Treat Conditions that Affect the Head & Neck | Trinity, FL & Spring Hill, FL

Head and Neck Conditions

The anatomy of your head and neck includes glands, bones, cartilage and other structures that work together to enable breathing and immunological responses. When any one of these structures fails to perform, you are at increased risk for developing complex medical issues.

The ENT physicians of Suncoast ENT Surgical Specialists have over 40 years combined experience in treating conditions related to the head and neck. Additionally, they spend each and every day with patients like you who live with the conditions. As board-certified Otolaryngology/Head and Neck Surgeons, our physicians are also qualified to perform any surgical interventions required for your treatment.

Because ENT treatment is so specialized, we encourage you to contact our office to schedule a consultation. Many of our patients are referred to us by their primary care physician. Depending on your medical coverage, you may be a self-directed patient who requires no referral. We can work with your family doctor to obtain a referral if necessary.

Head and Neck Treatment

Our ENT physicians treat a range of conditions that affect the head and neck:

Chronic Headaches

Parathyroidectomy (Parathyroid Removal)

Vertigo (Dizziness)

Parotidectomy (Salivary Gland Removal)

Tonsil Removal

Adenoid Removal

Excision of Branchial Cleft Cysts

Laryngoscopies

Submandibular Surgery

Thyroidectomy (Thyroid Removal)

Lymph Nodes

Cyst and Mass Removal

Tracheostomy

Chronic Headaches

Chronic headaches are defined as headaches that occur at least 15 days out of the month for three months in a row. Chronic headaches prevent people from functioning normally in their everyday lives. The headaches also interfere with concentration and make even the simplest tasks a hardship.

To make matters worse, chronic headaches can be a sign of serious underlying medical conditions, some of which are potentially life-threatening. Seeking treatment for your chronic headaches can help you rule out potentially dangerous complications and start getting your pain under control.

The types of chronic headaches include:

Chronic Migraines: These involve pain that ranges between moderate and intense and can include throbbing or pulsating sensations and sensitivity to sound and bright light. For many people, nausea and vomiting occur as well. Chronic migraines can be caused by food sensitivities or sinus infections (sinusitis).
Chronic Tension Headaches: These headaches cause a sensation of pressure or squeezing in the head. They sometimes involve sensitivity to light and sound, nausea and vomiting.
New Daily Persistent Headaches (NDPH): These headaches take only a short time to become constant. They are characterized by pain that occurs on both sides of the head with a sensation of extreme pressure.
Hemicrania Continua: These are continuous and occur on a daily basis, causing constant pain that ranges between moderate and intense. In many cases, they are also accompanied by redness and excessive tear production in one eye, contracted pupils and a stuffy nose.

In most cases, our physicians recommend comprehensive tests and examinations to discover the reason for a patient’s chronic headaches. Your physician may determine that your chronic headaches are associated with:

Hypertension
Glaucoma
Head injuries
Cancers of the neck and head
Stress
Nerve inflammation or injury
Jaw disorders
Blood vessel inflammation
Chronic sinusitis and obstructions or structural defects of the sinuses
Sleep apnea

Before your appointment, monitor for potential headache triggers such as foods, weather changes or your activities. Consider what improves or worsens it. Be sure to write this information in a journal, which should also contain the following details:

When and where you developed a headache
What symptoms you experienced
Which treatments helped
Anything you suspect as a potential cause

In some cases, chronic headaches can stem from head injuries. If you think this might apply to you, write a thoroughly detailed account of the injury so it can be reviewed by a Suncoast ENT.

Treatment options for chronic headaches are as numerous as the causes for the headaches. Potential treatments can include a variety of things from drugs to surgery. Treating chronic headaches typically involves relieving symptoms and eliminating any infection. Once a plan of treatment is developed, you’ll be notified on what you’ll need to do during your recovery period.

Vertigo (Dizziness)

Vertigo, also referred to as a balance disorder, is feeling motion when no motion is occurring. The causes of vertigo include a problem with the inner ear’s balance mechanisms or issues within the brain. Although vertigo is harmless, it can indicate a serious condition if it is accompanied by symptoms such as difficulty speaking or walking, double vision or severe headaches. Even if no other symptoms exist, we recommend that anyone experiencing vertigo be examined by one of our ENT specialists, but treatment is especially important if your symptoms worsen.

Dizziness is a term used to describe lightheadedness or to feel faint, weak and unsteady. Vertigo is the dizziness that creates the sensation that you or your surroundings are moving or spinning.

Dizziness ranks behind fatigue and chest for the top reasons that adults visit their doctors. Experiencing frequent dizzy spells or constant dizziness may affect your level of productivity, but it is rarely a serious, life-threatening condition. The treatment for dizziness is dependent upon your symptoms and the cause of the condition. The treatments are usually effective.

