Throat & Voice

Tonsils & Adenoids

The tonsils are two masses of tissue found on either side of the back of the throat. The adenoids are located high in the throat behind the nose and roof of the mouth. Together they form part of the ring of glandular tissue at the back of the throat. The tonsils and adenoids assist the body in defense against infection by "sampling" entering bacteria and viruses and becoming infected themselves. They then help form antibodies to resist and fight future infections. However, the tonsils and adenoids often become susceptible to recurrent bacterial infections and can even trigger airway obstruction.

Common problems afflicting the tonsils and adenoids include:

  • chronic tonsillitis or persistent infection of the tonsils
  • peritonsillar abscess, a collection of pus behind the tonsils that can lead to life-threatening complications if left untreated
  • enlargement of (hypertrophic) tonsils and adenoids, which can obstruct breathing and lead to sleep irregularities, among other problems

Bacterial infections of the tonsils and adenoids can be treated with various antibiotics. Surgical removal is considered when conditions are resistant to medical therapy or frequently recur.

Sore Throats

Pharyngitis is a viral infection that causes a sore throat and pain when swallowing, and is often a result of the common cold or strep throat. This infection causes an inflammation of the throat and sometimes the tonsils as well.

Pharyngitis associated with the common cold has no treatment other than bed rest and over-the-counter medication, while pharyngitis caused by strep throat can be treated with an antibiotic.

Hoarseness

Hoarseness refers to any abnormality of the voice and can manifest as changes in vocal characteristics resulting in a breathy, rough, raspy or strained quality with differences in vocal projection or pitch. These changes can occur as a result of many different causes, both acute and chronic, such as laryngitis or inflammation of the vocal folds, laryngopharyngeal reflux (LPR, acid reflux), vocal overuse, muscle tension and vocal fold masses (polyps, cysts, nodules). Dr. Cohen will decide which treatment is best for you after a thorough evaluation of your condition.

Swallowing Disorders

Dysphagia, or swallowing disorder, is a term used to describe the inability to move food from the mouth to the stomach. This condition can accompany a neurological disorder such as stroke, Parkinson's disease, cerebral palsy, Lou Gehrig's Disease, etc., as well as bacterial, viral, or fungal infections. Dysphagia can occur at any of the 3 stages of swallowing: oral, pharyngeal, and esophageal.

Depending on the type of swallowing disorder, changing a person's diet by adding thickeners and physical therapy may help alleviate the problem in noninvasive ways. Sometimes drug therapy helps relieve symptoms of the underlying neurological cause and thus relieves the swallowing problems. Less commonly, botulinum toxin injections can be used when food or liquid cannot enter the esophagus. Severely affected individuals may require surgery or feeding tubes.

Salivary Glands

The salivary glands are found in and around the mouth and throat. The major salivary glands are the parotid, submandibular, and sublingual glands. The parotid secretes saliva near the upper teeth, the submandibular from under the tongue, and the sublingual through the floor of the mouth. Additionally, many other minor salivary glands are located in the lips, inner cheeks, and throat. Saliva aids in digestion, oral lubrication and hygiene, and protection against tooth decay.

Disorders of the salivary glands include obstruction, infection, secondary infection from lymph node enlargement, and tumors. Conditions that can affect the salivary glands include autoimmune diseases, such as HIV, which attack the salivary glands and cause them to enlarge. Others are rheumatoid arthritis, which can cause dry mouth, and diabetes, which may result in swelling and enlargement.

Facial Paralysis

Facial paralysis involves a loss of voluntary muscle movement within the face, which may occur as a result of stroke, brain tumor, infection, trauma, Bell’s palsy or other factors. The facial nerve stretches down each side of the face and allows us to laugh, cry, smile or frown when functioning properly.

Treatment for facial paralysis depends on the underlying cause of the condition, but may include medication, physical therapy or surgery to relieve pressure on the facial nerve or to repair a severely damaged facial nerve.

Head & Neck Cancer

Head and neck cancers encompass several different diseases that can affect the mouth, nose, throat and other surrounding areas. Over 50,000 Americans are diagnosed with head and neck cancer each year, as these diseases account for 3 to 5 percent of all cancers. Many cases of head and neck cancer can be prevented through life changes.

Several different types of cancer can affect the areas of the head and neck. Most begin in the lining of moist, mucosal surfaces such as the mouth, nose and throat. The cells in the lining are known as squamous cells, and may therefore be affected by squamous cell carcinomas. The different types of cancer associated with the head and neck include:

  • Oral cavity
  • Salivary glands
  • Nasal cavity
  • Pharynx (including nasopharynx, oropharynx and hypopharynx)
  • Larynx
  • Lymph nodes

Like other types of cancer, these diseases can spread to other areas of the body and lead to serious complications. Prompt, thorough treatment is essential in restoring the health and overall well-being of patients with head and neck cancer.


For more information about Throat & Voice, contact our office at 818-609-0600 to schedule an appointment.

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