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Allergic Rhinitis

Allergic rhinitis is commonly known as hay fever. However, this name is misleading as it often has nothing to do with hay or developing a fever. Allergic rhinitis occurs when the immune system becomes sensitive to something in the environment and overreacts.

Symptoms of allergic rhinitis include:

  • Itchy skin, eyes or mouth
  • Runny nose
  • Sneezing
  • Coughing
  • Puffiness or swelling in the eyes
  • Congestion
  • Fatigue (often due to poor sleep as a result of nasal obstruction)

What triggers allergic rhinitis?

  • Irritants: diesel exhaust, cigarette smoke, perfume
  • Outdoor allergens: pollen from trees, weeds, and grass
  • Indoor allergens: mold, dust mites, pet hair or dander

How will my otolaryngologists diagnose allergic rhinitis?

Your doctor will start by asking questions about your lifestyle, symptoms and other medical conditions. Certain conditions like nasal polyps or a deviated septum (curvature of the bone and cartilage that separates the nostrils) may complicate allergic rhinitis.

How is allergic rhinitis treated?

The most important step in treatment will begin with making lifestyle changes to avoid the triggers of your allergic rhinitis.

Your doctor may also prescribe one of a combination of the following types of medications:

  • Intranasal corticosteroids
  • Antihistamines
  • Decongestants
  • Nasal sprays
  • Leukotriene pathway inhibitors
  • Eye drops

Facial Skin Lesions

A skin lesion is part of the skin that has grown abnormally or looks different compared to the skin around it. Skin lesions may be present at birth or acquired over your lifetime. Some skin lesions evolve from primary lesions or develop as a consequence of your lifestyle. For example, skin cancer melanoma results from sun exposure.
Your MMG ENT can diagnose all types of facial lesions while screening for facial skin cancer.

What causes facial lesions?

When mutations in the skin cells cause them to grow out of control, facial skin cancers occur. Ultraviolet radiation from sunlight and tanning beds is often the cause.

How do I know if a facial lesion is cancerous?

Always discuss any changes your notice in patches of skin with your doctor or new patches of skin that develop and look different than the rest of your skin.

Here are descriptions of the most common types of facial lesions that can develop:

  • Basal cell carcinomas appear as a flat, flesh-colored lesion; pearly, waxy bump; or are brown and scar-like. They affect the scalp, face, and ears.
  • Melanomas can be moles that change in color, size, or bleed; lesions with irregular borders and parts that appear blue-black, blue, red or white; brownish spots with dark speckles; and dark lesions on the mucous membranes of the nose and mouth. They can occur anywhere but are very common on the neck or head.
  • Squamous cell carcinomas may be firm, reddish nodules, or flat lesions with a scaly or crusty surface. They often occur on the ears, lips, and face.

How will my MMG ENT treat my facial lesions?

Treatment for facial skin cancer depends on the size, type, and location of the lesions, as well as your overall health. Your doctor may be able to remove smaller lesions on the skin’s surface with a simple skin biopsy. When detected early, other superficial skin cancers can often be removed by vaporizing with laser therapy or freezing with liquid nitrogen.

Excisional surgery for larger growths may need to be performed in the operating room as an outpatient procedure.

Radiation therapy or chemotherapy may be recommended. Chemotherapy for skin lesions involves using creams or lotions that contain cancer-killing drugs. This treatment is effective in cancers confined to the top layer of skin.

For cancers that spread to other parts of the body, systemic chemotherapy is usually effective.

Sleep Apnea

Sleep apnea is a sleep disorder that is potentially serious. Patients with this condition repeatedly stop and start breathing. Sleep apnea is caused by the brain not sending proper signals to the muscles, the throat muscles improperly relaxing, or a combination of the two. ENTs typically treat obstructive sleep apnea, which is the form of this condition caused by the relaxing throat muscles.

How will my doctor diagnose sleep apnea?

Your doctor will evaluate your symptoms and ask questions of those familiar with your sleep habits. He will likely refer you for a sleep study.

