Common Problems

Many people are currently suffering from common medical problems, such as allergies, sleep apnea, hearing loss, trouble swallowing and chronic dizziness. You can learn more about the symptoms associated with a problem that may be affecting you. Here are some common problems that our office can assist you with:


Allergies

An estimated 40 million Americans have allergies. Allergies are most common among children, but can develop at any age. An allergic reaction is the immune’s system’s response to an abnormal substance in the body. While allergies are genetic conditions, the underlying cause of an allergy is unknown.

There are a variety of substances that may cause an allergic reaction. Some of the most common allergens include pollen, dust, mold, animal dander and hair, feathers, medications, food and insect stings. Each of these allergens causes different reactions. While some allergens such as pollen and dust may cause hay fever or asthma, skin allergies occur when a person comes in contact with a specific allergen like plants or dyes.

Dr. Gilliam may use Skin Testing as a way to identify what you are allergic to. From these tests, we will be able to create a personalized treatment plan to meet your specific needs. Treatments vary depending on the type of allergy, but range from over-the-counter or prescribed medications to Immunotherapy, which uses a series of allergy serum injections to treat the patient.

Snoring

According to the American Academy of Otolaryngology, approximately 45% of adults snore occasionally. Within that group, 25% are habitual snorers, which generally qualify them for having a sleep disorder.

Snoring is caused by the obstruction of air flow through the nose, which may be a result of a deviated septum, polyps, unnecessary tissue in the back of the mouth (tonsils) and nose or even having a long palate or uvula.

It is important to seek medical advice to see if your snoring indicates another health concern, such as sleep apnea. Untreated habitual snoring may cause a lifetime of health problems such as high blood pressure and stroke.

Following a complete medical history and physical exam, Dr. Gilliam will be able to determine the best course of treatment for you. For some, simple lifestyle changes can help stop snoring, such as losing weight, avoiding alcohol consumption close to bedtime and sleeping on your side. While for others, oral appliances, CPAP (continuous positive airway pressure) devices or surgery may be necessary to prevent snoring.

Sleep Apnea

Sleep apnea is when a person’s breathing pauses – from a few seconds to minutes, which can be life threatening – one or more times while sleeping. Breathing pauses may occur five to 30 or more times within an hour. This common chronic sleep disorder can disrupt a person’s sleep three or more nights a week, resulting in poor sleep quality that makes you feel tired the following day.

Sleep apnea occurs in both males and females of any age, including children. It is one of the most undiagnosed conditions. Most people only realize they possibly have sleep apnea if a family member and/or bed partner notices symptoms.

There are three types of sleep apnea: obstructive sleep apnea, central sleep apnea and mixed sleep apnea. Obstructive sleep apnea is the most common form and occurs when the muscles in the throat relax causing the airway to be blocked; central sleep apnea happens when the muscles that control breathing fail to receive the proper signals from the brain; and complex sleep apnea is a combination of both obstructive and central sleep apnea.

You should consult your ENT specialist if you experience one or more of the following symptoms:

  • Extreme fatigue during the day
  • Loud snoring
  • Abrupt awakenings along with shortness of breath
  • Episodes of breathing pauses

Similar to treating snoring, sleep apnea treatments vary depending on the type and severity of the case. For milder cases, mere lifestyle changes such as stopping smoking or losing weight may be beneficial in improving the signs and symptoms of sleep apnea. More severe cases can be treated in a variety of ways from the use of certain devices such as continuous positive airway pressure (CPAP) devices, to surgery.

Hearing Loss

It is estimated that approximately one-third of Americans between 65 and 75 experience some level of hearing loss. It is common to gradually lose your hearing as you age. This is referred to as presbycusis. The most common factors that contribute to hearing loss are genetics and exposure to constant loud noises. Other factors, such as earwax buildup, may prevent your ears from functioning as well as they should.

If you are experiencing one or more of the following symptoms, you should see your doctor to confirm whether or not you have hearing loss.

  • The quality of speech/sounds is muffled.
  • Often asking others to repeat themselves and speak slower and louder.
  • Difficulty understanding words, especially when in a crowd or a noisy environment.
  • The tendency to withdraw from conversations.
  • Constant need to increase the volume on the television.
  • Often avoid certain social settings.

While there is no “cure” for hearing loss, there are steps a person can take to improve their hearing. Hearing aids can boost your self-confidence, enhance your relationships with others and improve your overall outlook on life.

Trouble Swallowing

Relentless difficulty in swallowing is also referred to as dysphagia. This serious medical condition requires a person to take more time and effort to swallow liquid or food. Dysphagia occurs most often in older adults, premature infants and persons with certain neurological or nervous system disorders.

It is important to seek medical care if you are experiencing symptoms of dysphagia.

