You might see an ear, nose, and throat (ENT) doctor for recurring sinus infections. Someone else might see one for a thyroid tumor, a voice that won’t return after a cold, or trouble breathing during sleep. They’re all within an ENT’s purview.
These doctors, formally called otolaryngologists, treat conditions involving the ears, nose, throat, and much of the head and neck. That includes problems affecting your hearing, swallowing, breathing, and voice—and some that require urgent care. “A lot of people will think, ‘Oh yeah, there’s no emergencies at ENT,’ and there absolutely are,” says Dr. Ryan Salvador, an ENT surgeon at Sinus & Snoring Specialists in Austin.
We asked three otolaryngologists what they wish patients wouldn’t ignore.
Sudden hearing loss in one ear
You answer your phone and realize you can barely hear your friend’s voice out of your left ear. Switch to your right side, and everything sounds normal. It’s tempting to assume the muffled ear needs to pop, Salvador says. But an abrupt change in hearing can be a medical emergency.
One possibility is sudden sensorineural hearing loss, which affects the inner ear. Salvador knows how easily it can be mistaken for something else: His father went to urgent care and was told he had fluid behind his eardrum. By the time he saw an ENT, about eight weeks had passed. “He’s completely deaf in that ear now,” Salvador says.
An ENT can examine the ear and arrange a hearing test to find out what’s causing the loss. If it is sudden sensorineural hearing loss, steroids may help—but, as Salvador puts it, “the earlier the better.” Seek medical care immediately if you suddenly lose hearing, even if your ear just feels full or you’ve recently had a cold.
A neck lump that doesn’t hurt
You might discover it while shaving, when your razor passes over a spot that suddenly isn’t smooth. Or perhaps you notice an unfamiliar bump in the mirror. Because it doesn’t hurt, you decide it can’t be that serious.
Dr. Arnbjorn Toset, the director of head and neck surgery at Good Samaritan University Hospital and Catholic Health in New York, hears that reasoning from patients: “Doctor, it’s not hurting me. I don’t have any symptoms.” But pain isn’t a reliable way to judge a neck lump. It might be an enlarged lymph node, a thyroid nodule, or a growth in a salivary gland. But some lumps are cancerous.
Dr. Shaun Desai, chair of otolaryngology at New York Medical College and Westchester Medical Center in New York, recalls a medical student who assumed his lump was related to a cold. “For eight months he sat on this lump in his neck,” Desai says. It turned out to be a salivary gland tumor. If a new lump has no clear explanation or is still there after two weeks, make an appointment.
A sore throat that keeps getting worse
A sore throat is hardly unusual. One that progresses from “this hurts” to “I can barely swallow” is another matter. Salvador pays particular attention when the pain keeps worsening and you’re also having trouble opening your mouth or your voice sounds muffled. “You talk like you’ve got a hot potato in your mouth,” he says.
Those changes can signal an abscess—a pocket of pus that forms around a tonsil. “These can be life threatening,” Salvador says. If swelling makes it difficult to breathe, seek emergency care. Worsening throat pain with trouble swallowing, opening your mouth, or speaking normally also warrants prompt evaluation.
Your partner says you stop breathing at night
Your partner hears you snoring. Then, suddenly, nothing. After a pause, you gasp and start breathing again. By morning, you may have no idea it happened.
The snoring may be what your partner complains about. Desai wants to know about the silence. “The bigger worry is, does your partner kind of stop breathing for a couple of seconds?” he says. Repeated pauses can be a sign of obstructive sleep apnea, in which the airway narrows or closes during sleep. You might wake up exhausted despite spending the whole night in bed. Untreated sleep apnea can also contribute to high blood pressure; Desai worries about people who become so sleepy during the day that they struggle to stay awake while driving.
Tell your doctor about the pauses, gasping, and any daytime sleepiness. A sleep study can show whether apnea is the cause. As Desai puts it, “Apnea is the bigger question, and that can be dangerous if not treated.”
Swelling around an eye during a sinus infection
Sinus pressure can make the area around your eyes ache. What Salvador doesn’t want you to chalk up to ordinary sinus misery is new swelling around an eye—especially if the area is red or your vision changes.
“The only thing that separates the sinus cavity from the eye is a very thin plate of bone,” he says. Rarely, an infection spreads into the tissues around the eye. Salvador has treated patients whose infections formed pockets of pus that had to be drained to protect their vision.
Get urgent medical attention for a newly swollen eye during a sinus infection. If you develop double vision or have trouble moving the eye, seek emergency care. Don’t wait for those symptoms to appear: Double vision is “a pretty late sign,” Salvador says.
Swelling under your jaw when you eat
Halfway through a meal, you notice a tender bump beneath your jaw. It settles down later—then returns the next time you eat.
