Frequently Asked Questions Snoring Is snoring serious? Can heavy snoring be cured? How Is Snoring Treated? What is somnoplasty? Does it hurt? What is the recovery time? How many treatments will I need? Do I have to pay for more than one treatment? Does insurance cover the procedure? What will happen at my initial consultation? Will my insurance cover the initial consultation? Who should be present at the consultation? Throat, Voice and Swallowing What are tonsils? What affects tonsils and adenoids? When should I see my doctor? What should I expect at the exam? How are tonsil and adenoid diseases treated? What is tonsillitis and its symptoms? What are enlarged adenoids and their symptoms? What Causes a Sore Throat? When Should I See a Doctor? When should I take antibiotics? Should other family members be treated or cultured? What if my throat culture is negative? How Can I Treat My Sore Throat? What is rhinitis? What causes allergic rhinitis? How are vocal disorders treated? Thyroid When is a thyroid gland abnormal? How Does Your Doctor Make the Diagnosis? What Is Thyroid Surgery? General Topics What are fever blisters (cold sores)? What is GERD? What are the symptoms of GERD and LPR? What role does an ear, nose, and throat specialist have in treating GERD and LPR? How do I know when my child has sinusitis? How will the physician treat sinusitis?     Medical Services Physicians - What is Otolaryngology, Photos and Bios Patient Services - Treatments and Procedures (sinus, tonsils, snoring & sleep disorders, ears, throat/voice) Patient Education - Medical Links, What Our Patients Say Surgery - Pre and Post-Op Instructions, Hospital Affiliations FAQ's - Frequently Asked Questions Patient Forms     Is snoring serious? Socially, yes! It can be, when it makes the snorer an object of ridicule and causes others sleepless nights and resentfulness. Medically, yes! It disturbs sleeping patterns and deprives the snorer of appropriate rest. When snoring is severe, it can cause serious, long-term health problems, including obstructive sleep apnea. Can heavy snoring be cured? Heavy snorers, those who snore in any position or are disruptive to the family, should seek medical advice to ensure that sleep apnea is not a problem. We will provide a thorough examination of the nose, mouth, throat, palate, and neck. A sleep study in a laboratory environment may be necessary to determine how serious the snoring is and what effects it has on the snorer's health. Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or tonsils and adenoids. We will determine the appropriate treatment for your snoring or obstructive sleep apnea. How Is Snoring Treated? Snoring can be diagnosed as primary snoring (simple snoring) or obstructive sleep apnea. Primary snoring is characterized by loud upper airway breathing sounds during sleep without episodes of apnea (cessation of breath). Obstructive sleep apnea is a serious medical condition where individuals have frequent episodes of apnea during sleep, contributing to an overall lack of restful sleep and severe health risks including heart attack and stroke. Various methods are used to alleviate primary snoring. They include behavior modification (such as weight loss), surgical and non-surgical treatments, and dental devices. What is somnoplasty? Somnoplasty uses controlled delivery of high frequency electric energy to destroy soft palate tissue. The energy is delivered with a probe that is inserted into the soft palate under local anesthetic. It is done as an office procedure and takes about twenty minutes. The resultant decrease in soft palate bulk and floppiness leads to decreased snoring. Does it hurt? The discomfort is usually described as mild to moderate and is controlled with cold fluids and ibuprofen. Rarely, stronger pain medicines are required. A mild sensation of swelling is usually noted. What is the recovery time? Most patients can return to work the same day. How many treatments will I need? Some patients will have adequate relief of their snoring with a single treatment. The average patient will require two treatments spread about six weeks apart. Rare patients will require a third treatment. Do I have to pay for more than one treatment? No, a single fee will cover as many treatments as the patient needs to control his/her snoring- up to one year from the last prior treatment. Does insurance cover the procedure? Most insurance companies will not cover somnoplasty. Therefore, we require payment of our fee prior to scheduling the procedure. Upon your request we will generate a form that you can submit to your insurance company for possible reimbursement. What will happen at my initial consultation? You will undergo a comprehensive medical history and examination to determine if you have underlying medical or anatomic problems leading to snoring. Possible coexisting or underlying conditions include sleep apnea, nasal obstruction, tonsillar enlargement and others. If any of these problems are identified, they will be evaluated and treated appropriately. Will my insurance cover the initial consultation? Usually yes, since this is a medical evaluation intended to identify underlying medical problems. If your insurance requires a referral and refuses to approve one, we require a payment of $60 to be applied toward the office visit. Who should be present at the consultation? Preferably the patient's spouse of partner should attend the consultation since a number of questions will be asked regarding sleeping patterns and habits. What are tonsils? Tonsils are the two pink lumps of tissue found on each side of the back of your throat. (Open your mouth wide and say 'ahhhh' in front of a mirror to see them.) Each grape-size lump fights off the bad bacteria or germs living in your body. What affects tonsils and adenoids? The most common problems affecting the tonsils and adenoids are recurrent infections (throat or ear) and significant enlargement or obstruction that causes breathing and swallowing problems. Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets within the tonsils that produce foul-smelling, cheese-like formations can also affect the tonsils and adenoids, making them sore and swollen. When should I see my doctor? You should see our physician when you or your child suffer the common symptoms of infected or enlarged tonsils or adenoids. What should I expect at the exam? Our physician will ask about problems of the ear, nose, and throat and examine the head and neck. He will use a small mirror or a flexible lighted instrument to see these areas. Cultures/strep tests are important in diagnosing certain infections in the throat, especially "strep" throat. X-rays are sometimes helpful in determining the size and shape of the adenoids. Blood tests can determine problems such as mononucleosis. How are tonsil and adenoid diseases treated? Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Sometimes, removal of the tonsils and/or adenoids may be recommended. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or adenoids. treatment with steroids (e.g., cortisone) is sometimes helpful. What is tonsillitis and its symptoms? Tonsillitis is an infection in one or both tonsils. One sign is swelling of the tonsils. Other signs or symptoms are: Redder than normal tonsils A white or yellow coating on the tonsils A slight voice change due to swelling Sore throat Uncomfortable or painful swallowing Swollen lymph nodes (glands) in the neck Fever Bad breath What are enlarged adenoids and their symptoms? If you or your child's adenoids are enlarged, it may be hard to breathe through the nose. Other signs of constant enlargement are: Breathing through the mouth instead of the nose most of the time Nose sounds "blocked" when the person speaks Noisy breathing during the day Recurrent ear infections Snoring at night Breathing stops for a few seconds at night during snoring or loud breathing (sleep apnea) What Causes a Sore Throat? Sore throat is a symptom of many medical disorders. Infections cause the majority of sore throats and are contagious. Infections are caused either by viruses such as the flu, the common cold, mononucleosis, or by bacteria such as strep, mycoplasma, or hemophilus. While bacteria respond to antibiotic treatment, viruses do not. When Should I See a Doctor? Whenever a sore throat is severe, persists longer than the usual five- to seven- day duration of a cold or flu, and is not associated with an avoidable allergy or irritation, you should seek medical attention. The following signs and symptoms should alert you to see your physician: Severe and prolonged sore throat Difficulty breathing Difficulty swallowing Difficulty opening the mouth Joint pain Earache Rash Fever (over 101°) Blood in saliva or phlegm Frequently recurring sore throat Lump in neck Hoarseness lasting over two weeks When should I take antibiotics? Antibiotics are drugs that kill or impair bacteria. Penicillin or erythromycin (well-known antibiotics) are prescribed when the physician suspects streptococcal or another bacterial infection that responds to them. However, a number of bacterial throat infections require other antibiotics instead. Antibiotics do not cure viral infections, but viruses do lower the patient's resistance to bacterial infections. When such a combined infection occurs, antibiotics may be recommended. When an antibiotic is prescribed, it should be taken as the physician directs for the full course (usually 10 days). Otherwise the infection will probably be suppressed rather than eliminated, and it can return. Some children will experience recurrent infection despite antibiotic treatment. When some of these are strep infections or are severe, your child may require a tonsillectomy. Should other family members be treated or cultured? When a strep test is positive, our physicians recommend treatment or culturing of other family members. Practice good sanitary habits; avoid close physical contact, and sharing of napkins, towels, and utensils with the infected person. Handwashing makes good sense. What if my throat culture is negative? A strep culture tests only for the presence of streptococcal infections. Many other infections, both bacterial and viral, will yield negative cultures and sometimes so does a streptococcal infection. Therefore, when your culture is negative, we will base our decision for treatment on the severity of your symptoms and the appearance of your throat on examination. How Can I Treat My Sore Throat? A mild sore throat associated with cold or flu symptoms can be made more comfortable with the following remedies: Increase your liquid intake. Warm tea with honey is a favorite home remedy. Use a steamer or humidifier in your bedroom. Gargle with warm salt water several times daily: _ tsp. salt to _ cup water. Take over-the-counter pain relievers acetaminophen or ibuprofen What is rhinitis? Rhinitis is the term for what occurs when the inside of your nose swells and hurts. When you pet your friend's dog or play outside and you sneeze and your nose starts to run, you have allergic rhinitis. What causes allergic rhinitis? There are two causes of allergic rhinitis: First, if your parents are allergic to stuff like soap and dogs, you are more likely to have allergies too than someone whose family does not have allergies. Second, your body reacts to exposure to allergens. An allergen is anything that causes an allergic reaction in you. How are vocal disorders treated? The treatment of hoarseness depends on the cause. Most hoarseness can be treated by simply resting the voice or modifying how it is used. Our physicians may make some recommendations about voice use behavior, refer the patient to other voice team members, and in some instances recommend surgery if a lesion, such as a polyp, is identified. Avoidance of smoking or exposure to secondhand smoke (passive smoking) is recommended to all patients. Drinking fluids and possibly using medications to thin the mucus are also helpful. When is a thyroid gland abnormal? Diseases of the thyroid gland are very common, affecting millions of people. The most common diseases are an over- or under-active gland. These conditions are called hyperthyroidism (e.g., Grave's disease) and hypothyroidism. Sometimes the thyroid gland can become enlarged from over-activity (as in Grave's disease) or from under-activity (as in hypothyroidism). An enlarged thyroid gland is often called a "goiter." Sometimes an inflammation of the thyroid gland (Hashimoto's disease) will cause enlargement of the gland. How Does Your Doctor Make the Diagnosis? The diagnosis of a thyroid abnormality in function or a thyroid mass is made by taking a medical history and a physical examination. Specifically, one of our physician's will examine your neck and ask you to lift up your chin to make your thyroid gland more prominent. You may be asked to swallow during the examination, which helps to feel the thyroid and any mass in it. Other tests we may order include: An ultrasound examination of your neck and thyroid Blood tests of thyroid function A radioactive thyroid scan A fine needle aspiration biopsy A chest X-ray A CT or MRI scan What Is Thyroid Surgery? Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital, and general anesthesia is usually required. Usually the operation removes the lobe of the thyroid gland containing the lump and possibly the isthmus. A frozen section (an immediate microscopic reading) may or may not be used to determine if the rest of the thyroid gland should be removed. Sometimes, based on the result of the frozen section, our surgeon may decide to stop and remove no more thyroid tissue, or proceed to remove the entire thyroid gland, and/or other tissue in the neck. This is a decision usually made in the operating room by the surgeon, based on findings at the time of surgery. Your surgeon will discuss these options with you preoperatively. What are fever blisters (cold sores)? These are common names for fluid filled blisters that commonly occur on the lips. They also can occur in the mouth, particularly on the gums and roof of the mouth (hard palate), but this is rare. Fever blisters are usually painful; in fact, the pain may precede the appearance of the lesion by a few days. The blisters rupture within hours, then crust over. They last about 7-10 days. The time from blister rupture until the sore is completely healed is the time of greatest risk for spread of infection. The virus can spread to your own eyes and genitalia, as well as to other people. What is GERD? Gastroesophageal reflux, often referred to as GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), contracts to keep the acidic contents of the stomach from "refluxing" or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid to move up the esophagus. When stomach acid touches the sensitive tissue lining the esophagus and throat, it causes a reaction similar to squirting lemon juice in your eye. This is why GERD is often characterized by the burning sensation known as heartburn. In some cases, reflux can be SILENT, with no symptoms until a problem arises. Almost all individuals have experienced reflux (GER), but the disease (GERD) occurs when reflux happens on a frequent basis often over a long period of time. What are the symptoms of GERD and LPR? The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning, or trouble swallowing. Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack. GERD can also cause a dry cough and bad breath. Some people with LPR may feel as if they have food stuck in their throat, a bitter taste in the mouth on waking, or difficulty breathing although uncommon. If you experience any symptoms on a regular basis (twice a week or more) then you may have GERD or LPR. For proper diagnosis and treatment, you should be evaluated by your primary care doctor for GERD or an ENT physician. What role does an ear, nose, and throat specialist have in treating GERD and LPR? A gastroenterologist, a specialist in treating gastrointestinal orders, will often provide initial treatment for GERD. But there are ear, nose, and throat problems that are either caused by or associated with GERD, such as hoarseness, laryngeal (singers) nodules, croup, airway stenosis (narrowing), swallowing difficulties, throat pain, and sinus infections. These problems require an ENT physician who has extensive experience with the tools that diagnose GERD and LPR. They treat many of the complications of GERD, including: sinus and ear infections, throat and laryngeal inflammation and lesions, as well as a change in the esophageal lining called Barrett's esophagus, which is a serious complication that can lead to cancer. Your primary care physician or pediatrician will often refer a case of LPR to for evaluation, diagnosis, and treatment. How do I know when my child has sinusitis? The following symptoms may indicate a sinus infection in your child: a "cold" lasting more than 10 to 14 days, sometimes with a low-grade fever thick yellow-green nasal drainage post-nasal drip (sometimes leading to or exhibited as sore throat) cough, bad breath, nausea, and/or vomiting headache, usually in children age six or older irritability or fatigue swelling around the eyes Young children have immature immune systems and are more prone to infections of the nose, sinus, and ears, especially in the first several years of life. These are most frequently caused by viral infections (colds), and they may be aggravated by allergies. However, when your child remains ill beyond the usual week to ten days, a serious sinus infection is likely. How will the physician treat sinusitis? Most children respond very well to antibiotic therapy. Nasal decongestants or topical nasal sprays may also be prescribed for short-term relief of stuffiness. Nasal saline (saltwater) drops or gentle spray can be helpful in thinning secretions and improving mucous membrane function. If your child has acute sinusitis, symptoms should improve within the first few days. Even if your child improves dramatically within the first week of treatment, it is important that you continue therapy until all the antibiotics have been taken. Our physician may decide to treat your child with additional medicines if he/she has allergies or other conditions that make the sinus infection worse. Home   |   Terms of Use   |   HIPAA   |   Financial Policy © 2006 Ear, Nose and Throat Specialists of Wisconsin