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Having irritation in upper throat. Scan report showed mild chronic sinusitis. Put on nasal spray. Suggestions?

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ENT Specialist
Practicing since : 1992
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For the past 4 months, I have been facing a irriration on the right side of my upper throat (near my mouth cavity). I have visited the ENT specialists multiple times and the diagnosis started step by step as below:

1. General visual check of the mouth cavity/larynx: No anomally. Put on antihistamine - 3 days. No improvement.
2. LDL/visual check of the mouth cavity/larynx: No anomally. Put on wikoryl suspecting Post Nasal Drip - 5 days. No improvement.
3. LDL/ XXXXXXX check of the mouth cavity/larynx: No anomally. Put on antihistamine for 2 weeks. No improvement.
4. CT Scan of PNS: Mild chronic sinusitis. Put on nasal spray - 1 month. No improvement.
5. Endoscopy of Throat/Eosohagus/Stomach: Slight Lax XXXXXXX Put on Reprazole (Raciper) for 4 weeks for acid reflux. No improvement.
6. MRI (Neck/Throat): No anomally.
7. CT Scan (Brain): No anomally

This persistent irration is driving me crazy although mild. Hope this is not cancer and how I get rid of it? Also sometimes while brushing hard, I cut my gums/mouth and small bleedings occur.


Additional Info:

Also, I have no pain or problem while swalling food or drinking liquids. I have smoked in the past but stopped since last 1 year. In between when this problem started, I smoked for 3 days. I used to drink alcohol moderately. Now, I have stopped. My weight is 94 Kgs and go through a stressful full job.
Posted Thu, 1 Aug 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Ravinder Sharma 15 hours later
Hello
I am Dr Ravinder Sharma ENT surgeon
On the basis of the information provided , investigations done and treatment taken in your case it suggests
1. It is not an allergic cause
2. It not an infection of throat or tonsils
3. Normal endoscopy of pharynx and larynx rules out malignancy

The history of 4 months and no response to reflux medication suggest it may be because of the post nasal drip secondary to chronic sinusitis (as the CT suggested)as a cause of these symptoms

Another possibility in your case may be because of enlarged styloid process on one side. This also presents in similar way

Your history of smoking and alcohol do raises a possibility of cancer and in early stage. One endoscopy will not be enough to give an answer. You can plan for a follow up endoscopy at 3 months if there is no improvement in symptoms.

I would suggest you to consult a ENT surgeon and discuss your problem. It will be difficult to give an accurate diagnosis on the basis of the history alone. I hope you got my point.

I hope this answers your concern. Feel free to contact me if you require more information about it

with regards
Ravinder Sharma

Above answer was peer-reviewed by
 
Follow-up: Having irritation in upper throat. Scan report showed mild chronic sinusitis. Put on nasal spray. Suggestions? 5 hours later
Hi Dr. Ravinder,

I have already visited ENT surgeons more than 7 times in the past 3.5 months and had got examined every time. Plus the MRI scan was conducted which shored no anomalies. Can't these findings rule out malignancy?

I also have frequent cough like white sputum in my throat. If this is suspected enlarged styloid, what is the risk and how it can be diagnosed. The MRI scan did not reveal this a normally.
 
 
Answered by Dr. Ravinder Sharma 4 days later
Hi,

Yes, these findings definitely rule out malignancy.

The frequent cough could be due to chronic bronchitis. You may want to get a 'throat swab and culture' done.

Enlarge styloid does not present this way. This can be seen on an x-ray or MRI.
There is no risk as such in you.

I hope this clarifies. Take care!


Above answer was peer-reviewed by
 
Follow-up: Having irritation in upper throat. Scan report showed mild chronic sinusitis. Put on nasal spray. Suggestions? 18 days later
Thanks Doctor. Based on your reply, I visited the same hospital and consulted another ENT surgeon. During the fiber optic endoscopy a sub lingual mass (2x2 cm) was found on the epiglottis. I do not know why this was not noticed earlier with the battery of check ups and tests. It was completely removed on 23rd XXXXXXX using radio frequency surgery. I experienced pain while swalowing in the first 2 weeks and avoided hard food. It is now 22 days and I have started normal food. But, I am experiencing mild sensation like foreign body now. Sometimes the sensation goes mildly to my right ear also. Is this normal and part of the recovery process due to healing or scar formation? How long will it take to completely heal and come out of this?

The biopsy report of the excised tissue confirmed that it was cyst and negative for malignancy.
 
 
Answered by Dr. Ravinder Sharma 27 hours later
Hi
I am Dr Ravinder Sharma
Thanks for a follow up query
On the basis of the information it appears that the foreign body sensation in throat is because of the healing process and as it settles down this problem will further reduce (may be 3 to 6 months). Your problem of pain / sensation in ear is also because of the common nerve supply of ear and throat. As this heals this will also improve further.

As the biopsy of the mass is negative or malignancy you need not to wory about it too much. I am sure you would have given up smoking and if not then this is the right time to think about it.

Plan for a follow up endoscopy at 6 months form now

I hope this answers your concern. Feel free to contact me if you have need more information about it

with regards
Ravinder Sharma
Above answer was peer-reviewed by
 
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