Hi
I'm a 42 year old male x-smoker non drinker with a sore throat and a
pollup in my esoghogus.
I have had the barium x-rays for swallowing and now have some pain
in my left ear, (which is the side with the problem).
I am having some occasional blurry vision, and sinus like headaches
that move from side to side.
I am coughing (non frequently) up a small amount of clear mucus.
swallowing is difficult at times and my adams apple (and surrounding
area) feels enlarged and clicks when I do swallow.
I have already seen an ENT man for this and his reccomendation is surgery.
First of all I'm scared.
But as equally important, tell me what to expect regarding surgery.
How long will I be in the hospital?
What is the regular mode of treatment?
Do they cut my neck open, or go in through my mouth?
How dangerouse is this?
What care should I take to insure that (God willing, and a good pair of
surgical eyes and hands) this does not happen again.
Please write soon, I have a 1:45 pm appt. for the scope on the nose visit on 4/12
Thanks
Answer ---------
Ideally, more information would be required to properly answer your questions, including the exact location of the polyp, as well as any other distinguishing features that are known about it - ie size, whether it is smooth-surfaced, pedunculated, inflammed, etc.
Masses in the lower throat or upper esophagus, whether benign or malignant are very uncommon. They may also be somewhat difficult to diagnose because of vague symptoms. Symptoms may include pain that is referred to the ear, vague difficulties swallowing, hoarseness, necessity to frequently clear the throat, varying degrees of throat discomfort etc. The use of a barium esophagram and endoscopy are common methods of diagnosis. A CT scan of the neck might also be recommended in some cases. Malignant masses in the lower pharynx or upper esophagus are commonly associated with a history of heavy cigarette and alcohol use.
There are often visible characteristics of esophageal masses that may help distinguish benign masses from malignant ones. This requires endoscopy, the passage of a tube through the mouth (if the mass is actually inside the esophagus) or through the nose (if the mass is just above the esophagus in the lower throat). However, the only definitive method of distinguishing a benign lesion from a malignant one is by surgical biopsy which can be done endoscopically in most cases.
Endoscopic biopsy can occasionally be done under local anesthesia with or without sedation, but often times will require general anesthesia. Endoscopic biopsy is a relatively low risk procedure that can be done as an outpatient. The actual risks depend on the exact location, size, and other specific characteristics of the mass. Also, if the mass is fairly small, complete removal might be possible endoscopically. That is, removal of the mass through a tube inserted through the mouth under anesthesia, without external incisions. Occasionally this might be assisted with the use of a laser.
Malignant esophageal masses or large benign esophageal masses, may require external approaches if surgical removal is the recommended treatment. When external approaches are necessary, the risks are higher. Hospitalization is generally required when this type of surgery is done.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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