Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
For the last almost three weeks, I am having a pain in the lower right-hand side of the soft palate while swallowing saliva (or while swallowing on empty, without food. It does not happen all the time, but it is frequent. When I swallow food or liquid, there is no pain. I feel that the pain originates somewhere behind the skin of the soft palate, or within the soft palate itself.When touching that region with my finger, there is no pain. I do not see any redness in the back of my mouth, and generally, I do not see any irregularities. However, this is not a doctor, but me viewing. Also, I noticed that the arc of the right-hand side soft palate is a bit dropped compared to the one on the left-hand side. I do not know if this condition was present before (I never paid attention to that) or is something that I have for a while, or since birth. I am 51 and have regular yearly medical exams (complete blood work, biomarkers, abdomen, prostate, etc.). I do not take any medications. So far, I have been a healthy man. Any advice is welcome. Any suggestions on what to check, look, or do, too. I am asking for advice because I do not have at the moment medical insurance. I will be back at home in three months.
Hello,
Welcome to icliniq.com.
I have seen the pictures, and your oral cavity seems to be normal. Can you highlight the area where you have pain? Do you have acidity? Generally in any infection of the oral cavity or larynx pain is more while swallowing saliva than swallowing solid bland food or liquid. So if you have a mild infection, you will not have much pain or any pain while having food. Also, let me know if the pain is associated with the diurnal variation. Any complaints of the dry throat or dental infection? Did you get your sugar levels checked recently? If yes, do let me know the values. Do you consume alcohol, tobacco?
Patient's Query
Thank you doctor,
Attached is the image with the area highlighted where I think the pain originates. My bloodwork taken for two years is also attached. As the tongue pushes saliva back along the hard and soft palate, I feel the pain somewhere where the hyoid bone upward movement ends and sort of touches the inner side of the soft palate. It is difficult to discern where exactly the pain is. It feels as if the hyoid bone, going upwards, pushes against the soft palate, and that is where I think I have the pain sensation. No, I do not have diurnal variation, nor do I have acidity. I never smoked nor consumed any alcohol. It is the first time that I have this pain, and with the throat, I am concerned about having some tumor. Do I need to have some bloodwork done (biomarkers), as a precaution, or this is my pure exaggeration?
Hello,
Welcome back to icliniq.com.
I understand where you feel the pain (attachment removed to protect patient identity). I would like to know and clarify a few things. You are right that one side of the arch is slightly inferior to others. In most cases, this is normal. But what I would want to rule out is any form of nerve paralysis. Can you open your mouth in front of the mirror and say aa and see if both the arches get lifted? Even if they do not get raised equally, it is fine. See if movements are there on both sides. Is there any weakness anywhere else on the body? Your reports seem normal. Sugar is fine. It is good that you do not consume alcohol or smoke. Hyoid bone can't touch the soft palate as it is quite inferior. During swallowing the back of tongue pushed the food against the oropharynx. You do not have to get any biomarkers right now. Eventually, you may get a laryngoscopy done at an ENT clinic whenever you decide to go. There is no hurry or urgency now. Most likely, the problem is that of silent acidity. Where there is reflux in the night, silently rising and causing inflammatory changes in the larynx, which causes the weird feeling you have. You should try taking some proton pump inhibitors of appropriate dose and timings. You need to follow some dietary and lifestyle changes. If you require elaboration, please get back. Tell us more about your nutritional habits, whether you consume milk and milk products, red meat, spicy and oily food, etc. Ate slightly overweight for your height? Do you sleep well in the night? Is there any snoring?
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Otolaryngology (E.N.T)
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