Laryngitis

                                                          

 

What is laryngitis?

The larynx joins the back of the throat to the trachea (windpipe). Laryngitis is inflammation of the larynx, usually due to a virus or overuse. The result is acute change in the voice. Viral laryngitis is self-limited. Other infectious or irritating causes may require specific treatment. 

Why does the voice become hoarse and can it get severe?

 The voice becomes hoarse because the vocal cords are thickened by inflammation and the areas around the cords also become thickened. Yes, when people try to talk when they have laryngitis it can lead to permanent damage to the vocal cords and long standing hoarseness of voice.

What are the symptoms of viral laryngitis?

You may feel sore over the 'Adams apple' and become hoarse shortly afterwards. You may also have a mild fever, and a cough. Breathing difficulty is an uncommon complication. This may occur if there is a lot of inflammation and swelling in the larynx which causes the windpipe to narrow. This is rare in adults, but sometimes happens in young children with smaller, narrower windpipes. 

 

Do I need an antibiotic?

Usually not. Laryngitis is usually caused by a virus. Antibiotics do not kill viruses, they only kill bacteria. Your immune system usually clears virus infections quickly.

A more severe laryngitis is sometimes due to bacteria. An antibiotic may be advised if the infection is severe, if it is not easing after a few days, or if your immune system is not working properly (for example, if you have had your spleen removed or if you are taking chemotherapy, etc).

 

Other causes of laryngitis and hoarseness

Laryngitis and hoarseness are occasionally due to other conditions that affect the vocal cords. For example: rare infections, allergies, voice overuse, tobacco smoke, or other irritants or chemicals that you may inhale. A benign (non-cancerous) cyst on a vocal cord sometimes causes hoarseness. A tumor (cancer) on the vocal cord is an uncommon cause. See a doctor if any of the following develop.

• Symptoms that are severe, or are different to those described above.
• Any flu-like symptoms which do not ease within 3-4 days.
• If hoarseness or soreness in the larynx persist more than 2-3 weeks. Particularly if you had no initial infection to account for the hoarseness.
• If swollen neck glands do not go within 2-3 weeks after an infection.
• If swollen glands appear in the neck without symptoms of infection.
  
  
  

My Typical Thyroid Incision - Nationally & Internationally - Irrespective of the Size

Its not easy to do small incision #thyroids especially in Middle East. These are technically very challenging and the space is extremely limited and one needs to be very sure about the Anatomy of the region. One mistake and you can either cut the nerve or you can injure an important blood vessel. I have been doing it for the last 15 years both in India and in International locations. The advantage is not just the non noticable scar but also early recovery since these do not need drains and patient can be discharged on the same day or utmost the next day.

Testimonial after Successful # Head&Neck Cancer Treatments...

Cancer is Curable if diagnosed early. I am herewith attaching testimonials from two patients who were misdiagnosed and came to me luckily in not a too advanced state, I had already posted some symptoms one should be aware of to create an awareness against this ever increasing disease...

Dear Dr.Kumaresh,

Please find below a small thank you note for the timely treatment of mu father in his battle against Cancer.

He first felt swallowing problems in his throat / mouth in November 2012, in Kolkata when he went to an ENT specialist there for consultation. The Doctor after examining him said that this was likely to be a case of Fungal infection of the mouth and prescribed him 'Fluconazole' for medication. This continued for a couple of months and he went to another Doctor in Pune for followup consultation towards the end of January, 2013. This Doctor said that this can be Fungal infection or malignancy. If medicine for fungal infection was curing the problems then it was fine else might have to check for malignancy and prescribed 'Ciprofloxacin'. The medicine seemed to provide some relief. However, suddenly at March 2013 one morning he started speaking in a Nasal tone. We initially thought it was due to cold which he had that time but the tone persisted for a few days.

We then took him to a local Hospital in Bangalore and consulted the ENT  and also consulted the visiting oncologist there. The CT Scan also did not reflect any problems (we later realized that the doctor prescribed CT Scan of the wrong area). This led us to look for an alternate specialist Doctor who can help us out and we reached out to Dr. Kumaresh Krishnamoorthy who is one of the best specialists inBangalore. Dr. Kumaresh helped us to go through an immediate Biopsy and confirmed that this was Carcinoma of the Soft Palate. Subsequently he along with an extremely senior and capable colleagues in Medical and Radiation Oncology treated him .

Their treatment resulted in his recovery and he appears to be in a much improved state than when we went to Dr. Kumaresh for the first time. I would like to sincerely extend my Thanks and Regards to Dr. Kumaresh and the panel of Doctors who treated him and for whom I am able to get my father back from the clutches of this dreaded disease.

