Dr Gadlage and Associates are well trained and experienced in all aspects of diagnosis of diseases of the Head and Neck, which would refer more to the non-sinus and ear part of the specialty. This has to do with anything from mouth lesions, sore throats, hoarseness, swallowing disorders, as well as lumps in the neck for both the adult and pediatric population.
A complete history will be performed and physical examination of the head and neck areas both by direct feel and vision in the office and may include a fiber-optic video examination of the nose and throat areas, as well as the ordering and examination of X-rays or other diagnostic tests.
Thyroid
The thyroid gland is located in the neck above the breastbone or sternum and is a bilobed gland that helps to regulate metabolism. Disease of the thyroid gland can range from being over-active to under-active and can include enlargement also known as a goiter. The gland also can develop nodules or lumps and the nodules or glandular enlargement can, in some cases, put pressure on the trachea and cause difficulty breathing or can press on the esophagus and cause difficulty swallowing. Extremely large goiters also cause a cosmetic deformity.
The thyroid gland can develop both benign and malignant tumors. If you fell nodules in the thyroid gland, these should be evaluated for relative risk of cancer development. This may involve Ct scans, uptake scans, ultrasound exams and fine needle biopsies of the nodules.
There are indications for removal of the thyroid gland based upon the outcome of the thyroid workup.
Parathyroid
The parathyroid glands usually four in number are located, in most cases, behind the thyroid gland and they regulate calcium metabolism. Most abnormalities of the parathyroid glands are found on blood tests and would include an elevation in serum calcium levels and an elevation of the serum parathyroid hormone. This disorder can lead to osteoporosis and the development of kidney stones.
When parathyroid tumors or adenomas develop, this becomes and indication for surgical removal of the affected gland.
Salivary Glands
There are multiple major salivary glands in the body, which include the following: the parotid glands, the submandibular glands, and the sublingual glands. In addition, there are many minor salivary glands located throughout the oral cavity. Disease of the major glands include benign and malignant tumors, inflammatory processes as well as the development of salivary duct stones.
Treatment can include surgical removal of the affected gland. A new technique available in our practice is the endoscopic treatment of salivary glandular disease, which can allow for non-surgical treatment and is much less invasive.
Zenker’s Diverticulae
The esophagus is a muscular tube which delivers food from the mouth down into the stomach. At times, a pouch can develop in the wall of the esophagus called a diverticulum or sac. When these pouches or sacs become large, food and pills can become lodged in the pouch causing difficulty swallowing and regurgitation of undigested food particles. This is also a risk factor for developing pneumonia from aspiration into the lungs.
This condition can be a surgical disease, which, in the past, could only be treated from an external approach requiring an incision in the neck and several days in the hospital.
In our practice, we are trained to perform repairs of these diverticulae endoscopically, avoiding the need for an external incision. In most cases, this avoids the hospital stay, has minimal discomfort and much more rapid healing.
The symptoms of difficulty swallowing and regurgitation of undigested food, along with recurrent pneumonia, should be evaluated to ensure that this condition does not exist. If this pouch is present these should be treated.
Pediatric Neck Masses
There are several congenital conditions which occur in pediatric patients. These include mid-line masses called thyroglossal duct cysts and more lateral masses called branchial cleft cysts.
These condition require surgical removal as they can become infected and, although rare, they can undergo malignant degeneration.
Enlarged lymph nodes can be inflammatory and can also be indicative of cancerous growths and should be evaluated. These can turn into abscesses and require antibiotics and drainage of the infection.