Hi,

Thank you for your query.

1. Get your throat examined and get a videolaryngoscopy done. If it is normal, there is no cause for worry.

2. I would look for abnormal movements or laxity of the soft palate and rule out a post nasal drip (sinus cyst 15 years ago), granular pharyngitis (lymphoid hypertrophy) and acid reflux. Do you snore? I would look for signs of Sleep Apnea Syndrome.What is your BMI (Body Mass index)? How long have you had hypothyroidism?

3. The blister like spot on the tonsil is usually due to concretion of food particles and pus lodged in the natural crypts of the palatine tonsils. The largest crypt is known as the crypta magna and is located near the upper pole of the palatine tonsil. Long standing concretions are known as Tonsilloliths. This is what the tonsils are designed to do. A close up image may help diagnose this area.

4. The fullness while swallowing is due to the mild inflammation that ensues. If fever develops, it is an infection. If there are no other symptoms, treatment is not a necessity. Allergy, Acid reflux and Post-Nasal Drip (PND) may also lead to a similar situation.

5. FEES (Fibreoptic Endoscopic Evaluation of Swallowing) may be done with a flexible nasopharyngoscope if avaialble.

6. No sore throat, fever, hoarseness (change in voice) or lumps in neck is a good signs that rule out acute infections and cancer at present.

I must emphasize that the chance of a cancerous growth at your age is rare. Cancer will be progressive and will not respond to medication. Your throat has not worsened for the past 6 months. It is good to hear that you have stopped smoking. These symptoms are usually investigated so as not to miss any rare cause. Kindly let me know the results of your investigations, with images and video of the videolaryngoscopy, if possible. This will help decide medication and further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

1. Your chronic post nasal drip must signify a stagnation and thickening of nasal secretions or an excess production due to some chronic irritation or inflammatory process, usually due to a deviated nasal septum, hypertrophied turbinates and also some problem in the sinuses. The source of the mucus is the nasal cavity and sinuses, which have a large XXXXXXX surface area and can produce a large amount of mucus. This post nasal drip irritates and infects the throat.

2. You need to get your ENT Specialist to examine your nose and throat, sometimes with a videolaryngoscope. Rule out granular pharyngitis. A throat swab may be taken for culture and antibiotic sensitivity. A plain CT PNS (Para Nasal Sinuses) and routine blood tests may be advised.

3. This is not something that you can always treat on your own. You may require broad spectrum antibiotics, anti inflammatory medication, anti-allergics, decongestants, mucolytics steroid nasal sprays, medicated gargles and steam inhalation. This should be done under medical supervision.

4. A Post Nasal drip also infects the throat and oral cavity and may increase acidity and acid reflux. Hence there may be a vicious cycle which has to be disrupted by medication. However this should be under medical supervision after your test results.

5. You may share any investigations, such as clinical and operative notes, Sinus CT scan images for further treatment options.

I must emphasize that this is a common treatable problem and not a cause for worry.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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