Persistent Throat and Oral Symptoms: A Patient's Journey

Oral and throat issues?

Hello Doctor, I would like to ask for your advice.
I have difficulty describing the exact location of my symptoms, but I will try to explain.
For the past few months, I have been experiencing inflammation in the area around the uvula and the posterior pharyngeal wall (below the nasopharynx) extending down to the throat.
There is a persistent inflammatory state accompanied by a throbbing pain and sharp sensations.
The mucosa at the base of my left tongue and the area where my teeth meet feels painful and has a foreign body sensation.
Occasionally, I experience sharp pain in my throat while eating, and sometimes I have a sour taste from the middle to the root of my left tongue.
The pharyngeal wall and deep throat feel like something is stuck, resembling a sharp bone, 24 hours a day.
It feels lighter upon waking but becomes more pronounced after about 5 to 10 minutes, accompanied by a sudden onset of tinnitus in my left ear that has persisted for 24 hours a day for the past five months.
The symptoms do not alleviate throughout the day, but swallowing is generally not an issue, although there is occasional sharp pain and a sensation of inflammation in certain areas of my mouth.
I am unsure of the cause of the tinnitus (I have had a brain MRI that showed no abnormalities).
Currently, the area at the base of my left tongue and the site of my previous tonsillectomy also feels inflamed and pulsating, with a sharp pain and foreign body sensation.
I feel like there is a persistent foreign body sensation in my entire throat and pharyngeal wall (below the nasopharynx, uvula, and the posterior nasopharyngeal wall).
Five months ago, I underwent a bilateral tonsillectomy.
I have followed up with my doctor, and in June, the doctor suggested that it might be caused by acid reflux.
An endoscopy showed some swelling in my throat and inflammation at the left base of my tongue, but I was not informed about the discovery of lymphadenopathy on the right side of my tongue.
Due to the severity of my symptoms, I underwent a gastroscopy in early July, which revealed only mild acid reflux.
I was prescribed medication for my stomach, but my symptoms did not improve.
At the end of July, I returned to the doctor and mentioned a lump on the right side of my tongue and throat with a white spot on its surface.
The doctor said it was a normal lingual tonsil and that the white spot might be food residue that would eventually fall off.
I expressed my concerns about the persistent foreign body sensation and inflammation in my throat, but the doctor only stated that the wound had healed and did not take further action.
To this day, I can see the lump in the mirror.
I feel that the pharyngeal wall and deep throat continue to have a foreign body sensation and sharp pain, and the left base of my tongue also has a pulsating pain and foreign body sensation.
I am very scared and worried.
Sometimes when I speak, I feel a sharp pain in the left side, possibly at the base of my tongue, and I wonder if there are any lesions in the underlying tissue or mucosa.
In August, I visited another ENT specialist and explained my symptoms.
That day, I had a nasopharyngeal endoscopy, and the doctor said there were no significant abnormalities.
He mentioned that the lump at the back of my tongue was lymphadenopathy and would gradually resolve.
I asked the doctor to examine my tongue, but he said it was unnecessary and arranged for a neck ultrasound, which I have to wait until mid-September to have.
This waiting period is very difficult, and my throat and mouth remain inflamed and pulsating.
The area below the nasopharynx, the pharyngeal wall, and deep throat also have a foreign body sensation and sharp pain.
The left base of my tongue has been painful for several months, and the surgeon mentioned that it was due to inflammation.
Why is it still painful after all this time? The uvula has been adjusted; could the sutures be causing a foreign body sensation? Is it possible that the surgery damaged a nerve? Is it abnormal that I have not recovered after several months? Could this be a complication?
I would like to ask if having undergone nasopharyngeal endoscopy, gastroscopy, and MRI of the head and neck can rule out any oral cancers, head and neck cancers, or esophageal lesions? Or do I need to undergo another gastroscopy with a narrow-band imaging (NBI) examination? I am very worried about the possibility of oral cancer, tongue cancer, lymphomas, or head and neck cancers.
The more uncomfortable I feel, the more fearful I become.
My child is not even three years old, and I am genuinely afraid of having a serious illness that is difficult to treat.
I feel helpless and do not know where to seek medical help (the original surgeon thought it was related to my emotions and suggested medication for that, and the hospital is inconveniently located in the south).
I currently live in Taipei and have attached photos, hoping you can advise me on where to seek medical attention or what tests I should undergo to rule out significant issues.
In April, I had a bilateral tonsillectomy and uvula trimming.
In May, I experienced sudden unilateral tinnitus that has persisted for 24 hours a day until now.
In June, I had a thyroid ultrasound that showed no significant abnormalities.
In July, I underwent gastroscopy that revealed no major issues.
On August 18, I had an MRI with contrast, and the doctor said there were no problems.
I checked the report online but did not fully understand it.
What does it mean that there are specific lymph nodes in both sides of the neck? The report did not specify their size.
The lymphadenopathy of my tongue was also not elaborated upon.
Does this mean that all the areas I mentioned have been checked and found to be normal, which is why there was no further comment? Or are there areas that cannot be examined?
Currently, my symptoms feel like there is a foreign body sensation and sharp pain at the left base of my tongue and tonsil area, and the pharyngeal wall and uvula feel hard and protruding.
I am unsure if this is normal, but I experience a persistent inflammatory and pulsating sensation throughout the day, which is quite uncomfortable.
The lymphadenopathy at the right base of my tongue has not resolved for three months; should I be worried or undergo further examination? Additionally, I would like to ask about the swelling at the injection site on my hand after receiving contrast two days ago.
The injection site and my wrist have also swollen.
I called the radiology department, and they advised me to see a dermatologist.
I visited the dermatologist, who suggested it might be vascular inflammation and prescribed antibiotics.
After a week, the pain did not completely subside, and now, 15 days later, I still have mild pain and a small bump at the injection site.
Should I see a dermatologist again or consult another specialist? Or should I just continue to observe? I apologize if I have asked too many questions, and I appreciate your patience in reading through my concerns.
How should I express my symptoms when seeking further medical attention? Thank you.

