Services & Symptoms – Dr Sharon Williams | ENT Specialist in Cape Town

Symptoms which are investigated and treated by Ear, Nose & Throat Specialists have been listed, with a short explanation to guide one in deciding whether an ENT Specialist / Surgeon would be an appropriate doctor to consult with for a given symptom or symptom complex.

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AREA	SYMPTOM	DESCRIPTION
Ear	Earache in Children	Most often the result of middle ear infection or an outer ear (from swimming or scratching in the ear canal).
Ear	Earache in Adults	Can be as a result of either a middle or outer ear infection but also can be refered from the jaw joint, the throat or the neck
Ear	Discharge from the Ear	Occurs as a result of middle & outer ear inflammations or infections and can be associated with pain or itchiness.
Ear	Wax Build up	Wax consists of waxy secretions & skin cells. Earbud use is the commonest cause of impacted wax as the bud pushes most of the wax deeper into the ear canal & eventually compacts it.
Ear	Poor Hearing	There are 2 main types of hearing loss, a conductive (mechanical) and senorineural (electrical) hearing loss or a combination of both. A hearing test is needed to differentiate the type of loss, so appripriate treatment can be undertaken, if necessary.
Ear	Sudden Hearing Loss	A sudden hearing loss requires urgent attention. If it is due to nerve damage, the sooner it is attended to the better the chances of recovering hearing.
Ear	Age Related Hearing Loss	As we get older we tend to develop poorer hearing in the high frequencies and resultant difficulty understanding what is being said especially in niosy environments.
Ear	Noise Intolerance or Sensitivity	Known as hyperacusis, is the difficulty tolerating sounds that are not considered loud by other peoples standards. It can be due to a variety of conditions and medication, as well anxiety & depression and requires evalution.
Ear	Facial Palsy	There are numerous causes, but the commonest cause is a viral infection that causes a Bell’s Palsy and requires treatment of the symptoms to prevent complications.
Ear	Dizziness, Imbalance & Vertigo	Dizziness, Imbalance & Vertigo can be debilitating symptoms that lead to increased risk of falling in the elderly and can be associated symptoms such as hearing loss and tinnitus and may require an extensive consultation and investigation.
Ear	Ringing or Buzzing in the Ear or Head	Tinnitus is a symptom that can represent an underlying hearing loss in one or more frequencies & so needs investigation.
Ear	Injury to the Outer Ear	Injury to the outer ear, as in a perichondrial haemotoma or seroma can leave the ear deformed, commonly refered to as a cauliflower ear. & injury
Ear	Injury to the Tympanic Membrane	Injury to the tympanic membrane typically occurs as a result of a foreign body like an earbud & can dislocate & damage the ossicles( the tiny little bones of hearing) and so result in hearing loss.
Ear	Diving related symptoms	Difficulties such as being unable to equalize ear pressures and sinus lock are related to inflammataion and swelling of the upper respiratory tract .
Ear	Swollen, Red or Painful Ear	Mainly due to a skin infection as in Cellulitis and can be associated with a discharging ear.
Ear	Dry skin or Eczema	Eczema of the ear canal is treated differently to eczema elsewhere, as the conditions in this environment are unique.
Ear	Clicking or Squeaking Sounds	Represent symptoms of poor eustachian tube function.
Ear	Auditory Processing Disorders	Generally known as Central Auditory Processing Disordersis a disorder where children experiencedifficulty distinguishing between similar sounds, difficulty understanding speech in noisy environments and difficulty following instructions and this impacts their scholistic performance.
Nose	Snoring	Occurs in both males and females, children and adults and is a result of vibration within the upper airway. This generally is the result of narrowing in the airway causing more turbulent airflow in the more expanded area of the airway.
Nose	Apnoea	Apnoea is a temporary cessation of breathing and can have harmful effects on the heart, raising blood pressure, increasing the risk of heart attacks and strokes. If apnoeic events occur frequently they disturb ones sleep leaving you tired and headachy.
Nose	Colds & Flu	Common upper respiratory tract viral infections that can be relieved with symptomatic treatment and which may cause middle ear and sinus infections, as well as bronchitis if neglected.
