Allergies are fairly common, affecting approximately 1 out of every five Americans. Allergies are caused by an abnormal response of the body’s immune system to a usually harmless substance found in the environment (Allergen) such as plant pollens, molds, dust mites, and animal hair. The Physicians at ENT Surgical Associates have additional advanced training in allergy therapy. Offering both allergy shots and oral allergy drops (SLIT) therapy.

Allergy symptoms can vary with the season and type of allergen involved, and may include sneezing, runny nose, nasal congestion, and itchy eyes and nose. Year-round prolonged exposure usually produces nasal congestion (chronic stuffy nose). Allergies can cause many ear, nose, and throat conditions, including:

  • Ear infections
  • Sore throats
  • Sinus infections

For some allergy sufferers, symptoms may be seasonal, but for others they produce year-round discomfort. Symptom control is most successful when multiple approaches are used simultaneously to manage the allergy. They may include minimizing exposure to allergens, medications, and in some cases subcutaneous immunotherapy (allergy shots) or sublingual immunotherapy (allergy drops) may be recommended. Immunotherapy is a method of treating allergies by desensitizing individuals to allergens over time, in many cases with the goal that they be cured of their allergies.

The physicians of E.N.T Surgical Associates have received additional, specialized training in the diagnosis and treatment of allergic conditions. Their expertise can help determine the substances causing your discomfort and develop a management plan that will help make life more enjoyable.

There are several types of allergy testing that your E.N.T. Allergy specialist can perform to test you for allergies. The two most common types of allergy testing performed are skin tests and blood tests.

Skin Tests

First, a screening “prick” test is performed on the skin of the forearm. A small amount of certain allergens is put into the skin by making a small indentation or “prick” on the surface of the skin.
If you have allergies, a small amount of swelling, redness and itching occurs on the skin surface at the prick test site.

Next, based on the results of the initial screening “prick” test, more sensitive “intradermal” tests may be done to further evaluate your allergies. The intradermal skin test is performed on the upper arm where a small amount of allergen is injected within the skin.
The results of the intradermal test are measured and recorded several minutes after they are applied. After the skin testing is complete, you and your physician will discuss the results and develop a treatment plan.

Skin tests are best performed in a physician’s office to assure the test results are read properly and to minimize the risk of rare, but potentially serious side effects.

Blood Tests

This type of allergy test is typically reserved for patients who are unable to undergo allergy skin testing, due to medication side-effects or skin conditions that may interfere with skin testing.

Blood tests are also used to test for Food allergies, such as to peanuts, when warranted by a patient’s history. Because the blood drawn for this type of allergy test is sent to an outside laboratory for processing, the results are not as rapidly available as with skin tests.

Have you ever had a cold or allergy attack that wouldn’t go away? If so, there’s a good chance you actually had sinusitis. Experts estimate that 37 million people are afflicted with sinusitis each year, making it one of the most common health conditions in America.

Unlike a cold, or allergy, bacterial sinusitis requires a physician’s diagnosis and treatment with an antibiotic to cure the infection and prevent future complications.

Normally, mucus collecting in the sinuses drains into the nasal passages. When you have a cold or allergy attack, your sinuses become inflamed and are unable to drain. This can lead to congestion and infection. Your doctor will diagnose acute sinusitis if you have up to 4 weeks of thick green-yellow nasal drainage accompanied by nasal obstruction, facial pain-pressure-fullness, or both. The sinus infection is likely bacterial if it persists for 10 days or longer, or if the symptoms worsen after an initial improvement.

Sinus infections can be categorized into two types, acute (short-term) and chronic (on-going) sinusitis. When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis. Symptoms of chronic sinusitis may be less severe than those of acute; however, untreated chronic sinusitis can cause damage to the sinuses that sometimes requires surgery to repair.

What are the Symptoms of Sinusitis vs. a cold or allergies?

