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Swallowing Difficulty (Dysphagia): Causes, Warning Signs and When to See an ENT Specialist

  Swallowing Difficulty (Dysphagia): What Causes It and When Should You Be Concerned? Most people swallow hundreds of times every day without noticing. When swallowing becomes uncomfortable, difficult or feels abnormal, it can quickly affect eating, drinking and quality of life. Some patients describe food “sticking” in the throat, while others notice coughing during meals, discomfort swallowing tablets or a persistent sensation of tightness in the throat. The medical term for swallowing difficulty is dysphagia . Swallowing problems can range from mild irritation to more significant conditions requiring specialist investigation. This article explains common causes of dysphagia, symptoms to look out for and when to seek ENT assessment. What is dysphagia? Dysphagia means difficulty swallowing. It may involve problems with: Swallowing solids Swallowing liquids Initiating a swallow Sensation of food sticking Pain during swallowing Coughing or choking while eating Symptoms ...

Is your nasal septum giving you trouble?






Can a deviated septum cause sinus infections?

Sinuses are air-filled, generally empty, spaces around the nasal cavity. These sinuses drain into the nasal cavity through small doors. Our nasal cavity is divided into right and left by the nasal septum. If you have deviated nasal septum, then it can block the drainage pathway of the nasal sinuses. High deviations can block the airway and hence recurrent sinusitis. Septoplasty can correct this deviation and help opening up drainage pathways along with balloon sinuplasty or endoscopic sinus surgery. 




Can deviated nasal septum cause high blood pressure or a heart problem?

Deviated nasal septum in anterior part can obstruct the airflow and can cause sleep apnoea symptoms. Some recent studies show a correlation between better control of high blood pressure with medication after septoplasty. 


Can deviated nasal septum cause sleep apnea?

Sleep apnea can be due to obstruction at different levels of your airway. Obstruction can be at the level of the nose due to a deviated septum, enlarged turbinates or at throat level due to enlarged tonsils, tongue or tongue falling back. These can be associated with loud snoring. There is strong evidence that septoplasty with/without nasal valve surgery can help your sleep apnea symptoms. If you are using CPAP due to sleep apnea then deviated septum can cause resistance and lead to high pressure and nose bleeds. A visit to ENT surgeon and assessment with endoscopy can help with diagnosis and decision if you are a suitable candidate for septoplasty or functional rhinoplasty with nasal valve surgery.



Can deviated nasal septum cause migraines or headaches?

The deviated nasal septum is very common finding presenting to ENT clinic with headache and migraine. Septoplasty can help with symptoms of nasal obstruction but unlikely to help with headaches. A visit to ENT surgeon can help with the diagnosis with history, endoscopic and sinus scan. A logical examination of patients with facial pain, headache and migraine can assist with appropriate management and avoid unnecessary use of antibiotics. 


Can deviated nasal septum cause nose bleeds or epistaxis?

A primary function of the nose is to filter and hydrate the air which reaches our lungs. The deviated nasal septum can cause the change in laminar airflow in the nose. This can dry nasal mucosa. Correction of nasal septum by septoplasty can help improve this symptom. 



How is septoplasty surgery done?

The septum is made of cartilage in the front and bone at the back. These are covered by the lining of the nose called nasal mucosa. A small cut is made inside the nose and the mucosa is lifted of septal cartilage and bone. Deviated part of the septum is addressed and nasal mucosa stitched back with dissolvable stitches. The procedure is done under general anaesthetic and takes around 60 minutes. Most of the cases are done as day case ie you will be able to go home the same day once you have fully recovered from your anaesthesia. In some cases, if you need sinus surgery this can be done at the same time. You will need two weeks time off after nose surgery. This is mainly to avoid catching an infection. If you can work from home you should be able to do so after 72hours.

What are post-operative complications of septoplasty surgery?

· Bleeding Nasal packs may be put into the nose at the end of the operation, these will stay in until the doctor advises removal. On removal of the packs it is usual for some bleeding to occur; this usually stops quickly. If the bleeding becomes severe a further pack may need to be put in.

· Infection This usually occurs as a discoloured discharge from the nostrils several days after the operation and you will need to see your doctor regarding this. You may also experience dry crusting mucous leading to discomfort, saline nasal douching should resolve this.

· Intranasal adhesions This can happen if the raw areas within your nose stick together or following an infection. These can be divided at a later date under a short general anaesthetic.

· Shape change Rarely the shape of the nose can become “saddled”. This is due to the collapse of cartilage in the centre of the nose if this should occur further surgery might be needed.

· Septal perforation There is a 1-2% risk of this happening. This is a hole in the middle partition of the nose, which will be permanent.

· Bruising/swelling You may develop bruising and swelling around the eyes/nose, this will resolve but may take a few weeks. You are advised to sleep propped up for a few nights to prevent pooling of blood/fluid and encourage natural drainage. Application of ice packs will reduce this.

· Nasal tip/teeth numbness This should resolve but may take some time.


What is post-procedure advice after septoplasty?
• Your doctor will advise you on a specific period of recovery but in general rest for one to two weeks. If you need a sick certificate, please ask the medical staff before you leave.
 • The nose will feel blocked due to post-operative swelling and can take a few weeks to settle down. If prescribed, apply any nasal drops/spray to decongest the nose and follow the recommended method of installation. You will be given antibiotic ointment to apply on the scar.
 • You may have a blood-stained watery discharge from the nose. This is normal and should settle after a few days.
• Scabbing within the nose may occur as it heals. Do not pick this off as the area will bleed. You may have been advised to douche (rinse) the nose and the nursing staff will advise you on the correct technique.
• For the first few days, avoid very hot drinks, meals, baths or showers. For one week, avoid blowing your nose and sneeze with your mouth wide open. These all help to reduce any risk of bleeding.
• Avoid or cut down on smoking as smoking affects the body’s ability to heal and irritates the inside of the nose. Staff can advise you on quitting, provide you aids to help you quit (e.g., nicotine patches) and contacts for support groups.
• Avoid crowded or dusty places and people with coughs and colds, as infection can be picked up in the nose.
• If nasal splints are in place, do not touch and attend the arranged-out patient's appointment for their removal. You may also have a splint inside your nose to help keep the partition straight, this stays in for one week or two and you will be informed if it is there.
• Avoid contact sports for eight weeks due to the risk of trauma and bleeding.
• If fresh, steady bleeding occurs, pinch the fleshy part of the nose, lean forward and apply ice to the forehead and bridge of the nose. A frozen bag of vegetables is a good alternative if you don’t have ice in the freezer. Avoid swallowing any blood as it can make you feel sick. If the bleeding does not stop after 30 minutes, ring the ward for advice.






Mr Gaurav Kumar
Consultant ENT Surgeon

To Book Appointment

Book Online

email info@entsurgeonclinic.co.uk
call 07494914140

website https://entsurgeonclinic.co.uk/



Disclaimer: For general information only, always seek medical advice from your treating consultant. 




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