Nose	Postnasal Drip or Phlegm	A postnasal drip can be thick or watery and profuse and may or may not be infected and may indirectly affect the ears and if infected may contribute to the risk of bronchitis.
Nose	Hayfever Symptoms / Nasal Allergy	Acute hayfever symptoms such as an itchy runny nose with profuse sneezing in relation to exposure to an animal or plant make for an easy diagnosis of allergy as opposed to the chronic blocked nose which occur slowly over time and can be representative of chronic allergy exposure.
Nose	Blocked nose – one or both sides	Nasal obstruction on both sides is likely to be as a result of allergies or infection but a unilateral (ie. One-sided) nasal obstruction is most likely as a result of an anatomical abnormality, such as a deviated nasal septum.
Nose	Noisy Breathing	Noisy breathing can be that as a result of a deviated septum and resultant more turbulent airflow or more commonly due to a septal perforation which disrupts nasal airflow resulting in noisy breathing and frequently an associated sensation of nasal obstruction.
Nose	Loss Smell and Taste	Smell and taste are associated in that in order to obtain the nuances of flavour beyond the five basic modalities of taste (butter, sweet, salty, sour and umani), functions of the tongue the flavour molecules of what we eat need to make contact with the olfactory area.
Nose	Sores in the nose	Nasal sores can be the result of a variety of infective processes or the result of constant irritation in an area. They can be painful and persistent and require investigation and treatment.
Nose	Swellings inside the nose	This can be due to nasal polyps. They appear like pale balloons of tissue that can even present at the entrance of the nasal cavity & cause nasal obstruction. Other smaller swellings or masses can occure & need an ENT opinion as well.
Nose	Pimples or boils on or inside the nose	The nasal or facial triangle from the corners of the mouth to the bridge of the nose is a dangerous area to “squeeze” pimples as the blood supply is such that infection can go to the brain. So marked redness & swelling due to infection needs to be treated with an appropriate antibiotic.
Nose	Eczema or dry skin in or around the nose	May be part of the patients eczematous condition or may represent an infection or staphlococcal carrier status and is best evaluated and treated by an ENT doctor.
Nose	“Sinus”	“Sinus” as a symptom is most often due to inhalant allergies. We inhale allergens very small particles that cause an allergic reaction in the nose as evidenced by any combination of a runny, sneezy, itchy or blocked nose and can be associated with headaches..
Nose	Deformity of Nose	Can be as a result of a previous fracture, or injury to the bone or cartilage & less commonly due to masses inside or outside the nose.
Nose	Nose Bleeds	Generally easily controlled by pinching the cartilaginous part of the nose for 10minutes & remaining calm. Recurrent nose bleeds require ENT evaluation and treatment.
Mouth	Dry Mouth	Occurs in a variety of medical conditions, post radiation, or as a result of dehydration, aging even smoking and needs symptomatic management to make swallowing & speaking comfortable & to improve the health of the oral cavity.
Mouth	Excessive Salivation	Known a ptyalism is caused by variety of disorders including nutritional causes & medication & due to either increased salivation or decreased clearance of saliva.
Mouth	Oral ulcers	Oral ulcers are painful & can be recurrent. Causes range from viral infections, to nutritional deficiencies to chronic bowel disorders, so may need investigation & respond well to symptomatic treatment.
Mouth	Red or white patches	There are a variety of causes for red or white oral patches, such as chronic irritation due to smoking, fungal disease etc. These lesions are not cancerous, but left unchecked can become cancerous.
Mouth	Painful or Burning Tongue	Can be associated with local infection or irritation, due to dental fillings or even due to systemic disease , hormonal or neurological factors or nutitional deficiencies and so requires extensive investigation.
Mouth	Bad Breath (Halitosis)	The commonest cause of halitosis is dental disease. If your oral hygiene is good then an ENT evaluation to exclude nasal, sinus, throat or even gastic contect reflux is important to resolve the problem.
Mouth	Tongue Tie	Can affect the infant or childs speech & swallowing and can be easily relieved by a simple surgical procedure where necessary.
