Tied Throat

Tied Throat

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The common term for ankyloglossia is tongue tie. In this condition, the tongue is literally “tied,” or tethered, to the floor of the mouth, sometimes inhibiting both speech and eating. A child is born with this condition.
The tongue is one of the most important muscles involved in swallowing and speech. Without free range of motion, these activities can be impaired. However, the severity of tongue tie varies among children, so the condition may be detected early or later in life. Primary care providers may not always check for this condition at birth or at the initial well-child visits, so tongue tie is sometimes first discovered when parents report difficulty breastfeeding in infants or when an older child is having problems eating or speaking.
Tongue tie is common, affecting nearly 5 percent of all newborns. It is three times more common among boys than girls and frequently runs in families.
Research has shown that a significant number of infants with breastfeeding problems have tongue tie, and that when corrected, those problems may eliminated. A provider cannot always predict, however, whether a mild case of tongue tie might lead to a speech problem, so surgical intervention is not always necessary.
Tongue tie can also be associated with oral hygiene and dental problems, in part because food doesn’t get cleared away naturally by the tongue. While the condition sometimes goes away on its own, the simple surgery to correct it supports a baby’s normal oral development and helps to prevent eating and speaking problems.
Tongue tie occurs when the frenulum (the band of tissue under the tongue) fails to separate from the tongue before birth. This may be caused by genetics. The band stays connected as the child grows because it’s unusually short or thick, creating a tightness to the tongue that limits its mobility. Tongue tie is usually seen as an isolated condition, without any other disorders in a child. However, it is occasionally associated with other syndromes.
Children are born with this condition, but depending on its severity, tongue tie can have a range of effects that are noticeable at different times. Here are the most common signs and symptoms:
If a parent notices any feeding difficulties in their infant, or speech impediments in their older child, they should bring their child to their primary care provider for an evaluation. The primary care provider will usually be able to make a diagnosis of tongue tie based on a physical exam. The primary care provider will then likely refer your child to an otolaryngologist or an ENT physician (ear, nose and throat specialist). This specialist will confirm the diagnosis and be able to recommend the best treatment. During the evaluation, the otolaryngologist may:
While some providers take a watchful waiting approach to see if tongue tie might go away in milder cases, others increasingly recommend a prompt treatment approach, to prevent continues feeding difficulties in an infant, or in an older child more subtle speech difficulties, dental problems, and associated social anxieties. Most cases of tongue tie are treated as soon as they are diagnosed, and depending on the child’s age, it can be done either in the office or in the operating room.
Tongue tie can be corrected in one of two simple ways:
This can often be done in the ENT’s office if tongue tie is discovered in a newborn. The physician examines the frenulum and then snips it free with sterile scissors. The procedure is quick and usually bloodless. Most of the time, local anesthesia isn’t used because discomfort is minimal due to few nerve endings and blood vessels in the frenulum. After the procedure, the baby will breast feed while in the office. The breast milk acts as pain relief and an antiseptic.
If the frenulum is too thick for a frenotomy, a slightly more extensive procedure, called a frenuloplasty, may be recommended. This procedure uses general anesthesia and surgical tools to free the tongue from the thick band or several bands tied to it. The wound is closed with stiches that absorb on their own within a couple of weeks. Your child will go home the same day as the operation and will most likely not need to stay in the hospital overnight.
Possible complications of a frenuloplasty are rare and include bleeding, infection, scarring, or damage to the tongue or salivary gland.
In the vast majority of cases, treatment for tongue tie permanently corrects the condition and prevents the eating, speech, and dental problems that frequently go along with tongue tie. Occasionally, the simple frenotomy procedure fails to eliminate tongue tie and the problem recurs. Follow-up treatment with a frenuloplasty is then recommended.
Older children whose speech was impaired by tongue tie generally overcome their enunciation problems within a year or two, with the aid of a speech therapist.
With an in-office frenotomy procedure, the frenulum is snipped and there is usually no need for a follow-up appointment. In an infant, breastfeeding can provide the pain relief and infection-fighting properties that promote a prompt recovery.
