can become irritable and moody and are at risk for health issues, including diabetes, high blood pressure, heart disease and lung disorders. Snoring can lead to increased urine production at night, which often results in bedwetting.

Snoring in children is often the result of overgrown tonsils and adenoids. If this is the case, surgical removal can often restore normal airflow. This is generally recommended only in severe cases. Other solutions include weight loss or the use of Continuous Positive Airway Pressure (CPAP) devices or mouth guards.

Nasal & Sinus Surgery

Lake Jackson ENT offers premier nasal and sinus surgical treatment options for conditions that either require surgery or aren’t responding to other medical or procedural treatment plans.
We treat many nasal and sinus conditions. Most of these can be managed or cured using nonsurgical treatments. In some cases, though, our physicians may recommend surgical solutions. Whether or not you’ll require surgery depends entirely on your individual health and personal needs. Some examples of conditions that may require nasal or sinus surgery include:

  • Nasal blockage
  • Chronic sinusitis
  • Deviated septum
  • Sinus or nasal trauma
  • Nose bleeds
  • Nasal polyps
  • Enlarged turbinates
  • Chronic stuffiness
  • Chronic breathing issues

Types of Nasal and Sinus Surgeries

Depending on your condition, insurance, lifestyle and symptoms, your ENT physician may recommend one or more surgical treatment options. Here are some of the most common procedures we perform:

  • Balloon sinuplasty uses a small balloon catheter that is inserted into the sinuses then inflated to open up the nasal passageways. Once the sinuses reach the desired width, the balloon is deflated and removed, leaving more space in the passageway.
  • Turbinate surgery reduces airway obstruction and difficulties breathing caused by enlarged or swollen turbinates, which are small bones that clean and humidify air as it passes through your nose. There are several types of turbinate surgery, including the turbinectomy (full or partial tissue removal), the turbinoplasty (tissue repositioning), radiofrequency or laser ablation surgery (tissue reduction) and submucous resection surgery (partial bone or cartilage removal).
  • Caldwell Luc operation improves drainage in the maxillary sinus by creating a window from this cavity to the nose. The surgeon enters the maxillary cavity endoscopically through the upper jaw above the molars.

Endoscopic Sinus Surgery

Functional endoscopic sinus surgery (FESS) is used to improve nasal drainage and open up the nasal passageways. To perform this outpatient procedure, your doctor uses an endoscope (a small probe with a camera on the end) to enter your sinuses and remove problematic tissues and diseased sinus mucosa.

Image guided surgery is an option wherein a three-dimensional mapping system is constructed using CT scans for extreme precision. This is used when disease encroaches the space near the orbit (eye socket) or the skull base (bone separating the sinuses from the brain), when prior surgery has altered the normal anatomy or when severe polyps make the normal anatomy difficult to identify.

Nasal Fracture

Septoplasty and septorhinoplasty procedures reshape, reduce or reposition portions of the septum’s bone or cartilage to open up the nasal passageway. These procedures are used to reduce blockage, fix a deviated septum, repair damaged cartilage and resolve other conditions related to a nasal fracture.