Throat

Globus Sensation

Globus sensation is a feeling of something in the throat where we can’t find anything wrong. It is a very real feeling – it is not something you “are making up”. You may feel it as a lump, a ledge, catarrh, a tickle or simply an area of discomfort; different people have different ways of describing it.

What is the cause?

The simple answer to this is we don’t know! Acid coming up from the stomach may be responsible in some patients and if you suffer from heartburn or water brash (acid coming up into your mouth) it should be treated; unfortunately the throat feeling doesn’t always respond to such treatment but your heartburn should. Stress does seem to play a part in globus sensation in about two thirds of patients, so often a change of lifestyle or relaxation exercises help. Many patients worry that their globus sensation is a sign of throat cancer and find that after they’ve been checked out at ENT they spontaneously get better.

Is there a cure?

There is no specific treatment for globus sensation at present, although treatment of oesophageal reflux may help, if present. If you can, try to ignore it because the more you think about it, the worse it seems to get. Excessive swallowing or throat clearing simply irritates the throat making the sensation worse, and you can get into a vicious circle, so try to consciously stop yourself from doing this. If your globus is particularly bad, having an ice-cold drink or sucking a sweet should help by keeping the throat moist.


Hoarseness

Hoarseness is defined as a change in the voice and is usually obvious to both patient and observers. It is a common condition, which may arise for many different reasons. The most common cause is simple viral laryngitis which usually recovers spontaneously within a week or two.

Other causes include vocal abuse, smoking, vocal cord paralysis, vocal cord polyps, aging and steroid inhaler use.


Panendoscopy

Throat problems present in various ways, including sore throat, irritation, coughing, swallowing difficulty, voice disorder and feelings of a lump or foreign body within the throat. Also possible is the presence of a lump which can be felt in the neck. Scans of various types may be required, but panendoscopy may be necessary to fully investigate such symptoms. This is an endoscopic investigation which involves passing an endoscope through the mouth to visualize some or all of: the pharynx, larynx, oesophagus, trachea and post-nasal space. This is required to visualize or biopsy any suspicious areas within these structures.

The procedure is carried out under general anesthetic by an ENT Surgeon and takes about 30-40min. In most cases, it can be safely done as a day-case, meaning the patient may go home the same day. If there are no other associated problems, the patient may return to work after 48 hours. There is generally a moderate sore throat post-operatively, which may take a week to settle. If biopsy samples are taken, the patient may experience some blood in the saliva for a few days, although there is seldom much. If any vocal cord procedures are undertaken, such as in micro-laryngoscopy, voice rest is advisable for a week – neither shouting, speaking with a raised voice or whispering. Biopsy results usually take a week to return from the lab.


Tonsillectomy

Tonsils are paired glandular structures at the back of the throat (visible on each side of the tongue at the back) made out of lymphoid tissue. They are supposed to protect the throat from infection by capturing and processing germs, but unfortunately, in many cases, they themselves become chronically infected. When this happens the structure of the tonsils may be damaged, leading to further infections, or the development of deep crevices which contain bacteria and often produce foul-smelling whitish/yellow solid material. For many, tonsillitis is the consequence. This produces a very sore throat in the majority.

What Symptoms do Tonsils Produce & Why Remove Them?

  • Tonsillitis: Sore throat, painful swallow, fever, headache, lethargy, painful, enlarged neck glands are among the common symptoms. It is a common throat infection that affects children and young adults. It can be recurrent and very debilitating and result in a lot of absenteeism from school, college job etc. Poor appetite, growth impediment and ear infections may occur. Pyrexial seizures may occur in younger children due to severe temperature elevation. Frequent courses of antibiotics are required, although these only help temporarily. Tonsillectomy cures all of this, and it never occurs again. See “Tonsillectomy” under “Procedures”
  • Enlarged tonsils: Difficult swallowing / eating, snoring, sleep apnea, ( stopping breathing, snoring heavily or choking when sleeping). Cured by tonsillectomy.
  • Tonsil “stones”: In this condition small whitish-yellow lumps of very offensive-smelling matter collect in the tonsillar crevices. The can cause discomfort, but more commonly, the patient experiences very bad breath and odour – sometimes a foul taste as well. It is very unpleasant but does not respond to antibiotics. Removing the tonsils cures the problem.

Mr. Marais uses Coblation (radiofrequency) to remove tonsils in most cases. This results in less post-op pain and less chance of post-op infection.

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