Signs and symptoms you should look out for include:

Lightheadedness
Blurred Vision
Dizziness
Disorientation
Headaches
Earaches
Nasal congestion and drainage
Hearing loss
Frequent falls
Ringing in the ears (tinnitus)

People with a balance disorder may experience other symptoms that include:

Confusion
Depression
Loss of concentration
Diarrhea
Faintness
Nausea and vomiting
Anxiety
Fatigue
Depression

We advise our patients that vertigo and dizziness are not the same. Vertigo is the sensation of movement in your surroundings while dizziness is a feeling of disequilibrium and lightheadedness.

Your Suncoast ENT diagnoses vertigo based on your description of your symptoms. Vertigo is divided into two categories, peripheral and central.

Peripheral vertigo: the most common form, includes labyrinthitis, Ménière’s disease, and benign positional vertigo. Positional vertigo is diagnosed when moving the head is the cause of the vertigo and returning the head to its original position relieves the symptoms. Labyrinthitis and Ménière’s attacks usually occur abruptly. The episodes can last from a few hours to a couple of days. Intense nausea, vomiting and variable hearing loss may occur during the episode.
Central vertigo: a more serious problem within the cerebellum (the back part of the brain or brain stem).

Your Suncoast ENT will examine your eyes to look for any abnormal, jerking motions (nystagmus). The pattern of your eye movement can help your physician determine if the issue is central or peripheral. Usually, you will not need any further testing unless it is suspected that you have central vertigo. If your physician believes that you have central vertigo, your Suncoast ENT will order a computed tomography (CT) scan or magnetic resonance imaging (MRI) of your brain.

The types of treatment used depend on the causes of the vertigo or dizziness. Some remedies include medications (sedatives, antibiotics, steroids, and antihistamines), balance retraining exercises (vestibular rehabilitation), surgery, physical therapy and lifestyle changes (changes in diet, avoiding alcohol and nicotine).

If you are not careful, vertigo can cause you to fall. The following tips will help you reduce your chances of falling.

Try to avoid changing positions quickly. When you rise from your bed or chair, take a moment to sit on the edge. Then, lift yourself up slowly.
Ask your doctor about exercises that can improve your balance and reduce the symptoms of vertigo.
Sit down when you start to feel like the room is spinning.

Tonsillectomy (Tonsil Removal)

Near the back of an individual’s mouth are two small pieces of soft tissue known as tonsils, small pieces of soft tissue that are located on each side of the mouth. As a part of the body’s overall immune system, tonsils are the first line of defense in helping the human body fight off viruses and bacteria.

A tonsillectomy is a common procedure in which the tonsils are removed in order to treat sleep apnea, improve one’s breathing, or help those that struggle with chronic tonsillitis. A tonsillectomy is typically completed in less than an hour from start to finish. The patient is first put to sleep with general anesthesia and will remain asleep throughout the entire process.

Your Suncoast ENT will use a laser or scalpel to carefully cut away the tonsils and remove them entirely. Some patients may also benefit from an adenoidectomy, which can be carried out at the same time. The surgery has been completed once the tonsils and adenoids have been removed, and the bleeding has gone down.

While the tonsils may be beneficial for some people for improving their overall immune system, other patients may find that their tonsils are actually doing more harm than good. Some of the benefits of a tonsillectomy include

Less inflammation in the mouth and throat
Fewer sore throats for those with frequent discomfort
Better sleep for patients with breathing problems or sleep apnea
Minimal complications

The most common reason for removing the tonsils is to allow a child to breathe and sleep easier. The mass of soft tissue has a habit of growing slightly faster than other parts of the body, so a child’s airway is at risk for being partially blocked. Our physicians understand that there is no single reason why some children have enlarged or oddly-placed tonsils while others do not.

When the breathing passages are partially blocked, both the parents and the children may notice a wide variety of problems. The child may appear to be tired throughout the day, they may have difficulty in school, and they may be constantly irritable. When these breathing issues take place at night, it is referred to as sleep apnea.

By removing the tonsils and adenoids, we have the ability to open up their airway. A tonsillectomy will not prevent the common flu or a sore throat, but it will mean that the child can no longer get tonsillitis. For children that get this infection frequently, removing the tonsils could help them avoid countless medical problems throughout their lifetime.

Regarding immune system function, the tonsils are just a minor component of the entire system. Studies have shown that children who have had their tonsils and adenoids removed do not actually get more illnesses than those who keep them. The immune system has multiple layers of protection, and this means that other parts of the system can carry out the same job.

A tonsillectomy is not as invasive as many other procedures, but we advise adults and children to prepare correctly for this surgery in order to avoid complications.