Tips to Prevent Sinusitis

As always, an ounce of prevention is worth a pound of cure. To avoid developing sinusitis during a cold or allergy attack, keep your sinuses clear by:

  1. Using an oral decongestant or a short course of nasal spray decongestant
  2. Gently blowing your nose, blocking one nostril while blowing through the other
  3. Drinking plenty of fluids to keep nasal
discharge thin
  4. Avoiding air travel. If you must fly, use a nasal spray decongestant before take off to prevent blockage of the sinuses allowing mucus to drain
  5. If you have allergies, try to avoid contact with things that trigger attacks. If you cannot, use over-the-counter or prescription antihistamines and/or a prescription nasal spray to control allergy attacks.

How is Sinusitis Treated?

Most cases of acute sinusitis (symptoms less than 4 weeks), and many cases of chronic sinusitis (persistent or recurring symptoms for 12 weeks or more) respond well to treatment with medication. To reduce congestion, the physician may prescribe nasal sprays, nose drops, or oral decongestants. Antibiotics are prescribed for any bacterial infection found in the sinuses (antibiotics are not effective against a viral infection). Antihistamines may be recommended for the treatment of allergies.

Mucus is produced by the sinus cavities to act as a lubricant. The mucous is moved across membrane linings toward the opening of the sinus by the action of millions of microscopic cilia (a mobile extension of a cell). Inflammation from allergy or infection causes membrane swelling and the sinus opening to narrow, thereby blocking mucus movement. If antibiotics are not effective, sinus surgery may be required to correct the problem. The goal of sinus surgery is to enlarge the natural opening to the sinuses, restoring the sinus drainage pathways.

Recent advances in sinus surgery have led to the development of a less invasive technique of sinus surgery called Balloon Sinuplasty. Sinuses are opened in the same way that doctors open up blocked arteries of the heart during a balloon coronary angioplasty. The technology has been extensively studied and shown to be safe and effective.

Balloon Sinuplasty serves as a minimally invasive surgical treatment option to traditional sinus surgery.

In performing the Balloon Sinuplasty procedure, doctors thread a small, flexible guide wire into the sinus cavity, over which a balloon catheter is fed and positioned into the area of sinus blockage. The balloon is then inflated, which dilates and enlarges the opening of the sinus drainage passageway, ultimately relieving the sinus obstruction. The balloon is then deflated and removed from the nose.

Balloon Sinuplasty In-Office

The physicians at E.N.T. Surgical Associates are performing Balloon Sinuplasty in the office under local anesthesia for select patients.
Benefits of In-Office Balloon Sinuplasty

Local Anesthesia
In-Office Balloon Sinuplasty is an option for patients who desire to avoid or, due to other medical conditions, are ineligible for general anesthesia.

Fast Recovery
While recovery time varies with each patient, most patients who undergo Balloon Sinuplasty in the office can return to normal activities and work within 1-2 days.

Comfortable Surroundings
Experience the procedure in the comfort of your physician’s office rather than a hospital operating room.

High Patient Satisfaction
The majority of patients who had Balloon Sinuplasty In-Office would recommend the procedure to family and friends.

Potential for Significant Cost Savings
Some eligible patients may have lower out-of-pocket costs if the procedure is performed in a lower cost of care setting, such as a physician’s office.

See How Balloon Sinuplasty Works

For more information about this new, minimally invasive surgical treatment option for sinusitis, visit

Bruises around the eyes and/or a slightly crooked nose following injury usually indicate a fractured nose, and immediate medical attention is ideal. But once soft tissue swelling distorts the nose, waiting 48-72 hours for a doctor's appointment may actually help the doctor in evaluating your injury as the swelling recedes.

For markedly displaced nasal bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia. This is usually done within seven to ten days after injury, so that the bones don't heal in a displaced position.

Nasal trauma often results in compromised breathing through the nose, which requires corrective nasal surgery to fix the nasal obstruction (septoplasty) in addition to correcting any external nasal deformities (rhinoplasty). Depending on the nature of the injury, these procedures may be performed together or individually, and are typically done on an outpatient basis.

Hearing Loss

You may have hearing loss, and not even be aware of it. People of all ages experience gradual hearing loss, often due to the natural aging process or long exposure to loud noise. Other causes of hearing loss include viruses or bacteria, heart conditions or stroke, head injuries, tumors, and certain medications. Treatment for hearing loss will depend on your diagnosis and the specific cause of the hearing loss.

