Chronic come-and-go sore throat

[mitchgo]

i have a recurring sore throat in one specific spot in the
back of my throat for about two months. it hung around
for a couple of weeks and then went away. it seems to go
away for a few days and then come back for a few. often,
on days when i feel it, it ebbs and flows...goes away entirely
for three hours, comes back for a few, etc. it's extremely inconsistent
and variable.

at its least painful, it's a mild dry irritation. at its worst it's
maybe a four or five on the pain scale...moderately irritating
but not really that bad.

two years ago i suffered a bout of sinusitis. it lasted six
weeks. a spot in my throat would be sore for a day,then go
away, then recur in a different spot. this time i think the spot
has stayed in the same place. i had a mild cold in the past
two months but nothing like the sinus infection from two years
ago.  i believe i've always had a deviated septum...i can't remember
a time in my life when i've been able to breathe through both
nostrils normally. i use Breathe Right strips at night to help breathing.

i'm kind of a hypochondriac which isn't helping. ;-) i've noticed some
pain in my left ear (same side as the throat) but the pain is really identical
to ear pain i've had off and on for fifteen years (the ear opening is tender
to the touch, but the pain isn't deep, and you can't feel it when i swallow
or talk...it seems very topical, like a mild infection on the very outer part
of the ear opening, away from the ear drum. it comes and goes. i know
ear pain can be a symptom of throat cancer, which doesn't help my peace
of mind.

i'm 43, no tobacco or alchohol use, exercise daily, eat very well. i suspect
this throat thing is sinusitis related (its ebbing and flowing for days or
hours makes me think there isn't any lump or growth; i have no problems
swallowing. it doesn't *feel* like anything is in there.)

I'm seeing my DR tomorrow, but he's an internist, not an ENT. i'm hoping
he can look and rule out anything serious. overall it's a very mild but annoying
problem, worse for a hypochrondriac like me.

Just wondering if you have any wisdom...thanks!

[dabbarao]

1 Get a Throat swab for Group A Streptococci and serum ASO test.
2 Take Penidure LA 12 IM once in 3 weeks for 6 months

[National Jewish]

The sinuses are hollow areas within your head.  The maxillary sinuses are behind your cheeks.  The frontal sinuses are behind your forehead.  The ethmoid sinuses are behind and below the frontal sinuses.  The sphenoid sinuses are behind your nose.  To work properly, mucus needs to drain well from the sinuses.  The nasal septum is a plate of bone and cartilage along the center of the nose.  A deviated nasal septum is shifted to one side.  When your septum is deviated there is less space on the side that the septum leans towards.  Generally this area is squeezed.  A deviated nasal septum may cause blockage of the sinuses on that side to the point that the sinuses do not drain as well.  This can cause swelling of the nasal and sinus passages.  As the sinuses become swollen, the drainage openings that lead from each sinus into the nose become blocked.  Both the swelling and the mucus that collects in the sealed-off sinus can cause pressure.  This is a possible explanation of the recurring sore throat in the specific spot in the back of your throat and your left ear pain.  Surgery would return the septum to its usual position in the center of the nose.  This is generally helpful in clearing the blockage and decreasing sinus infections.

Sinusitis is an inflammation of the mucous membranes that line the sinus cavities.  Inflammation of the sinuses could be due to an allergy, an infection, or ongoing exposure to an irritant, such as pollution or smoke.  Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, an odor coming from the nose, postnasal drip, cough, sore throat, laryngitis, lightheadedness, constant low fever, and thick, yellow to green nasal drainage.  This inflammation can block sinus drainage and cause increased mucus production.  The mucus can drain from the nose and sinuses down the back of the throat causing a constant or intermittent postnasal drip and sore throat.

The best way to identify a sinus infection is with a sinus CT scan, although sinus x-rays are a decent alternative.  A sinus CT scan will also identify if any of the openings that drain your sinuses are blocked.  If your symptoms are due to sinusitis, they will last as long as the inflammation continues.  Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sin.html for more information about ways to clear up the inflammation.  Please check with your doctor to see which of these would work best for you.  Usually sinus surgery is considered when these techniques have not been helpful.