Depending on the circumstances surrounding the procedure, our doctor will most likely request that the patient stops eating and avoids all liquids but water in the hours leading up to the surgery. The easiest way to remember this is to stop eating solids and drinking non-water liquids at midnight before the surgery.

For patients that do drive, they will need to arrange a ride to and from the office as the anesthesia will make it unsafe to drive for at least a few hours. Our team will keep the patient in the office until they are sure that there are no complications and that the swelling and bleeding have gone down. Before leaving our office, we schedule a follow-up appointment with our doctor to determine if the surgery was successful. Our team will also give you a full list of aftercare instructions.

While the neck is still swollen and sore, avoid any solid foods, hot foods, or extremely cold foods. Some of the best options for those first few hours after surgery include broth, ice cream, and pudding. At the very least, patients will want to spend 24 to 48 hours recovering. Even if you feel better, putting your body under strain before that could have adverse effects.

Adenoidectomy (Adenoid Removal)

You may have heard of an adenoidectomy, but you may not know what it is or even where the adenoids are located in the human body. As part of your body’s immune system, the adenoid helps protect you from viruses and bacteria. Sometimes referred to as a pharyngeal tonsil, the adenoid is a single mass of tissue that helps our bodies recognize the different types of germs. Unfortunately, the adenoid may cause more problems than benefits, such as obstructed airway and infections.

The goal of an adenoidectomy is to allow the patient to live a healthier and more comfortable lifestyle. An adenoidectomy is performed under general anesthesia so the patient is asleep as our Suncoast ENT removes the gland through the mouth. The physician uses a small instrument known as a “curette” or diathermy instrument which produces high-frequency electrical currents that burn the adenoid, then the tissue is scraped away. After the adenoid is removed and the wound stitched up, the patient is brought out of anesthesia.

The main goal of an adenoidectomy is to enhance the patient’s health. If you suffer from chronic upper airway infections, sleep apnea, chronic earaches, or snoring, an adenoidectomy may be the right solution for you.

There are additional ancillary benefits to an adenoidectomy that include but are certainly not limited to, the following:

If the gland obstructed the patient’s airway, removal of this gland would allow the patient to have a better quality of sleep
Decreased amount of upper airway infections
In children, a removed adenoid will allow for proper facial development
Adenoid removal has a quick recovery time

Our physician may recommend the removal of your child’s adenoid for a number of reasons. The most common reason is that, when the adenoid is enlarged, the child will have difficulty breathing and sleeping. Once the adenoid is removed, that problem goes away.

In the most severe cases of an enlarged adenoid, the gland can block the entire back of the nose. As an end result, your child will snore loudly, or have a disrupted sleep pattern. Lack of proper sleep can result in the child’s concentration patterns being disrupted, as well as experiencing bedwetting, behavioral changes, and sleep apnea.

Another reason a child may have their adenoid removed is to solve the problem of chronic ear infections. The adenoid is located close to the Eustachian tube, responsible for keeping our ears healthy. An adenoid that is chronically inflamed can actually lead to an inflamed and malfunctioning Eustachian tube, so removal of the chronically inflamed adenoid will drastically reduce chronic ear infections and/or ear fluid buildup.

Although uncommon, the adenoid can be removed to cure the problem of chronic nasal infections. Having regular thick, green or yellow drainage is a sign of a chronic nasal infection. When left untreated, chronic nasal infection can lead to a chronic sinus infection. You should note that while an adenoidectomy will help manage chronic nasal infections, the procedure will not have any effect on other things that cause nasal drainage, such as the common cold.

Regarding immune system function, if an adenoid gland is removed, the immune system has other ways of learning to recognize different germs. As such, children who “lose” their adenoid are in no worse condition than those who “keep” their adenoid. In fact, the opposite is true: children who suffer from certain kinds of infections, such as nasal infections, will get them much less frequently when their adenoid is taken out.

We advise our patients not to eat or drink anything on the day of the surgery because you will be undergoing general anesthesia. Because of the side effects of the anesthesia, you should arrange transportation to and from the facility.

You will be required to eat and drink cold items to reduce the pain and swelling at the wound site, and the recovery process should take no more than ten days. In addition, after you finished the recovery process, you will be required to have a follow-up visit with your Suncoast ENT to ensure that the healing process completed without any issues.

Thyroidectomy (Thyroid Removal)

The thyroid is an endocrine gland that governs over all the others in your body. The gland produces hormones that control metabolism, sex hormone production and numerous other body functions. The butterfly-shaped thyroid gland is situated in the throat just underneath the larynx (voice box) and just above the collarbone, and it is partially wrapped around the trachea (windpipe).

The term “thyroidectomy” describes a surgical procedure that removes some or all of the thyroid gland. The procedure is usually done in cases of thyroid cancer or other thyroid disorders such as goiter or hyperthyroidism. A thyroidectomy should only be performed when absolutely necessary and by a highly-skilled surgeon.