The Physicians at E.N.T. Surgical Associates offer a complete line of hearing aids and specialized assistive listening devises, including BAHA (Bone Anchored Hearing Aid). We feel that hearing aids are best dispensed by our qualified audiologists.

BAHA (Bone-Anchored Hearing Aids)

New Development for Hearing Implants - We at E.N.T. Surgical Associates are pleased and excited to announce that we are certified to perform the BAHA procedure (Bone Anchored Hearing Appliance). The BAHA system is useful for Single Sided Deafness (SSD) and conductive hearing loss where a conventional hearing aid cannot be worn. This would include patients who experience chronic drainage and/or congenital abnormalities (canal atresia) of the ear. Single Sided Deafness is a unilateral, sensorineural hearing loss. For many years, SSD has been an underestimated handicap. The main reason is the lack of any convincing treatment option. Recent clinical trials have shown that the BAHA system provides a unique benefit for people suffering from SSD by enabling them to hear and understand sounds from both sides, where previously they could only hear from one side.

Did You Know? Every year there are approximately 200 new cases of SSD per million inhabitants. Some etiology for SSD might include idiopathic sudden deafness, trauma, infectious disease and surgical intervention, or in cases of severe Meniere's disease. We are pleased to offer this new, state-of-the-art procedure to patients. If we can be of any assistance to you and your patients, please do not hesitate to contact us.

What can I do to improve my hearing?

  • Eliminate or lower unnecessary noises around you.
  • Let friends and family know about your hearing loss and ask them to speak slowly and more clearly.
  • Ask people to face you when they are speaking to you, so you can watch their faces and see their expressions.
  • Utilize sound amplifying devices on phones.
  • Use personal listening systems to reduce background noise.

Tips to maintain hearing health

  • If you work in noisy places or commute to work in noisy traffic or construction, choose quiet leisure activities instead of noisy ones.
  • Develop the habit of wearing earplugs when you know you will be exposed to noise for a long time.
  • Earplugs can reduce the volume of sound reaching the ear to a safer level.
  • Try not to use several noisy machines at the
same time.
  • Try to keep television sets, stereos and headsets low in volume.

How loud is too loud?

Unprotected exposure to sounds above 85 decibels for a prolonged period of time can lead to hearing loss. Use the scale below to help determine the approximate decibel levels of sounds around you.

Click “Here” and use the Interactive Loudness Scale to help answer the question - How loud is too loud?

I don't hear well. What should I do?

First, visit a physician who can refer you to an ear, nose, and throat (otolaryngologist) specialist, because many hearing problems can be corrected medically. If you have ear pain, drainage, excess earwax, hearing loss in only one ear, sudden or rapidly progressive hearing loss, or dizziness, it is especially important that you see an ear, nose, and throat specialist, as these may be symptoms indicating a serious medical problem. After your exam, the otolaryngologist will help you obtain a hearing assessment from an audiologist. A screening test from a hearing aid dealer may not be adequate. The results of these tests will indicate the degree of hearing loss, the type of loss and other medical information about your ears and health. E.N.T Surgical Associates has three full-time certified audiologists on staff who are available at all office locations to meet your hearing assessment and hearing aid needs.

Where do I purchase hearing aids?

Federal regulation prohibits any hearing aid sale unless the buyer has first received a physician’s evaluation, so you will need to see your doctor before you purchase a hearing aid. However, the regulation also says that if you are over 18 and aware of the recommendation for a medical exam, you may sign a waiver to forego it.
An otolaryngologist, audiologist, or independent dispenser can dispense aids. Hearing aids should be custom-fit to your ear and hearing needs. Mail-order hearing aids typically cannot be custom-fit.

There are several styles of hearing aids

Behind-the-ear (BTE)
Aids go over the ear and are connected with tubing to custom-fitted earpieces.

Open fit receiver-in-the-ear (RITE)
aids are a newer design, and while still placed over the ear, they are extremely small and nearly invisible.

In-the-ear (ITE)
Hearing aids fill the entire bowl of the ear and part of the ear canal.

Smaller versions of ITEs are called half-shell and in-the-canal (ITC).

