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What Causes A Constant Raspy Voice While Having Swollen Lymph Nodes In The Neck And GERD?
Question: Hello, I have been dealing with numerous swollen lymph nodes in my neck for about 2+ years. I have had multiple ultrasounds and they just keep showing more swollen lymph nodes, and some of which are getting larger. I am a marijuana smoker and have been for a very long time (12 years). I also have had vocal cord nodule that have subsided, but my voice is still constantly hoarse and raspy. I also have thyroid nodules, but those have pretty much stayed the same and my thyroid doctor isn’t concerned about them. I am only 25 years old, so all of these issues are really starting to make me think I either have throat cancer, lymphoma, or something else majorly wrong in my throat. Please give me some insight as to what you may think is going on! I have a follow up this week with my ENT doctor, and i really just want answers since this has been an ongoing thing for the past 2 years.
I also have been diagnosed with GERD. Not sure if this is something of importance.
I also have been diagnosed with GERD. Not sure if this is something of importance.
Brief Answer:
Repeated Ultrasound guided FNAC and biopsies.
Detailed Answer:
Hi,
I can understand your concerns as you are 25 years old and having multiple lymph nodes in the neck, thyroid nodules, treated vocal cord nodule yet the voice is hoarse and raspy; Negative, inconclusive biopsy and GERD.
Excision biopsy per se is the final diagnosis in most of the cases. But when one does not get the confirmed diagnosis I would advise to have a repeat excision that is complete removal of suspected lymph node as on ultrasonography to get the proper diagnosis.
Sometimes a repeat biopsy or repeated Ultrasound guided FNAC, fine needle aspiration cytology can give an appropriate diagnosis and thus allow for a specific treatment. Please insist on this.
When nothing specific is found then a course of oral steroids and anti-inflammatory medication may help resolve the problems. Many a time the diagnosis can be non-specific lymphadenitis and thus respond well to oral steroid when it is thought that the cause can be a sort of reaction to something that may not be found.
Also needed is ultrasound-guided FNAC of the thyroid nodules.
Stopping smoking can help to improve voice as well as you have to have control over speech, talk least possible, no loud or strained speech. What we call as voice-rest.
GERD is gastroesophageal reflux disease which in turn can cause throat problems if the acid comes up to the throat and can be contributory in voice changes. Hence it is important to have a proper treatment with a PPI like OMeprazole, Domperidone to control motility problem and avoid reflux, antacids help to neutralize stomach acid. Also needed is to stop the instigating or enhancing factors, foods and beverages to get better results. Needs very good observation and control.
I am hopeful that this answer helps you, helps in discussion with your ENT Surgeon, clinical evaluation and investigations to get an appropriate diagnosis and proper management.
Insist for repeated FNAC and/or excision biopsy of lymph nodes and thyroid under ultrasonography guidance.
Hope I have answered your query.
Regards,
Dr. T Chandrakant, General Surgeon
Repeated Ultrasound guided FNAC and biopsies.
Detailed Answer:
Hi,
I can understand your concerns as you are 25 years old and having multiple lymph nodes in the neck, thyroid nodules, treated vocal cord nodule yet the voice is hoarse and raspy; Negative, inconclusive biopsy and GERD.
Excision biopsy per se is the final diagnosis in most of the cases. But when one does not get the confirmed diagnosis I would advise to have a repeat excision that is complete removal of suspected lymph node as on ultrasonography to get the proper diagnosis.
Sometimes a repeat biopsy or repeated Ultrasound guided FNAC, fine needle aspiration cytology can give an appropriate diagnosis and thus allow for a specific treatment. Please insist on this.
When nothing specific is found then a course of oral steroids and anti-inflammatory medication may help resolve the problems. Many a time the diagnosis can be non-specific lymphadenitis and thus respond well to oral steroid when it is thought that the cause can be a sort of reaction to something that may not be found.
Also needed is ultrasound-guided FNAC of the thyroid nodules.
Stopping smoking can help to improve voice as well as you have to have control over speech, talk least possible, no loud or strained speech. What we call as voice-rest.
GERD is gastroesophageal reflux disease which in turn can cause throat problems if the acid comes up to the throat and can be contributory in voice changes. Hence it is important to have a proper treatment with a PPI like OMeprazole, Domperidone to control motility problem and avoid reflux, antacids help to neutralize stomach acid. Also needed is to stop the instigating or enhancing factors, foods and beverages to get better results. Needs very good observation and control.
I am hopeful that this answer helps you, helps in discussion with your ENT Surgeon, clinical evaluation and investigations to get an appropriate diagnosis and proper management.
Insist for repeated FNAC and/or excision biopsy of lymph nodes and thyroid under ultrasonography guidance.
Hope I have answered your query.
Regards,
Dr. T Chandrakant, General Surgeon
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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