Thyroidectomy is usually performed on patients with thyroid cancer, hyperthyroidism or goiter.

When malignant (cancerous) or benign (non-cancerous) tumors develop in the thyroid gland, they may often produce visible masses on the neck. Cancerous tumors can result in symptoms such as enlarged lymph nodes, hoarseness, and difficulty or pain when breathing or swallowing.

People with goiter have a thyroid gland that is enlarged and spread out as a result of improper chemical signals. If a goiter is large enough, the condition can be easily detected during a physical examination.

Nodules usually take the form of small masses in the neck that are detectable by touch. Many of those that cannot be felt are revealed through imaging methods such as CT scans or ultrasounds. As these grow larger, they inflict pressure on the neck’s structures. This may cause difficulty swallowing or breathing.

In some situations, the surgery may be recommended for cosmetic reasons, such as an oversized thyroid that functions normally but disrupts appearance.

When a large nodule or enlarged thyroid is discovered, your ENT specialist determines if surgery is necessary by performing additional testing, such as ultrasound, radioactive iodine or needle biopsies.

The surgical procedures used to remove the thyroid or parathyroid glands depend on the underlying disorder. Your Suncoast ENT may remove all (total thyroidectomy) or some (partial thyroidectomy). For partial thyroidectomies, the gland may still function properly afterward. For full thyroidectomies, you must supplement daily with thyroid hormone to maintain healthy metabolic function.

Thyroidectomies are performed under general anesthesia. An incision is made across the neck just over the thyroid gland, allowing for better healing and a clearer view of the laryngeal nerves and thyroid. The surgeon may place a drain during the surgery, which is usually removed one to two days later.

Total thyroidectomy, which removes the whole thyroid gland, is typically performed on people with thyroid cancer. Less extreme variations exist, such as a hemithyroidectomy or unilateral lobectomy, wherein half the thyroid is taken out, or subtotal thyroidectomy, wherein most of the gland is removed, but a small part is left behind in the hope that it functions properly afterward.

Although thyroidectomies are common, as with any surgery, complications are possible, such as vocal changes, disturbed calcium metabolism, infection, excessive bleeding, life-long dependence on thyroid hormone supplementation and paralysis of the vocal cords that can cause airway obstruction.

For the first few days following your surgery, you’ll be restricted to soft and liquid foods. Some patients may cough after swallowing liquids. If this happens to you, consider eating foods with a more pudding-like consistency. If the condition persists, you develop a fever or experience chest pain, call your doctor right away. For vocal cord weakness following surgery, consider seeing a speech pathologist to help improve healing and speed recovery.

Other postoperative care includes:

Keep the incision site dry and clean.
Don’t allow the incision to come into contact with water for five to seven days. Dry immediately if wetness occurs.
Keep lotions, creams or cosmetics away from the incision.
Adhere to your neck exercise regimen.
Take any medications as directed by your doctor or surgeon.

The results of your surgery depend on why the thyroidectomy was performed. If removal was for hyperthyroidism, these symptoms should improve:

Weight loss
Intractable fatigue
Nervousness and anxiety
Heart palpitations
Excessive sweating
Feeling consistently hot
Menstrual irregularities
Tremors

If removal was done to address nodules, tumors or goiter, these outcomes might include:

Excising cancerous tissue
Improving the ability to breathe and swallow, which can be hindered by an enlarged thyroid

Parathyroidectomy (Parathyroid Removal)

Parathyroid glands are located in your neck and balance the amount of calcium in your blood by producing parathyroid hormone. A majority of people have four of these glands, but one or more of them can become overactive, resulting in too much calcium in your blood. Hypercalcemia, a condition in which your body has too much calcium, places you at risk for kidney stones, bone weakening, and other conditions.

A parathyroidectomy is a surgical procedure in which one or all four of your parathyroid glands are removed. After a parathyroidectomy, the symptoms related to the overactivity of your parathyroid glands should improve. The surgery can also help reduce the risk of your heart, bones or kidneys becoming damaged.

A parathyroidectomy is recommended when one or all of your parathyroid glands are over-producing parathyroid hormone, a condition that is called hyperparathyroidism. The condition is also an indication for parathyroid cancer.

During the parathyroidectomy, the surgeon assesses the parathyroid glands to determine which ones are enlarged, which is referred to as hypertrophied. The glands that are enlarged are the ones that are overactive.

In most cases, patients have a single adenoma, which is one overactive gland. When all four glands are overactive, however, the surgeon usually removes all but half of one so that the patient can preserve some parathyroid tissue that functions. If this is not performed, the patient could develop hypoparathyroidism, which is a lack of sufficient parathyroid hormone levels.

