Ferguson, Catherine Mary

Definitions

Otolaryngology deals with diagnosis and treatment of diseases and disorders of the ear, nose, throat (ENT) and related structures of the head and neck, including the sinuses, larynx (voice box), oral cavity, and upper pharynx (mouth and throat). Otolaryngology is commonly called ENT.moreSnoring is common in adults and can be a social problem. Those who share a bed with someone who snores can develop sleep difficulties. Snoring can sometimes be a sign of a sleep disorder calledobstructive sleep apnoea (OSA). Apnoea involves periods when you partly or completely stop breathing for more than 10 seconds while asleep. The episode is followed by a sudden gasp or snort when breathing resumes. Then, snoring starts again. With OSA, the pauses in breathing occur because the airway has become narrowed, blocked or floppy. As well as OSA, some causes for snoring may include: being overweight; pregnancy; nasal congestion; swelling of the roof of the mouth (soft palate) or uvula (the tissue that hangs down in the back of the mouth); swollen adenoids and tonsils that block the airways; use of sleeping pills, antihistamines or alcohol before bedtime; large tongue size compared to the mouth; and abnormalities in the bones of the face. Factors that increase the risk of OSA include: certain shapes of the palate or airway that make it narrower or collapse more easily; large tonsils and adenoids in children that can block the airway; large neck size; and large tongue. Sleeping on the back also increases sleep apnoea episodes. Many people with OSA wake up unrefreshed in the morning and feel sleepy throughout the day. OSA may lead to leg swelling; depression; and hyperactive behaviour, especially in children. Tests will include an examination of mouth, neck and throat. You may be given a survey on daytime sleepiness, sleep quality and bedtime habits. A sleep study (polysomnogram) is often used to confirm OSA. Treatment aims to keep the airway open so that breathing does not stop during sleep. Lifestyle changes to relieve symptoms, including snoring, may involve: avoiding alcohol or sedatives at bedtime; not sleeping on the back; and losing weight. Continuous positive airway pressure (CPAP) is a common treatment. CPAP is delivered by a machine with a tight-fitting face mask. It aims to decrease snoring and prevent sleep apnoea. Other treatment options may include: dental appliances to prevent the tongue from falling back; and surgery to the palate, nose, sinuses and airways.moreThe thyroid gland is located in the lower part of the neck, below the Adam’s apple, wrapped around the trachea (windpipe). It produces hormones which help regulate the heart rate, blood pressure,body temperature and metabolism (the rate at which food is converted into energy). Thyroid disorders can include an overactive gland, called hyperthyroidism, or an underactive gland, called hypothyroidism. Both can result in an enlarged thyroid gland. Sometimes surgery is required to remove the thyroid gland. A thyroid nodule is a small swelling or lump in the thyroid gland. They are usually examined with imaging such as ultrasound or MRI, and a fine-needle aspiration biopsy, a relatively painless procedure to take tissue fluid samples from the nodule. Thyroid surgery may be required when: the biopsy indicates the nodule is cancerous; the nodules are getting bigger; or the trachea or oesophagus is compressed because the thyroid is very large. Thyroid surgery involves removing part or all of the thyroid gland, under general anaesthesia. Usually, the lobe of the thyroid gland containing the nodule lump is removed. An analysis of tissue will determine if the rest of the thyroid gland should be removed, during the same surgery. (Alternatively, surgery may be done at a later date.)more