Know your symptoms: when blocked ears or nose or a sore throat get serious

One of the things that makes ENT such an interesting speciality is the wide variety of symptoms that patients present with. However, as a patient this one of the reasons ear, nose and throat symptoms can be so worrying. These symptoms often give rise to anxiety, which can lead to other problems such as poor concentration, sleeplessness and forgetfulness, which makes matters worse.  

When we have symptoms that we haven't had before it is usually unsettling and often gives rise to concern that something serious is wrong. On most occasions, this isn't the case, although there are some symptoms that should be checked more urgently. These are often referred to as 'red-flag' symptoms and should be seen as a matter of priority, in order that a diagnosis can be made.

It is worth noting that even if you do have these symptoms, it is often the case that there is nothing to be worried about. Whilst it varies from region to region in the UK, overall, only about 1 in 20 patients referred with red-flag symptoms are ultimately found to have cancer. However, if you smoke, or drink alcohol heavily, the risk of having cancer is increased. Whilst there are other serious illnesses that are not cancer that can cause ear, nose and throat symptoms, these are rare. 

The most common red-flag ear, nose and throat symptoms are listed below:

Earache ('otalgia') in one ear for more than four weeks. 

An unexplained lump in the head and neck region that has been present for more than four weeks. 

A hoarse or husky voice that has persisted for more than three weeks. 

Glue ear on one side (unilateral 'middle ear effusion') that has persisted for more than three weeks. 

Persistent or worsening difficulty in swallowing food or food sticking in the throat (also known as 'dysphagia') 

An ulcer on the tongue or lining of the mouth that has persisted for more than three weeks. 

A sore throat that has persisted for more than three weeks. 

Swelling/protrusion of the eye, mouth or face that has lasted for more than three weeks. 
(note: sudden or rapid onset swelling or protrusion of the eye should be reviewed as an emergency).

Persistent (more than three weeks) red or white patches in the mouth, with either pain, bleeding or swelling.

A loose or wobbly tooth that isn't due to infection or inflammation around the tooth.

A blocked nose on one side, with associated bloody or mucky discharge for more than three weeks. 

Unexplained numbness or weakness in the face or mouth. 

If you do have any of these symptoms, it is advisable to have an urgent review with either your GP or an ENT specialist, who can take the necessary steps to diagnose the problem. In most cases, this entails taking a detailed history, performing a careful examination of the head and neck region and sometimes arranging further tests.