Regards
D Mukherjee

Dear Kumaresh,

There is no objection from our side to use this testimonial in your website of blog.

It is my pleasure to write this small note about you and the way you practice.

Thanks so much for all you have done for my father. I hope this testimonial helps others decide as easily as I did to choose you for cancer surgery involving your specialty.

It has been a 1.5 year since my father was diagnosed and treated for his tongue cancer. It is hard to believe that no one would ever know what has happened to my father, he was being treated as simple ulcer and it was Dr. Kumaresh who first correctly diagnosed him as having Cancer of the tongue and that it was in a slightly advanced state. I am so grateful to have had Dr Kumaresh as my father's cancer surgeon.

Words cannot describe how happy we were when my father recovered after the reconstruction of new tongue. Dr.Kumaresh and his plastic surgery colleague are truly talented and gifted men. Our experience with his staff was also wonderful. My father tongue recovery was unbelievably fast. He felt almost normal tongue after 5 months. I would definitely recommend anyone having tongue cancer or any cancer in the area of Dr. Kumaresh specialty to contact him only.

Sincerely,

Shashi A.S

My recommendation after Cancer Surgery

Dear Doctor
 I am enclosing my recommendation:
 " I was suffering from recurrent Mouth Ulcers and contacted Dr. Kumaresh from Phnom Penh, Cambodia (where I was working) by Phone and eMail and set up appointment to meet him as soon as I reached India. The moment I came to India and met him, he immediately identified my problem and on the same day Biopsy and CT Scan were done. On receipt of results, PET Scan was done to confirm Cancer in floor of mouth.
 He decided it was best to
operate and remove the Jaw bone, Floor of mouth, part of tongue and some Lymph nodes in the left side of my face and replace the same with my Fibula (from Leg) and connected tissues and skin. He immediately identified one of the best Plastic Surgeons and the surgery was done with in a week in xxxxxxx Hospital, Bangalore. He recommended Post operative Radiotherapy and Chemotheapy to be done in  xxxxxx Hospital.

 

Now I am substantially recovered from my surgery and am cured of Mouth Cancer. I am slowly recovering from the side effects of the Raidiation and Chemo Therapies.
 All through my above ordeal, Dr. Kumaresh stood behind me like a rock and supported me in all my turbulations. Being a

Cancer Survivor himself, he was quiet understanding and supportive in all stages of my pre and post operative stages of my treatment.

He is a good surgeon, a good care giver, very good in planning dfferent stages of treatment, good in identifying the supportive care givers and institutions but above all a very good human being, so much so that, he is now trying to help me find employment in Bangalore as I am not desirous of going back to Cambodia as Medical facilities there are negligible.
 DR. KUMARESH IS A GREAT DOCTOR AND I WISH HIM WELL IN ALL HIS FUTURE ENDEAVOURS."

With Warm Regards,
Mr. G

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Post Thyroidectomy Testimonials

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From: kishore

Sent: Friday, September 28, 2012 2:54 PM

To: drkkumaresh

Subject: TESTIMONIAL

Dear Dr.Kumaresh,
Before giving a note on my surgery. let me thank Dr.Harpreet Singh Kochar who diagnosed and fond out my disease (Papillary Carcinoma).Once i came to know i have to undergo for the surgery, was in Noida and planned come back to Banglore and decided to get operated here. But I dont know any surgeon over here, after a long discussion, Dr.Kochar referred Dr.Kumaresh. First thing in my mind was how can I believe the doctor with out knowing anything. Initially i thought let me just consult Dr.Kumaresh then will decide on the surgeon. But after my first meeting with Dr.Kumaresh, i decided to operate the surgery with him only.

The way you have spoken with me was very appreciable. Those kind of words definitely reduces the patients depression and boost up their energy. Those 20mins of the discussion with you changed my mind and the way of thinking towards my problem. My half of my disease got cleared off on that day itself and remaining was cleared off by the surgery and your treatment. Your surgery,treatment and caring made my health in good condition. Once again let me thank you from my bottom of the heart for your caring and treatment.

The way you have given the confidence to my parents on my treatment and surgery was wonderful. Thanks again for keeping my health well.
Regards,
Kishore GLN

From: Padma

Sent: Friday, October 05, 2012 10:47 PM

To: drkumaresh@hotmail.com

Subject: My sincere thanks to you

Dear Dr. Kumaresh Krishnamoorthy

 I would like to extend to you my heartful thanks and appreciation for the good service and support to complete the Thyroid gland removal procedure to me . Before we came to the hospital we are nervous and not clear about the treatment. You explained very clearly about the treatment and inform us upfront what other risk involved in this.  Your straightforwardness creates Trust and faith on you.