Some symptoms include:

  • The inability to swallow
  • Experiencing pain while swallowing
  • Persistent choking or coughing while eating
  • Constant heartburn
  • Regurgitation
  • Unexplained weight loss

Infants and children who have difficulty swallowing may experience many symptoms, including recurrent pneumonia, and lengthy feeding or eating times. In addition, they may spit up or vomit during meals. Any child experiencing these symptoms should also be seen by an ENT specialist.

There are different kinds and causes of dysphagia, therefore treatments vary. Treatments range from practicing specific exercises to improve muscle coordination or taking medications. Persons with severe dysphagia may be placed on a special liquid diet or need a feeding tube.

Dr. Gilliam will be able to determine the exact cause of your dysphagia and create a personalized treatment plan to alleviate your symptoms.

Dizziness

The term “dizziness” is often used to describe the feeling of being lightheaded or vertigo. Along with back pains and headaches, dizziness is one of the most common reasons adults visit the doctor.

Balance relies on up to three sensory systems (eyes, ears and sensory nerves) functioning well together at the same time. If one or more of these systems are failing to function properly, the body’s central nervous system has difficult processing the signals, and therefore causes dizziness. Depending on the type of dizziness a person experiences will determine the exact cause of their symptoms.

You should see your doctor if you experience persistent, unexplained or relentless dizziness. Some common signs and symptoms include:

  • Loss of balance
  • Faintness
  • Weakness/Fatigue
  • Vertigo (the feeling your surroundings are spinning)
  • Nausea
  • Blurred vision while moving your head quickly
  • Trouble focusing

Obtaining an exact diagnosis for dizziness can sometimes be complicated. After receiving a complete medical history and conducting a thorough physical examination, your doctor may perform a number of tests, such as a hearing test, to make an accurate diagnosis. Depending on the specific diagnosis, treatments may include medications, dietary changes, vestibular rehabilitation and/or surgery.

Hoarseness

Hoarseness problems range from annoying to life-threatening. Often times, people are concerned that their hoarseness is related to cancer. In my experience, many hoarseness problems are related to benign causes and can be successfully treated with medications. However, you need to be evaluated by an ENT to assure no cancerous lesions are present. Even non-smokers can get upper airway cancer. If you do smoke, you have higher risk of having cancer and need to be evaluated. Head and neck cancer has a high cure rate and if caught early the chance of cure can be up to 95%.

The vocal cords can be visualized in the clinic with a fiber-optic laryngoscopy. This is a painless, in-office procedure that is performed by spraying a topical anesthetic in the nose and placing a fiber optic laryngoscope through the nose then down to the level of the voice box. Even patients with strong gag reflexes can tolerate the procedure with minimal discomfort. This office procedure offers superb visualization of the vocal cords in order to diagnose your situation and offer treatment options.

Medical Treatment

The majority of hoarseness problems are related to laryngopharyngeal reflux. This refers to stomach acid that rolls upwards into the voice box, typically during sleep. The important thing to note is that 40% of patients who are having laryngopharyngeal reflux do not have symptoms of heartburn, indigestion, burping, belching, etc.

Laryngopharyngeal reflux is easily treated in most patients with medication such as Zegerid, Aciphex, Nexium, Pepcid, etc. However, in many patients twice a day dosing is required to get control of the symptoms. Several items in our diet can cause worsening of reflux; however, four of the top items are caffeine, alcohol, peppermint, and chocolate. Also, eating late prior to going to bed is a problem for a lot of people.

Though reflux is a main stay in medical therapy, patients also need to be evaluated for vocal cord polyps, vocal cord nodules, reinke's edema, etc. These are all medical conditions that can cause hoarseness. Many can be treated with a combination of speech therapy, reflux treatment, smoking cessation, or decrease in vocal abuse.

Additionally, with age our voice weakens and we can get bowing of our vocal cords causing air to escape. Due to not being able to close the cords well the voice is hoarser and we have to compensate for the abnormality causing even more problems with hoarseness. This can be evaluated with laryngoscopy and can be improved with an injection of material into the vocal cord to help let the cords touch in the midline.

Surgical Treatment

Years ago, it was very common to do vocal cord biopsies and to remove nodules for hoarseness. With the discovery of the significant effect that laryngopharyngeal reflux has on the voice box, medical treatment with medications has significantly reduced the number of operations on the voice box for hoarseness. Biopsy of lesions may need to be done to rule out cancer. Also, for vocal cord polyps occasionally surgery needs to be performed to remove the lesion. There are other lesions that can grow on the vocal cords called papillomatosis, this disease usually recurs and requires medical and surgical therapy.

A full evaluation, to rule out cancer along with evaluating all causes of hoarseness, is needed for anyone with persistent hoarseness lasting over 3 weeks, hoarseness despite medical therapy, or recurrent hoarseness.