The membranes lining the mouth (oral mucosa) can become inflamed because of changes in the environment within the oral cavity or because of viral or fungal infections. If the symptoms don’t disappear within a few days of treatment with simple home remedies, you should consult a doctor. You may have an obstinate infection requiring antibiotics and you need to make sure that there are no malignant changes that need further investigation.
The most common condition affecting the pharynx is a viral infection that causes a sore throat and discomfort on swallowing. If the discomfort doesn’t disappear within a few days of the usual treatment with throat sprays, gargling, and other simple home remedies or if you get a fever or swallowing becomes more difficult, you should be examined by a doctor. One reason for symptoms getting worse may be a bacterial infection of the tonsils (tonsillitis), but in rare cases the infection may lie deeper in the throat. The close proximity of the larynx (voice box) makes it worthwhile performing an examination with an endoscope in these cases. Endoscopy is absolutely essential in severe cases to determine whether or not there is any involvement of the deeper regions of the pharynx, the epiglottis, and the larynx.
An acute onset of hoarseness is usually the result of a viral infection of the upper airways (a cold). If the hoarseness is associated with pain on swallowing, you must see an ENT surgeon as an EMERGENCY for an endoscopic examination of the larynx. Even though bacterial infections are less common, they can be very dangerous and must not be missed. You should also have endoscopy to examine the larynx if the hoarseness persists for more than four weeks, as there may be changes in the vocal cords that need surgical treatment.
Difficulty swallowing occurs with the infections already mentioned, but needs to be investigated the same day if it is associated with pain and a hoarse voice. Difficulty in swallowing without any discomfort may be due to acid reflux from the stomach, pouches in the oesophagus, functional problems with swallowing or changes in the deeper pharynx or larynx, and need to be investigated accordingly. Besides endoscopic examination by an ENT surgeon, further investigations by a radiologist (barium swallow) or a gastrointestinal specialist may be necessary.
Ultrasound scanning is an imaging technique in real time, using harmless high-frequency sound waves. Ultrasound scans are particularly useful to show changes in the soft tissues of the neck, the salivary glands, and lymph nodes in the neck. Ultrasound scanning (ultrasonography) is an important part of ENT diagnostic investigation and can also be used without harm in infants. Swellings, enlarged lymph nodes, and undiagnosed sore throats need an ultrasound scan as do, in some cases, also hoarseness and difficulty swallowing. During cancer aftercare (looking after patients who have been treated for cancer), ultrasound scans are a key aspect of follow-up over the years, in addition to clinical examinations.