Thanks for your at most support to remove my gland (left ). After this operation I back to my teaching profession without any damage to my voice

Once Again Thanks for you, I will pray God to give you good health and prosperity and help the society with your service ,Knowledge and care.

Your's truly

Padma 

 

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Posted via email from drkumaresh's posterous

Thyroid Nodules

I get lot of patients who are not bothered by their thyroid swelling thinking it is something small...more

What can be done to reduce the risk of developing a second new cancer?

People who have been treated for head and neck cancer have an increased chance of developing a new cancer, usually in the head and neck, food pipe or lungs. The chance is higher for people who smoke and drink alcohol. Patients who do not smoke should never start. Those who smoke should do their best to quit.

How are head and neck cancers treated?

The treatment plan for an individual patient depends on a number of factors. The patient and the doctor should consider treatment options carefully.

• Surgery is a good way to remove the cancer especially if it has been diagnosed early.

• Radiation therapy involves the use of high-energy x-rays to kill cancer cells.

• Chemotherapy is used to kill cancer cells throughout the body. In general, anticancer drugs affect rapidly growing cells, including blood cells that fight infection.

Warning Signs of Head and Neck Cancer

Having any of the following symptoms for more than three weeks warrants a visit to a head and neck specialist:
A sore on the lip or in the mouth that does not heal

A lump on the lip or in the mouth or throat

A white (leukoplakia) or red patch on the gums, tongue or lining of the mouth

Unusual bleeding, pain or numbness in the mouth

A sore throat or a feeling that something is caught in the throat that
Difficulty or pain with chewing or swallowing

Swelling of the jaw that causes dentures to fit poorly or become uncomfortable

A change in the voice or hoarseness

Pain in the ear without evidence of local ear problems

Slurred speech

Loose teeth not associated with any gum problems

Swelling, numbness, paralysis of the muscles in the face

Chronic sinus infections that do not respond to treatment with antibiotics

Bleeding through the nose, frequent headaches, swelling or other trouble with the eyes.

These symptoms may be caused by cancer or by other, less serious conditions.

Some problems associated with tonsils

Tonsillitis
Tonsillitis is an infection of the tonsils. A sore throat is the common symptom. In addition, you may also have a cough, fever, headache, feel sick, feel tired, painful swallowing, and swollen neck glands. Pus may appear as white spots on the enlarged tonsils. Symptoms typically get worse over 2-3 days and then gradually go, usually within a week. Most cases of tonsillitis are caused by viruses, some are caused by bacteria. See separate leaflet called 'Tonsillitis' for more details.
Infectious mononucleosis (glandular fever)
Infectious mononucleosis is caused by a virus (the Epstein-Barr virus). It tends to cause a severe bout of tonsillitis in addition to other symptoms. See separate leaflet called 'Glandular Fever' for more details.
Quinsy
This is also known as 'peritonsillar abscess. An abscess is a collection of pus. Quinsy is an uncommon condition where an abscess develops next to a tonsil due to a bacterial infection. It usually develops just on one side. It may follow tonsillitis or develop without a preceding tonsillitis. The tonsil on the affected side may be swollen or look normal, but is pushed towards the midline as pus forms and the abscess next to the tonsil gets bigger and bigger. Quinsy is very painful and can make you feel quite unwell. It is treated with antibiotics, but also the pus often needs to be drained with a small operation.

When do I need my tonsils taken out?
Removing the tonsils (tonsillectomy) may be an option if you have frequent and severe bouts of tonsillitis. That is, five or more infections over a year or when each infection is severe enough to affect normal life (such as needing time off work or school). Throat infections are not prevented if the tonsils are removed. However, for some people, the number and severity of throat infections may be reduced after tonsillectomy.

Problems of Adenoids and when to remove it

Some problems associated with adenoids
Swollen or enlarged adenoids are common in children. Causes include:
• Infections with viruses or bacteria. Once an infection clears, the swelling often goes down but sometimes the adenoids remain enlarged.
• Allergies.
• Often there is no apparent cause.

Symptoms of swollen enlarged adenoids include the following
• Difficulty breathing through the nose. The child then mainly 'mouth breathes'.
• The nose sounds blocked - that is the child may talk with a nasal voice (as if someone is pinching the nose when they talk).
• A constantly runny nose.
• Breathing through the nose may be noisy.
• Snoring at night. In severe cases sleep may be disrupted by the blocked nose and difficulty breathing.
• Swollen adenoids may block the entrance of the eustachian tube. This is the tube that goes from the back of the nose to the middle ear. It normally allows air to get into the middle ear. If this tube is blocked it may contribute to the formation of 'glue ear' (fluid in the middle ear). See separate leaflet called 'glue ear'.

