The process of swallowing consists of three phases. The oral phase is the process of sucking, chewing and moving food or liquid from the mouth toward the throat. The pharyngeal phase is the start of the swallowing reflex when food is squeezed into the throat and the airway is closed to prevent choking. The esophageal phase is the relaxing and tightening of the openings at the top and bottom of the esophagus (feeding tube) and the movement of the food into the stomach. A swallowing disorder can occur at any of these phases.

Some symptoms of a swallowing disorder include coughing during or after eating or drinking, gurgling of the voice after eating or drinking, expending extra effort to chew or swallow, leaking food or liquid out of the mouth and feeling congested in the chest after eating or drinking. As a result of these symptoms, those suffering severely from a swallowing disorder may be malnourished or chronically dehydrated, at risk for choking or developing pneumonia and may feel embarrassed or isolated in social situations involving eating and drinking.

In adults, there are many causes for swallowing disorders. Sometimes they are caused by damage to the nervous system such as from a stroke, spinal or brain injury, Parkinson’s disease, multiple sclerosis, ALS, cerebral palsy, muscular dystrophy or Alzheimer’s disease. They can also be caused by gastroesophageal reflux, cancer in the mouth or throat, injury or surgery of the head or neck and dental issues like decayed or missing teeth and poorly fitting dentures.

Therapy with a speech-language pathologist (SLP) is often a recommended treatment for swallowing disorders. SLPs can teach patients specific exercises to improve muscle movements, positions or strategies to make swallowing easier and recommend specific foods that may be easiest and safest to swallow.

Reflux
Acid reflux disease is a condition wherein the stomach contents travel back up the esophagus due to the lower esophageal sphincter (LES) not contracting over the stomach valve after swallowing. Common symptoms include tasting acid in the back of the mouth, heartburn, bad breath, a lump sensation in the throat, breathing problems and eroding teeth. Symptoms of acid reflux may be relieved by avoiding lying down for several hours after eating, avoiding certain foods, losing weight and quitting smoking. If symptoms still persist, medication or surgery may be necessary. For more information, please visit: entnet.org

FEES
Fiberoptic endoscopic evaluation of swallowing (FEES) is a procedure where a doctor assesses the body’s swallowing mechanisms by inserting a small, flexible telescope through the nose to observe the swallowing mechanism. The procedure is performed by providing local anesthesia to the patient, inserting a telescope through the nose and giving various foods to the patient for them to eat. The doctor is then able to observe and evaluate the swallowing process to determine if and where the swallowing disorder takes place.

Dry Mouth/Throat
Our bodies produce saliva to moisten and cleanse our mouths, to fight infections and to help us digest food. When we don’t produce enough saliva, a common symptom is dry mouth and throat. Dry mouth is often caused by medication side effects, nerve damage, dehydration, infections, other diseases and tobacco use. Treating dry mouth may require evaluation from a doctor to first determine the underlying cause.

Burning Mouth
A burning, tickling or numbness in the mouth can have many causes including allergies to metals or foods, dry mouth, diabetes, neurological problems, certain medications (such as blood pressure medications), nutritional deficiencies, infection and acid reflux. Treatments for burning mouth include treating the underlying cause, taking medications, staying hydrated, changing medications, chewing sugarless gum and avoiding irritating substances. Talk to your doctor to determine the cause of your burning mouth and possible treatment options.

Zenker’s Diverticulum
Zenker’s diverticulum refers to an abnormal pouch or swelling of the mucus membrane of the pharynx. In other words, it is when excessive pressure in the lower pharynx causes the pharyngeal walls to balloon out several centimeters in diameter. This can cause difficulty swallowing, regurgitation, cough, bad breath, infection and trap food and debris. Severe cases may necessitate neck surgery to correct the muscle’s position.

Masses of the head and neck can be malignant or benign. It is important to have masses evaluated right away so that if they are dangerous, treatment can start early. There are three major categories of head and neck masses: congenital, inflammatory and neoplastic.

Congenital masses are most common in children, but can be present in adults. They are typically benign, slow-growing and painless. Congenital masses generally require surgery for removal.

Bacterial and viral infections can cause neck masses – swollen lymph nodes being the most common form. These are benign and some may possibly go away on their own. Other infections like cat-scratch disease and tuberculosis can cause neck masses, which may require antibiotics and other medicines to treat.

Some masses can be benign, such as lipomas, hemangiomas, neuromas and fibromas. Others, such as thyroid cancer, mucosal cancer and metastatic disease are all examples of malignant masses; these are very serious and require immediate treatment.

