Throat Archives - ENT Health https://www.enthealth.org/health_and_wellness_categories/throat-latest-research-guidelines/ Mon, 14 Aug 2023 18:55:05 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.3 249128111 FAQs Comparing Nonopioid and Opioid Medications https://www.enthealth.org/be_ent_smart/faqs-comparing-nonopioid-and-opioid-medications/ Tue, 06 Apr 2021 06:00:44 +0000 https://www.enthealth.org/?post_type=be_ent_smart&p=2170 From the Clinical Practice Guideline: Opioid Prescribing for Analgesia after Common Otolaryngology Operations, this information provides answers to frequently asked questions comparing nonopioid and opioid medications.

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FAQs Comparing Nonopioid and Opioid Medications

NSAIDs = Nonsteroidal Anti-inflammatory Drugs

Can I Be Addicted to This?

  • Opioids: Yes
  • NSAIDs: No
  • Acetaminophin: No
  • Gabapentinoids: Yes

When Are They Used? What Levels of Pain?

  • Opioids: Severe
  • NSAIDs: Mild-Severe
  • Acetaminophin: Mild-Severe
  • Gabapentinoids: Mild-Moderate

Should I Start with This Medication?

  • Opioids: No, use only if around-the-clock nonopioid medications are not enough.
  • NSAIDs: Yes, you may start with this medication.
  • Acetaminophin: Yes, you may start with this medication.
  • Gabapentinoids: No, only use if NSAIDs and/or acetaminophen is not enough.

Is This Used Alone or with Other Medications?

  • Opioids: Should be used in combination with other pain medications.
  • NSAIDs: Can be used alone or in combination.
  • Acetaminophin: Can be used alone or in combination.
  • Gabapentinoids: Should be used in combination with other pain medications.

Can I Stop Using This Medication and How Do I Stop?

  • Opioids: Sometimes this needs to be slowly stopped (“tapered”) depending on how much you have taken. Talk about this with your health care provider.
  • NSAIDs: This can be stopped at any time.
  • Acetaminophin: This can be stopped at any time.
  • Gabapentinoids: Sometimes this needs to be slowly stopped (“tapered”) depending on how much you have taken. Talk about this with your health care provider.

What Are the Common Side Effects (Reported in 3% or More of Patients)?

  • Opioids: Dizziness, nausea (very common), headache, drowsiness (feeling sleepy or tired), vomiting, dry mouth, itching, and constipation.
  • NSAIDs: Upset stomach. 
  • Acetaminophin: Nausea, vomiting, headache, and insomnia (being unable to sleep).
  • Gabapentinoids: Dizziness, drowsiness (feeling sleepy or tired), swelling in the hands and feet, weight gain, and blurred vision.

What Are the Serious Risks and What is the Risk of Addiction or Dependence?

  • Opioids: Respiratory depression (very slow breathing), misuse, abuse, addiction, overdose, and death from respiratory depression. Your risk of opioid abuse increases the longer you take the medication.
  • NSAIDs: Stomach bleeding or ulcers, heart attack, kidney damage, and stroke. Celecoxib has a lower risk of stomach bleeding and/or ulcer formation over the short term.
  • Acetaminophin: Liver damage may occur at high doses (greater than 3,000 milligrams in 24 hours).
  • Gabapentinoids: Suicidal thoughts, respiratory depression. Risks increase if you have kidney, liver, or heart disease or have suicidal thoughts.

SOURCE: Anne SA, Mims JW, Tunkel DE, et al. Clinical practice guideline: opioid prescribing for analgesia after common otolaryngology operations. Otolaryngol Head Neck Surg. 2021;164(2_suppl):S1-S42.

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FAQs about Opioids

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 2170 Tonsillectomy and Airway Obstruction During Sleep: Caregiver Counseling https://www.enthealth.org/be_ent_smart/tonsillectomy-and-airway-obstruction-during-sleep-caregiver-counseling/ Tue, 05 Feb 2019 15:28:10 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1661 Be ENT Smart / Latest Research & Guidelines What Is Obstructive Sleep-Disordered Breathing? oSDB is when air is blocked during sleep. It can be caused by large tonsils and adenoids. Children that are overweight may also have oSDB. Children with…

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Tonsillectomy and Airway Obstruction During Sleep: Caregiver Counseling

What Is Obstructive Sleep-Disordered Breathing?

oSDB is when air is blocked during sleep. It can be caused by large tonsils and adenoids. Children that are overweight may also have oSDB. Children with oSDB may be sleepy during the day, act out, struggle in school, have nighttime bedwetting and be small for their age.

