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Throat Pain, Lump In Throat While Swallowing, Discomfort In Nasal Cavity, Face Tightness. What Is Going On?

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Posted on Sun, 24 Jun 2012
Question: I am hoping that I can receive some insight with a current health issue. In November of 2010, I had (unprotected) oral sex with two different women. A week later, I started to experience a general soreness on the right side of my throat/neck.
I went to see the doctor and he stated that my throat appeared a little red. He gave me some medicine for what he believed to be a cold.
However, I started to wonder if what I had was STD related. I started to do some research and thought I might be infected with HPV. In December of 2010, I then went to see an ear, nose and throat specialist. I did not mention my sexual activity to him. He looked at my throat with a laryngoscope/camera that did not show any abnormalities in the area where the pain was. He also ordered blood work and the results of the test showed that the SCC marker came back at 1.8. He said that this is a little over their benchmark of 1.5, so he ordered a CT scan of the neck which was performed in late December. During my follow up visit, he also looked at my neck with a different laryngoscope which had a special ultraviolet light attached that would show any abnormalities on the monitor. He took several pictures and there was nothing unusual that showed on any of these pictures. Also, the results of the CT Scan came back negative. He then ordered another round of blood work (mid January 2011) and the SCC marker came back at 1.2.
I went back to see the same doctor at Iwate University hospital in Morioka, Japan in May of 2011. At this time I disclosed my sexual activity. He once again looked at my throat by doing another laryngoscopy. He also swabbed for gonorrhea and syphilis. He ordered blood work to look for potential STDs including gonorrhea, syphilis, Chlamydia, HSV-1 and HSV-2. All test results came back negative. He said he could not find anything and that I should come back if it persists.
In October, I went to another clinic that specializes in STDs that is also located in the city of Morioka. I explained my sexual activity to him and he did a swab for gonorrhea, syphilis and Chlamydia. The results came back negative.
In December of 2011 I once again went to the Iwate University hospital and they ordered more blood work to check for STDs and this time included a test for HIV. The results came back negative for any signs of STDs.

My symptoms during the past 14 months have included a constant discomfort/slight pain that is located on the right side of my neck/throat. When eating or drinking there is no pain such as burning, but I do notice a persistent sensation that there is a lump in the right side my throat (in the area of the thyroid). I especially notice it when swallowing. I have also been experiencing constant discomfort in the lining (mucous membrane) of the nasal cavity and pharynx, but only on the right side. In the last few months, I have also been experiencing tightness in the muscles on the right side of my face. This tightness is not always constant. For the most part the symptoms I have described are relegated to the right side of my neck/throat and face. But occasionally I have a similar discomfort/pain on the left side of the lining of the nasal cavity and pharynx.

Other illnesses over the past 14 months include having the flu. I have also had some sinus headaches (as I suffer from sinusitis). I recently had a cold that lasted around a week. But none of these have worsened my condition. I have not lost any weight, noticed any lumps or discovered any lesions or sores in my mouth or throat.

I hope that by detailing my symptoms I can somehow be given an idea of what may be going on in my throat/neck. I would like to know if there are any additional tests, examines, MRIs that I should request to help diagnose my health issue. I want to thank you for taking the time to read my letter.
Sincerely,
J.J.
doctor
Answered by Dr. Sumit Bhatti (2 hours later)
Hi,

Thank you for your query.

1. Since multiple and detailed tests have ruled out any STD's, it is unlikely that you need to repeat any further tests except a follow up HIV test after six months.

2. Your symptoms may be due to a post nasal drip or acid reflux (LPR or Laryngo-Pharyngeal Reflux) which are exaggerated by anxiety.

3. You may request a Neck Sonography (USG) and a CT PNS (Para Nasal Sinuses).

4. An MRI study of the brain and cranial nerves will be required only if the tightness in your face worsens.

5. You must request for a trial with medication for chronic sinusitis and acid reflux. This should be under medical supervision.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Throat Pain, Lump In Throat While Swallowing, Discomfort In Nasal Cavity, Face Tightness. What Is Going On?

Hi,

Thank you for your query.

1. Since multiple and detailed tests have ruled out any STD's, it is unlikely that you need to repeat any further tests except a follow up HIV test after six months.

2. Your symptoms may be due to a post nasal drip or acid reflux (LPR or Laryngo-Pharyngeal Reflux) which are exaggerated by anxiety.

3. You may request a Neck Sonography (USG) and a CT PNS (Para Nasal Sinuses).

4. An MRI study of the brain and cranial nerves will be required only if the tightness in your face worsens.

5. You must request for a trial with medication for chronic sinusitis and acid reflux. This should be under medical supervision.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.