With frenuloplasty, a follow-up appointment may be scheduled to check on your child’s healing in the treated area. There is no need for the removal of stitches, however, because they will absorb on their own.
Your child may be required to do tongue movement exercises to encourage proper movement and reduce the risk of scarring. Depending on your child’s speech, your child’s primary care provider may recommend working with a speech therapist, to correct enunciation problems.
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Read about Tickle in Throat Symptoms, Causes & Common Questions
Resident in Emergency Medicine at the University of Washington
Associate Professor of Medicine, Brigham and Women’s Hospital
Resident in Emergency Medicine at the University of Washington
Associate Professor of Medicine, Brigham and Women’s Hospital
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Illustration of a doctor beside a bedridden patient.
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Associate Professor of Medicine, Brigham and Women’s Hospital
A persistent dry cough can be caused from a upper respiratory infection or bronchitis. Other common causes for a dry throat cough include asthma, smoking, or viral throat infection. Viral pneumonia and COPD are less common causes of dry cough.
Your cough can be caused by viruses, bacterial infections, COVID-19, allergies, and a number of other conditions. Learn what your cough symptoms mean, how to get the right diagnosis, and what treatments actually help.
Congestion can be more than just a stuffy nose—and a sign of a lot of different conditions. Here are the 6 most common reasons you might feel congested and the best way to treat it.
A persistent dry cough can be caused from a upper respiratory infection or bronchitis. Other common causes for a dry throat cough include asthma, smoking, or viral throat infection. Viral pneumonia and COPD are less common causes of dry cough.
Your cough can be caused by viruses, bacterial infections, COVID-19, allergies, and a number of other conditions. Learn what your cough symptoms mean, how to get the right diagnosis, and what treatments actually help.
Congestion can be more than just a stuffy nose—and a sign of a lot of different conditions. Here are the 6 most common reasons you might feel congested and the best way to treat it.
A persistent dry cough can be caused from a upper respiratory infection or bronchitis. Other common causes for a dry throat cough include asthma, smoking, or viral throat infection. Viral pneumonia and COPD are less common causes of dry cough.
Your cough can be caused by viruses, bacterial infections, COVID-19, allergies, and a number of other conditions. Learn what your cough symptoms mean, how to get the right diagnosis, and what treatments actually help.
Congestion can be more than just a stuffy nose—and a sign of a lot of different conditions. Here are the 6 most common reasons you might feel congested and the best way to treat it.
References Chung KF. Approach to Chronic Cough: The Neuropathic Basis for Cough Hypersensitivity Syndrome. Journal of Thoracic Disease. 2014;6(Suppl 7):S699-S707. NCBI Link Walling AD. The Top Three Causes of Chronic Cough. American Family Physician. 2003;67(1):169-174. AAFP Link Upper Respiratory Infection (URI or Common Cold). Stanford Children's Health. Stanford Children's Health Link Bishop S. Postnasal Drip Not Usually Related to Bad Breath. Mayo Clinic. Published June 1, 2012. Mayo Clinic Link Ryan NM, Gibson PG, Birring SS. Arnold's Nerve Cough Reflex: Evidence for Chronic Cough as a Sensory Vagal Neuropathy. Journal of Thoracic Disease. 2014;6(Suppl 7):S748-5752. NCBI Link Bishop S. Cough That Lasts May Be Sign of Underlying Problem. Mayo Clinic. Published April 6, 2012. Mayo Clinic Link Sandhu GS, Kuchai R. The Larynx in Cough. Cough. 2013;9(1):16. NCBI Link Bishop S. Postnasal Drip Not Usually Related to Bad Breath. Mayo Clinic. Published June 1, 2012. Mayo Clinic Link
Take a quiz to find out what's causing your throat tickle.
A tickle in your throat can be caused by an infection, inflammatory conditions, or other chronic conditions, and treatments range from home treatment to doctor visits. Read more below to learn about that tickle sensation in your throat and its possible causes, treatments, and more.
