DEAR DR. ROACH: Several weeks ago, I noticed that my face was swollen in front of my ear. I went to my primary doctor, and he put me on Augmentin and methylprednisolone, but that did not work, and the area is still swollen. I searched the Internet and found that the parotid gland is in the swollen area. A dentist told me that it IS the parotid gland, and it could be a sinus blockage. Who should I see next, an ENT doctor? This all started with my teeth on that side hurting. Could it be a dental problem? — D.N.

ANSWER: The parotid glands are the largest of the salivary glands and are located behind the teeth and in front of the ear in both cheeks. In my experience, the most likely cause of a swollen parotid gland on one side is a salivary gland stone, called sialolithiasis.

I can’t understand why both your parotid gland would be swollen and your teeth hurting from the same condition. Parotid stones typically hurt worse with eating or anticipation of eating.

If the dentist who examined you said it’s the parotid gland (and presumably not a dental problem), then an ENT physician is certainly the expert on disorders of the parotid glands. If it’s a stone, it usually can be removed by the ENT physician.

DEAR DR. ROACH: Six or seven years ago, after a longstanding runny nose and cough, I had an allergy test. I was told I had nonallergic rhinitis and that there was no treatment. After seeing a new ENT doctor, I had another allergy test, with the result being that I am allergic to MANY things: pollen, dust mites, animals, etc. I have been getting five shots per week for over a year now, and there is no change.

My coughing, blowing my nose, eyes burning and tearing have gotten worse. I really am at a standstill as to direction. There has been no change in my symptoms, and, as a matter of fact, I think they have gotten worse. — S.

ANSWER: “Nonallergic rhinitis” is a term given to a group of related medical conditions, which share symptoms of sneezing, runny nose, nasal congestion and post-nasal drip. Eye symptoms are not common in nonallergic rhinitis, and since in hindsight these have become more of a problem, I suspect your second ENT doctor is right, that your condition is allergic.

The symptoms of allergic rhinitis are similar: sneezing, often in groups; runny nose and nasal congestion; but often prominent are eye symptoms, such as watery and itchy eyes. Cough and postnasal drip also are common.

There is treatment for both allergic and nonallergic rhinitis. In allergic rhinitis, avoiding what you are allergic to is common sense, but it’s not always possible. You are getting immunotherapy (shots). I am (very) surprised you didn’t tell me about medication therapy, since there are many different classes of effective medications that are normally tried before going on to immunotherapy. Like any treatment, including medications, not everyone gets a benefit from immunotherapy. A year usually is long enough to begin seeing benefits, but some people continue to improve up to three and even five years after starting treatment.

The most effective single treatment for allergic rhinitis is a preparation of nasal steroids; however, since there are many, many prescription, nonprescription and complementary and alternative approaches, you need to go back to your doctor and discuss your next options, and whether to continue the immunotherapy.

One treatment I will highlight that is safe, effective and improves other treatments is irrigation of the nose with saline. This can be done before using other medications to help their absorption.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

(c) 2014 North America Syndicate Inc.

All Rights Reserved

              

               ENT can handle blocked salivary gland

 

               DEAR DR. ROACH: Several weeks ago, I noticed that my face was swollen in front of my ear.  I went to my primary doctor, and he put me on Augmentin and methylprednisolone, but that did not work, and the area is still swollen.  I searched the Internet and found that the parotid gland is in the swollen area. A dentist told me that it IS the parotid gland, and it could be a sinus blockage. Who should I see next, an ENT doctor?  This all started with my teeth on that side hurting.  Could it be a dental problem? — D.N.

               ANSWER: The parotid glands are the largest of the salivary glands and are located behind the teeth and in front of the ear in both cheeks. In my experience, the most likely cause of a swollen parotid gland on one side is a salivary gland stone, called sialolithiasis.

               I can’t understand why both your parotid gland would be swollen and your teeth hurting from the same condition. Parotid stones typically hurt worse with eating or anticipation of eating.

               If the dentist who examined you said it’s the parotid gland (and presumably not a dental problem), then an ENT physician is certainly the expert on disorders of the parotid glands. If it’s a stone, it usually can be removed by the ENT physician.

               DEAR DR. ROACH: Six or seven years ago, after a longstanding runny nose and cough, I had an allergy test. I was told I had nonallergic rhinitis and that there was no treatment. After seeing a new ENT doctor, I had another allergy test, with the result being that I am allergic to MANY things: pollen, dust mites, animals, etc. I have been getting five shots per week for over a year now, and there is no change.

               My coughing, blowing my nose, eyes burning and tearing have gotten worse. I really am at a standstill as to direction. There has been no change in my symptoms, and, as a matter of fact, I think they have gotten worse. — S.

               ANSWER: “Nonallergic rhinitis” is a term given to a group of related medical conditions, which share symptoms of sneezing, runny nose, nasal congestion and post-nasal drip. Eye symptoms are not common in nonallergic rhinitis, and since in hindsight these have become more of a problem, I suspect your second ENT doctor is right, that your condition is allergic.

               The symptoms of allergic rhinitis are similar: sneezing, often in groups; runny nose and nasal congestion; but often prominent are eye symptoms, such as watery and itchy eyes. Cough and postnasal drip also are common.

               There is treatment for both allergic and nonallergic rhinitis. In allergic rhinitis, avoiding what you are allergic to is common sense, but it’s not always possible. You are getting immunotherapy (shots). I am (very) surprised you didn’t tell me about medication therapy, since there are many different classes of effective medications that are normally tried before going on to immunotherapy. Like any treatment, including medications, not everyone gets a benefit from immunotherapy. A year usually is long enough to begin seeing benefits, but some people continue to improve up to three and even five years after starting treatment.

               The most effective single treatment for allergic rhinitis is a preparation of nasal steroids; however, since there are many, many prescription, nonprescription and complementary and alternative approaches, you need to go back to your doctor and discuss your next options, and whether to continue the immunotherapy.

               One treatment I will highlight that is safe, effective and improves other treatments is irrigation of the nose with saline. This can be done before using other medications to help their absorption.

             

               Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

               (c) 2014 North America Syndicate Inc.

               All Rights Reserved

              

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