Dr Magherra and his staff are here
to provide Ear, Nose and Throat specialist services at your doorstep. Our comprehensive range of ENT services include:
Ear infections can present with pain, itch, discharge, and
hearing loss. It is usually bacterial or fungal in origin but can sometimes be
caused by viruses. The treatment may require ear micro suction to remove pus
and infected wax followed by using medication.
HEARING LOSS
Hearing loss has numerous causes. It is crucial to seek
treatment as early as possible if the hearing loss is of sudden onset or if
there is a one-sided hearing loss.
EAR LUMPS
Lumps on the ear pinna can be benign conditions like keloids,
sebaceous cysts or pre auricular sinuses. These lumps can be removed under
local anaesthetic. Malignant lumps on the ear skin are usually caused by
excessive exposure to ultraviolet rays from the sun.
EAR WAX
Ear wax is normal dead skin. It will need to be removed by
ear micro suction if it accumulates excessively causing ear discomfort, itch
and/or hearing loss.
EAR ITCH
It can also be caused by fungal/bacterial infections or skin
eczema. This common condition could also be due to excessive ear picking.
GIDDINESS/Vertigo
The ear contains our balance organs. Loss of function of
this organ due to a viral infection, aging, crystal displacement or autoimmune
conditions can lead to a spinning sensation called vertigo. Treatment may
require specific manoeuvres, exercises and/or medication. Giddiness /vertigo
associated with a sudden loss of hearing requires immediate ENT attention.
RINGING NOISE IN THE EAR OR TINNITUS
This can be caused by ear infections, ear wax, aging or noise
exposure. Sometimes, no obvious cause is found. Tinnitus rehabilitation therapy plays major role in treating patients
with no obvious cause for the ringing noise.
NOSE
SINUSITIS
Paranasal sinuses are air spaces in our facial bones that are
connected to the nose by small passageways. Sinusitis is an infection of these
air spaces, and it is caused primarily by blockage of these passageways. Treatment is with medication and endoscopic
sinus surgery reserved for certain cases.
NOSE ALLERGY
The symptoms are frequent nasal blockage, itching, sneezing,
runny nose and even snoring. House dust mites are the main cause of allergic
rhinitis in Singapore. Treatment is with
long term medication and allergen avoidance. Radiofrequency ablation of the nasal
turbinate can be performed in the clinic if blocked nose persists.
BLOCKED AND RUNNY NOSE
Apart from nose allergy, the above symptom could be due to a
deviated nasal septum/bone, sinus infection, vasomotor rhinitis (reactive nose)
and nasal polyps. We will examine the nose carefully to identify the cause and
offer the necessary treatment. Radiofrequency turbinate ablation performed in
the clinic is a possible treatment for long term nasal obstruction that is not
responding to medication.
SNORING
Snoring is a social noise problem. However, snoring becomes
medically serious if there is a significant blockage of breathing during sleep
called severe obstructive sleep apnoea (OSA). A sleep study and nasoendoscopic examination
is required to identify the possible causes and to offer the appropriate
treatment.
NOSEBLEED
Nosebleeds will require a nasoendocopy examination of the
nasal passages to identify the cause and rule out a serious condition. Surface bleeding is treated with cautery in
the clinic.
NOSE INJURY
A knock on the nose can cause the nasal bone to fracture
requiring a manipulation and reduction procedure if there is bony fragment
displacement with a crooked nose. Persistent
nosebleed and blocked nose after the injury will also require a complete examination.
NOSE CANCER
Also called nasopharyngeal carcinoma, which is the 6th most common cancer amongst males in Singapore. The main cause is the Epstein
Barr virus. Symptoms are a mass in the neck, blood-stained phlegm, nosebleed,
one sided hearing loss and headaches. Treatment depending on disease staging is
with radiotherapy with or without chemotherapy.
THROAT AND MOUTH
TONSILLITIS
Acute and recurrent acute tonsillitis is caused by a
bacterial infection and presents with fever, severe sore throat, and painful
swallowing. Antibiotics are the mainstay treatment with surgery to remove the
tonsils indicated for frequent tonsillitis and for enlarged tonsils causing
obstruction.
THROAT INFECTION
This condition encompasses infections of the throat and
voice box region (larynx). Bacterial infections of the voice box can cause
airway narrowing and breathing difficulties. See a doctor immediately if you
have a sore throat with voice change, difficulty swallowing or difficulty
breathing.
