Ear, Nose, Throat, and Oral Health Issues: Symptoms and Concerns

Problems related to otolaryngology, neck, and oral cavity?

Hello Doctor, I have a history of allergic rhinitis and vocal cord atrophy.
Since April, I have occasionally experienced a sensation of heat in my left ear, followed by persistent tinnitus in the left ear.
Occasionally, I also experience reduced hearing in the left ear, pain in the left ear, and a feeling of numbness on the left side of my face extending to my neck.
My face feels numb, and I have a hoarse throat with pain.
There is slight swelling near the left side of my throat around the Adam's apple.
I also have nasal congestion and my eyes have become very dry and easily reddened.
Since I am overseas, I could only see a general practitioner (GP), who diagnosed me with allergic rhinitis but did not refer me to an otolaryngologist for a detailed examination.
Later, I discovered a growth in my left oral cavity, which I initially thought was due to heat.
This growth has persisted without resolution (before I left the country, my allergy symptoms were limited to post-nasal drip and nasal congestion, which I had not experienced before; these are new symptoms).
These symptoms have been intermittent.
Between August and mid-October, the symptoms became very mild and were usually unnoticeable.
However, during this period, I began to develop protrusions in my left outer ear and ear canal that would appear and then disappear (I am unsure if they are acne; I can only describe them this way).
In November, after taking oxytetracycline to treat acne, the aforementioned symptoms suddenly intensified, and I experienced shortness of breath, a foreign body sensation in my throat, oral ulcers, a metallic taste in my mouth, and significant swelling at the junction of my upper throat and lower jaw, approximately 2 cm in size.
Local medical personnel were called in due to my shortness of breath and assessed that my vital signs were normal, oxygen levels were fine, and my throat appeared red and infected.
They temporarily ruled out drug allergy and suggested it might be a viral infection (but they also stated it was only a preliminary diagnosis and that I should see a specialist).
Later, my breathing improved significantly, but I still have a sore throat, swelling at the junction of my upper throat and lower jaw, and on the left side of my throat.
My left ear continues to develop growths, and I experience pain, occasional tinnitus, and reduced hearing in the left ear.
My left face feels numb, my voice is hoarse, my throat hurts, I have a metallic taste in my mouth, and the ulcerated areas feel thickened.
In recent days, I have also felt tooth sensitivity and occasional pain in my left cheek.
I can rule out the possibility of having COVID-19, as I have been tested and confirmed negative, and these symptoms have persisted for a long time.
Due to these symptoms, I have the following questions for the doctors: 1.
In the absence of being able to see a doctor in the past month, would you recommend taking pain relievers or other alternative medications and helpful foods? 2.
What could these symptoms indicate? I am very worried about the possibility of cancer or tumors...
I am also concerned that my original allergies may have developed into chronic symptoms, leading to potential hearing loss and weakness in the future...
3.
I will return to Taiwan in January; under these circumstances, would you recommend that I see an emergency doctor for an initial diagnosis and treatment upon arrival? Otherwise, I would have to wait until after my quarantine and self-management, which would be in February, but I am really anxious.
4.
Which specialties do you recommend I see afterward? I am very uncomfortable, so I have many questions.
Thank you very much for your responses; I really appreciate it.

Robin, 30~39 year old female. Ask Date: 2020/12/27

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you are experiencing pain, you can first use acetaminophen to manage it, as it generally has a lower risk of causing allergic reactions.
Additionally, it is advisable to drink plenty of water and avoid consuming irritating spicy foods.
Since there are no typical symptoms, it is recommended to visit a general internal medicine or family medicine clinic for an examination.
If necessary, the physician can refer you to other specialties based on the examination results.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/12/27

More Info

Your symptoms and concerns regarding your ear, nose, throat, and oral health are indeed complex and warrant careful consideration. Based on the information you've provided, it seems that you are experiencing a range of issues, including ear discomfort, throat pain, potential oral lesions, and systemic symptoms like facial numbness and difficulty swallowing. Here’s a breakdown of your concerns and some recommendations based on medical knowledge.

1. Pain Management and Dietary Considerations: Given that you are unable to see a doctor for the next month, it may be reasonable to use over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil) to manage your discomfort. Additionally, staying hydrated and avoiding spicy or irritating foods may help alleviate some symptoms. Soft foods might be easier to swallow if you are experiencing throat pain.

2. Potential Conditions: Your symptoms could be indicative of several conditions. The combination of ear ringing (tinnitus), hearing loss, throat swelling, and facial numbness raises concerns about possible Eustachian tube dysfunction, which can occur with allergies or infections. The presence of oral lesions and a blood taste could suggest an inflammatory process or infection, possibly exacerbated by your existing allergic rhinitis. While it is natural to worry about serious conditions such as cancer, it is essential to remember that many of these symptoms can be attributed to less severe issues, such as chronic allergies or infections. However, persistent symptoms, especially those involving swelling and pain, should not be ignored.

3. Emergency Care Upon Return: Given the severity of your symptoms, particularly the difficulty breathing and significant throat swelling, it would be wise to seek emergency care upon your return to Taiwan. Emergency physicians can provide a thorough evaluation and may perform necessary imaging or referrals to specialists. It’s crucial to address these symptoms promptly to rule out any serious conditions.

4. Specialist Referrals: Upon your return, you should consider seeing an Ear, Nose, and Throat (ENT) specialist first. They can evaluate your ear and throat symptoms comprehensively. If oral lesions persist, a referral to an oral surgeon or a dentist specializing in oral pathology may also be necessary. Given your history of allergies, an allergist could help manage your allergic rhinitis and assess whether it contributes to your current symptoms.

5. Monitoring and Follow-Up: It’s important to keep a close watch on your symptoms. If you notice any worsening, such as increased swelling, difficulty breathing, or new symptoms, seek medical attention immediately. Documenting your symptoms, including their frequency and severity, can be helpful for healthcare providers.

In summary, while your symptoms are concerning, many potential causes are treatable. It is essential to seek medical evaluation as soon as possible, especially given the complexity of your symptoms and their duration. Your health and well-being are paramount, and addressing these issues with the appropriate specialists will provide you with the best chance for recovery.

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