General anesthesia is administered at the beginning of this procedure so that you fall asleep. , An incision is made across the lower part of your neck and the surgeon locates your parathyroid glands behind the thyroid gland. The glands are examined to determine which ones are hypertrophied, and then they are removed. Some of the tissue is left behind if all four of your parathyroid glands are enlarged.

You are likely to remain in the hospital for less than a week following this procedure.

Parotidectomy (Salivary Gland Removal)

The parotid gland is the largest salivary gland, which is responsible for the production of saliva to aid in consuming food. The gland is located behind the ear and extends into the upper neck. Tumors inside the gland are the most frequently seen problem with the parotid gland. Most parotid tumors are benign and do not require surgery. Malignancies can vary greatly in terms of their aggressiveness and eventual prognosis, and many less severe parotid cancers can be cured using surgery. Sometimes, recurrent infections require surgery.

A parotidectomy is a surgical procedure to remove the parotid gland. Most parotid gland tumors are located in the superficial area of the gland, although some can be found in the deep lobe. A superficial parotidectomy is when just the superficial lobe of the gland is taken out. A total parotidectomy is when both deep lobes and the superficial lobes are removed.

For the removal of a parotid gland tumor
The removal of potential cancerous lymph nodes
The treatment of recurrent parotid gland infections

A pleomorphic adenoma is the most commonly seen form of parotid tumor and is usually typified by the appearance of a painless jawline lump at the front part of the ear. These types of tumors respond well to a parotidectomy, as well as more serious ones, such as adenoid carcinoma.

The parotidectomy procedure is performed under general anesthesia, lasting about three hours. An incision is made that goes around the lobe of the ear, toward the neck. The surgeon usually takes advantage of a skin crease to hide the resulting scar, rendering it nearly unnoticeable. The part of the gland with the tumor is excised from the facial nerve. Then, the skin is closed with sutures.

Sometimes, allowance is made for drainage of the wound, which is then removed a day or two following surgery. Normally, the procedure is not painful and well tolerated by most patients. As such, patients typically resume their normal schedules within a few days after surgery.

Excision of Branchial Cleft Cysts

A branchial cleft cyst is a skin-lined cavity that is filled with mucus that forms on the side of your neck. The abnormality is congenital, which means that it occurs during fetal development. Branchial arches are gill-like embryonic structures that normally disappear as part of fetal development. In some cases, though, the arches fail to disappear and may cause cysts later in life. The fluid-filled pouch that is left may not be noticeable for years and increases the risk for infection.

Branchial cleft cysts often appear during childhood and young adulthood as painless, slow-growing masses, which are generally the chief complaint. As the cysts enlarge or become infected, they can cause breathlessness and trouble swallowing. In 2% of cases, cysts appear on both sides of the neck.

There are four types of branchial cleft cysts, each of which is named for the associated branchial arches:

First branchial cleft abscesses are split into two types. Type I first branchial cleft abnormalities rarely occur and represent a copy of the external ear canal. Type II first branchial cleft cysts occur more often and appear as masses right below where the jaw begins to angle.

Second branchial cleft abscesses happen the most often out of the four types and could involve painless masses under the jawline and around the sternocleidomastoid, which is a large neck muscle.
Third branchial cleft cysts are rare masses that may occur in the lower lateral neck.
Fourth branchial cleft abscesses are rare masses that might drain into the throat.

During the procedure, the surgeon makes an incision in the skin that covers the mass and then carefully separates the cyst from the surrounding tissue. Sutures and electrocautery are used to control bleeding during and after the procedure. A temporary drain is fitted to the surgical site, and the surgeon closes the incision in the neck with removable and dissolvable sutures.

When infection arises that creates breathing and swallowing problems, sometimes an emergency incision is required. However, this can cause extra scarring and make it more challenging for a surgeon to perform definitive surgery at a later date.

After the procedure, the dressing needs to be changed for one or two days until the surgical site is producing only minimal drainage. Then, the drain is removed, and the dressing is reapplied for one more day. Patients should avoid water exposure for about one week until the sutures are removed.

A codeine type of pain medication will be prescribed to relieve discomfort during the recovery process. Since it can cause drowsiness, operating machinery or a motor vehicle is not permitted while taking the medication. Daily activities such as school and work cannot resume until the medication is no longer needed during the day.

Submandibular Surgery

Everyone has a pair of submandibular or salivary glands under their jawbone. Each submandibular gland creates saliva that travels through a long duct to be secreted in the mouth. Saliva secreted by the submandibular glands is slightly thicker than the saliva produced by other salivary glands which can lead to the formation of little stones.

