Dr. Akshay. B. K.
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
Hi doctor,
I have had a sore throat on one side for the past four weeks, with no improvement, and referred ear pain, painful glands, painful swallowing, and when muscles contract by the larynx. The pain comes and goes at times during the day, and it is more painful when the throat is dry. Glands are swollen but not huge. I had tonsilitis months ago, but the pain was not in the upper area. This pain began following an illness where my nose was blocked, and I could only breathe through my mouth. I am very worried. Can you please help?
Hello,
Welcome to icliniq.com.
I understand your concern. I will try and help you out. Please provide me with some information to help you better. As you say, you are having throat pain only on one side. Could you send me a pic of your throat with your tongue? It might be tonsillitis. Does it prick even when you swallow saliva? How many episodes of throat pain do you usually have in a year? And by the term glands, do you mean swollen lymph nodes? Do you have a fever?
Patient's Query
Hi doctor,
Thank you for the reply. It is not my tonsils because the pain is lower near my larynx. The glands are quite painful under my jaw and in the neck. I am really worried if it is cancer because it has been there for a long time. The pain in my glands aches a lot. The pain next to my larynx is when I swallow or flex my muscles. It is only on the right-hand side.
Hello,
Welcome to icliniq.com.
Yeah, I can see a swelling in the right submandibular area (attachment removed to protect the patient’s identity). It looks like an inflamed submandibular salivary gland. Please do not worry, as cancers will usually not be painful. The initial appearance looks like an inflamed submandibular gland. It would be best to visit your ENT (ear, nose, and throat) doctor. Get a USG (ultrasound) scan of the neck, and if submandibular salivary duct calculi (aka stone) is suspected, get a sialendoscopy or an X-ray. You can start with the following drugs to reduce the inflammation, but an ENT visit is mandatory. 1. Tablet Amoxicillin with Clavulanic acid 625 mg twice daily after food. 2. Tablet Aceclofenac with Serratiopeptidase twice daily after food. 3. Tablet Pantoprazole 40 mg once in the morning on an empty stomach.
Patient's Query
Hi doctor,
Thank you for the reply. Yes, I smoke. Does that change things? I am really worried. My mum had mouth cancer recently, which was painful, so I thought it might be cancer.
Hello,
Welcome to icliniq.com.
Do not worry, as cancers might cause pain only when associated with infection or if it involves a nerve. And the genetic association of mouth cancer in the offspring is very less. However, I would like you to start the treatment I have told and visit an ENT surgeon as early as possible. If that is not feasible, at least get an ultrasound scan of the neck, which would give further details. When she had cancer, I am sure your mom had many other symptoms associated with pain, so do not be afraid. And smoking does add a risk factor in the causation of cancers. However, all people who smoke do not get cancer. I know getting an ENT appointment could be very difficult. However, could you get an ultrasound scan of your neck if feasible?
Patient's Query
Hi doctor,
Thank you for the reply. When you say nerve pain, do you mean the cancer presses on a nerve? The pain is like a burning sensation when I contract my throat muscles (when I cough), and it seems to be less painful if I lie down. It hurts to speak certain pitches too. If it was cancer, what kind of cancer would it be? Unfortunately, I could get an appointment a few days later. The ear pain is bad, like a dull aching pain. Also, is the bony nodule on the front of my neck being asymmetrical a bad sign? Do cancers feel like boney masses? Thank you.
Hello,
Welcome to icliniq.com.
Cancer pressing on a nerve or infiltrating a nerve can cause pain. Usually, the pain will be much of a shooting kind. I am not thinking of cancer here. But if there is a lesion, it could be anywhere from your teeth, buccal mucosa, tongue, the floor of the mouth, oropharynx, or hypopharynx, which could have given the secondaries in the neck. And cancer nodes are hard to touch. And is the bony swelling you are telling about in the thyroid region or the center of your chin? Do not worry. Get an ultrasound done, and let us see. I hope things are positive.
Patient's Query
Hi doctor,
Thank you for the reply. The pain is in the region, too. It is painful if I clench the muscle like if you wretch when you throw up.
Hello,
Welcome to icliniq.com.
The thyroid cartilage that you mentioned as uneven is of no concern. It is normal. As I said, the pain of the gland radiates to your ear and neck also. So a complete ENT examination could answer all your queries.
Patient's Query
Hi doctor,
Thank you for the reply. So, could it be a thyroid problem? I do not know how my mental health will hold up until my appointment. I want to be convinced that it is something not bad. Is there any chance that a four-week one-sided throat pain is not to be worried about?
Hello,
Welcome to icliniq.com.
No, I do not think it could be a thyroid problem since you complain of swelling in the submandibular region. But I can understand the mental agony you are going through. So to give you some mental strength, I would say at first, stop looking for your symptoms online. It portrays as if you have all the problems in the world. And I am sorry to see that many patients do not get the earliest appointment with a specialist in a well-developed country like yours. Four-week duration of the pain could be for many reasons. But I do not want to worry you by telling you different differential diagnoses. Please start with the medications which I told you. Have your hopes high and be positive.
Patient's Query
Hi doctor,
Thank you for the reply, but the four weeks does not mean it is bad, right?
Hello,
Welcome to icliniq.com.
Please do not worry about the waiting time. In the meantime, we will also start the treatment, and let us wait until you get a thorough ENT examination. If you need any help, I will be happy to help you.
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Otolaryngology (E.N.T)
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