What is the treatment for enlarged adenoids?
In most cases no treatment is needed. Often the symptoms are mild but may flare up during a cold or throat infection. Adenoids normally gradually shrink in later childhood and usually almost disappear by the teenage years. So symptoms tend to clear in time.
If symptoms are severe then a doctor may consider removing the adenoids. For example, if a child regularly has difficulty sleeping or disrupted nights sleep due to a blocked nose. Also, some children with glue ear may benefit from removing the adenoids.

What are the treatments for aphthous ulcers?

Treatment aims to ease the pain when ulcers occur, and to help them to heal as quickly as possible. (There is no treatment that prevents aphthous mouth ulcers from recurring.)
• No treatment may be needed. The pain is often mild, particularly with the common 'minor' type of aphthous ulcer. Each bout of ulcers will go without treatment.
• General measures include:
o Avoid spicy foods, acidic fruit drinks, and very salty foods (such as crisps) which can make the pain worse.
o Use a straw to drink, to by-pass ulcers in the front of the mouth. (Note: do not drink hot drinks with a straw, as you may burn your throat. Only cold drinks.)
o Use a very soft toothbrush. See a dentist if you have badly fitting dentures.
o If you suspect a medication is causing the ulcers, then a change may be possible. For example, if you are using oral nicotine replacement therapy (nicotine gum or lozenges), it may help to use a different type instead such as patches or nasal spray.
• Lidocaine paste (gel) for pain control
• A painkilling oral rinse, gel, or mouth spray may help to ease pain. However, the effect of each dose does not last very long.
Other treatments may be tried if the above do not help or where the pain and ulceration are severe.

What causes aphthous mouth ulcers?

The cause is not known. They are not infectious, and you cannot 'catch' aphthous mouth ulcers.
• In most cases, the ulcers develop for no apparent reason in people who are healthy.
• In some cases, the ulcers are related to other factors or diseases. These include:
o Injury - such as badly fitting dentures, a graze from a harsh toothbrush, etc. Increased acidity can cause mouth ulcers too.
o Changes in hormone levels. Some women find that mouth ulcers occur just before their period. In some women, the ulcers only develop after the menopause.
o Some ex-smokers find they develop ulcers only after stopping smoking.
o A lack of iron, or a lack of certain vitamins (such as Vitamin B12 and Folic acid) may be a factor in some cases.
o Rarely, a food allergy may be the cause.
o Mouth ulcers run in some families. So, a genetic factor may play a part in some cases.
o Stress or anxiety is said to trigger aphthous mouth ulcers in some people.
o A reaction to a medication is a rare cause. For example, anti-inflammatory drugs have been reported to cause mouth ulcers in some people.
o Mouth ulcers are more common in people with Crohn's disease, coeliac disease, HIV infection, and Bechet's disease. But the ulcers may not be aphthous type.
Tell your doctor if you have any other symptoms in addition to the mouth ulcers. Sometimes a blood sample or other tests are advised if any of the above conditions are suspected.

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What are aphthous mouth ulcers?

Aphthous mouth ulcers are painful sores that can occur anywhere inside the mouth. They are the most common type of mouth ulcer. At least 1 in 5 people develop aphthous mouth ulcers at some stage in their life. Women are affected more often than men.
There are three types:
• Minor aphthous ulcers are the most common (8 in 10 cases). They are small, round, or oval, and are less than 10 mm across. They look pale yellow, but the area around them may look swollen and red. Only one ulcer may develop, but up to five may appear at the same time. Each ulcer lasts 7-10 days, and then goes without leaving a scar. They are not usually very painful.
• Major aphthous ulcers occur in about 1 in 10 cases. These are 10 mm or larger. Usually only one or two appear at a time. Each ulcer lasts from two weeks to several months, and then goes but leaves a scar. They can be very painful - eating may become difficult.
• Pinpoint aphthous ulcers occur in about 1 in 10 cases. These are tiny, about 1-2 mm across. Many occur at the same time, but some may join together and form irregular shapes. Each ulcer lasts one week to two months. (These are sometimes called 'herpetiform ulcers', but they have nothing to do with herpes or the herpes virus.)
Aphthous ulcers usually first occur between the ages of 10 and 40. They then recur from time to time. There can be days, weeks, months, or years between each bout of ulcers. The ulcers tend to recur less often as you become older. In many cases, they eventually stop coming back. Some people feel a burning in part(s) of the mouth for a day or so before an ulcer appears.

