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What causes throat pain?

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Posted on Mon, 29 Sep 2014
Question: Hello,
my name is XXXX and I am 33 years old. I am originally from Germany but I live in Costa Rica. I have been suffering from a pain in my throat which changes from day to day in its severity but also in its location, sometimes it is very difficult for me to say where the pain is, apart my throat is slightly red and I have to constantly clear my throat with very thin mucus. From time to time I feel pressure on my eyes and a slight headache. I was first suspected to have acid reflux and went through a ph metry, manometry and gastro endoscopy with all negative results. Since the doctor however still insisted in acid reflux i was treated with an aggressive acid reflux treatment (twice a day Nexium 40mg, after every meal Malox and still other anti-acids i do not remember). There was no response and I continued to have the same symptoms. I was then recommended with an ENT specialist who first made a CAT scanner check and I was diagnosed with chronic sinusitis, cysts in my paranasal sinuses and a deviated septum. After a treatment with antibiotics and cortisone nasal spray with no response i received 6 weeks ago a surgery. Unfortunately there was no improvement. I am still suffering from pain in my throat. Last week I went again with my doctor and this time my pain was very easy to describe as I could easily tell him the painful location (exactly over my larynx) the ENT specialist supposed it could be a problem with a tyroglosal cyst so he sent me to do and ultrasound and yes he was right. They found two cysts which however are small with a size of 8mm and 4mm. This doctor who did the ultrasound pushed exactly on the point where the pain was and said here is the cyst so it was clear were the pain was from. He then inserted an injection and extracted the liquid out of it which was very little actually and he said that he cannot imagine that my general throat pain is related to this. I am very confused now and also very nervous since nobody can tell me what I really have. The ENT specialist says he thinks this was the root of all of my problems and that we will do another surgery but I am not sure what to do now. I have had already a surgery which did not help anything related to my problem and now they find something were I hear different opinions if this might be the activator of my symptoms or not. The day I went to the ultrasound and when say extracted the liquid out of the tyroglosal cyst was three days ago and I still have a painful throat – not anymore were the pain was (the place of the cyst) but the general pain in my larynx is still there.
i would like to still mention that there was an incredably big amount of blood tests which were made including allergies, thyroid, hiv etc etc with all normal/negative results
doctor
Answered by Dr. Krunal Karade (49 minutes later)
Brief Answer:
Need report of CT scan & Ultrasound.

Detailed Answer:
Hi, Thanks for the query.

I have read your query , reviewed your medications and understand your concern.

To help you better i need report of CT scan, Ultrasound neck & others.

If I were your treating doctor, For symptomatic I would advice you

Antiseptic chlorhexidine Mouth Wash twice daily ,
Plenty of fluids ,
Steam Inhalation twice daily,
Saline nasal spray 2 puff each nostril twice daily followed by Combination Steroid nasal spray with antihistamine 2 puff each nostril twice daily,
Paracetamol for pain & Vitamin C twice daily .

You will get relief from throat pain.

Hope this information helpful to you .If you have any further questions I will be happy to help.
Regards.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Krunal Karade (3 hours later)
Dear Dr. Krunal Karade, thank you for your quick response. I still have two doubts: first, would you recomend a antihistamine in Tablet form or nasal spray? i currently take once a day a cortisone nasal spray and several times a salt wáter spray.
secondly, do you recomend the removal of the 8mm tyroglosal cyst - i know it is hard to say without my studies but they are in Spanish. does it make sence that this is really the cause of my problem or do we have two different things here? if it is two different things i can handle the problem with the cyst because i feel this point were it is located just sometimes painful but not all the time as my larynx. thank you again
doctor
Answered by Dr. Krunal Karade (21 minutes later)
Brief Answer:
Most likely you have two different things .

Detailed Answer:
Thanks for the follow up query.

If I were your treating doctor, I would advice you
Saline nasal spray 3 puff each nostril twice daily followed by
Combination Steroid nasal spray with antihistamine 2 puff each nostril twice daily for 3 month than antihistamine in Tablet form .

Since nasal spray are locally acting .

Use warm water gargle 20 mins after steroid nasal spray to clear any steroid spray in throat .

If this 8 mm thyroglossal cyst is not infected & not increasing with normal thyroid hormone level you can wait .

Most likely you have two different things . One in larynxgopharynx can be seen on Videolaryngoscopy & other outside thyroglossal cyst.

Hope this information helpful to you .If you have any further questions I will be happy to help.
Regards.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Krunal Karade (1 hour later)
Doctor, i just received the test result to the cyst and the result is that it is filled with macrophage material.

best regards
doctor
Answered by Dr. Krunal Karade (12 minutes later)
Brief Answer:
Macrophage material can leads to pus formation .

Detailed Answer:
Thanks for the follow up query.

The cyst that it is filled with macrophage material can leads to pus formation .
In future , you will probably need to go for thyroglossal cyst excision . It is not an emergency unless it gets infected.

Hope this information helpful to you .If you have any further questions I will be happy to help.
Regards.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Krunal Karade

ENT Specialist

Practicing since :2009

Answered : 1000 Questions

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What causes throat pain?

Brief Answer: Need report of CT scan & Ultrasound. Detailed Answer: Hi, Thanks for the query. I have read your query , reviewed your medications and understand your concern. To help you better i need report of CT scan, Ultrasound neck & others. If I were your treating doctor, For symptomatic I would advice you Antiseptic chlorhexidine Mouth Wash twice daily , Plenty of fluids , Steam Inhalation twice daily, Saline nasal spray 2 puff each nostril twice daily followed by Combination Steroid nasal spray with antihistamine 2 puff each nostril twice daily, Paracetamol for pain & Vitamin C twice daily . You will get relief from throat pain. Hope this information helpful to you .If you have any further questions I will be happy to help. Regards.