Laryngopharyngeal reflux (LPR)
What is Laryngopharyngeal reflux (LPR)?
LPR is a medical condition where stomach contents (acidic) have travelled from the stomach back up to the food pipe (esophagus) and to the level of the voice box (larynx). Common symptoms of reflux include:
- Feeling of something stuck in the throat (Globus sensation)
- Choking sensation in the throat
- Itchy throat and frequent throat clearing
- Hoarse or rough voice
- Sorethroat or throat discomfort
- Sour or bitter taste in the mouth (usually worse in the morning)
- Phlegm in the throat
Diagnosis of LPR is usually made based on a combination of suggestive clinical history and findings from nasoendoscopy (Figure 1a-c). The treatment of LPR involves a combination of lifestyle modifications and the use of acid suppressant medications.
Frequent tonsil infection (Recurrent tonsillitis)
What is Frequent tonsil infection (Recurrent tonsillitis)?
Tonsils are two oval-shaped cluster of tissues located at the back of your throat (left tonsil and right tonsil) (Figure 1).They are part of your immune system that protects you against infection and illness. Although the tonsils are part of your immune system, they play a very small part. Other parts of the immune system such as the lymphatic system, bone marrow, spleen and thymus are the main parts of the immune system.
When you have a tonsil infection, you will experience severe sorethroat, painful swallowing and fever. Sometimes you may have difficulty eating or swallowing. The symptoms usually last longer than 5 days. The treatment of tonsillitis involves adequate rest, hydration, antibiotics (in cases of bacterial tonsillitis), pain relievers,mouth gargle and lozenges.
Some people are prone to getting frequent tonsil infections. The reason for this is unknown. If you experience frequent severe tonsil infections requiring significant amount of time off work or requiring hospitalization, you should consider having your tonsils removed (procedure is known as Tonsillectomy). Removal of the tonsils does not weaken your immune system nor doesit make you more susceptible to infections. There are many studies that have shown that tonsillectomy has no clinically significant negative effect on the immune system
Benign vocal cord (Voice box) growths or lesions
What is a Benign vocal cord (Voice box) growths or lesions?
Benign vocal cord growth and lesions usually occur as a result of voice abuse. In some cases, they can be caused by frequent screaming or yelling, speaking in an improper pitch, speaking for a prolonged period of time without rest and using the voice excessively when sick. Due to the nature of their jobs, teachers, lecturers and singers are at highest risk of developing benign vocal cord lesions.
Vocal cord nodules are the most common vocal cord lesions. They are also known as Singer’s or screamer’s nodes. These are non-cancerous growths (like calluses) on the vocal cords. Other benign lesions that can develop on the vocal cord includes vocal cord polyp (Figure 1) and cyst. Vocal cord nodules will interfere with the vibratory function of the vocal cords, causing hoarse voice. Often patients also complain of a breathy voice that fatigues easily.
The treatments of benign vocal cord lesions include voice rest and voice therapy. Like calluses, vocal cord nodules usually disappear when overuse of that area is stopped. Sometimes a course of acid suppressant medication and lifestyle modification to prevent acid reflux may help in reducing acid irritation of the voice box, thereby allowing resolution of the nodules. For vocal cord polyps and cysts, surgery involving microsurgical instruments and technique is usually required to remove these lesions
Cancer of the throat
What is Cancer of the throat?
If you are a smoker, heavy alcohol drinker and have hoarse voice for a prolonged period of time, you need to have your throat checked by an ENT Specialist to rule out cancer of the throat (Cancer of the larynx). A full ENT, head & neck examination, including a flexible nasoendoscopy will be performed. If there is a growth on the voice box, a biopsy (removing a small piece of tissue for testing) of the growth is required to confirm the presence or absence of cancer. The extent of the cancer is the determined by an imaging scan (either CT scan or MRI scan) of the neck area. The treatment of throat cancer depends on the stage of the condition. Treatment options include radiotherapy, chemotherapy and surgery.