Symptoms of Throat Pain

Throat Pain: Sore throat, Painful throat, Pharyngitis, Tonsillitis

There are many causes of a sore throat. It is useful to consider the causes of a sore throat according to whether the sore throat is generalized (affecting most of the throat) or is localized (affecting one area or one side of the throat).

A generalized sore throat may be caused by pharyngitis (infection/inflammation of the throat), tonsillitis, sinusitis (infection/inflammation of the sinuses), acid reflux, mouth breathing, environmental irritants (eg. from smoking, vaping, chemical exposure) or may be secondary to an underlying voice problem.

A localized sore throat may be caused by trauma, a swallowed foreign body, localized infection or by a more serious disorder, such as cancer of the throat or voicebox.

It is especially important to have a sore throat checked out quickly if the lain is localized to one side, or if it is associated with other symptoms such as ear pain, swallowing difficulty, a change in the voice or a neck lump.

How do we evaluate a sore throat?

People with a sore throat are evaluated by taking a thorough medical history and by performing an examination of the neck and the upper airway, including endoscopy. Standard endoscopy of the upper airwayis called laryngoscopy, in which an endoscope (a slim tube with a camera on the end)is passed through the noseusing local anaesthetic to examine the airway. A biopsy (a sample of tissue) is performed if any unusual masses or ulcers are found. This may be performed in the office using local anaesthetic, however in many cases this biopsy is performed under general anaesthetic in the operating room.

A biopsy of the neck lump may be required also by performing a fine needle aspirate (FNA), in which a fine bore needle is inserted into the lump to take a sample of cells for inspection by a pathologist.

Additional investigations may be required to complete the evaluation. These include: a CT and/or MRI scan of the neck and throat, a CT scan of the sinuses, more extensive endoscopy (transnasaloesophagoscopy), and reflux investigations.

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