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Common Conditions

Tonsillitis

  • Tonsillitis can start with a cold or flu
  • The tonsils at the back of your throat will be red and swollen often with white spots
  • The main symptoms in children and adults are:
  • A sore throat, difficulty swallowing, hoarse or loss of voice, a high temperature of 38C or above, coughing, headache, feeling sick, earache, feeling tired, swollen painful glands in your neck – feels like a lump on the side of your neck, bad breath
  • Complications with tonsillitis are very rare. If they happen they mostly affect teenagers and young adults. Sometimes you can get a pocket filled with pus (abscess) between your tonsils and the wall of your throat. This is called a quinsy with severe pain on one side and earache. Often it is difficult to open your mouth because of pain. Treatment usually involves admission to hospital for 24-48 hours for intra-venous antibiotics and pain relief
  • Treatment is with antibiotics but recurrent tonsillitis may indicate having the tonsils removed

Glue ear and Adenoids

  • The adenoids are part of the immune system and are like the tonsils, but smaller and are situated in the midline at the back of the nose, behind the soft palate, between the openings of the Eustachean tubes which ventilate the middle ears. They get smaller in teenage years and usually disappear in adults.
  • In children the adenoids may enlarge and cause a stuffy or blocked nose.
  • They may also block the openings of the Eustachean tubes so that air can not get to the middle ear.
  • This results in fluid filling the middle ear which becomes thicker and like glue if it has been there for a few months, hence the name ‘glue ear’, This causes deafness of between 20-40%.
  • The onset is often painless and as the child is young and may not appreciate the deafness, they may become withdrawn or ‘in a world of their own’ because they can’t hear others speaking. Their speech may also be delayed.
  • Treatment is by draining the fluid through a tiny incision in the eardrum under a short general anaesthetic (myringotomy). A small grommet(ventilation tube) may be inserted in the eardrum to ventilate the middle ear. These usually come out on their own in 6-12 months.
  • Adenoidectomy is also often carried out at the same time
  • Glue ear can also occur in adults following colds and with flying because of rapid change in ear pressure

Deviated nasal septum

  • This is a very common condition causing difficulty breathing through the nose or snoring
  • The septum is a thin (2-3 mm) plate of cartilage (front) and bone (behind) about 6-7 cm in length and about 7 cm in height that separates the right and left nasal airway and supports the nose.
  • On each side it is covered with pink mucosa, rather like a sandwich, which is continuous with the mucosal lining of the rest of the nose and throat
  • The nose is vulnerable to trauma and fracture and the septal cartilage/bone may be bent, causing narrowing of the airway on one or both sides of the nose.
  • There may be no obvious history of trauma, and it may have been due to an injury in childhood or the nose being ‘squashed’ during normal childbirth, or it may just be ‘the family nose’. The blockage may develop during late teens when the nose is rapidly growing
  • Correction of the deviation with a simple operation (SMR or septoplasty), carried out with small instuments through a tiny incision inside the nose gives immediate relief. It doesn’t affect the shape of the nose and the operation is remarkably painless.

Thyroid problems

  • The thyroid is a ‘butterfly–shaped’ endocrine gland which is situated in the central part of the lower anterior neck, just in front of the trachea. It produces a hormone called thyroxine which is important as it regulates the rate of metabolism of all cells in the body
  • Hyperthyroidism (or thyrotoxicosis) is a condition where the gland produces too much thyroxine; symptoms may include palpitations, tremors, feeling hot, losing weight, diarrhoea and sweating. This may be due to general over-activity (Grave’s disease) or a toxic nodule. Treatment is usually medical, but surgery may be required
  • Hypothyroidism is where the gland is underactive; symptoms include tiredness, weight gain, dry skin, feeling cold, constipation, hair loss. It may be due to an auto-immune condition (Hashimoto’s)
  • Nodules in the thyroid gland are very common in adults and most commonly are benign cystic or solid degenerative nodules. These are usually small and cause no symptoms or swelling, but if they enlarge, they may cause pressure on the oesophagus, trachea and voice box, resulting in a sensation of pressure in the lower neck, particularly at night when lying down, or some feeling of obstruction on swallowing or a change in voice. They may be single or multiple and if large, may contribute to a lower neck swelling called a ‘goitre’. Ultrasound examination is important to identify these nodules and indicate treatment
  • Thyroid cancer is rare but fortunately the usual papillary type has a cure rate of over 90% with treatment