Take a quiz to find out what's causing your throat tickle.
Approximately 1% of the population reports a tickling or dripping sensation in the back of the throat which persists in spite of repeated attempts to clear it. The sensation is often accompanied by a persistent dry cough. This sensation is known as postnasal drip syndrome and is caused by inflammation the upper respiratory tract.
Many conditions can cause upper respiratory tract inflammation, with some of the most common being infections, allergies, or environmental irritants. Postnasal drip syndrome can typically be managed with over the counter medications and will resolve on its own. However, airway irritation or cough that persists for more than 8 weeks should be evaluated by a medical doctor to rule out more serious chronic conditions like obstructive airway disease, chronic infection, or gastrointestinal reflux disease.
If you're experiencing this symptom , it may also be accompanied by [2-4]:
A tickling sensation in the back of the throat is due to irritation in the upper airway. This is commonly due to infection or inflammation in the upper respiratory tract. Infections can cause the irritating sensation, and the sensation can persist for weeks following resolution of the infection . Inflammation due to environmental factors like dust or pollen or due to medications is another common cause of upper airway irritation. Some chronic medical conditions can also cause upper airway irritation and tickle in throat symptoms.
Infectious causes of tickle in the throat may include the following.
Inflammation may occur due to the following, resulting in a tickle in your throat.
Chronic conditions can result in a tickle in your throat as an accompanying symptom.
This list does not constitute medical advice and may not accurately represent what you have.
Post-infectious cough is a cough that begins with a cold or other upper respiratory infection, but does not clear up when the infection does. Instead, it lingers for three weeks or more and becomes chronic.
Most susceptible are smokers, because the irritation from the smoke provokes the cough. Other common causes are post-nasal drip, asthma, and some high blood pressure medications.
Symptoms include an irritating sensation in the throat that may provoke severe bouts of coughing. Some coughing is normal and is part of the body's mechanism to clear the air passages and expel any foreign material, but such a cough should only be brief and intermittent.
A post-infectious cough can interfere with quality of life. A medical provider should be seen for help with the condition, both to ease the symptoms and to rule out a more serious cause for the coughing.
Diagnosis is made through patient history, physical examination, and chest x-ray, with the goal of ruling out different conditions one by one until the actual cause is found and can be treated.
Top Symptoms: cough, congestion, clear runny nose, mucous dripping in the back of the throat, hoarse voice
Symptoms that always occur with post-infectious cough: cough
Symptoms that never occur with post-infectious cough: fever
Urgency: Phone call or in-person visit
Take a quiz to find out what's causing your throat tickle.
Rhinitis simply means "inflammation of the nose." When it is caused by something other than allergies, it is called vasomotor rhinitis. "Vasomotor" simply refers to the constriction or dilation of blood vessels.
Different substances can trigger the vasomotor reaction, even though it is not an allergic reaction. Common causes are certain medications; air pollution; and chronic medical conditions.
Symptoms include runny nose, sneezing, congestion, and postnasal drip. Since no allergy is involved, there will not be the scratchy throat or itchy eyes and nose of allergic rhinitis.
A medical provider should be seen for ongoing symptoms, since they can interfere with quality of life. Also, using over-the-counter medications meant for allergic rhinitis will not help in a case of vasomotor rhinitis.
Diagnosis is made through patient history, physical examination, and allergy tests, in order to rule out allergies as a cause of the symptoms.
Treatment involves using the appropriate medications to ease the symptoms, and avoiding any triggers as much as possible.
Top Symptoms: congestion, mucous dripping in the back of the throat, runny nose, frequent sneezing, eye itch
Symptoms that never occur with non-allergic rhinitis: fever, sinus pain, facial fullness or pressure
Coronavirus (COVID-19) is a contagious viral infection that can cause fever, cough, trouble breathing, loss of smell, loss of taste, fatigue, muscle aches, and low appetite. Most people fully recover from COVID-19. Some people have more severe symptoms.
Consider calling your primary care provider or an urgent care center to see if you should be seen for testing. A nose swab or saliva (spit) test can be used to help diagnose a current COVID-19 infection. A blood test shows if someone has had the infection in the past.