Toset says that pattern can point to a blocked salivary gland. Eating triggers saliva production, but a stone can keep the saliva from draining, causing the gland to swell. It may also become painful or red.
If it keeps happening, have it examined. Toset says the cause is often benign, but an exam and sometimes imaging can distinguish a stone from another problem with the gland. If the swelling keeps returning, have the gland checked—even if it goes down between meals
A voice that won’t come back
You talked all weekend. You recently had a cold. Of course your voice sounds rough—or maybe it’s become oddly breathy, and you can’t project the way you used to. These are reasonable explanations for a temporary change, Desai says. They become less reassuring when your voice doesn’t recover.
Salvador remembers a teacher who was struggling to speak loudly enough for her class. “I can’t project,” she told him. When he examined her, he discovered that one of her vocal cords wasn’t moving properly because of a thyroid tumor. Persistent hoarseness can have other explanations, including irritation or a benign growth, but an ENT needs to look to find out.
If hoarseness lasts four weeks, see an ENT—sooner if you smoke or have other concerning symptoms. The doctor may pass a small camera through your nose to look at your vocal cords. If that sounds daunting, Desai says the office exam “just takes a minute or two.”
Dentures that suddenly don’t fit comfortably
Your dentures fit fine last month. Now they rub the same spot every time you put them in, or they don’t sit quite right. You might need an adjustment—or someone to look at what’s going on underneath.
Toset says new discomfort may draw your attention to “a little ulcer on the gum line.” Rubbing can cause a sore, but a growth in the mouth can also change how dentures fit. That’s one possible sign of oral cancer, though there are other explanations.
Ask your dentist to examine the tissue beneath the denture, especially if a sore hasn’t healed after two weeks. They can check what’s changed before adjusting the fit.
A nosebleed that won’t stop
Most nosebleeds start near the front of the nose and stop with pressure. A bleed that starts farther back can be harder to control. The blood vessels there can “pump and pump and pump,” Salvador says, and blood may run down the back of your throat. Doctors call this a posterior nosebleed.
If your nose starts bleeding, lean forward and pinch its soft part with steady pressure for 15 minutes. If the bleeding is heavy or won’t stop, or you feel weak or lightheaded, seek emergency care.
A nosebleed that does stop can still be worth investigating if it keeps coming back. Salvador remembers a man in his 30s who had consistent nosebleeds for about six months before an examination revealed a tumor inside his nose. That’s an uncommon cause, but a good reason to tell your doctor about repeated bleeding—especially if it keeps happening on the same side.
Ear pain when nothing seems wrong
Your ear hurts, so you probably have an ear infection, right? Not necessarily. Sometimes an examination turns up nothing wrong with the ear itself. Nerves in the head and neck carry a signal from somewhere else, and sometimes, “your brain is tricking you” about where it started, Toset says.
The source might be your jaw joint, which sits just in front of your ear. Less commonly, it could be a problem in your throat or at the base of your tongue. If the pain persists despite a normal ear exam, ask your doctor what else should be checked—especially if it hurts to swallow or you’ve noticed a lump in your neck.
One nostril that stays blocked
Colds and allergies can make your whole nose miserable. A blockage that sticks around on just one side gets Desai’s attention. “When you can’t breathe out of one nostril, it’s always a little more concerning,” he says.
The explanation might be a deviated septum, but a growth inside the nose or sinuses can also block one side. Desai worries about the delay when people tell themselves, “Oh, it’s a cold,” or “I just have a bloody nose.” If the blockage outlasts what seems like an ordinary cold—especially if that side also bleeds repeatedly—have it examined.
A sore on your tongue that won’t heal
Most small mouth sores clear up within a week or two. Toset is more concerned about one that stays put, grows, or becomes increasingly painful—particularly on the side of the tongue.
He remembers seeing a young woman in the emergency room on a Friday night. She had developed swelling in her neck, and the doctors who called Toset thought it might be an abscess. During his examination, he noticed a sore on the side of her tongue. She’d seen dentists and other specialists, and earlier biopsies had come back benign, but the sore had persisted for about six months.
“I had a biopsy. Biopsy was negative, so I left it alone,” Toset recalls her telling him. He examined the sore and grew concerned. “I had to break it to her,” he says: “I think you have tongue cancer.” Another biopsy confirmed it; the swelling in her neck was where the cancer had spread.
A reassuring biopsy shouldn’t be the end of the conversation if the sore is still there. Any mouth sore that hasn’t healed after two weeks should be evaluated, according to the American Academy of Otolaryngology–Head and Neck Surgery.
“I’d rather see someone early on in the process where I can pick up on something that is possibly benign or an early type of cancer,” Toset says, than see them after a delay that makes treatment more difficult.
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