How is oSDB Diagnosed?

A sleep study or polysomnography (pol-ee-som-nog-ruh-fee) or “PSG” may be needed to see if your child has oSDB. The test is done in a sleep lab. A medical technician will put small discs or pads on your child’s head and body. Your child’s heart rate, body movements, oxygen levels, and breathing through their mouth and nose will be measured.

Will My Child's oSDB Go Away after Tonsillectomy?

Tonsillectomy helps almost all normal-weight children with oSDB and it improves sleep in most children in this group. Tonsillectomy also helps overweight children with oSDB but sleep is not always improved. Your child’s oSDB may not go away or it may return even after tonsillectomy.

What if I have More Questions?

Contact your healthcare provider if you have any further questions.

Source:

Adapted from Mitchell, RB, Archer, SA, Ishman, SL, et al. Clinical practice guideline: tonsillectomy in children (update). Otolaryngol Head Neck Surg. 2019;160(Suppl 1):S1-S42.

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Post-Tonsillectomy Pain Management for Children: Education for Caregivers

Kids ENT Health

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1661 Post-Tonsillectomy Pain Management for Children: Education for Caregivers https://www.enthealth.org/be_ent_smart/post-tonsillectomy-pain-management-for-children-education-for-caregivers/ Tue, 05 Feb 2019 14:49:00 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1654 Be ENT Smart / Latest Research & Guidelines How Long Is the Recovery after Surgery? Pain lasts about 7-10 days and can last as long as two weeks. Your child may complain of throat pain, ear pain and neck pain.…

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Post-Tonsillectomy Pain Management for Children: Education for Caregivers

How Long Is the Recovery after Surgery?

Pain lasts about 7-10 days and can last as long as two weeks. Your child may complain of throat pain, ear pain and neck pain. The pain may be worse in the morning; this is normal. You should ask your child if they are having any pain every four hours remembering that they may not say they are in pain.

Will My Child Be Taking Pain Medication

Yes, your child will be prescribed pain medications such as ibuprofen or acetaminophen. Ibuprofen can be used safely after surgery. Pain medication should be given on a regular schedule. You may be asked to give pain medication around the clock for the first few days after surgery, waking your child up when he or she is sleeping at night. Alternating medication such as ibuprofen and acetaminophen may be recommended. Rectal acetaminophen may be given if your child refuses to take pain medication by mouth. Ask your child if their pain has improved after giving pain medication.

Does My Child Need to Restrict Their Diet after Surgery?

YNo, your child can eat as they normally would as long as it does not bother them. Make sure your child drinks plenty of fluids like water or juice. Offer frequent small amounts of fluids by bottle, sippy cup or glass. Fluids can help with their pain. Encourage your child to chew and eat food including fruit snacks, popsicles, pudding, yogurt or ice cream.

Will Other Things Besides Pain Medication Help My Child's Pain?

Yes, there are things other than medication that can also be utilized. You can distract your child by playing with them, having their favorite toys or video games available, applying a cold or hot pack to their neck and/or ears, blowing bubbles, doing an art project, coloring, watching television or reading a book.

What Should I Do if I Cannot Manage My Child's Pain?

Call your healthcare provider.

Source:

Adapted from Mitchell, RB, Archer, SA, Ishman, SL, et al. Clinical practice guideline: tonsillectomy in children (update). Otolaryngol Head Neck Surg. 2019;160(Suppl 1):S1-S42.

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Tonsillitis

Tonsils and Adenoids

Tonsillectomy and Airway Obstruction During Sleep: Caregiver Counseling

Kids ENT Health

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1654 How to Prevent Hoarseness (Dysphonia) https://www.enthealth.org/be_ent_smart/how-to-prevent-hoarseness-dysphonia/ Tue, 02 Oct 2018 14:46:42 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1324 Hoarseness, or dysphonia, is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication as assessed by a clinician and/or affects quality of life.

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How to Prevent Hoarseness (Dysphonia)

What is Dysphonia?

Altered vocal quality, pitch, loudness, or vocal effort that impairs communication as assessed by a clinician and/or affects quality of life.

Who is at Greatest Risk for Developing Dysphonia (Hoarseness)?

Individuals who professionally use their voices such as singers, teachers, and call-center operators, certain age groups including children, older persons, and smokers.

What Preventive Measures Can Help Reduce Voice Disorders?