My next blog would be on the causes of Aphthous Ulcer

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What is Sore Throat

The sudden change in weather from a bright, warm sunny day to a cold, chilly day can leave many of us afflicted with a cold and sore throat as our bodies are caught unaware by the quick change in weather.
A sore throat is a symptom, not a disease. A sore throat is one of the most common conditions seen by an ENT specialist. Viral infections cause the majority of sore throats. These viruses are highly contagious and spread quickly. The first indication of the infection is usually scratchiness or tickling in the throat. Other people can catch the infection even before you experience symptoms, which is one reason why sore throats are hard to prevent.
The same pollens and molds that irritate the nose when they are inhaled also may irritate the throat. Cat and dog dander’s and house dust are common causes of sore throats for people with allergies to them.
During the cold winter months, dry heat may create a recurring, mild sore throat with a parched feeling, especially in the mornings. Patients with a chronic stuffy nose, causing mouth breathing, also suffer with a dry throat. Pollutants and chemicals in the air can irritate the nose and throat, but the most common air pollutant is tobacco smoke.
A person who strains his or her voice (yelling at a sports event, for example) gets a sore throat. Sore throats may also be the result of irritation caused by secretions from the nose draining down the throat in association with a cold or allergy. An occasional cause of morning sore throat is regurgitation of stomach acids up into the back of the throat. Growths of the throat, tongue, and voice box are usually (but not always) associated with long-time use of tobacco and alcohol. Sore throat and difficulty swallowing—sometimes with pain radiating to the ear—may be symptoms of such a growth.

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Sore Throat

When should I see a doctor for my sore throat?
Whenever a sore throat is severe, persists longer than the usual five- to seven- day duration 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 that persists longer than seven days
• Difficulty breathing
• Pain with swallowing is to be expected with a sore throat but if you have difficulty swallowing or opening the mouth you should see a doctor
• Fever of 101º F lasting three or more days or fever greater than 103º F
• Sore throat with a rash
• Blood in saliva or phlegm
• Frequently recurring sore throat
• Enlarged tonsils with fever or one tonsil much larger than the other
• Headache with stiff neck, fever, confusion, vomiting and/or rash
• If you have been in contact with someone with bacterial sore throat and you have a sore throat.
• If your sore throat is not associated with cold symptoms or is associated with a swollen "glands" (lymph nodes), or white patches on the back of your throat.

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Smoke Please!

For all the smokers out there, here is some of the chemicals which you all cherish and inhale. This is worst than drinking water from the sewage!!!

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Effects of Tobacco

First two pictures are those of people who were chewing paan, now have cancer and difficulty in opening the mouth respectively. The picture on the bottom is a person who had been smoking for 30 years and now has cancer in his tongue, he lost his entire tongue in the process.

Tomorrow is the WHO "No Tobacco Day". There are lot of people who are not aware of the ill effects of tobacco, including smokeless tobacco like paan. Kindly take a look at these pictures and decide whether you want to continue using tobacco. Tobacco not only affects you, it also affects your near and dear ones. I have had children coming to me with ear complaints and all of them had one thing in common, their father was smoking at home!. The least you can do is to smoke in private away from your kids and away from a public place.

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Preparing Yourself for Cancer Treatment

Until your treatment actually starts, you won't know exactly what, if any, side effects you may have or how you'll feel. One way to prepare is to think of your treatment as a time for you to concentrate on yourself and on getting well. The most important thing is:
Think Positively
· Many people have few or no eating-related side effects. Even if you do, they may be mild, and most go away after cancer treatment ends. Also, there are new drugs now that can work well to control side effects.
· Having a positive attitude, talking out your feelings, becoming well-informed about your cancer and treatment, and planning ways to cope can all help reduce worry and anxiety, make you feel more in control, and help you keep your appetite.Give food a chance. Even if you do have eating problems, you'll have days when eating is a pleasure

Head Neck cancer

Head and neck cancer is the term given to a variety of malignant tumors that develop in the
oral cavity (mouth); pharynx (throat); paranasal sinuses (small hollow spaces around the nose lined with cells that secrete mucus); nasal cavity (airway just behind the nose);
larynx ("Adam's apple" or voice box); and salivary glands (parotid, submanidular, sublingual glands that secrete saliva).
Many authorities also include skin tumors of the face and neck and tumors of the cervical lymph nodes.
Excluding superficial skin cancers, but including cancer of the larynx and thyroid, it is conservatively estimated that about 60,000 people are diagnosed with head and neck cancer annually - about 5% of all cancers diagnosed in the United States. There are more than half a million survivors of oral, head, and neck cancer living in the United States today.