Neck masses can originate from lymph nodes, the thyroid or salivary glands. Rarely they can arise from bone, cartilage, muscles, veins or nerves. The location and size of the mass as well as the health and age of the patient can help the doctor identify the mass’s origin.

Lymph Node Excision
Lymph nodes are an important part of the immune system; they contain lymphocytes which fight against foreign bodies that cause sickness and infection. A lymph node excision, also called a lymphadenectomy, may be necessary if the lymph node is possibly cancerous or if it is prone to chronic infection. The procedure usually consists of providing general anesthesia, making an incision in the skin and removing the lymph node and surrounding tissues.

Parotidectomy
A parotidectomy is the surgical removal of one of the body’s major salivary glands, called the parotid gland. The parotid gland is located on the sides of the face, just behind the cheek and in front of the ear. It may need to be removed due to neoplasms, or tumors, which may be cancerous. A patient undergoing a parotidectomy is given general anesthesia, then the doctor makes an incision near the ear through which they remove the gland and surrounding tissues.

Submandibular Gland Excision
The submandibular gland, located under the jaw, is another of the body’s major salivary glands. This gland may also require removal if it becomes chronically infected or grows tumors. The excision procedure consists of providing general anesthesia, making a small incision in the skin under the jaw and removing the submandibular gland.

Throat Cancer
There are several types of throat cancer, including pharyngeal and laryngeal cancer. Pharyngeal cancer forms on your pharynx (breathing and digestive tube) and laryngeal cancer forms on your larynx (voice box). Symptoms of throat cancer include coughing up blood, trouble swallowing, hoarseness, throat pain, ear pain or feeling lumps in the throat or neck. There are several treatment options depending on the size and prevalence of cancerous tumors.

The tonsils and adenoids are lymph glands made up of tissues, fibers and white blood cells in the body’s immune system.

Tonsils are the two round lumps in your throat that the doctor examines when he tells you to stick out your tongue and say “ah.” Tonsils are prone to swelling, soreness and abscesses when they become infected. Swollen tonsils can obstruct the throat and make swallowing, breathing and sleeping difficult.

Adenoids have the same function as tonsils, but they are located in the throat behind the nose and above the soft palate. Adenoids are prone to the same conditions as tonsils, but they can cause additional problems with the ear, because the adenoids are located near the Eustachian tubes. Symptoms of adenoid and tonsil infections may include sore throat, stuffy nose, bad breath, earache, fever, swallowing difficulties and snoring.

Bacterial tonsil and adenoid infections are first treated with antibiotics, as is the case with most bacterial infections. However, chronic infections or other serious problems may require surgery. If your tonsils and adenoids make you chronically or recurrently sick and uncomfortable, you and your doctor may decide that removal is the best option. Surgery of the tonsils is called tonsillectomy. Surgery of the adenoids is called adenoidectomy.

Tonsillectomies and adenoidectomies are more commonly performed on children, but occasionally adults may require a tonsillectomy or adenoidectomy as well. Visit an ENT doctor if you notice prolonged symptoms of infected or enlarged tonsils or adenoids.

Please click this link to view the updated clinical practice guidelines for tonsillectomy surgery in children from the American Academy of Otolaryngology- Head and Neck Surgery Foundation.

Nosebleeds
Nosebleeds (epistaxis) are a common nasal condition that has many causes including dryness, inflammation, injury, high blood pressure and tumors. Treatment for nosebleeds depends on the underlying cause, which is determined by your doctor after an examination.

Nasal Irrigations
Nasal irrigation systems are devices to flush the nose or sinuses to remove mucus or debris and to relieve congestion . Neti® pots are the most common form of nasal irrigations, in which a warm salt water solution is poured into one nostril until it runs out the other. Saline nasal sprays are another form of nasal irrigation. Nasal irrigation is an effective treatment for acute sinusitis and congestion caused by colds and allergies.

For more information, see our step-by-step instructions

The goal of nasal and sinus surgery is to remove infections, growths, injury, or congenital abnormalities in the sinus or nasal cavities to promote drainage and prevent problems like sinusitis, or sinus infections.
Types of sinus and nasal surgeries include removal of infected, swollen or damaged tissues, reconstruction of bone to create wider openings for drainage, removal or polyps and other growths or abnormalities.

Surgery may be the best option for those with chronic or recurring sinusitis that have failed medical management.

If you suspect sinus blockage or abnormalities that are causing chronic or recurrent sinusitis, contact us at (479) 750-2080 to discuss your treatment options.