The least visible aids are completely-in-the-canal (CIC).
The best hearing aid for you depends upon your particular hearing loss and listening needs, the size and shape of your ear and ear canal, and the dexterity of your hands.

The physicians and audiologists of E.N.T Surgical Associates have been trained in the latest and most advanced methods of diagnosis and treatment of all conditions that cause hearing loss.

Diagnosis and Treatment of Balance Disorders
Patients with balance disorders may be tested with electronystagmography (ENG), auditory brainstem evoked response (ABR), audiometry, and vestibular autorotation testing (VAT) available at the office of E.N.T. Surgical Associates.

Dizziness (Vertigo)
Dizziness and vertigo are often caused by disorders of the inner ear. In addition to hearing, the ear's "vestibular system" functions to help control our balance. Therefore, an evaluation by an ENT physician to rule-out an inner ear problem is recommended for many patients with dizziness or vertigo.

Dizziness can be described in many ways, such as feeling lightheaded, unsteady, giddy, or feeling a floating sensation. Vertigo is a specific type of dizziness experienced as an illusion of movement of one’s self or the environment.

Some experience dizziness in the form of motion sickness, a nauseating feeling brought on by the motion of riding in an airplane, a roller coaster, or a boat. Dizziness, vertigo, and motion sickness all relate to the sense of balance and equilibrium. Your sense of balance is maintained by a complex interaction of the following parts of the nervous system:

  • The inner ear, which monitors the directions of motion, such as turning, rolling, forward-backward, side-to-side, and up-and-down motions.
  • The eyes, which monitor where the body is in space (i.e., upside-down, right-side up, etc.) and also directions of motion.
  • The pressure receptors in the joints of the lower extremities and the spine, which tell what part of the body is down and touching the ground.
  • The muscle and joint sensory receptors tell what parts of the body are moving.
  • The brain and spinal cord, which processes all the information from the four other systems to maintain balance and equilibrium.

The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems.

Vertigo can be caused by many things, but most cases are due to one of the three conditions listed below:

Infection, such as the ones that cause the common cold, can cause temporary vertigo via an ear infection. This inner ear infection is generally viral and usually goes away within a few weeks, but medications are available if it’s severe.

Benign paroxysmal positional vertigo or BPPV, is caused by movement of a tiny calcium particle/crystal (otolith), the size of a grain of sand, from the part of the ear that senses gravity to the part that senses rotation motion. The person feels as if they are turning or spinning when they aren’t. A therapy done in the doctor's office can reposition the otolith back to where it belongs and fix the problem. This therapy is called an Epley maneuver, and cures approximately 80% vertigo due to BPPV.

Meniere's disease is a disorder characterized by long-lasting, recurring episodes of vertigo that can range from mild to severe. Other symptoms of Meniere's disease include ringing in the ear (tinnitus), fluctuating hearing loss, and pressure or fullness in the ear.
Most cases of dizziness and motion sickness are mild and self-limited. But severe cases and those that become progressively worse deserve the attention of a doctor with specialized skills in treating diseases of the ear, nose, throat, balance, and equilibrium systems.

Otitis Media is inflammation of the middle ear space (behind the eardrum). Commonly, the inflammation occurs as the result of a middle ear infection, and can occur in one or both of the ears.

If it isn't treated promptly and effectively, hearing loss can result, which may impair a child's learning capacity or cause a delay in the development of normal speech. It can also cause severe earaches, and if left untreated for prolonged periods, the infection can spread to nearby structures in the head, especially the mastoid.

Acute Otitis Media is commonly caused by a bacteria or virus that enters into the middle ear space by traveling through the Eustachian Tube from the nose or throat.

Symptoms of Acute Otitis Media often include:

  • Ear pain or earache
  • A feeling of blockage or pressure in the ear or ears
  • Younger children may tug, rub or pull at the affected ear or hit the side of head
  • Fever and pain often accompanies the earache, especially in children
  • Hearing is typically muffled or diminished

Hearing Loss
Presbycusis is a progressive hearing loss that develops later in life and comes on slowly. It's usually a permanent type of hearing loss and often gets gradually worse with age.

