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FAQs


1. When is a Thyroid Gland Abnormal?

Diseases of the thyroid gland are very common, affecting millions of people. The most common diseases are an over- or under-active gland. These conditions are called hyperthyroidism (e.g., Grave's disease) and hypothyroidism. Sometimes the thyroid gland can become enlarged from over-activity (as in Grave's disease) or from under-activity (as in hypothyroidism). An enlarged thyroid gland is often called a "goiter." Sometimes an inflammation of the thyroid gland (Hashimoto's disease) will cause enlargement of the gland.

2. How Do We Diagnose and Treat Thyroid Disorders?

The diagnosis of a thyroid abnormality in function or a thyroid mass is made by taking a medical history and a physical examination. We are the only thyroid surgeons in Northeast Wisconsin who perform our own thyroid ultrasounds and ultrasound guided thyroid fine needle aspiration biopsies. Our practice is also the only specialists to use Afirma thyroid biopsy analysis tool that is capable of eliminating many unnecessary thyroid surgeries.

3. How are Vocal Disorders Treated?

The treatment of hoarseness depends on the cause. Most hoarseness can be treated by simply resting the voice or modifying how it is used. Our physicians may make some recommendations about voice use behavior, refer the patient to other voice team members, and in some instances recommend surgery if a lesion, such as a polyp, is identified. Avoidance of smoking or exposure to secondhand smoke (passive smoking) is recommended to all patients. Drinking fluids and possibly using medications to thin the mucus are also helpful.
At Ear, Nose the Throat Specialists of Wisconsin, we perform videostroboscopy to analyze voice issues. This technique uses light to down the vibrations of the vocal folds so the most accurate diagnosis can be made. Our doctors can assess real-time information concerning vibration using a permanent video record of the examination.

4. What are Tonsils?

Tonsils are the two pink lumps of tissue found on each side of the back of your throat. (Open your mouth wide and say 'ahhhh' in front of a mirror to see them.) Each grape-size lump fights off the bad bacteria or germs living in your body.

5. What Affects Tonsils and Adenoids?

The most common problems affecting the tonsils and adenoids are recurrent infections (throat or ear) and significant enlargement or obstruction that causes breathing and swallowing problems.
Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets within the tonsils that produce foul-smelling, cheese-like formations can also affect the tonsils and adenoids, making them sore and swollen.

6. What is Tonsillitis and Its Symptoms?

Tonsillitis is an infection in one or both tonsils. One sign is swelling of the tonsils. Other signs or symptoms are:
Redder than normal tonsils
A white or yellow coating on the tonsils
A slight voice change due to swelling
Sore throat
Uncomfortable or painful swallowing
Swollen lymph nodes (glands) in the neck
Fever
Bad breath

7. What are Enlarged Adenoids and their Symptoms?

If you or your child's adenoids are enlarged, it may be hard to breathe through the nose. Other signs of constant enlargement are: Breathing through the mouth instead of the nose most of the time, Nose sounds "blocked" when the person speaks, Noisy breathing during the day, Recurrent ear infections, Snoring at night, Breathing stops for a few seconds at night during snoring or loud breathing (sleep apnea).
How Does Ear Nose and Throat Specialists Treat Tonsils and Adenoids?
Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Sometimes, removal of the tonsils and/or adenoids may be recommended. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or adenoids. Treatment with steroids (e.g., cortisone) is sometimes helpful.

8. What Causes a Sore Throat?

Sore throat is a symptom of many medical disorders. Infections cause the majority of sore throats and are contagious. Infections are caused either by viruses such as the flu, the common cold, mononucleosis, or by bacteria such as strep, mycoplasma, or hemophilus. While bacteria responds to antibiotic treatment, viruses do not.