SORE THROAT
Apart form bacterial and viral infections, persistent sore
throat can also be caused by acid reflux, allergies, irritants/pollutants, and
cancer. A nasoendoscopic examination is required to identify the cause.
CHRONIC COUGH
The ENT causes are allergies, postnasal drip from sinusitis
and laryngopharyngeal reflux (acid reflux from the stomach to the throat). Laryngopharyngeal reflux will present with
other throat symptoms apart from cough and will require long term treatment
with acid suppressants.
SWALLOWING DIFFICULTY
The
causes can be due to obstruction from growths/cancers/infections in the throat
and neck or nerve problems affecting the swallowing (stroke or damage to the
voice box nerve).
THROAT PHLEGM/LUMP
This common complaint can be caused by laryngopharyngeal
reflux, postnasal drip, allergies, chronic throat infection, throat spasm or
occasionally throat cancers. A nasoendoscopy examination is needed to identify
the cause.
VOICE CHANGE
This symptom can come in the form of hoarseness, a weak
voice, hyper-nasal voice or even an inability to reach certain pitches. A
common cause is voice abuse/strain, however there could be more sinister causes
like cancers. Patients who are heavy smokers and or drinkers with voice change should
seek medical attention early.
ULCER/LUMPS IN THE MOUTH
These can occur in any part of the mouth/tongue and have
either a whitish or reddish discolouration and can be painful or painless. All mouth lesions need to be looked at by a doctor
especially if persistent. A biopsy may be required.
NECK
NECK SWELLING
Neck
swellings could be due to infection, inflammation, enlarged lymph nodes,
tumours, cancers, and they can be benign or malignant. Full investigation involving biopsy test,
blood tests and nasoendoscopy is required for persistent neck swellings.
THYROID NODULE
Lumps
in the thyroid gland are called thyroid nodules. They are mostly benign and
slightly more common in females. All thyroid nodules that meet the size
criteria will need to be investigated by a blood test, needle biopsy and an
ultrasound scan to check for cancer. The
decision whether to surgically remove thyroid nodule will depend on the nature
and size of the nodule and whether the nodule is causing any blockage symptoms.
SALIVARY GLAND LUMPS
These are usually tumours (benign or malignant).
Investigated by needle biopsy and scans.
LYMPH NODE ENLARGEMENT
Enlarged lymph nodes in the neck that are persistent and growing
needs full investigation. The causes could be infection, head and neck cancers,
lymphoma, and other rare infiltrative conditions. We normally first investigate
persistently enlarged lymph nodes with a needle biopsy and scans.
NECK CANCER
Neck cancers are enlarged cancerous lymph nodes from
lymphoma, leukaemia or spread from cancers in the Ear, Nose and Throat region.
They are normally treated together with the primary site. The treatment options
available are surgery, radiation therapy and chemotherapy.
FRONT OF NECK INJURY
This injury can be either blunt or penetrative (cut or
penetrated by sharp object). This can be an emergency as the front of the neck
has both the airway and large blood vessels and any significant injury can
cause profuse bleeding and/or airway blockage.
EMERGENCIES
REMOVAL OF FOREIGN BODY IN THROAT
A foreign body, commonly a fish bone can get lodged anywhere
in the tonsils, base of tongue to the gullet. Foreign bodies stuck in the
tonsils and base of tongue can be removed in the clinic. If lodged in the
gullet, then a removal with esophagoscopy under general anaesthesia is
required.
SEVERE BLEEDING NOSE
This condition is usually caused by a ruptured blood vessel
in the nose. If it happens, perform first aid by pinching both nostrils while using
the mouth to breath, place an ice pack on the forehead and seek medical help as
soon as possible. Treatment may require nasal packing with or without cautery
of the bleeding blood vessel.
SEVERE SORE THROAT
Seek medical attention immediately as an emergency if the
sore throat is severe and unable to swallow, speak, have difficulty breathing
or with a large painful neck swelling. The cause is usually a severe throat
infection with possibly an abscess formation.
UNABLE TO SWALLOW
Gradual swallowing difficulty could be due to a nerve
problem or a cancer. Sudden onset of difficulty swallowing could be a stroke
and is an emergency.
BLOCKED AIRWAY OR BREATHING
Can be caused by severe throat infections, head and neck
cancers, bleeding in the ENT region or a sudden neurological event like a
stroke. A loud breathing sound called stridor is heard and this is an emergency.
PAINFUL NECK SWELLINGS
They are usually enlarged lymph nodes from infection or
congenital lumps/ tumours in the neck that have become infected. Fast growing
neck cancers can be painful too.