Most of these types of hearing losses can be effectively improved by individually selected, prescribed and fitted hearing aids and occasionally surgery.

Some adults can have their hearing loss corrected by an ENT physician or surgeon, so its important to have an evaluation that makes this determination. Hearing aid dealers are not equipped to make this determination.

Cerumen (Wax) Impaction
Excessive cerumen or "ear wax" can become impacted and obstruct the ear canal, which can cause symptoms such as, ear fullness, pressure or hearing loss.

We strongly advise against attempting to remove impacted ear wax yourself by digging out with a Q-tip, bobby-pin, paper clip, tooth pick or other sharp object. This usually only results in further injury to the ear and risks perforating the eardrum, which may cause permanent hearing loss and ear infections.

If over-the-counter ear wax softening drops are not successful in clearing the wax out of the ear, we recommend making an appointment with one of our ENT physicians to have the ear properly evacuated.

Ringing in the Ears (Tinnitus)
Tinnitus is a subjective experience of hearing a sound, a ringing or a noise when no such external physical sound is present. Some call it "head noises", "ringing" or other similar things. Although, most cases of tinnitus are not associated with serious disease processes, there are a few very serious and potentially life-threatening diseases that can present with tinnitus. Therefore, it is recommended to have an evaluation by an ENT physician if you are experiencing tinnitus or ringing in the ears. Ringing in the ears especially if it is associated with vertigo or dizziness

Repair of Ear Drums
Is needed when there is a permanent perforation or hole in the eardrum. If not repaired permanently, hearing loss and infection (ear pain) can develop and can be a sign of a serious problem.

Draining Ears
An operation called a myringotomy involves a small surgical incision (opening) in the eardrum to promote drainage of the pus and mucus and to relieve pain. The incision heals within a few days and creates practically no scarring or injury to the eardrum. This is a common procedure done for children with fluid behind the ear drums.

Earlobe Repair
Are required mainly for ear lobes that have been damaged by ill-fitting earrings or trauma.

Treatment for Snoring and Obstructive Sleep Apnea
We provide complete evaluations and treatment for snoring and obstructive sleep apnea. Sleep studies are scheduled and interpreted, coupled with a thorough physical evaluation of the patient. Non-surgical and surgical treatment options are available.

Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a serious health condition characterized by a repetitive stopping or slowing of breathing that can occur hundreds of times during the night. This often leads to poor quality sleep and excessive daytime sleepiness. Risks of untreated sleep apnea include high blood pressure, stroke, heart disease, and motor vehicle accidents. It is estimated that 1 in 5 Americans have at least mild OSA. The following symptoms are commonly associated with obstructive sleep apnea:

  1. Daytime sleepiness & irritability
  2. Snoring
  3. Poor concentration
  4. Irregular sleep patterns
  5. Awaking with shortness of breath
  6. Morning headaches

A variety of surgical and non-surgical options are available for the treatment of snoring and sleep apnea. Medical options include positive pressure (i.e. CPAP), oral appliances, and weight loss. Many of these treatment options depend on regular, long-term adherence to be effective. In patients having difficulty with other treatments, surgical procedures for the nose and throat can be a beneficial alternative. Surgical therapy can also be effective when used as an adjunct to improve tolerance and success with CPAP or an oral appliance

Surgical Treatments

Increased nasal congestion has been shown to cause or contribute to snoring, disrupted sleep, and even sleep apnea. It is also a leading cause of failure of medical treatments for OSA, such as CPAP or an oral appliance. Nasal obstruction may result from many causes including allergies, polyps, deviated septum, enlarged adenoids, and enlarged turbinates.
Medical treatment options, such as a nasal steroid spray or allergy management, may be helpful in some patients. Structural problems, such as a deviated septum, often benefit from surgical treatment. One surgical option, known as radiofrequency turbinate reduction (RFTR), can be performed in the office under local anesthesia. RFTR uses radiofrequency to shrink swollen tissues in each side of the nose.