Deviated Septum
The septum is the bone and cartilage that separates the nostrils. A deviated septum is a condition in which the septum is significantly crooked or off center. In general, a person is born with a deviated septum, but sometimes it is caused by trauma or injury to the face. A deviated septum can cause difficulty breathing, nosebleeds, headache and snoring. Surgery is required to fix this condition.

Endoscopic Surgery
An endoscopy, also called endoscopic surgery, is a procedure in which the doctor operates on internal organs and vessels via natural body openings. Examples include bronchoscopy (lung procedure) and laryngoscopy (larynx, or voice box, procedure) wherein the doctor inserts a scope through the mouth or nose to operate.

Nasal Fracture
Since the nose protrudes from the face and is made of thin bone and cartilage, it’s no surprise that it is the most commonly broken facial bone. A broken nose is usually obvious due to bleeding, swelling, bruising on both the nose and around the eyes and visible caving of the nasal structure. It can also affect your ability to breathe. Minor breaks and nondisplaced fractures will heal on their own, but more severe breaks may require resetting and/or surgery.

Nasal Reconstruction
Nasal reconstruction surgery can correct a deviated septum, a nasal fracture, congenital abnormalities and tumors or growths. A doctor can reconstruct the nose’s skin, bone, cartilage lining and overall structure with relatively minor surgery. The procedure is generally performed on an outpatient basis under local or general anesthesia.

Rhinoplasty
Rhinoplasty is a specific nasal reconstruction procedure that is usually elective and performed for cosmetic purposes. The procedure is performed on an outpatient basis under local or general anesthesia. The doctor lifts the skin to reshape, remove or rearrange the bone and cartilage, then replaces the skin back in place.

Turbinoplasty
Turbinoplasty is another type of nasal surgery. Turbinates are long, thin bones in the nose that direct airflow into the nasal cavity. Sometimes turbinates are large and block airflow, making it difficult to breathe. Turbinoplasty is a surgery wherein parts of the turbinates are removed to allow airflow. This procedure is recommended for those with chronically swollen turbinates.

Sinusitis is inflammation and infections of the sinuses – the small, air-filled pockets in the nose and forehead that produce mucus. Symptoms of sinusitis include a runny nose, reduced sense of smell, pain or tenderness around the sinus area, nasal drainage and headaches. Chronic sinusitis is inflammation that persists in one or more of the sinuses even after treatment or for more than twelve weeks; it is generally caused by growths, injury or congenital abnormality of the sinus area, which can prevent normal, necessary drainage.

Balloon sinuplasty is a surgical procedure to treat chronic or recurring sinusitis. It is usually only recommended to those for whom more conservative treatments, like antibiotics and steroids, have failed.

Balloon sinuplasty is different than the traditional functional endoscopic sinus surgery because it does not require cutting, bone and tissue removal or sharp metal operating tools. Instead, the surgeon inserts a small, flexible balloon catheter into the inflamed sinus, inflates it and flushes in saline spray. Once the balloon is removed, the sinuses are left cleared and open with no damage to the surrounding tissues.

This procedure can be performed in the doctor’s office under local anesthesia. The patient will have a short recovery time, often returning to their daily routine by the following morning with little bleeding or need for prescription pain medication. The complication rate is less than one percent.

Outcome goals of the surgery are symptom improvement, decline in sinusitis episodes and improvements in work and productivity. If you are suffering from chronic or recurring sinusitis, contact us at (479) 750-2080 to discuss if balloon sinuplasty is a good treatment option for you.

Allergies, or allergic diseases, refer to the immune system’s hypersensitivity to something in one’s environment. Some allergies include hay fever, food allergies, dermatitis, allergic asthma and anaphylaxis. Allergy symptoms include itchy eyes, swelling, rash, runny or stuffy nose, shortness of breath and itchy or plugged ears. Common allergens are pollens, grasses, molds, dust mites and pets. Dr. Lollar has completed a fellowship in rhinology and is a board-certified allergist.

There are several treatment options for people with allergies. The first is avoidance of the offending allergen. Additionally, there are multiple symptomatic treatments with over the counter medicines. Another effective, treatment option is allergen immunotherapy via shots or drops. The idea behind immunotherapy is that by continually introducing an allergen to the patient’s body, they will eventually develop an immunity, curing their allergies.

Contact us today at (479) 750-2080 if you experience persisting allergy symptoms.

Hay Fever
Allergic rhinitis, also called hay fever, is inflammation due to airborne allergens. Symptoms are usually concentrated around the face and include runny nose, red itchy eyes and sneezing. Hay fever symptoms typically occur when someone is exposed to pollen or grass seed allergens. In most cases, hay fever is seasonal and only occurs during the spring and summer. Treatment options include over-the-counter medications and immunotherapy.