Throat & Neck	Grinding Teeth (Bruxism)	Bruxism is fairly common and may present with a variety of ENT symptoms such as ear pain, tinnitus, dizziness, as well as painful teeth. There are a variety of treatment modalities that are effective in the treatment of bruxism.
Throat & Neck	Reflux	Reflux of gastric acid or gastric contents can reach as high as the back of the nose and so can cause a variety of symptoms from heart burn to voice disorders to burning throats & bitter taste to a post nasal drip and cough.
Throat & Neck	Sore Throat	Most commonly due to viral or bacterial infections. Pharyngitis does not involve the tonsils and tends to cause less pain than tonsilitis.
Throat & Neck	Swollen Tonsils	Can involve one or both tonsils & can be acute as a result of tonsilitis, chronic because of chronic tonsilitis, due to herniation of the tonsil from the tonsillar fossa or may ber due to a mass. If only one side is involved this is an indication for a tonsillectomy.
Throat & Neck	White Patches on Tonsils	Large white patches on the tonsils are the hallmark of follicular tonsilitis a bacterial tonsilitis that presents with fever, difficulty swallowing, pain and tender enlarged neck glands.
Throat & Neck	Scratchy throat	A scratchy throat is often the result of allergy or irritation from environmental irritants. Other causes include a dry throat from mouth breathing or even infection.
Throat & Neck	Burning Throat	Can be due to infection, viral or bacterial or even reflux of gastric contents including gastric acid.
Throat & Neck	Persistent Cough	There are multiple causes of a persistent cough, from a post nasal drip, to gastro-oesphageal reflux, which if occuring this high is called laryngopharyngeal reflux, to allergy & infective conditions.
Throat & Neck	Speech Difficulties	Speech difficulties in both childhood & adulthood can be diverse in origin. In adults it can be associated with swallowing difficulties. An ENT evaulation is useful before being refered to a speech therapist.
Throat & Neck	Swallowing Difficulties	There are numerous causes of swallowing difficulties from obstruction, aas in a child swallowing a coin, to inco-ordinate swallowing , woth causes ranging from stress, to gasto-oesphageal reflux to neurological disease. Treatments range from medical, to surgical to speech therapy.
Throat & Neck	Sensation of a “lump in the Throat	This sensation may occur when swallowing saliva but not when eating, or it can occur regardless of what is being swallowed. Depending on the symptom complex different causes would be excluded.
Throat & Neck	Swollen Neck Glands	Painful swollen glands suggest an infective cause, whereas painless neck swellings may be due to cysts & benign or malignant masses.
Throat & Neck	Hoarseness	A common voice presentation. Frequently due to some form of voice misuse but if present for 3 weeks or longer need to be investigated to exclude growths or malignancies of the vocal apparatus.
Throat & Neck	Choking	Choking with difficulty breathing in may wake the patient in the middle of the night & can be attributed gastro-oesophageal or laryngo-oesphageaol reflux. Chronic choking while eating or drinking may be due to a neurological defect that can be localised or as part of a more systemic condition.
Throat & Neck	Breathing Difficulties	Breathing difficulties can be attributed to upper respiratory tract causes from the larynx to the nose or lower respiratory causes from belwo the vocal cords ie. trachea to the chest, as in asthma.
Throat & Neck	Salivary Gland Swellings & Masses	Occur because of infections, stones in the gland or duct or due to abnormal growth of certain cell types as in benign or malignant masses.
Throat & Neck	Mumps	Otherwise known as parotitis, being a viral infection of the parotid salivary gland is treated symptomatically & as its is infective requires isloation of the affected person for up to 10 days.
General	Learning Difficulties	Can be related to hearing difficulties, poor sleep due to apnoea, even untreated allergic rhinitis has affects on learning & listening.
General	Difficulty Concentrating	As for learning difficulties may be related to a hearing loss or even poor sleep & apnoea.
General	Headaches	May occur in infective conditions of the ear, nose & throat or due to poor sleep as a result of apnoea & frequent awking during the sleep cycle in both children & adults.
General	Waking tired & exhausted	May be result of disturbed sleep due to apnoea.
General	Falling asleep while driving or daytime activity	Urgent referral to an ENT to exclude obstructive sleep apnoea is required.
AREA	SYMPTOM	DESCRIPTION