Upper throat (palate, tonsils, uvula)

In many patients with OSA, airway narrowing and collapse occurs in the area of the soft palate (back part of the roof of the mouth), tonsils, and uvula. The specific type and combination of procedures that are indicated depend on each individual’s unique anatomy and pattern of collapse. Therefore the procedure selection and surgical plan must be customized to each patient. In general, these procedures aim to enlarge and stabilize the airway in the upper portion of the throat.

The tonsils and adenoids may be the sole cause of snoring and sleep apnea in some patients, particularly children. In children, and in select adults, with OSA and enlarged tonsils/adenoids, tonsillectomy/adenoidectomy alone can provide excellent resolution of snoring, sleep apnea, and associated symptoms.

Lower Airway (tongue, epiglottis, lateral walls)

In many patients with OSA, the airway narrowing and collapse occurs in the area behind the tongue and above the epiglottis.  A procedure called hyoid suspension  opens and stabilizes this part or the airway to increase the size of the airway and reduce the chances for collapse.  Dr. Brandes offers the AIRLIFT hyoid suspension procedure which is an effective technique for performing hyoid suspension.  There is more information on the AIRLIFT procedure at this link:  AIRLIFT PROCEDURE

What should I know before considering surgery?
Surgery is an effective and safe treatment option for many patients with snoring and sleep apnea, particularly those who are unable to use or tolerate CPAP. Proper patient and procedure selection is critical to successful surgical management of obstructive sleep apnea. Make an appointment to see one of the Ear, Nose, and Throat specialists at E.N.T. Surgical Associates for a complete evaluation and to learn what treatment may be best for you.

Our offices provide a complete evaluation of voice and swallowing problems, including an in-office, non-invasive examination of these areas using state-of-the-art microscopic technology, long term (greater than 2 weeks) can be a sign of serious problems.

Heartburn/Reflux disease
If you or someone you know suffers from hoarseness, difficulty swallowing, frequent throat clearing, or something a sensation that something is “stuck" in the throat that have been unresponsive to treatment, you may suffer from undiagnosed LPR (laryngopharyngeal reflux).

LPR has traditionally been difficult to diagnose for two reasons. First, most patients experiencing LPR don't experience symptoms of "heartburn", and second, the symptoms produced by LPR can also be produced by common illnesses of the head and neck, such as, colds and flus, sinus and allergy inflammation.

The physicians of E.N.T Surgical Associates have been performing 24-hour pharyngeal pH probe testing (described in video below) in our office for over 3-years with very successful results. The primary advantage of this test, is that is allows doctors to quickly and accurately make the correct diagnosis, avoiding several weeks of trial & error courses of medications.

If you or someone you know is suffering from persistent symptoms of the nose or throat, an evaluation by one of the specialists of E.N.T. Surgical Associates may be warranted. Sore throat, laryngitis, hoarseness, difficulty swallowing all are symptoms of potential serious problems (tumors, cancers). If any of these symptoms last more than 2 weeks, a complete ear, nose and throat examination is needed

Sore throat
Infections from viruses or bacteria are the main cause of sore throats and can make it difficult to talk and breathe. Allergies and sinus infections can also contribute to a sore throat. If you have a sore throat that lasts for more than five to seven days, you should see your doctor. While increasing your liquid intake, gargling with warm salt water, or taking over-the-counter pain relievers may help, if appropriate, your doctor may write you a prescription for an antibiotic.

Laryngitis means inflammation of the larynx or “voice box”. Acute laryngitis is the most common cause of hoarseness and voice loss that starts suddenly. The most common cause is acute laryngitis—swelling of the vocal folds that occurs during a common cold, upper respiratory tract viral infection, or from voice strain. When the vocal cords swell, they vibrate differently, leading to hoarseness. The best treatment for this condition is to stay well hydrated and to rest or reduce your voice use. Serious injury to the vocal cords can result from strenuous voice use during an episode of acute laryngitis.

Abnormal changes in the voice are called “hoarseness.” When hoarse, the voice may sound breathy, raspy, strained, or show changes in volume or pitch. Voice changes are related to disorders in the sound-producing parts (vocal folds) of the voice box (larynx). While breathing, the vocal folds remain apart. When speaking or singing, they come together and, as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal folds hinder vibration, altering voice quality, volume, and pitch.

