Throat Issues: Diagnosing Cysts and Other Concerns

Q: Throat Issues: Diagnosing Cysts and Other Concerns

Hello： A thyroglossal duct cyst typically appears as a swelling in the center of the neck. <br>If a cyst is present, it can usually be detected by ultrasound. <br>If you are concerned, you may first visit a nearby hospital for an examination, or return to your original hospital f

Throat issues

Hello Doctor, I previously inquired about the examination methods for a hyoid cyst.
I have been experiencing a severe sensation of a foreign body in my throat, along with sharp pain when swallowing saliva.
Three months ago, I underwent a bilateral tonsillectomy and uvuloplasty, but the sensation of a foreign body persists.
I cannot clearly identify the location; it just feels uncomfortable throughout my oral cavity.
The uvula was also shortened during surgery, and I feel discomfort in the posterior wall, which seems like a foreign body sensation as well.

It has been three months since the surgery, and I have had follow-up appointments two or three times.
The doctors I consulted suggested that it might be caused by acid reflux.
However, after taking medication for ten days, there has been no improvement.
I am experiencing a constant sensation of a foreign body and sharp pain 24 hours a day, which is very distressing.
I am worried about whether I might have cancer, as the sensation and pain extend deep into my throat.
I fear it could be laryngeal cancer, hypopharyngeal cancer, tongue cancer, esophageal cancer, or even something malignant in the base of my neck.

The surgeon performed an endoscopy and mentioned inflammation at the base of the tongue, likely due to reflux.
At that time, I did not mention the granular appearance at the base of my tongue.
Now, after ten days of medication, the sensation of a foreign body and pain in my throat has not improved.

I would like to know if an out-of-pocket MRI of the head and neck can accurately determine if there are any abnormalities in my tongue, neck, throat, or nose.
The sensation of a foreign body and pain has significantly affected my quality of life.
I was originally scheduled to return to the surgeon at the end of July, but I cannot wait that long, especially since the surgical hospital is far from my home in the south, making follow-ups inconvenient.

Additionally, I have been experiencing unilateral tinnitus for three months.
I have undergone hearing tests, which showed no issues, and I have taken medication without improvement.
I am concerned whether the tinnitus is related to my throat issues.
Externally, doctors cannot identify any problems, but I am suffering from these symptoms.
I have also had a thyroid examination that showed no significant issues.
If there is an esophageal problem, would I experience difficulty swallowing?
Is it possible to request examinations at another hospital? Or could Dr.
Zheng help analyze my issues and determine what might be wrong? I would appreciate any insights into what conditions my symptoms might resemble.
Thank you.

Ms. Lin, 40~49 year old female. Ask Date: 2021/07/08

Dr. Zheng Jueyi reply Otolaryngology

Hello: A thyroglossal duct cyst typically appears as a swelling in the center of the neck.
If a cyst is present, it can usually be detected by ultrasound.
If you are concerned, you may first visit a nearby hospital for an examination, or return to your original hospital for further evaluation.
Wishing you safety and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/07/08

More Info

When it comes to throat issues, particularly concerning sensations of foreign body presence, pain, and discomfort, it is essential to approach the situation with a comprehensive understanding of potential underlying causes. Based on your description, you have undergone tonsillectomy and uvuloplasty three months ago, and you are experiencing persistent sensations of discomfort, pain, and a feeling of something being stuck in your throat. This can understandably lead to anxiety, especially with concerns about serious conditions such as cancer.

Firstly, it is important to consider the possibility of post-surgical complications. After surgeries involving the throat, such as tonsillectomy, patients may experience a range of symptoms, including swelling, inflammation, and changes in sensation. The sensation of a foreign body can be attributed to residual swelling or irritation in the throat, particularly around the surgical site. Additionally, the healing process can sometimes lead to scar tissue formation, which may contribute to discomfort.

You mentioned that a doctor suggested gastroesophageal reflux disease (GERD) as a potential cause of your symptoms. GERD can indeed lead to throat discomfort, as stomach acid can irritate the lining of the throat, leading to sensations of pain or a lump in the throat. If you have been on medication for ten days without improvement, it may be worth discussing with your physician the possibility of adjusting your treatment or exploring other options.

Regarding your concern about cysts or other growths, imaging studies such as an MRI of the head and neck can be beneficial in identifying structural abnormalities, including cysts, tumors, or other lesions. An MRI is particularly useful because it provides detailed images of soft tissues, which can help in assessing the throat, tongue, and surrounding areas. If you are considering self-paying for an MRI, it is advisable to consult with a healthcare provider who can guide you on the appropriateness of this imaging based on your symptoms and medical history.

In terms of your ear symptoms, such as unilateral tinnitus (ear ringing), it is not uncommon for throat and ear issues to be interconnected due to the shared anatomical pathways. Eustachian tube dysfunction, which can occur after throat surgery or due to inflammation, may lead to ear symptoms. It is essential to discuss these symptoms with an ENT specialist who can evaluate both your throat and ear concerns comprehensively.

If you feel that your current healthcare provider is not addressing your concerns adequately, seeking a second opinion is entirely appropriate. You can request evaluations from other specialists, such as an otolaryngologist (ENT), who can perform a thorough examination and possibly conduct additional tests, including endoscopy, to visualize the throat and assess for any abnormalities.

In summary, your symptoms warrant a thorough evaluation, and while imaging studies like an MRI can provide valuable information, it is crucial to have a healthcare provider who understands your concerns and can guide you through the diagnostic process. Persistent throat discomfort, especially after surgery, should be taken seriously, and you deserve a comprehensive assessment to rule out any serious conditions and to find effective relief for your symptoms.

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