  • DO: Adequately hydrate by drinking plenty of water daily.
  • DO: Use of amplification (microphone or megaphone) in large noisy spaces can help reduce shouting and voice strain.
  • DO: Rest your voice briefly to prevent voice fatigue, straining, and overuse.
  • DO: Provide indoor air humidification in dry, arid environments.
  • AVOID: Smoking and second-hand smoke from cigarettes, cigars, and pipes that can irritate your airway, throat, nose, and mouth.
  • AVOID: Overusing or straining your voice by yelling, shouting, speaking over loud noises, and whispering.
  • AVOID: Excessive throat clearing and coughing.
  • AVOID: Alcohol (beer, wine, liquor) and caffeine beverages (coffee, soft drinks) as they can dry the throat resulting in mucous thickening.
  • AVOID: Use of drying medications (some antihistamines, diuretics).

Source:

Adapted from Stachler RJ, Francis DO, Schwartz SR et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018; 158(1 Suppl):S1-S42.

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Voice Therapy - FAQs

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1324 Voice Therapy – FAQs https://www.enthealth.org/be_ent_smart/voice-therapy-faqs/ Tue, 02 Oct 2018 13:50:10 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1322 Voice therapy has been demonstrated to be effective for dysphonia across the lifespan from children to older adults.

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Voice Therapy – FAQs

Why is Voice Therapy Recommended for Dysphonia?

Voice therapy has been demonstrated to be effective for dysphonia across the lifespan from children to older adults. Voice therapy is the first line of treatment for vocal fold lesions like vocal nodules, polyps, or cysts. These lesions often occur in people with vocally intense occupations like teachers, attorneys, or clergy. Another possible cause of these lesions is vocal overdoing often seen in sports enthusiasts; in socially active, aggressive, or loud children; or in high energy adults who often speak loudly. Voice therapy, specifically the Lee Silverman Voice Therapy method, has been demonstrated to be the most effective method of treating the lower volume, lower energy, and rapid-rate voice/speech of individuals with Parkinson’s disease.

Voice therapy has been used to treat dysphonia concurrently with other medical therapies like botulinum toxin injections for spasmodic dysphonia and/or tremor. Voice therapy has been used alone in the treatment of unilateral vocal fold paralysis, presbyphonia, vocal process granuloma, and has been used to improve the outcome of surgical procedures as in vocal fold augmentation or thyroplasty. Voice therapy is an important component of any comprehensive surgical treatment for dysphonia.

What Happens in Voice Therapy?

Voice therapy is a program designed to reduce dysphonia through guided change in vocal behaviors and lifestyle changes. Voice therapy consists of a variety of tasks designed to eliminate harmful vocal behavior, shape healthy vocal behavior, and assist in vocal fold wound healing after surgery or injury. Voice therapy for dysphonia generally consists of 1 to 2 therapy sessions each week for 4 to 8 weeks. The duration of therapy is determined by the origin of the dysphonia and severity of the problem, co-occurring medical therapy, and importantly, to patient commitment to the practice and generalization of new vocal behaviors outside the therapy session.

How Do I Find a Qualified Speech Language Pathologist Who Has Experience in Voice?

The American Speech Language and Hearing Association (ASHA) is an excellent resource for finding a certified speech-language pathologist by going to the ASHA website (www.asha.org) or by accessing ASHA’s online search engine called ProSearch at: http://www.asha.org/proserv. You may also contact ASHA’s Action Center, Monday through Friday (8:30am-5:00pm) at: 1-800-498-2071; Fax: 301-296-8580; TTY (Text Telephone Communication Device): 301-296-5650; E-mail: actioncenter@asha.org.

Does Insurance Cover Voice Therapy?

Generally, Medicare, under the guidelines for coverage of speech therapy, will cover voice therapy if provided by a certified and licensed speech-language pathologist, ordered by a physician, and is deemed medically necessary for the diagnosis. Medicaid varies from state to state but generally covers voice therapy, under the rules for speech therapy, up to the age of 18 years old. It is best to contact your local Medicaid office, as there are state differences and program differences. Private insurance companies vary and the consumer is guided to contact their insurance company for specific guidelines for their purchased policies.

Are Speech Therapy and Voice Therapy the Same?

Speech therapy is a term that encompasses a variety of therapies including voice therapy. Most insurance companies refer to voice therapy as speech therapy but they are the same thing if provided by a certified and licensed speech-language pathologist.

Source

Stachler RJ, Francis DO, Schwartz SR et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018; 158(1 Suppl):S1-S42.

Related CONDITIONS

Hoarseness

How to Prevent Hoarseness (Dysphonia)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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