Adult ENT – FAQs
I get a lot of sinus infections. Do I need surgery?
Sinusitis is a common problem. It is often worse in the winter and typically occurs when cold and flu season comes around. In most cases it is a self-limiting (short duration) problem. Sinus irrigation and nasal steroids can help reduce the severity of symptoms. If after a few days the infection starts to worsen, this may represent a bacterial co-infection and warrants review by your primary care doc and possibly a course of antibiotics. Nearly all cases of sinusitis can be managed medically (saline irrigation of the nose +/- a nasal steroid). Chronic sinusitis (lasting more than 6 weeks) despite appropriate medical therapy may indicate a need for surgical intervention. If you have poorly controlled sinusitis or have other concerns, you should make an appointment to discuss your needs.
I feel like something is stuck in my throat
Globus pharyngeus is the medical term used to describe the sensation of something stuck in the back of the throat. It is extremely important to ensure that there is not a sinister cause for this. A careful history, physical examination and a flexible scope through the nose to examine the throat is necessary. In many cases it can be managed with diet modification and medical therapy. If you suffer from this sensation, talk with your GP about a referral to an ENT specialist for evaluation.
I have developed a lump in my neck
Unlike children, when adults develop a lump in the neck it is more concerning. In some cases it may be associated with a change in swallowing or hoarseness. If you have developed a new lump in your neck that has persisted for more than a week, you should talk with your GP about referral to an Ear Nose and Throat surgeon.
I get tonsillitis a lot, should I get my tonsils out?
Tonsillitis is a common problem. In most people, it only occurs once or twice in a lifetime. In some people however, it can recur often, resulting in multiple courses of antibiotics and time missed from work, sport or other commitments. Currently, we use the “Paradise criteria” as a guide. This criteria is met with 7 episodes of tonsillitis in one year, 5 episodes in two consecutive years or 3 episodes annually in 3 consecutive years. Importantly, there are other reasons for taking the tonsils out in patients who do not reach these criteria. If you meet these criteria or are concerned about your tonsils you should schedule an appointment to discuss whether surgery (tonsillectomy) is the right option for you.
What do the tonsils do? What happens if they are removed?
The tonsils are part of your body’s defensive mechanism. They recognize foreign substances that you eat, drink or breathe and communicate with your immune system to defend against infections. It is likely they serve a more important role in the first year of life, however after that, there are so many other sites that detect these foreign substances that the tonsils are no longer essential. Removing the tonsils will make no difference in your body’s ability to protect itself.
What are adenoids? What happens if they are removed?
Adenoids are mounds of tissue at the back of the nose. They are the same tissue type as the tonsils in your mouth just in a different location. Like the tonsils, they can detect foreign substances that we sniff in and alert the immune system. They often grow in size around the age of two and can contribute to snoring, recurrent ear problems and even recurrent sinus infections. It is for this reason that we sometimes recommend removing them. Adenoids tend to involute (disappear) in the early teenage years and so are typically a problem of childhood.
What are grommets?
Grommets (or tympanostomy tubes) are small devices we use to maintain a hole in the eardrum to allow either drainage of fluid from the middle ear (the space behind the eardrum) or to aid delivery of medication (often antibiotic drops). They are designed to be temporary and the ear will typically push the grommet out over time. Occasionally the grommet may fall out too soon or get blocked meaning another tube needs to be placed. Rarely it doesn’t get pushed out and needs another operation to remove it. In 1-4% it will fall out and leave a small hole that will need to be fixed with another operation.
Recurrent ear infections
An ear infection can be a very painful condition. If you’ve ever had one, you are familiar with the symptoms of pain and pressure in the ear. It can be associated with a fever and often has associated hearing loss. Fortunately in most cases it is brief lasting only a few days not requiring medical intervention. Most people (adults and children) have had at least one ear infection. For some people however these infections do not settle down or are recurrent. This can result in multiple episodes of fever and illness, time of work/school and many trips to either a GP or emergency department and courses of antibiotics. For recurrent infections, if you or your child has had more than 4 ear infections in 6 months or 6 infections in one calendar year, grommets may de indicated. If you are concerned about your ears and infections, you should talk to your GP about a referral to an ENT specialist for an opinion.