Medical Therapy
Medical therapy to treat allergies typically takes two forms: subcutaneous immunotherapy and sublingual immunotherapy. The science behind the two methods is the same – expose the patient to allergens regularly so that the immune system can develop a tolerance. After an average of three to five years of immunotherapy, allergy symptoms begin to disappear. The difference between the two is how they are administered; subcutaneous immunotherapy takes the form of shots and must be administered in a medical clinic, while sublingual immunotherapy involves tablets or droplets for the mouth that can be administered at home.

SLIT (Sublingual Immunotherapy)
Allergy drops, also known as sublingual immunotherapy, are a long-term treatment that decreases symptoms by increasing the body’s immunity. The patient drips liquid containing allergens under the tongue and holds it there for one to two minutes before swallowing. This is a more convenient option than allergy shots for many patients because allergy drops can be safely administered at home rather than at the doctor’s office.

Chronic Sinusitis
Sinusitis, also called sinus infection or chronic rhinosinusitis, involves inflammation of the sinus – the small, air-filled pockets in the nose and forehead that produce mucus. It is a condition that interferes with the drainage of mucus and may cause painful buildup, trouble bleeding, nasal drainage or facial swelling. Sinusitis generally flares up during episodes of cold or flu, dental infections or nasal allergies.

Symptoms of sinusitis include a runny nose, reduced sense of smell, pain or tenderness around the sinus area, nasal drainage and headaches. Doctors diagnose sinusitis based on reported symptoms and their duration. Chronic sinusitis is classified as inflammation that persists in one or more of the sinuses even after treatment or for more than twelve weeks; it is generally caused by nasal problems that prevent normal, necessary drainage.

Acute sinusitis can be treated with antibiotics, nasal sprays, steroids, painkillers, nasal washes, antihistamines and decongestant medications. With chronic sinusitis, however, surgery may be necessary to allow the sinuses to drain properly and prevent further infection or inflammation. Two major sinus surgeries are called balloon sinuplasty and functional endoscopic sinus surgery, both of which expand the sinus area to allow proper drainage.

If left untreated, chronic sinusitis may spread to nearby areas such as the eyes, facial bones, blood and brain. Although sinusitis is more common in adults, children with sinusitis may also have complications. Call us today at (479) 750-2080 if you experience persisting symptoms of sinusitis.

Recurrent Sinusitis
Recurrent sinusitis is defined as recurring bouts of acute sinusitis. This means symptoms last less than 12 weeks but continue to return after days, weeks or months. Recurrent sinusitis can be caused by illnesses like the cold or flu or by abnormalities of the sinuses.

Earwax Removal
Earwax, also called cerumen, is produced by glands in the ears to clean, lubricate and protect the ears from bacteria. It is important that the ear produces earwax, but sometimes it produces too much. When this happens, people sometimes stick foreign objects like cotton swabs or bobby pins into the ear canal to clean it out, but this is actually a common cause for blockage. Sticking foreign objects into the ears can pack earwax even further into the ear canal, and when earwax becomes impacted, it may require removal from a doctor.

TMJ Treatment
Temporomandibular muscle and joint (TMJ) disorders are classified as pain and muscle dysfunction in the jaw joint but are a very common cause of ear pain. Symptoms include pain or tenderness in the jaw or temporomandibular joints, aching in or around the ear, difficulty or pain while chewing and locking of the jaw joint. In some cases, symptoms of TMJ may go away on their own. If symptoms persist and/or affect your quality of life, contact your doctor.

Tinnitus
Tinnitus is described as an irritating buzzing, humming or ringing in the ears. What many don’t realize is that it is maybe a symptom of a greater problem. The first step to treating tinnitus is to diagnose the underlying issue. Some common causes of tinnitus include hearing loss, an infection, middle ear or nerve tumors, circulation disorders, noise-induced hearing loss of the inner ear, migraines and medications. It is important to see a doctor to identify tinnitus and prevent hearing loss.
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Ear infections can occur when fluid becomes trapped in the middle ear behind the eardrum. They usually occur during or after a cold, infection or allergic reaction when the immune system is compromised. Ear infections can be acute (painful but short in duration) or chronic (recurring infections or a single infection that does not heal). It is important to treat chronic ear infections because they can cause permanent damage to the middle and inner ear.

Young children are most prone to ear infections because their Eustachian tubes – the tubes that equalize pressure at the back of the nose – are small and narrow. Children often need tubes surgically implanted in their ears to help compensate for Eustachian tubes that are not working well.