If you have obstructive sleep apnea, your MMG ENT will evaluate you to rule out a blockage in your nose or throat.

What are the symptoms of sleep apnea?

The most common signs of sleep apnea include:

  • Loud snoring
  • Gasping for air during sleep
  • Episodes in which you stop breathing during sleep (observed by someone else)
  • Irritability
  • Difficulty paying attention while awake
  • Morning headache
  • Awakening with a dry mouth
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Feeling sleepy after a full night of rest

How will my MMG ENT treat my obstructive sleep apnea?

If your obstructive sleep apnea is mild, your doctor may recommend certain lifestyle changes such as:

  • Exercising regularly.
  • Not sleeping on your back.
  • Losing weight if you’re overweight.
  • Drinking alcohol moderately, if at all.
  • Not drinking several hours before bedtime.
  • Quit smoking.
  • Using nasal decongestants or allergy medications.

If these measures don’t improve your sleep, or if your apnea is moderate to severe, then your doctor may recommend other treatments. Certain devices can help open up a blocked airway such as mouthpieces and CPAP machines.

In other cases, surgery may be necessary.

Neck Masses

A variety of masses may develop in your head or neck. These masses may also be called growths, lumps, or tumors. While some masses are cancerous, many are not. It is important to see your physician if any abnormal lumps persist for more than two weeks. Early detection provides the highest chance of successful treatment if cancer is present.

What causes head or neck masses?

The causes of head and neck masses can include:

  • Benign masses
    Benign masses will not spread to the surrounding tissue. They are also not cancerous. Benign masses can be serious though if they impact nerves or exert pressure in the head and neck. These include thyroid masses, cysts, vascular masses, and salivary gland masses.
  • Enlargement of lymph nodes
    Lymph nodes can enlarge when the body works to fight infection. When an infection recedes, lymph swelling decreases as well. Enlarged lymph nodes are the most common cause of new neck masses.
  • Cancers
    Malignant head and neck masses can spread to surrounding tissue or to other parts of the body. Tumors may be either primary or secondary.

Primary tumors originate in the head or neck. This includes the throat, thyroid, salivary gland, larynx, brain or other areas. Typically, primary tumors of the head and neck spread to the lymph nodes in the neck. The majority of head and neck cancers are caused by tobacco and alcohol use. Those exposed to radiation should be screened yearly for thyroid cancer.

Secondary cancers are tumors that spread from primary tumors into other parts of the body to the neck or head. Oftentimes, secondary tumors of the neck originate in the kidney, lung, breast, or from skin cancers.

What symptoms should I be aware of?

You should see your doctor if you notice any of the following symptoms:

  • A growth in the mouth.
  • A change in your voice including persistent hoarseness.
  • A persistent lump in the neck not associated with an infection such as the flu or a cold.
  • Tongue swelling.
  • Unexplained weight loss.
  • Bloody saliva or phlegm.
  • Difficulty swallowing.
  • Ear pain that is persistent or when swallowing – this may be a symptom of growth in the throat or infection.

How will my MMG ENT treat my symptoms?

A physical examination of some masses may allow a physician to identify their cause. Otherwise, additional tests may be needed including:

PET (Positron Emission Tomography) and SPECT (Single Photon Emission Tomography)
These tests are useful after diagnosis to help determine the grade of a tumor. They may also distinguish between dead scar tissue and cancer. These tests are performed with injections with a radioactive tracer.

Biopsy
A tissue sample is examined under a microscope to determine if it is benign or malignant. Your doctor will most likely remove a benign neck mass or cysts by surgical excision. Treatment by some combination of chemotherapy and surgery may be used, or radiation therapy, depending on nature.

CT Scan
Computed Tomography (CT) combines sophisticated x-ray and computer technology. It helps locate tumors and determine their types, detect swelling or bleeding, and evaluate the effects of treatments. Injected iodine dye contrast material may be used to enhance the visibility of abnormal tissue during CT scans.

MRI
Magnetic Resonance Imaging clearly shows brainstem masses, tumors near bones, and small tumors. MRI uses a magnetic field instead of x-ray radiation.