ENT Issues: Lymph Nodes, Nasal Problems, and Tinnitus

Nasal, cervical, and ear-related issues?

Hello, doctor.
I have some questions I would like to ask for clarification.

1.
About 1.2 months ago, a nasal endoscopy revealed some swelling, but the doctor did not think it was a tumor.
After performing a neck ultrasound, a 1.5 cm lymph node was found.
The doctor assessed it and felt it did not appear to be a tumor, suggesting that I could be reassured.
He mentioned that I should return for examination only if I experience neck discomfort or if the lymph node enlarges again.
Do you think it is possible to make an accurate assessment based solely on appearance without a biopsy? If I am concerned, how long should I wait before returning for a check-up? What nasal diseases could potentially cause swelling in the nasopharynx?
2.
Recently, I have noticed that my nasal mucus seems to be draining backward.
Due to my longer tongue, I can extend it back towards the soft palate, where I noticed that the area feels thick and the left side is indented while the right side has some tissue.
Could this be related to nasopharyngeal conditions?
3.
I have been experiencing tinnitus in both ears for several years.
Although hearing tests have shown normal results, the tinnitus is still quite noticeable when using headphones or in quiet environments.
Is there a way to completely cure tinnitus? What condition is associated with long-term bilateral tinnitus?

Jason, 20~29 year old female. Ask Date: 2021/12/21

Dr. Zheng Jueyi reply Otolaryngology

1.
If the clinical examination by the physician shows no significant abnormalities, it is recommended to return for a follow-up examination in three months.

2.
The nasopharynx is located directly behind the nasal cavity, and it is not possible to extend the tongue to the nasopharynx.
Post-nasal drip is commonly associated with allergic rhinitis, sinusitis, or chronic rhinitis.

3.
If the hearing test is normal, it is often benign tinnitus.
It is recommended to use music or white noise to mask the tinnitus and reduce auditory sensitivity.

Wishing you peace and health,
Dr.
Cheng Jue-Yi,
Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/12/21

More Info

Understanding ENT Issues: Lymph Nodes, Nasal Problems, and Tinnitus
Hello! Thank you for your questions regarding your ENT (ear, nose, and throat) concerns. Let’s address each of your inquiries systematically.

1. Lymph Node Concerns: You mentioned that a recent neck ultrasound revealed a 1.5 cm lymph node, which your doctor assessed as not likely being a tumor. In general, lymph nodes can become enlarged due to a variety of reasons, including infections, inflammatory conditions, or malignancies. The appearance of a lymph node on imaging studies can provide some information, but it is not definitive. For instance, characteristics such as shape, borders, and internal structure can suggest whether a lymph node is reactive (due to infection or inflammation) or suspicious for malignancy. However, without a biopsy, it is challenging to make a conclusive diagnosis. If you are feeling anxious about this finding, it is reasonable to follow up with your physician in a few months or sooner if you notice any changes, such as increased size or discomfort.
As for nasal diseases that could lead to a mass in the nasopharynx, conditions such as chronic rhinosinusitis, nasal polyps, or even infections could be potential causes. If you have persistent symptoms, further evaluation by an ENT specialist may be warranted.

2. Postnasal Drip and Nasopharyngeal Findings: You noted that your nasal mucus seems to be draining backward, which is often referred to as postnasal drip. This can occur due to various conditions, including allergies, sinus infections, or structural abnormalities in the nasal passages. The sensation of thick mucus in the nasopharynx can be uncomfortable and may lead to throat irritation or a cough. The observation of a "depressed" area on one side and a "meaty" area on the other could indicate the presence of an anatomical variation or a polyp. It is essential to have a thorough examination by an ENT specialist, who may recommend imaging studies or endoscopy to better visualize the area and determine the cause of these findings.

3. Tinnitus: Tinnitus, or ringing in the ears, can be a frustrating condition. It is often associated with hearing loss, exposure to loud noises, ear infections, or even stress. While you mentioned that your hearing tests are normal, it is still possible to experience tinnitus without any detectable hearing loss. Unfortunately, there is no one-size-fits-all cure for tinnitus, but there are various management strategies. These may include sound therapy, cognitive behavioral therapy, or tinnitus retraining therapy, which can help you cope with the perception of sound. It is advisable to consult with an audiologist or an ENT specialist who can provide tailored recommendations based on your specific situation.

In summary, while your concerns are valid, many of the issues you are experiencing can be managed effectively with the right medical guidance. Regular follow-ups with your healthcare provider, especially if you notice changes in your symptoms, are crucial. Additionally, maintaining open communication with your ENT specialist will help ensure that any underlying conditions are addressed promptly. If you have any further questions or need clarification on any points, feel free to ask!

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