When should I see an otolaryngologist?

  • If hoarseness lasts longer than three weeks, especially if you smoke
  • If you do not have a cold or flu
  • If you are coughing up blood
  • If you have difficulty swallowing
  • If you feel a lump in the neck
  • If you observe loss or severe changes in voice lasting longer than a few days
  • If you experience pain when speaking or swallowing
  • If difficulty breathing accompanies your voice change
  • If your hoarseness interferes with your livelihood
  • If you are a vocal performer and unable to perform

If you become hoarse frequently or notice voice change for an extended period of time, please make an appointment to see one of the Ear, Nose, and Throat specialists at E.N.T. Surgical Associates for an evaluation.

Difficulty swallowing
Difficulty in swallowing (dysphagia) is common among all age groups, especially the elderly. The term dysphagia refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. This may be caused by many factors, most of which are temporary and not threatening. Difficulties in swallowing rarely represent a more serious disease, such as a tumor or a progressive neurological disorder. When the difficulty does not clear up by itself in a short period of time, you should see one of the Ear, Nose, and Throat specialists at E.N.T. Surgical Associates for an evaluation.

Tonsils and Adenoids
Tonsils and adenoids are composed of tissue that is similar to the lymph nodes or “glands” found in the neck, groin, and armpits. The adenoids are high in the throat, in the back of the nose and behind the soft palate (roof of the mouth) and, unlike tonsils, are not visible through the mouth without special instruments. The tonsils are the two masses of tissue on either side of the back of the throat.

The most common problems affecting the tonsils and adenoids in children are recurrent infections (causing sore throats) and significant enlargement (causing trouble with breathing and swallowing).

Post Nasal Drip
Glands in your nose and throat continually produce mucus (one to two quarts a day). Mucus moistens and cleans the nasal membranes, humidifies air, traps and clears inhaled foreign matter, and fights infection. Although it is normally swallowed unconsciously, the feeling of it accumulating in the throat or dripping from the back of your nose is called post-nasal drip. This sensation can be caused by excessively thick secretions or by throat muscle and swallowing disorders.

Increased thick secretions in the winter often result from dryness in heated buildings and homes. They can also result from sinus infections and allergies. If thin secretions become thick, and turn green or yellow, it is likely that a bacterial sinus infection is developing. In children, thick secretions from one side of the nose can mean that something is stuck in the nose such as a bean, wadded paper, or piece of toy. If these symptoms are observed, seek a physician for examination.

How is swallowing affected?
Swallowing problems may result in accumulation of solids or liquids in the throat that may complicate or feel like post-nasal drip. When the nerves and muscles in the mouth, throat, and food passage (esophagus) aren’t interacting properly, overflow secretions can spill into the voice box (larynx) and breathing passages (trachea and bronchi), causing hoarseness, throat clearing, or coughing.

How is the throat affected?
Post-nasal drip often leads to a sore, irritated throat. Although there is usually no infection, the tonsils and other tissues in the throat may swell. This can cause discomfort or a feeling that there is a lump in the throat. Successful treatment of the post-nasal drip will usually clear up these throat symptoms.

Comprehensive Care for Head and Neck Disorders
E.N.T. Surgical Associates have dealt extensively with the diagnosis and treatment of benign and malignant tumors of the head and neck region, including tumors of the ears, nose, throat, neck, larynx, salivary glands, thyroid and parathyroid glands. Many of these problems are worsened by smoking and excessive drinking of alcoholic beverages.

Head and Neck Cancer
This year, more than 55,000 Americans will develop cancer of the head and neck (most of which is preventable); nearly 13,000 of them will die from it.

Early detection of head and neck cancer
Tobacco use is the most preventable cause of these deaths. In the United States, up to 200,000 people die each year from smoking-related illnesses. The good news is that this figure has decreased due to the increasing number of Americans who have quit smoking. The bad news is that some of these smokers switched to smokeless or spit tobacco, assuming it is a safe alternative. This is untrue. By doing so, they are only changing the site of the cancer risk from their lungs to their mouths. While lung cancer cases are decreasing, cancers in the head and neck appear to be increasing, but they are curable if caught early. Fortunately, most head and neck cancers produce early symptoms. You should know the potential warning signs so you can alert your doctor as soon as possible. Remember—successful treatment of head and neck cancer depends on early detection. Knowing and recognizing its signs can save your life.

