Throat

The throat is the passage through to the stomach and lungs containing the pharynx and upper part of the oesophagus, the larynx, and the trachea. Throat problems are common and often the cause is a viral infection, but other causes include allergies, infection or the upward movement of stomach acids into the oesophagus.

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ENT Consultant treats adults and children with problems of the throat

Overview

Sometimes very young children are affected by problems with their tonsils, adenoids and snoring where the breathing becomes obstructed. Your first consultation with Mr Patel will include a thorough discussion around your medical history and may involve an investigative examination of your throat using a flexible nasopharyngolaryngoscopy. This is a sophisticated way to be able to examine and visualise the upper airways and the pharynx.

A local anaesthetic is often used in preparation for one of these examinations. All examinations are undertaken by Mr Patel himself. He is highly skilled in using these methods and particularly able at ensuring children feel at ease.

All cases are discussed with you in detail before any decision regarding a procedure is made.

At The Lister Hospital, Mr Patel has access to a Videolaryngostroboscopy, a specialist machine used in assessing disorders of the throat.

Conditions treated include

Cough

A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke. Coughs may be dry or chesty and most coughs clear up within three weeks. However, when coughs do not clear up, it is possible to carry out allergy testing to see whether the cough is caused by an allergy, for instance to house dust mites. Possible non-infectious causes include allergic rhinitis, such as hay fever.

Sore throat

A sore throat (pharyngitis) is normally a symptom of a bacterial or viral infection. A sore throat may also be a sign of swollen tonsils (tonsillitis). Symptoms include; enlarged and tender glands in the neck discomfort when swallowing, a persistent high temperature above 38C (100.4F), which does not go down after taking medication or symptoms not improving within a week.

It is important to investigate the cause of a temperature because it may be the result of a more serious condition, such as; epiglottitis (swelling and redness of the epiglottis which left untreated, can cause breathing difficulties), quinsy (an abscess that develops between the back of the tonsil and the wall of the throat, usually caused by a bout of severe tonsillitis.) A sore throat lasting more than three to four weeks may be symptom of a more serious condition.

Dysphagia

Dysphagia is the medical term for swallowing difficulties. Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow at all. Other signs of dysphagia include; coughing or choking when eating or drinking, bringing food back up, sometimes through the nose, a sensation that food is stuck in your throat or chest or persistent drooling of saliva. Over time, dysphagia can also cause symptoms such as weight loss and repeated chest infections.

High dysphagia is swallowing difficulties caused by problems with the mouth or throat. Low dysphagia is swallowing difficulties caused by problems with the oesophagus. Endoscopic dilation is widely used to treat dysphagia caused by obstruction. It can also be used to stretch the oesophagus if it’s scarred.

Lump in the throat / Globus pharyngeus

A persistent lump in the throat feeling is sometimes described as Globus.

The most common cause of globus, is acid reflux from the stomach. Further tests such as ph-studies, measure the acidity levels at various points in the digestive system or an endoscopy can be used to view the stomach lining.

Treatment may include treating the acid reflux or Physiotherapy for the muscles around the throat.

Snoring

Snoring is where a person makes a snorting or rattling noise when they breathe during sleep. The noise comes from the soft palate and tissue in the mouth, nose or throat vibrating. Some people snore infrequently and the sound they make isn’t particularly loud, while others may snore every night, loud enough to be heard in the next room. Several surgical techniques can be used to correct snoring. In cases where there are obvious anatomical problems contributing towards snoring, such as having large tonsils, surgery to remove the tonsils may be recommended.

Cryptic tonsils / Tonsilloliths

Tonsils have crypts which increase their surface area, their function is significant in the first few months of life and then this tissue tends to regress. However, in some cases, tissue regression does not occur and these crypts may become quite deep and allow food and bacterial debris to collect. Cryptic tonsils, also known as Tonsilloliths look like white beads on the tonsils or patches of pus. Because of this, the condition looks similar to strep throat or another throat infection.

When a tonsil stone and tonsillitis occur together, it can be difficult to determine whether the pain in your throat is caused by your infection or the tonsil stone. The presence of a tonsil stone itself, though, may cause pain or discomfort in the area where it is lodged.

Tonsillitis

Tonsillitis is inflammation of the tonsils. It’s usually caused by a viral infection or, less commonly, a bacterial infection. It’s a common type of infection in children, although it can sometimes affect adults. There are four main signs which indicate that tonsillitis is caused by a bacterial infection rather than a viral infection. They are; a high temperature, white pus-filled spots on the tonsils; no cough; swollen and tender lymph glands. In most cases, tonsillitis gets better within a week. However, a small number of children and adults have tonsillitis for longer or it keeps returning. This is known as chronic tonsillitis and a tonsillectomy (removal of the tonsils) may be needed.

Operations treated include

  • Tonsillectomy (paediatric and adult)
  • Adenoidectomy
  • Endoscopy (Pharyngoscopy, Laryngoscopy, Oesophagoscopy)
  • Microlaryngoscopy
  • Uvulopalatoplasty

Mr Patel works with Consultant Anaesthetists Dr Richard Waddington and Dr Bernard Norman. Dr Waddington and Dr Bernard both have sub speciality expertise in paediatric anaesthetics and also serve as lead paediatric / Obstetric anaesthetists in two NHS trusts in London.

Ear

Mr Patel treats both adults and children with problems of the ear and specialises in areas of allergy and otology including balance and tinnitus.

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Nose

Problems of the nose can be complex to treat. Mr Patel has a special interest in diseases of the nose and sinuses and treats both adults and children.

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Teacher sees ENT specialist in London

Case Study: School teacher frustrated by hoarseness and voice problems

Mrs Granger had been suffering with years of intermittent hoarseness in her voice. As the symptoms increased, she began to worry that her day to day teaching would be affected.

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“Thank you Dr Patel for looking after Dad.”

Sophie, age 8, Surrey