New-onset seasonal allergies , also called adult-onset seasonal allergies, are sensitivities to pollen, mold, and other irritants that cause nasal congestion, runny nose, sneezing, itchy eyes, and sore throat.
Seasonal allergies commonly begin in childhood but can start at any age, especially among those with a family history. Moving to a different geographic location may trigger the allergy in someone with a genetic predisposition. Anyone with asthma is more likely to experience adult-onset seasonal allergies.
Sometimes the symptoms are actually from "pregnancy rhinitis" – nasal congestion and sneezing due to the effects of pregnancy hormones on the nasal tissue.
A new-onset allergy is often thought to be a cold, but a cold will clear up without treatment. Allergies persist, never getting better or worse, and can interfere with quality of life.
Diagnosis is made by an allergist, who will use skin tests and blood tests.
There is no cure for seasonal allergies but the symptoms can be managed for greater comfort and relief. Antihistamines, corticosteroid nasal sprays, and immunotherapy or "allergy shots" can be very effective.
Top Symptoms: fatigue, irritability, trouble sleeping, runny nose, congestion
Symptoms that never occur with chronic allergies: fever, yellow-green runny nose, chills, muscle aches
Asthma is a common ailment of children. Asthma is caused by hyperactive inflammation of the lung's airways.
You should visit your pediatrician to discuss the diagnosis of asthma , which requires a breathing test for confirmation. Upon diagnosis, your doctor will prescribe a treatment plan depending the severity of your symptoms. Typically an inhaled steroid (an inhaler) is prescribed. Your doctor will review how and when to use the inhaler.
Anaphylaxis is the sudden onset of breathing or heart rate changes that are caused by a whole-body allergic reaction. This can be a deadly situation.
Call 911 immediately for an ambulance. If you have been prescribed an epinephrine pen, use it. Don't do this if you have never been prescribed one!
Gastroesophageal reflux disease is also called GERD , acid reflux disease, and heartburn. It is caused by a weakening in the muscle at the end of esophagus. This allows stomach acid to flow backward, or reflux, up into the esophagus.
Risks factors for GERD include obesity, smoking, diabetes, hiatal hernia, and pregnancy.
Symptoms include a painful burning sensation in the chest and throat, and sometimes difficulty swallowing.
If heartburn occurs more than twice a week, a doctor should be consulted. If symptoms are accompanied by jaw or arm pain, and/or shortness of breath, these may be signs of a heart attack and constitute a medical emergency.
Repeated exposure to stomach acid damages the lining of the esophagus, causing bleeding, pain, and scar tissue.
Diagnosis is made by patient history and sometimes by x-ray, upper endoscopy, or other tests to measure refluxed acid.
Treatment begins with over-the-counter antacids and lifestyle changes. Medication may be used to reduce stomach acid, and surgery may be done to strengthen the sphincter muscle at the lower end of the esophagus.
New-onset seasonal allergies, also called adult-onset seasonal allergies, are sensitivities to pollen, mold, and other irritants that cause nasal congestion, runny nose, sneezing, itchy eyes, and sore throat.
Seasonal allergies commonly begin in childhood but can start at any age, especially among those with a family history. Moving to a different geographic location may trigger the allergy in someone with a genetic predisposition. Anyone with asthma is more likely to experience adult-onset seasonal allergies.
Sometimes the symptoms are actually from "pregnancy rhinitis" – nasal congestion and sneezing due to the effects of pregnancy hormones on the nasal tissue.
A new-onset allergy is often thought to be a cold, but a cold will clear up without treatment. Allergies persist, never getting better or worse, and can interfere with quality of life.
Diagnosis is made by an allergist, who will use skin tests and blood tests.
There is no cure for seasonal allergies but the symptoms can be managed for greater comfort and relief. Antihistamines, corticosteroid nasal sprays, and immunotherapy or "allergy shots" can be very effective.
Top Symptoms: sore throat, congestion, cough with dry or watery sputu
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