The most common problem concerning the submandibular gland is a blockage caused by a narrowing of the duct or the presence of small stones. When a blockage occurs in the duct, have a symptom of painful swelling of the glands while eating or drinking. Stones and blockages inside the submandibular gland are removed easily with a surgical procedure inside the mouth.

Occasionally, the swelling subsides without treatment, but severe blockages frequently lead to persistent inflammation. In addition, a large lump may develop within the submandibular gland. While these lumps are painless, up to 50% are cancerous or precancerous, requiring removal along with laboratory testing. All of these lumps become larger gradually, making removal when it is small a better plan.

General anesthesia is used to allow patients to remain comfortable during the submandibular procedure. The surgeon makes a tiny incision on the side of the neck approximately one inch below the patient’s jawbone. The gland is dissected from surrounding tissues carefully before the deep layers of the wound and skin are closed with sutures.

After the gland is removed, a drain is inserted near the incision to remove blood from the wound. Patients typically remain in the hospital for one to two days after surgery to recuperate. When the drain is removed, the patient returns home for two weeks to recover completely.

After surgery, patients experience mild discomfort that subsides gradually over the next few days. Patients can resume their normal activities in as little as one or two days and can consume a regular diet soon after because saliva production is not usually affected.

All of the sutures used in this procedure are made of biodegradable materials which are absorbed into the body. There is no follow-up appointment for removal of sutures. Patients living out-of-town are permitted to travel after removal of the drain, and no follow-up is required unless a surgeon advises otherwise.

Lymph Nodes

Located throughout your body, lymph nodes are an important part of your immune system. The small, soft glands may be oval or round in shape and are encased in connective tissue. Inside are special types of cells that promote immunity — lymphocytes to trap pathogens and macrophages to destroy and remove the trapped pathogens. The pathogens are removed from your body through the lymphatic vessels that connect to your circulatory system.

Even though many lymph nodes are just under your skin, the small size makes them difficult to detect unless the glands are swollen. Swollen lymph nodes are easily palpable, which is why your physician touches your glands when you have certain symptoms. The swelling is an indication that the glands are actively removing a pathogen from your body. The most common cause of swollen lymph nodes is infections stemming from viral, bacterial, fungal and parasitic origins.

Swollen lymph nodes typically indicate an underlying condition that requires treatment. Your ENT specialist may recommend additional testing, especially if your symptoms indicate that lymph nodes deeper in the body are affected. Additionally, your ENT specialist may ask about recent illnesses and symptoms that you have experienced.

Viral causes of swollen lymph nodes include:

HIV
Adenovirus
Common colds
Measles and chicken pox
Infectious mononucleosis, also known as “kissing disease” or “mono”

Bacterial causes of swollen lymph nodes include:

Sexually transmitted diseases, such as Chlamydia and syphilis
Streptococcus
Tuberculosis
Staphylococcus

The lymph nodes may also increase in size due to inflammation caused by lupus, rheumatoid arthritis, cancer, and other medical conditions.

Treatment varies by condition, but you feel confident in knowing that our board-certified Otolaryngologist/Head and Neck Surgeons recognize even the most subtle signs of conditions affecting your lymph nodes.

Cyst and Mass Removal

The development of a mass, growth, tumor or cyst on the head or neck can be a very serious health issue. Common types of cysts and masses include:

Benign lesions: Benign growths are irregular growths that are determined to be non-cancerous. As such, benign lesions do not spread to neighboring body tissue. Despite the connotation of this designation, many sufferers sustain damage to their nerves in the head and neck area from aggressive benign tumors and growths.
Damaged lymph nodes: Irregular tumors and growths can trigger the body’s immune system to react, overloading and swelling the nearby lymph nodes in the head and neck area to create non-metastasizing growths and masses.
Cancer: Cancerous growths are classified by an insistent colonization of neighboring body tissue. Malignant and metastasizing cancerous tumors and growths are classified into two categories: primary or secondary.
Primary – Primary cancerous tumors and growths first develop in the head or neck area, laying their roots inside the human throat, salivary gland, larynx, thyroid and the brain itself.
Secondary – Second-generation tumors that have colonized new tissue for the primary tumors which originated in areas of the body lower than the neck.

We highly recommend that you consult with a physician if you experience any of the following symptoms:

Lumps, bumps or small growths on the scalp, neck or head
Lumps, bumps or small irregular growths that persist more than two weeks. Of special concern are lumps that are not associated with a cold, flu or other pulmonary infection.
Persistent hoarseness or roughening of the voice
Irregular growth inside the mouth
Fresh blood in the saliva, sputum or phlegm
Difficulty or discomfort while swallowing solids
Irregular growths or tumorous entities growing on the skin – all growing or expanding irregular lumps on the skin need to be examined by a qualified dermatologist. Microscopic examinations can reveal whether skin growths are basal cell carcinoma, squamous cell cancer or malignant melanoma forms of cancer. The two most common starting points for squamous cell skin cancers are the lower lip and ear.
Chronic Ear Pain – persistent ear pain, especially when swallowing solids, may be a clear symptom of an irregular growth or tumor in the throat

Nearly 90% of neck and head cancerous growths and tumors are directly caused by tobacco and alcohol abuse.

