ENT Insights and Blogs

Nasopharyngeal carcinoma (NPC) is one of the most common head and neck cancers in Chinese men in Southeast Asia. Haemoptysis — coughing up blood — can be the first and only symptom of NPC, and is frequently misattributed to the lungs or throat. The nasopharynx cannot be seen without specialist equipment — a normal GP or general examination does not exclude a nasopharyngeal tumour EBV (Epstein-Barr virus) blood titres are a key diagnostic and monitoring tool in NPC.

Swallowing disorders (dysphagia) occur when the coordinated muscle and nerve action required for swallowing breaks down. In Singapore, common causes include laryngopharyngeal reflux, cricopharyngeal dysfunction, Zenker's diverticulum, neurological conditions such as Parkinson's disease or stroke, and head and neck cancer. Treatment depends on the cause and may include botulinum toxin injection, endoscopic dilation, laser or stapling surgery, or swallowing rehabilitation.

Head and neck cancer encompasses malignancies of the throat, voice box, mouth, nose, salivary glands, and neck lymph nodes. In Singapore, nasopharyngeal cancer (NPC) is particularly prevalent, especially in men of Chinese ethnicity. Key warning signs include a persistent neck lump, hoarseness lasting more than 3 weeks, a mouth ulcer that won't heal, and one-sided nasal or ear symptoms. Treatment combines surgery, radiotherapy, and chemotherapy depending on cancer type and sta

Bell's palsy causes sudden one-sided weakness affecting the eye, mouth, and cheek It is caused by inflammation of the facial nerve and affects around 20–30 per 100,000 people each year Steroids started within 72 hours significantly improve the chance of full recovery Most patients recover well with prompt treatment Bell's palsy causes sudden one-sided facial weakness — affecting the eye, mouth, and cheek on the affected side. Early treatment with steroids within 72 hours sign

Globus is the sensation of a lump or tightness in the throat with no actual obstruction Laryngopharyngeal reflux (LPR) is a common cause — and many patients have no heartburn at all This post explains why throat symptoms can occur without classic reflux signs Diagnosis and management options are outlined Laryngopharyngeal reflux causes inflammation of the throat and voice box, producing the characteristic sensation of a lump or tightness — even in patients who have no heartbu

Tonsillitis is most commonly viral and self-limiting, but recurrent bacterial tonsillitis significantly affecting quality of life — typically seven or more episodes in a year — is a recognised indication for tonsillectomy. In children, enlarged tonsils causing obstructive sleep apnoea are an equally important reason for surgery, which resolves sleep-disordered breathing in the majority of cases.

The salivary glands are among the least-discussed structures in the head and neck — until something goes wrong with them. A painful swelling under the jaw at mealtimes, a lump in front of the ear, or a persistently dry mouth can all point to a salivary gland problem. Most of the time these conditions are benign and highly treatable, but they do require accurate diagnosis to ensure the right treatment is chosen.

The majority of neck lumps in adults are benign — most are reactive lymph nodes responding to infection that resolve within a few weeks. However, a lump that persists beyond two to three weeks, is growing, or is accompanied by voice change, difficulty swallowing, or unexplained weight loss should be assessed promptly by an ENT specialist.

Acid reflux is widely associated with heartburn — a burning sensation in the chest that most people recognise immediately. But a significant number of patients experience reflux in a completely different way: with symptoms in the throat, not the chest. No heartburn. No obvious gastric complaint. Just a persistent throat problem that doesn't seem to go away.

Laryngopharyngeal reflux — where stomach contents reach the throat and voice box — frequently occurs without heartburn, which is why it is so often missed or misdiagnosed. The characteristic symptoms are throat clearing, chronic cough, globus sensation, and hoarseness rather than the burning chest discomfort of typical gastro-oesophageal reflux, and treatment requires both dietary modification and acid suppression over a sustained period.

A diagnosis of thyroid cancer is frightening, and the prospect of surgery adds another layer of anxiety. One of the most important things I try to convey to patients at the outset is this: thyroid cancer is one of the most treatable cancers we know of.

There are four main types of thyroid cancer — papillary, follicular, medullary, and anaplastic — each with different biological behaviour, treatment approach, and prognosis. Papillary thyroid cancer, the most common type, has an excellent long-term prognosis with appropriate surgical and radioiodine treatment, while anaplastic thyroid cancer is rare but aggressive and requires urgent multidisciplinary management.

Neurolaryngology is the subspecialty concerned with voice and swallowing disorders caused by neurological conditions — including vocal cord paralysis, spasmodic dysphonia, vocal tremor, and voice changes associated with Parkinson's disease or stroke. Accurate diagnosis requires direct visualisation of the vocal cords alongside a detailed assessment of the underlying neurological condition, and treatment is highly individualised.

Tonsil stones — calcified debris accumulating in the crypts of the tonsils — cause persistent bad breath and a foreign body sensation in the throat that can be difficult to manage at home. For patients with recurrent, symptomatic tonsil stones that do not respond to irrigation or conservative measures, tonsillectomy provides a definitive and permanent solution.

Thyroid surgery — thyroidectomy — is recommended for thyroid nodules that are malignant or suspicious on biopsy, significantly enlarged goitres causing compression symptoms, or hyperthyroidism not controlled by medication. Performed by an experienced ENT head and neck surgeon, the risks to the recurrent laryngeal nerve and parathyroid glands are minimised, and most patients are discharged within one to two days.