HomeAnswersOtolaryngology (E.N.T)numbnessI have numbness at the base of my tongue and a globus sensation in the throat. Why?

What could be the reason for numbness of the tongue base and a globus sensation in the throat?

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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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Published At April 16, 2023
Reviewed AtNovember 30, 2023

Patient's Query

Hello doctor,

I have the following symptoms, numbness at the right side of the base of the tongue at the back, and a globus sensation at the right side back of the throat. Sometimes I get a sharp stabbing pain that comes and goes. Pain radiating to my right ear and surrounding the ear. This sensation has been present for one year. It used to come and go but is not persistent. I also have a tight sternocleidomastoid muscle and tightness around what I believe is the pterygoid muscle. I did receive botox in the jaw (masseter muscle and temporalis). Botox alleviated some discomfort for a short time but not all. I get pain while drinking coffee and alcohol. I visited an ENT and he did a scope and blood work. The only thing he said about the scope is that my epiglottis has a flatter shape rather than a cupping shape. I had mucus on my vocal cords and a deviated septum on the right side of my nose. He prescribed me 40 mg of Omeprazole magnesium. I have been on this medication for a few months and the symptoms have not resolved. I do believe I get acid reflux as I have painful burps after eating and a burning sensation (the pain seems to only affect my right side). My left tonsil is very large for the last 10 months. I also have a slightly deviated uvula. My right side lymph nodes are noticeably large and feel achy. I had a lymph node biopsy and it showed high lymphocytes (however, I was getting over a cold at the time of this biopsy). When I touch the back of my throat there is mucus and the mucus smells foul (sour). I also notice a white spot near the soft palate in front of the tonsil on the right side. This has been going on for quite some time. I got braces a year back. I felt like I was getting a sore throat after some time. Last year I received trigger point injections in my upper back and neck. One of the injections in my neck, close to the spine, triggered a sharp pain in my throat and temple. I had issues with swallowing and felt numbness at the base of the tongue. I went into a panic attack and the globus sensation in my throat has been present ever since. I had double jaw surgery in three weeks. I met with an accident when I was 5 years old which broke my jaw and knocked out my teeth. Surgery was unrelated to any pain but to correct sleep apnea and to get the jaw to a normal location, build up bone and eventually get teeth implants. The picture showing my skull is a mock-up of pre-surgery (titanium not in yet). However, the styloid process on my right side seems longer and pointy. I have read about Eagles syndrome which concerns me as my symptoms match it. Not to mention the facial trauma I have (missing teeth, molar cavities, and I have had a root canal). Kindly help. Thank you.

Hello,

Welcome to icliniq.com.

I have read the complaint carefully and watched all the files and pictures (attachments removed to protect the patient's identity). Throat and tongue numbness is mainly a neurological complaint that needs a neurologist, not an ENT doctor. There are two main causes of right-side throat pain. The first cause is the elongated right stylomastoid which needs a surgical shortening, the second cause is reflux. You have tried the first line of reflux treatment, which is Omeprazole, and it has failed, so you need to visit a gastroenterology surgeon. The painful enlarged lymph nodes are inflammatory in nature according to the biopsy. The offensive throat mucus reflects a severe sinus infection, which needs an antibiotic course of treatment. You can use Moxifloxacin 400 mg once daily for 10 days, after consulting your specialist doctor. The antibiotic will act on the inflamed lymph nodes, too. I think that the neck injection has a role in tongue numbness, but it is still a matter of neurology, not ENT. I hope this helps. Thank you.

Patient's Query

Hello doctor,

I have been on two rounds of antibiotics, and they were not effective. As far as the styloid process is concerned, the need for surgery cannot be determined until a CT (computed tomography) scan has been completed. It is also apparently extremely rare but possible. Thank you.

Hello,

Welcome back to icliniq.com.

The CT scan not only helps to detect the styloid process issue but also to detect any hidden sinus problems that can interfere with the effect of the antibiotic treatment. Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Mohammed Osama Aboborda
Dr. Mohammed Osama Aboborda

Otolaryngology (E.N.T)

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