Symptoms of head and neck cancer

A lump in the neck. Cancers that begin in the head or neck usually spread to lymph nodes in the neck before they spread elsewhere. A lump in the neck that lasts more than two weeks should be seen by a physician as soon as possible. Of course, not all lumps are cancer. But a lump (or lumps) in the neck can be the first sign of cancer of the mouth, throat, voicebox (larynx), thyroid gland, or of certain lymphomas and blood cancers. Such lumps are generally painless and continue to enlarge steadily.

Change in the voice. Most cancers in the larynx cause some changes in voice. An otolaryngologist is a head and neck specialist who can examine your vocal cords easily and painlessly. While most voice changes are not caused by cancer, you shouldn’t take chances. If you are hoarse or notice voice changes for more than two weeks, see your doctor.

A growth in the mouth. Most cancers of the mouth or tongue cause a sore or swelling that doesn’t go away. These may be painless, which can be misleading. Bleeding may occur, but often not until late in the disease. If an ulcer or swelling is accompanied by lumps in the neck, you should be concerned. In addition, any sore or swelling in the mouth that does not go away after a week should be evaluated by a physician. Your dentist or doctor can determine if a biopsy (tissue sample test) is needed and can refer you to a head and neck surgeon who can perform this procedure.

Bringing up blood. This is often caused by something other than cancer. However, tumors in the nose, mouth, throat, or lungs can cause bleeding. If blood appears in your saliva or phlegm for more than a few days, you should see your physician.

Swallowing problems. Cancer of the throat or esophagus (swallowing tube) may make swallowing solid foods—and sometimes liquids—difficult. The food may “stick” at a certain point and then either go through to the stomach or come back up. If you have trouble almost every time you try to swallow something, you should be examined by a physician. Usually a barium swallow x-ray or an esophagoscopy (direct examination of the swallowing tube with a scope) will be performed to find the cause.

Changes in the skin. The most common head and neck cancer is basal cell cancer of the skin. Fortunately, this is rarely serious if treated early. Basal cell cancers appear most often on sun-exposed areas like the forehead, face, and ears, but can occur almost anywhere on the skin. Basal cell cancer often begins as a small, pale patch that enlarges slowly, producing a central “dimple” and eventually an ulcer. Parts of the ulcer may heal, but the major portion remains ulcerated. Some basal cell cancers show color changes. Other kinds of cancer, including squamous cell cancer and malignant melanoma, also occur on the head and neck. Most squamous cell cancers occur on the lower lip and ear. They may look like basal cell cancers, and if caught early and properly treated, usually are not dangerous. If there is a sore on the lip, lower face, or ear that does not heal, consult a physician. Malignant melanoma typically produces a blue-black or black discoloration of the skin. However, any mole that changes size, color, or begins to bleed may mean trouble. A black or blue-black spot on the face or neck, particularly if it changes size or shape, should be seen as soon as possible by a dermatologist or other physician.

Persistent earache. Constant pain in or around the ear when you swallow can be a sign of infection or tumor growth in the throat. This is particularly serious if it is associated with difficulty in swallowing, hoarseness, or a lump in the neck. These symptoms should be evaluated by an otolaryngologist.

Lymph Nodes
Medical or surgical treatment of lymph nodes and/or neck masses.

Neck Masses
Surgical resection of neck masses to treat benign or malignant disease.

Thyroid Nodules
Medical and surgical treatment of thyroid diseases.

Salivary Glands
(Parotid – Submandibular-Sublingual) Medical and surgical treatment of masses of the face and neck.

  • Parotid
  • Submandibular
  • Sublingual

Parathyroid Glands
Removal of the parathyroid gland to improve the thyroid and calcium body metabolism.

Throat (Pharynx)
Medical and surgical treatment of diseases and lesions of the throat and larynx (voice box).

Vocal Cord Tumors
Removal of benign and malignant growths of the vocal cords (voice box).