Diagnosis & Treatment

ENT DOC 24/7 is a division of the Advanced Center for Specialty Care providing comprehensive ear, nose & throat care* by physicians board-certified in Otolaryngology – head and neck surgery.  Although we provide  appointments six days a week, the Advanced Center for Specialty Care is not an urgent care center.  Each patient receives a comprehensive ENT consultation with appropriate and medically necessary testing.  Testing is generally done in the first visit whenever possible. 

Conditions, concerns, complications treated promptly at Advanced Center for Specialty Care:

Sinusitis:

Sinusitis is a condition consisting of infection or inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues. Newer classifications of sinusitis refer to it as rhino sinusitis, taking into account the thought that inflammation of the sinuses cannot occur without some inflammation of the nose as well (rhinitis).

Deep neck abscess:

The cardinal symptoms and signs of any kind of inflammatory process are redness (rubor), heat (calor), swelling (tumor), pain (dolor) and loss of function. Abscesses may occur in any kind of solid tissue but most frequently on skin surface (where they may be superficial pustules (boils) or deep skin abscesses), in the lungs, brain, teeth, kidneys and tonsils. Major complications are spreading of the abscess material to adjacent or remote tissues and extensive regional tissue death (gangrene). Abscesses in most parts of the body rarely heal themselves, so prompt medical attention is indicated at the first suspicion of an abscess. An abscess could potentially be fatal (although this is rare) if it compresses vital structures such as the trachea in the context of a deep neck abscess.

Dizziness:

Dizziness refers to an impairment in spatial perception and stability  It is considered imprecise. It can be used to mean vertigo, presyncope, disequilibrium or for a non-specific feeling such as giddiness or foolishness.

Ear infection:

When the middle ear becomes acutely infected by bacteria, pressure builds up behind the ear drum, usually but not always causing pain. In severe or untreated cases, the tympanic membrane may rupture, allowing the pus in the middle ear space to drain into the ear canal. If there is enough of it, this drainage may be obvious. Even though the rupture of the tympanic membrane suggests a traumatic process, it is almost always associated with the dramatic relief of pressure and pain. In a simple case of acute otitis media in an otherwise healthy person, the body's defenses are likely to resolve the infection and the ear drum nearly always heals. Antibiotic administration can prevent perforation of the eardrum and hasten recovery of the ear.

Facial trauma:

Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw, as well as trauma such as eye injuries. Symptoms are specific to the type of injury; for example, fractures may involve pain, swelling, loss of function, or changes in the shape of facial structures.

Head & neck tumors:

Throat cancer usually begins with symptoms that seem harmless enough, like an enlarged lymph node on the outside of the neck, a sore throat or a hoarse sounding voice. However, in the case of throat cancer, these conditions may persist and become chronic. There may be a lump or a sore in the throat or neck that does not heal or go away. There may be difficult or painful swallowing. Speaking may become difficult. There may be a persistent earache. Other possible but less common symptoms include some numbness or paralysis of the face muscles.

Presenting symptoms include:

• Mass in the neck
• Neck pain
• Bleeding from the mouth
• Sinus congestion, especially with nasopharyngeal carcinoma
• Bad breath
• Sometimes a sore tongue
• Painless ulcer or sores in the mouth that do not heal.
• White, red or dark patches in the mouth that will not go away.
• Ear-ache.
• Unusual bleeding or numbness in the mouth.
• A lump in your lip, mouth or gums.
• Enlarged lymph glands in the neck.
• If the cancer affects the tongue it may cause some slurring of speech.
• A hoarse voice, which persists for more than six weeks.
• A sore throat which persists for more than six weeks
• difficulty swallowing food,
• change in diet or weight loss,
• any neck lumps which persists for more than three weeks.
• A mouth ulcer that does not heal

Nose Bleeds:

Nose Bleeds is the relatively common occurrence of hemorrhage from the nose, usually noticed when the blood drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, more likely to require medical attention). Sometimes in more severe cases, the blood can come up the nasolacrimal duct and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause nausea and vomiting

Peritonsillar Abscess:

Unlike tonsillitis, which is more common in the pediatric age group, PTA has a more even age spread — from children to adults. Symptoms start appearing 2–8 days before the formation of abscess. Progressively worsening unilateral sore throat and pain during swallowing usually are the earliest symptoms. As the abscess develops, persistent pain in the peritonsillar area, fever, malaise, headache and a distortion of vowels informally known as "hot potato voice" may appear. Neck pain associated with tender, swollen lymph nodes, referred ear pain and halitosis are also common. Whilst these signs may be present in tonsillitis itself, a PTA should be specifically considered if there is limited ability to open the mouth (trismus).

