Bad Breath (Halitosis)

Bad breath is commonly caused by acute or chronic throat infections, tonsilloliths, chronic rhinosinusitis with a post-nasal drip and poor mouth and dental hygene. It may also be due to dietary factors, such as eating onions or garlic, or perhaps insufficient food leading to the formation of ketones in the stomach.

Diagnostics

Throat Swab for Microscopy and Culture

Why?

Infections caused by bacteria or fungi require antimicrobial treatment, which varies depending on the specific infective organism. Acute infections result in the production of pus, which is commonly thick yellow-green in colour and may have an unpleasant smell. When an infection is seen or suspected, a sample is therefore sent for laboratory analysis.

How?

After inserting a sterile tongue depressor, a fine sterile cotton bud probe is inserted into the throat and rubbed over the tissue to be sampled. It is then immediately removed for storage in preservative for transfer to the laboratory. Examination under the microscope (microscopy) by the Microbiologist enables the presence and type of infective organism to be diagnosed. Subsequently, growing the organism on a special gel (culture) and applying various drugs allows the specific antimicrobial agent required to kill the infective organisms to be determined.

Nasal Rigid / Flexible Endoscopy

Why?

The nostrils are quite small, so even using a very bright halogen headlight and a dilator instrument (speculum) to expand the nostril, it is impossible to see any more than the front part inside the nasal cavity. The introduction of a small sterile rigid endoscope with an angled lens, or a sterile flexible endoscope whose tip can be manually rotated in various directions, allows a very detailed inspection of the whole of the nasal cavity and the site of the sinus openings. Further back the nasopharynx and Eustachian tube openings can also be examined.

How?

Cophenylcaine, a surface local anaesthetic and decongestant, is sprayed into each nostril held open by a dilator speculum. This drug is absorbed very quickly and numbs and shrinks the nasal lining. Although the introduction of an endoscope is an unusual feeling it is not unpleasant. The subsequent examination will take less than 5 minutes.