Some symptoms of ear infections may include pain and swelling in the ear, ear pressure (similar to what one feels under several feet of water or on an airplane), ear drainage and hearing loss. These symptoms may persist or come and go. One or both ears may become infected.

To diagnose an ear infection, your doctor will examine your or your child’s ears with an otoscope, which has a light and a magnifying lens. They will look for redness, fluid buildup or a swollen or perforated eardrum. These are all signs of an ear infection.

The doctor will determine which treatment method is best based on the severity of the infection.

Cholesteatoma
Cholesteatoma is a growth that occurs in the middle ear. It is not cancerous; however, it can still be dangerous because it may become infected and/or cause permanent hearing loss. Cholesteatoma can erode the bones of the ear, the balance canals and the bone under the brain as the cholesteatoma expands. Common symptoms include ear discharge and hearing loss. Cholesteatoma removal requires minor surgery.

Ear Drainage
Ear drainage may be a problem in itself, or it can be a symptom of a bigger issue. Ear drainage can be caused by something as benign as earwax buildup, but it can also indicate trauma, an infection or a perforated eardrum. Waxy drainage is usually normal and nothing to worry about; however, bloody or foul-smelling drainage could indicate a serious issue. Contact your doctor right away if you notice unusual drainage from the ear.

Recurrent Ear Infections
Recurrent or chronic ear infections are infections that don’t go away or that continue to come back even after treatment. It is important to treat chronic ear infections because they may cause permanent damage to the middle and inner ear or other complications. Young children are most prone to chronic ear infections because their Eustachian tubes – the tubes that drain ear fluids – are small and narrow. Children often need tubes surgically implanted in their ears to help with drainage that causes infections.

On average, adults wait seven years before they seek help for their hearing loss. In most cases, hearing aids can be a solution to improve symptoms. Hearing aids are electronic devices that bring sound into the ear and amplify it to a level that the damaged ear can recognize. Though there may be differences in designs and features, all hearing aids have the same basic parts: a microphone, an amplifier and a speaker. Most hearing aids are worn in the ear or behind the ear.

Extended-wear hearing aids and implants are also available. Extended-wear hearing aids are placed in the ear non-surgically by an audiologist and can be worn for an extended period of time without removal. Implants are surgically implanted in or behind the ear. Implants are beneficial to people of all ages with severe hearing loss and profound deafness.

An evaluation of your hearing may determine the need for and potential benefit of the many different types of hearing aids available. Time is spent discussing which aids are most appropriate based on the particular needs and personal preferences of each individual. The hearing aids available today are better suited to treat hearing loss than ever before. Programmable digital technology has enabled the development of aids that can be effectively customized to meet your individual hearing needs in different sound environments.

Our hearing aid program is administered by board certified medical professionals, all with advanced graduate degrees and extensive clinical training. Our hearing-aid specialists, Patti Crews, Au.D. and Mary O’Brien, Au.D., work in collaboration with our ear, nose and throat specialist physicians to provide the highest level of honest personalized care.

Here are some of the main types of hearing aids:

• Completely-in-canal (CIC) or mini-CIC devices are molded to fit your ear canal. They work best for mild to moderate hearing loss in adults.
• In-the-canal (ITC) hearing aids are custom molded to fit partly in the ear canal. This style is best for mild to moderate hearing loss in adults.
• In-the-ear (ITE) devices are custom molded to fit most of the outer ear or just the lower part of the outer ear. They are best for mild to severe hearing loss in adults.
• Behind-the-ear (BTE) hearing aids have plastic molds that fit around the outer ear. They are useful for all age groups who experience mild to profound deafness.

Hearing Aid Financing
Our goal is for you to obtain the most benefit at the lowest price. We provide a wide variety of aids that range in price from $1000 to $3000 per ear. A three-year manufacturer’s warranty is included in the cost of the aid(s). Hearing aids come with a 30-day trial. When hearing aids are ordered you will be asked to pay a $100-per-aid nonrefundable deposit; the balance is due when the aids are fit and distributed. If at the end of 30 days you wish to return your hearing aids, you will be reimbursed the cost of the aids minus the deposit. If insurance benefits can be verified, we will bill your insurance for any portion they may cover of the total cost of amplification. For more information, please contact one of our expert audiologists.

Bone-Anchored Hearing Aids
A bone-anchored hearing aid is a surgically implanted hearing aid that works by transmitting soundwaves directly through the skull rather than through air waves that pass through the ear. People with normal hearing can hear sounds coming through both air waves and through bone. Those with outer or middle ear damage, however, are often unable to process sound waves through air. This is where the bone-anchored hearing aid comes in; it allows the user to still hear sounds more naturally, similar to how one hears their own voice.