Physical signs include redness and edema in the tonsillar area of the affected side and swelling of the jugulodigastric lymph nodes. The uvula may be displaced towards the unaffected side. Odynophagia (pain during swallowing), and ipsilateral earache also can occur.

Snoring & Sleep Apnea:

Obstructive sleep apnea (OSA) is a common sleep apnea caused by obstruction of the airway. It is characterized by pauses in breathing during sleep. These episodes, called apneas (literally, "without breath"), each last long enough that one or more breaths are missed, and occur repeatedly throughout sleep. In obstructive sleep apnea, breathing is interrupted by a physical block to airflow, despite the effort to breathe.

The individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body (sequelae). Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

Sore throat:

Pharyngitis is an inflammation of the throat or pharynx. In most cases it is painful, and thus is often referred to as a sore throat. Like many types of inflammation, pharyngitis can be acute – characterized by a rapid onset and typically a relatively short course – or chronic. Acute pharyngitis can result in very large tonsils which cause trouble swallowing and breathing. Some cases are accompanied by a cough or fever. Most acute cases are caused by viral infections (40%–60%), with the remainder caused by bacterial infections, fungal infections, or irritants such as pollutants or chemical substances. Treatment of viral causes are mainly symptomatic while bacterial or fungal causes may be amenable to antibiotics and anti-fungals respectively.

Sudden hearing loss:

A hearing impairment or deafness is a full or partial decrease in the ability to detect or understand sounds. Caused by a wide range of biological and environmental factors, loss of hearing can happen to any organism that perceives sound.
Sound waves vary in amplitude and in frequency. Amplitude is the sound wave's peak pressure variation. Frequency is the number of cycles per second of a sinusoidal component of a sound wave. Loss of the ability to detect some frequencies, or to detect low-amplitude sounds that an organism naturally detects, is a hearing impairment.

Thyroid Problems:

Hyperthyroid symptoms: Hyperthyroidism is the term for overactive tissue within the thyroid gland, resulting in overproduction and thus an excess of circulating free thyroid hormones: thyroxine (T4),triiodothyronine (T3), or both. Thyroid hormone is important at a cellular level, affecting nearly every type of tissue in the body.

Major clinical signs include weight loss (often accompanied by an increased appetite), anxiety, intolerance to heat, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia, delirium, tremor, pretibial myxedema, and sweating. Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. Long term untreated hyperthyroidism can lead to osteoporosis. In the elderly, these classical symptoms may not be present.

Hypothyroid symptoms: Hypothyroidism is the disease state in humans and in animals caused by insufficient production of thyroid hormone by the thyroid gland.

Early symptoms:

• Poor muscle tone (muscle hypotonia)
• Fatigue
• Cold intolerance, increased sensitivity to cold
• Depression
• Muscle cramps and joint pain
• Carpal Tunnel Syndrome
• Goiter
• Thin, brittle fingernails
• Thin, brittle hair
• Paleness
• Decreased sweating
• Dry, itchy skin
• Weight gain and water retention
• Bradycardia (low heart rate – less than sixty beats per minute)
• Constipation

Late symptoms:

• Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed
• Dry puffy skin, especially on the face
• Thinning of the outer third of the eyebrows (sign of Hertoghe)
• Abnormal menstrual cycles
• Low basal body temperature

Voice loss:

Laryngitis is an inflammation of the larynx. It causes hoarse voice or the complete loss of the voice because of irritation to the vocal folds (vocal cords). Laryngitis is categorized as acute if it lasts less than a few days. Otherwise it is categorized as chronic, and may last over 3 weeks.

Symptoms of laryngitis can vary, depending on the severity and also the cause. The most common, and obvious, symptom is impaired speech, ranging from a raspy hoarseness to the total loss of ability to speak, except at a whisper.

Other symptoms can include:

• Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed
• Dry puffy skin, especially on the face
• Thinning of the outer third of the eyebrows (sign of Hertoghe)
• Abnormal menstrual cycles
• Low basal body temperature

Please schedule a prompt appointment by contacting our 24/7 appointment desk at 1-800-4-ENT DOC, 1-800-436-8362 or 1-312-236-3642