Miss Lin, 40~49 year old female. Ask Date: 2021/09/03

Dr. Liao Yaopan reply Family Medicine

Hello, regarding your concerns, it is indeed difficult to clarify.
This area still requires assistance from an otolaryngologist.
Whether to perform a narrow-band imaging (NBI) endoscopy will still need to be assessed by the physician based on the condition after the use of contrast agents.
If there is no improvement, it is still recommended to consult a dermatologist for further treatment.
Online consultations are not equivalent to in-person medical visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2021/09/03

More Info

It sounds like you are experiencing a complex and distressing set of symptoms following your tonsillectomy and uvulopalatopharyngoplasty (UPPP). Your ongoing throat and oral symptoms, including pain, a sensation of a foreign body, and persistent ear ringing (tinnitus), can be quite alarming, especially when they persist for several months.

From your description, it appears that you have undergone multiple evaluations, including MRI, endoscopy, and a gastroscopy, which have not revealed any significant abnormalities. However, the symptoms you are experiencing—such as the pain in the throat, the sensation of something stuck, and the ear symptoms—can be indicative of several potential issues.

1. Post-Surgical Inflammation: After surgeries like tonsillectomy and UPPP, it is not uncommon for patients to experience prolonged inflammation in the throat and surrounding areas. This inflammation can lead to discomfort, a sensation of tightness, and even referred pain to the ears. The healing process can vary significantly from person to person, and some may experience lingering symptoms for months.

2. Nerve Sensitivity: Surgical procedures in the throat area can sometimes lead to nerve irritation or damage, which may manifest as pain or unusual sensations in the throat and tongue. This could explain the "jumping" pain and the sensation of a foreign body in your throat.

