Throat Issues

This common condition can cause signficant concern for patients with a feeling of something being stuck in the throat. Assessment is recommended including at least a nasoendoscopy to ensure that the upper aeordigestive tract is normal.

change in voice can occur for a variety of reasons including voice strain, issues with the vocal cords, problems with movement of the vocal cords and even tumours of the larynx.

Careful clinical assessment is required including a nasoendsocpy to accurately diagnose the underlying cause and plan treatment.

Once a diagnosis is established then further treatment can be discussed. This may comprise speech therapy, treatment for underlying sinus disease or acid reflux and in some cases surgery to remove a laryngeal polyp or biopsy a lesion.

Neck lumps can appear for a variety of reasons including enlargement or nodularity of the thryoid gland, salivary glands and lymph nodes. A new neck lump or change in an existing thryoid mass should be reviewed and assessed. It is important to do this promptly so that if there is a serious underlying cause it is recognised and treatment can be instigated.

Mr Howe is highly experienced in the management and treatment of neck lumps including complex surgical treatments.

Assessment requires clinical examination as well as use of imaging techniques including ultrasound, CT, MRI and PET scans.

Sinusitis is a common condition related to inflammation of the lining of the paranasal sinuses.

This can be a chronic condition if the symptoms persist for more than 12 weeks. Patients experience symptoms of nasal congestion, poor sense of smell and nasal discharge. Some patients may experience facial pain.

The treatment for sinusitis is often medical treatment in the first instance often with a combination of antibiotics and nasal drops. However, a significant number of patients don’t get resolution without further treatment.

Diagnosis of sinusitis requires assessment with a nasoendoscope to examine the inner nose to look for signs of sinus disease such as nasal polyps or pus arising from the sinuses. CT scans are often used to assist assessment as well as to determine if there is an underlying cause such as chronic dental infection.

In patients where symptoms don’t respond to medical treatment there is the option of endoscopic sinus surgery. This surgery is undertaken predominantly under general anaesthesia and allows removal of nasal polyps as well as opening of the sinuses to improve the drainage.

This surgery is undertaken using tiny instruments being placed in the nostrils and does not requiring any external incisions.

This surgery is safe and comes with a risk of post operation bleeding and the need for nasal packing. Nasal polyps can often recur after surgery. Serious complications arising from endoscopic sinus surgery are rare but can include injury to the eye causing double vision or affecting the eyesight. The skull base is immediately adjacent to the sinuses and there a small risk of causing a leaking of CSF (fluid from around the brain) into the nose which can be repaired if required.

Mr Howe is happy to see patients with more general ENT conditions such as tonsillitis, nasal blockage, allergic rhinitis, nose bleeds and ear issues.

There are large salivary glands in the neck such as the parotid and submandibular glands as well as numerous tiny, minor salivary glands that cover the lining of the mouth and throat.

Tumours can arise in the salivary glands and present as a palpable mass in many cases. Occasionally these growths can be picked up incidentally when undergoing a scan for an unrelated condition.

Assessment of salivary lumps requires a combination of clinical assessment as well as scans and often fine needle biopsies. The risk of malignancy varies significantly depending on which salivary gland is affected.

Treatment may include surgery to delicately remove the tumour from the salivary gland whilst striving to protect vital structures such as nerves adjacent to the tumour.

The salivary gland most commonly affected by tumours is the parotid gland, surgery to remove tumours from this gland is called a parotidectomy. This surgery is a very delicate operation that aims to carefully remove the tumour from the salivary gland whilst peeling the branches of the facial nerve away from the tumour.

Inflammation of the salivary glands can arise due to stones blocking the ducts that allow saliva to flow from the salivary gland into the mouth. This obstruction can result in swelling of the salivary gland and discomfort particularly after eating. Depending on the specific cases management may include encourage saliva production, massage, remove of the stone, keyhole surgery to remove the stone or even surgery to remove the affected salivary gland.

For insured patients Mr Howe charges within the agreed insurer’s fee schedule.

For self funding patients Mr Howe’s fees are

Please note that the private hospital will levy an additional fee for procedures which should be confirmed at the
time of the appointment and may be subject to change.