Neck Mass

A lump or mass on your neck does not mean you have cancer. Risks for malignancy may include if the mass has been present for longer than 4 weeks, voice change, swallowing difficulties, pain on swallowing, weight loss, sore throat, ear pain or hearing loss. A referral from your GP can be marked urgent. Your ENT surgeon will ask for a detailed medical history and will conduct a thorough head and neck examination. The ENT specialist may also perform a laryngoscopy and use a camera to examine your throat and a local anaesthetic will be administered prior to this. You may require medical imaging (CT scan or MRI scan) and/or a fine needle aspiration (FNA) with a follow-up appointment within a short period of time. An examination under a general anaesthesia may be required to evaluate the throat, larynx, back of your nose, upper trachea and upper oesophagus. Your ENT surgeon may collect tissue for histology or pathology. Results are usually available in 48-72 hours.

Gastro-oesophageal Reflux Disease and Laryngo-pharyngeal Reflux Disease

Gastro-oesophageal Reflux Disease is simply the return of the stomach’s contents back up into the oesophagus. Your general practitioner may refer you to an ENT surgeon for more detailed examination namely an endoscopy. An endoscopy is a procedure that involves the use of a small lighted tube which has a video camera on the end this known as an endoscope. The ENT surgeon will place this down into the oesophagus to ascertain whether there is inflammation or irritation of the tissue in the lining of the larynx parents an oesophagus. In the event that your ENT surgeon discovers suspicious tissue or cells it may warrant further examination or a biopsy under a general anaesthetic.

The Royal College of General Practitioners report in 2017 (Fraser-Kirk, 2017) stated half of the laryngeal complaints referred to ENT specialists are ultimately diagnosed as laryngeal pharyngeal reflux disease. Laryngopharyngeal reflux is a distinct entity to gastro oesophageal reflux disease. It is known as the passage of gastric contents beyond the upper oesophageal sphincter with contamination of the larynx pharynx and lungs. Constant exposure of these contents may cause mucosal injury damage to dilated respiratory epithelium and mucus stasis. Common symptoms include throat tightness and discomfort or a feeling of something stuck, hoarseness of voice and reduced vocal quality. Referral to an ENT specialist will result in a laryngoscopy. Your specialist may also refer you for a barium swallow to determine if there is a hiatus hernia or pharyngeal pouch. In isolated cases, an oesophageal endoscopy under general anaesthetic may be required. Medical management may include altering diet food avoidance speech and language therapy altered sleeping patterns treatment for anxiety and antacid treatment. Surgery may be indicated if maximum medical therapy fails.

Hoarseness (Dysphonia)

Hoarseness of voice is known as dysphonia and is sometimes referred to as impaired voice production or impaired voice quality. Dysphonia is common and can affect children and adults. The symptoms of dysphonia can include loss of projection and poor quality of voice. Common causes of dysphonia include overuse of voice (particularly in teacher and performing artists), acid reflux, allergies, age-related changes, side effects of certain medications and smoking. The most dysphonia is related to upper respiratory tract infection and will resolve in time. A referral to an ENT specialist may be require for persistent symptoms and will require a full head and neck examination and laryngoscopy of the larynx, pharynx and oropharynx to observe anatomy. Hoarseness can be treated with voice rest, voice therapy, Botox injection or surgery. Surgery may require direct laryngoscopy under a general anaesthetic. Recovery from throat surgery requires voice rest, regular pain medication and plenty of fluids to rehydrate. Discuss with your ENT surgeon which option is best suited for you.

Personal care, dedicated to resolutions.

Mackay Ear, Nose and Throat Specialists work closely with sleep study facilities and can also help with snoring and breathing problems including sleep apnoea.

Post operative care is a critical component of Mackay Ear, Nose and Throat Specialists’ service and all procedures and surgeries are followed up personally by our Specialists until they are satisfied the problem has been resolved.

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