3. Gastroesophageal Reflux Disease (GERD): You mentioned that a doctor suggested acid reflux as a potential cause of your symptoms. GERD can lead to throat irritation and inflammation, which may contribute to your symptoms. Even mild reflux can cause significant discomfort in the throat and may require dietary modifications and possibly medication to manage.

4. Lymphoid Tissue: The presence of enlarged lymphoid tissue, such as the lingual tonsils, can also cause discomfort and a sensation of fullness or pressure in the throat. If your doctor has noted that this tissue is enlarged but not concerning, it may still be contributing to your symptoms.

5. Psychological Factors: Anxiety and stress can exacerbate physical symptoms, especially in the context of chronic pain or discomfort. If you are feeling anxious about your health, it may be worthwhile to discuss this with a healthcare provider who can help you manage these feelings.

Regarding your concerns about cancer, it is understandable to feel anxious, especially with persistent symptoms. However, the tests you have undergone (MRI, endoscopy, etc.) are quite thorough and typically would have identified any significant issues. If you are still concerned, seeking a second opinion from an ENT specialist or a head and neck surgeon may provide additional reassurance.

As for the lump and pain at the injection site from the contrast agent, it is not uncommon to experience localized reactions. If the swelling and pain persist, it would be advisable to follow up with a dermatologist or the physician who performed the injection to ensure proper evaluation and management.

In summary, while your symptoms are concerning and understandably distressing, they may be related to post-surgical inflammation, nerve sensitivity, or reflux rather than a more serious underlying condition. Continuing to communicate openly with your healthcare providers about your symptoms and concerns is essential, and seeking further evaluations or referrals as needed can help you find relief.

Similar Q&A

Persistent Throat Discomfort: Causes and Treatment Options

I have been feeling a sensation of a foreign body and phlegm in my throat, which I cannot control, leading to frequent swallowing every 1 to 2 minutes. This issue persists even at night, making it difficult for me to sleep as I keep swallowing saliva. Speaking also causes pain. H...

Dr. Ye Dawei reply Otolaryngology
Dear Sir/Madam: Please schedule an appointment for an examination at the Ear, Nose, and Throat (ENT) outpatient clinic. It is possible that there is an issue. Dr. Yeh Da-Wei, Head of the ENT Department, Hsinchu Hospital.

Persistent Throat Sensation: Causes and Solutions for Discomfort

Hello doctor, for the past two months, I've been feeling like there's something stuck in my throat, and speaking feels "very" laborious. I went to the hospital for an endoscopy, and the doctor said my vocal cords looked a bit red and swollen, but taking medica...

Dr. Zheng Jueyi reply Otolaryngology
Hello, common factors related to chronic pharyngitis include not only the use of medications but also dietary management. It is recommended to reduce the intake of coffee, tea, and sweets to minimize gastroesophageal reflux, and to maintain a healthy lifestyle. Wishing you peace ...

Persistent Throat Pain and Swollen Tongue: Seeking Answers

My husband has been experiencing a dry and painful throat for the past three months, with dark red streaks in his phlegm when he coughs. He often feels nauseous and describes his saliva as salty. The base of his tongue is red and swollen. He drinks enough water daily to meet his ...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if you have already undergone examinations and no abnormalities were found, the most common issue is still chronic inflammation, which may be related to gastroesophageal reflux, high stress leading to chronic fatigue, insufficient sleep, smoking, or other potential causes ...

Understanding Persistent Throat Swelling: Is It Laryngitis or Something Else?

Due to my role as a teacher, I often have to speak loudly for more than 9 hours a day. Since last year, I have frequently experienced a swollen sensation on both sides of my throat, with symptoms that come and go. A doctor at a clinic previously diagnosed me with "laryngitis...

Dr. Zheng Jueyi reply Otolaryngology
Hello: Chronic pharyngitis may commonly be related to prolonged speaking, especially in certain professions. If there is no improvement, it is recommended to consult an otolaryngologist or a gastroenterologist for further evaluation. Wishing you health and safety. Sincerely, Dr. ...