The third most common vector for primary cancers is radiation exposure in patients. Sometimes caused by past therapeutic administrations or industrial contamination from nuclear facilities, patients who have sustained a significant radiological incident should be screened yearly for cancer.

Most secondary tumors are offshoots from the original cancerous growths in lungs, kidneys, breasts or melanoma growths on the skin.

Physicians and trained medical analysts can examine tumors and other head and neck masses, and determine the cause of their origin by studying and carefully analyzing their location, size and consistency over time. Other more proactive analytical measures are available, including:

MRI: the powerful technology of the full-body Magnetic Resonance Imaging system can scan the affected area to create a detailed map of formerly hidden small tumors affecting bones, other small tumors, and irregular growths on the brain stem.
CT Scan: the trusted historic breakthrough technology of computed tomography precisely directs a series of X-rays to penetrate the affected area of the human body. In some cases, a special dye may be injected into the afflicted area in order to help improve the resolution of images assembled during scans.
PET Scan: using positron emission tomography technology, interior scans can be assembled to help grade or rank tumors as well as to separate dead cell tissue from cancerous cells. PET scans usually involve the injection of the examined individual with a harmless radioactive tracer.
SPECT Scan: similar to a PET scan, internal images of the body can be taken performing real-time data return analysis on Single Photo Emission Tomography beams.
Biopsy: a sample of suspect tissue is physically removed and prepared for microscopic examination and interpreted along an established series of best practices to determine whether the cells in question are malignant

Treatments and therapies for head and neck irregular growths, masses and tumors are determined by the original cause. Some skin lesions and other aggressive growths can be removed by a simple surgical excision. More aggressive head and neck cancers can be treated by a spectrum of radiological therapies, surgery, or some combination thereof, depending on the determined nature of the neck or head growth.

Tracheostomy

A tracheostomy is a surgical procedure that involves making a hole in the neck to access the airway, specifically the windpipe. While some people only need a tracheostomy for a short period of time, others need a tracheostomy for the rest of their lives.

In general, the following situations will call for a tracheostomy insertion:

When a ventilator is prescribed to a patient for more than two (2) weeks.
When a medical condition, such as throat cancer or vocal cord paralysis, obstructs the airway.
When neurological conditions make it difficult for you to expectorate the secretions from your throat.
When you’re preparing for surgery to your head or neck and require breathing assistance.
When you experience severe trauma to your head, face, or neck that causes airway obstruction.
Whenever there is any type of emergency situation that obstructs your airway, and emergency medical technicians cannot insert a breathing tube into your mouth.

A tracheostomy is most commonly performed under general anesthesia and in an operating room. However, under emergency conditions, or if the surgeon is concerned that the patient will not react well to general anesthesia, local anesthetic may be used instead.

During the procedure, a surgeon makes a horizontal cut through the skin at the bottom of the neck. A small incision is made into the thyroid gland, which will expose the trachea. Finally, the surgeon creates a hole here where the tracheostomy tube will be inserted. Following the completion of this process, a faceplate and a neck tube will be attached to prevent the tracheostomy from slipping. If necessary, a few temporary sutures will also be used to keep the faceplate in position on the skin of the neck.

Expect to spend several days in the hospital after you finish getting your tracheostomy. During this time, you can expect that the tracheostomy will heal. Do not perform any strenuous activity for six weeks after your surgery.

Before you leave the hospital you will be taught to properly care for your tracheostomy tube, including how to change your dressing, how to clean the hole, as well as how to clean, replace, and suction the tracheostomy tube. You will need to care for your tracheostomy tube at least twice a day. You will need to do this for as long as you have a tracheostomy tube, in order to prevent infection.

Speaking may be challenging. When you get a tracheostomy, the air in your lungs will exit through your tracheostomy hole, rather than up through your larynx. For those that are unable to speak after their tracheostomy, there are devices and techniques that will help you redirect your air so that speech is possible. A nurse and/or a speech therapist will work with you to teach you these techniques.

Eating will also change. For as long as you have your tracheostomy tube, you will be required to obtain your nutrients through an IV or through a feeding tube. When you have your tracheostomy tube removed, you will meet with a speech therapist to help you redevelop your muscles that will help you swallow again.

Because the air you breathe will not be moisturized by the normal breathing process, it will be much drier. You will have a device put on your tracheostomy tube in order to moisturize the air that you will be breathing. This heat and moisture exchanger will use a saline solution to humidify the air that you breathe. Failing to do this will result in excess mucus build-up and irritation of the tracheostomy.