9. When Should I See a Doctor?

Whenever a sore throat is severe, persists longer than the usual five- to seven- day duration of a cold or flu, and is not associated with an avoidable allergy or irritation, you should seek medical attention. The following signs and symptoms should alert you to see your physician:
Severe and prolonged sore throat
Difficulty breathing
Difficulty swallowing
Difficulty opening the mouth
Joint pain
Earache
Rash
Fever (over 101°)
Blood in saliva or phlegm
Frequently recurring sore throat
Lump in neck
Hoarseness lasting over two weeks

10. When Should I Take Antibiotics?

Antibiotics are drugs that kill or impair bacteria. Penicillin or erythromycin (well-known antibiotics) are prescribed when the physician suspects streptococcal or another bacterial infection that responds to them. However, a number of bacterial throat infections require other antibiotics instead. Antibiotics do not cure viral infections, but viruses do lower the patient's resistance to bacterial infections. When such a combined infection occurs, antibiotics may be recommended. When an antibiotic is prescribed, it should be taken as the physician directs for the full course (usually 10 days). Otherwise the infection will probably be suppressed rather than eliminated, and it can return. Some children will experience recurrent infection despite antibiotic treatment. When some of these are strep infections or are severe, your child may require a tonsillectomy.

11. How Can I Treat My Sore Throat?

A mild sore throat associated with cold or flu symptoms can be made more comfortable with the following remedies: Increase your liquid intake. Warm tea with honey is a favorite home remedy. Use a steamer or humidifier in your bedroom. Gargle with warm salt water several times daily: 1 tsp. salt to 1 cup water. Take over-the-counter pain relievers acetaminophen or ibuprofen

12. What Is Dizziness?

Some people describe a balance problem by saying they feel dizzy, lightheaded, unsteady, or giddy. This feeling of imbalance or disequilibrium, without a sensation of turning or spinning, is sometimes due to an inner ear problem.

13. What Is Vertigo?

A few people describe their balance problem by using the word vertigo, which comes from the Latin verb "to turn". They often say that they or their surroundings are turning or spinning. Vertigo is frequently due to an inner ear problem.

14. What Is Motion Sickness and Sea Sickness?

Some people experience nausea and even vomiting when riding in an airplane, automobile, or amusement park ride, and this is called motion sickness. Many people experience motion sickness when riding on a boat or ship, and this is called seasickness even though it is the same disorder.
Motion sickness or seasickness is usually just a minor annoyance and does not signify any serious medical illness, but some travelers are incapacitated by it, and a few even suffer symptoms for a few days after the trip.

15. What Will an ENT Physician Do for My Dizziness?

The doctor will ask you to describe your dizziness, whether it is light headedness or a sensation of motion, how long and how often the dizziness has troubled you, how long a dizzy episode lasts, and whether it is associated with hearing loss or nausea and vomiting. You might be asked for circumstances that might bring on a dizzy spell. You will need to answer questions about your general health, any medicines, you are taking, head injuries, recent infections, and other questions about your ear and neurological system.
Your physician will examine your ears, nose, and throat and do tests of nerve and balance function. Because the inner ear controls both balance and hearing, disorders of balance often affect hearing and vice versa. Therefore, your physician will probably recommend hearing tests (audiograms). The physician might order X-rays, a CT or MRI scan of your head, or special tests of eye motion after warm or cold water is used to stimulate the inner ear (ENG - electronystagmography). In some cases, blood tests or a cardiology (heart) evaluation might be recommended.
Not every patient will require every test. The physician's judgment will be based on each particular patient. Similarly, the treatments recommended by your physician will depend on the diagnosis.

16. What are common causes of nasal obstruction?

Common causes of nasal obstruction include a deviated nasal septum, nasal turbinate enlargement and nasal polyps (benign growths).

Deviated nasal septum:
The midline of the nose consists of a cartilage and bony nasal septum that separates the two sides of the nasal cavity. A deviation or bend in this structure can be present at birth or can occur following a nasal fracture. The obstruction caused by such a deviation can be corrected by surgically straightening the septum, called a septoplasty. A septoplasty is a commonly performed outpatient surgery done through incisions within the nasal cavity, removing the obstructing portion of bone and cartilage.

Nasal turbinate enlargement:
The nasal turbinates are three bony and soft-tissue structures lining the sides of the nasal cavity. As part of the normal nasal cycle, the turbinates alternately swell and enlarge. In some persons, the turbinates can be excessively large, resulting in significant nasal obstruction. Allergy treatment, typically with nasal steroid sprays, may help to decrease this swelling. When allergy management does sufficiently relieve nasal obstruction, the inferior turbinates can be surgically reduced. In many cases this can be done as an office procedure.