To prevent infection, clean your tracheostomy hole at least twice a day with either a Q-tip or some cotton balls.

The hole around your tube should be pink and painless, but there will normally be a small amount of mucus around the hole and the tube. Keep the tube free of thick mucus, and carry around a spare tube with you in case the tube you are using fills up.

When you go outside, cover your tracheostomy hole with a cloth or a tracheostomy cover. This cloth and/or cover will also work to keep your clothes clean, and to keep you from breathing too heavily. Always carry a tissue around with you to catch any expectorant mucus from the tube.

You can keep the air that you breathe moist in a few simple ways:

Put a wet gauze or cloth outside your tube, and always keep it moist.
Invest in a humidifier for your home.
Use saline drops to unclog your tubes should they get clogged, and to cough up excess mucus in your system.

Do not get your tracheostomy hole wet. Cover it when you’re in the shower, and don’t go swimming.

Change the ribbons (trach ties) that keep your tube in place if they get dirty. Hold the tube in place, and be sure you can fit two fingers underneath the trach ties to make sure it isn’t too tight.

Change your gauze dressing, which catches mucus in addition to keeping the tube in place on your neck, at least once a day, or every time it gets dirty.

Bronchoscopies have quite a few benefits including the fact that they can be carried out with the patient awake and do not require IVs, oxygen tubes, oxygen monitors, or blood pressure monitors.

The first step is to numb the inside of the throat so that the patient remains as comfortable as possible. We then place the bronchoscope down the throat. Once the bronchoscope is in place, we will then carefully inspect the bronchial tube and trachea and look for any unusual growths. If any suspicious soft tissue is found, a small sample can be taken. Instruments can be used to remove any foreign bodies or mucus plugs detected. The tube is then withdrawn, and the procedure is over.

There are two types of bronchoscopy:

Flexible Bronchoscopy For a flexible bronchoscopy, the physician uses a long and thin tube that is lit from end to end for a better view of the airways. This is generally the preferred method due to a number of unique benefits. With a flexible bronchoscopy, the patient does not need general anesthesia, it is often found to be more comfortable, and it gives the specialist a more complete view of the area.
Rigid Bronchoscopy For a rigid bronchoscopy, the physician uses a straight and long metal tube instead of a smaller flexible tube. Rigid bronchoscopies are typically recommended:
- To remove larger tissue samples
- If there is serious bleeding
- To clear larger obstructions
- To dilate the airway for other instruments

Laryngoscopies

A laryngoscopy is a procedure whereby a doctor examines the back of your throat, larynx (voice box) and vocal cords using a laryngoscope.

A laryngoscopy may be performed for a number of reasons, such as:

Assisting with an intubation to help with breathing
Checking possible causes of persistent earaches
Diagnosing the cause of a persistent cough, bloody cough, hoarseness, throat pain, or bad breath
Evaluating reasons for difficulty swallowing
Performing biopsies
Removing foreign objects
Removing polyps
Viewing masses in the throat

Suncoast ENT Surgical Specialists performs two types of laryngoscopy procedures: indirect and direct fiber-optic.

Indirect Laryngoscopy: An indirect laryngoscopy only takes a few minutes. During an indirect laryngoscopy, your throat is numbed with spray anesthesia. Your tongue is then covered with gauze and held with the doctor’s hand to allow a warm mirror to be placed near the back of your throat. You are then asked to make a specific sound while the doctor watches your larynx.

Direct Fiber-optic Laryngoscopy: A direct fiber-optic laryngoscopy is most often performed after an indirect procedure has been done. It may also be used if your gag reflex prevented a thorough exam from being performed with the indirect method. During a direct fiber-optic laryngoscopy, a special scope will be inserted through either your nose or mouth and down into your throat. This scope contains an eyepiece that allows the doctor to view your larynx. This method also permits the doctor to collect tissue samples or remove growths or foreign objects that are trapped in the throat. It is typically performed in an operating room under general anesthesia. A direct laryngoscopy may take anywhere from 5 to 45 minutes, depending on the reason for performing it.

You may be given some instructions from your doctor, which should be followed carefully. These may include:

No smoking for at least 24 hours after your procedures
Keeping the area dry, which may involve taking only sponge baths
Drinking plenty of water

It may be difficult for you to swallow because your gag reflex has been temporarily disabled. It normally takes around two hours for it to return, so in the meantime, spit out saliva and secretions. Use throat lozenges to help alleviate any discomfort you feel.

After your procedure, any tissue that was removed during your laryngoscopy will be sent to a laboratory for evaluation. You should receive the results of this biopsy within three to five days.