Nasal polyps: 
Nasal polyps are a type of inflammatory tissue that can grow in the nasal cavity and sinuses. They occur more frequently in persons with allergies and/or asthma. Nasal obstruction is the most common symptom. The sinus drainage tracts may also be blocked, resulting in chronic sinus disease. Nasal polyps are controlled with steroid sprays as well as removal by endoscopic surgery. Persons whose polyps arise from asthma may have serious allergic reactions to aspirin.

17. What causes sinusitis and how is it treated?

Infection of the sinus cavities often occurs due to inflammation and obstruction of the sinus drainage pathways. Typical symptoms of a sinus infection include facial pain and pressure, nasal obstruction, yellow or green nasal drainage, fatigue and fever. Treatment of a sinus infection may include nasal decongestants and antibiotics. People with chronic sinus drainage may benefit from endoscopic sinus surgery.

18. At what point would my child benefit from a tonsillectomy and adenoidectomy?

Surgical removal of the tonsils and adenoids in children is performed for two primary reasons: recurrent tonsil/adenoid infections and snoring with associated sleep apnea.

Tonsil infections:
As a general guideline, a tonsillectomy is recommended in patients with seven or more tonsil infections in one year, five infections a year for two years, or three infections for three or more years.

Sleep apnea:
Enlargement of tonsil and adenoid tissue in children can obstruct airways during sleep. Children with sleep apnea typically are mouth breathers who snore loudly and can be heard to stop breathing or make gasping noises during sleep. Sleep apnea results in fragmented sleep that can lead to daytime fatigue or hyperactivity, failure to thrive, difficulties in concentrating, and occasional problems with bedwetting.

Surgical procedure:
Tonsils and adenoids are removed through the mouth with no external scars. In most children, this is outpatient surgery.

19. What causes my hoarseness?

Hoarseness, due to irritation of the larynx, is commonly caused by upper respiratory infections, reflux of stomach acid and/or postnasal drip.

Upper respiratory infections:
People frequently develop a persistent cough following a common cold. A cycle may develop in which episodic coughing results in throat irritation, which causes more coughing and more irritation. The larynx then becomes even more susceptible to other irritants such as acid reflux and posterior drainage from the nose. It is important to break the coughing cycle by maintaining adequate hydration, taking throat lozenges, and avoiding throat clearing.

Gastrointestinal Reflux Disease (GERD): 
Acid from the stomach can reflux up through the esophagus to the larynx. The resulting acid exposure can cause a multitude of symptoms, including hoarseness, throat discomfort, swallowing problems and a feeling of a foreign body caught in the throat. Acid reflux may occur at night, so that sleeping patients do not notice symptoms of heartburn. Treatment of GERD includes antacids, elevating the head of the bed, changing the diet, and avoiding caffeine and alcohol.

Postnasal drainage:Mucous drainage from the nose can cause throat irritation and hoarseness. Nasal steroid sprays and non-sedating antihistamines may help reduce the amount of drainage.

Less common causes of hoarseness and voice change include decreased thyroid function, vocal cord paralysis, vocal cord nodules or polyps, and tumors of the larynx. Hoarseness lasting more than four-six weeks should be evaluated by a physician. Otolaryngologists can visualize the both mirrors and flexible fiber optic telescopes.

20. What can be done about my snoring?

Snoring is a common problem that may occur alone or in combination with obstructive sleep apnea.

Primary snoring:
Snoring typically is caused by vibration of tissues within the oral pharynx (the uvula and palate). Nasal obstruction can be another cause. In mild snoring, these measures may help: losing weight, sleeping on your side rather than your back, avoiding sedatives and alcohol. Surgery can reduce the size of the soft tissue of uvula and palate, and also relieve nasal obstruction. The PAMF Department of Otolaryngology uses a carbon dioxide laser to remove excess uvular and palatal soft tissue, an office procedure using local anesthesia. Office turbinate surgery may also help snoring by improving nasal breathing.

Obstructive Sleep Apnea:
Obstructive apnea is a cessation of breathing that last ten seconds or more. Repeated episodes can significantly disrupt sleep. Manifestations of sleep apnea include snoring, restless sleep, and daytime fatigue. Many advances have been made in treatment of sleep apnea.

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