head and neck

Vicki and Kevin Mahoney are all smiles after their care experience with Sara Richer, MD, at Bridgeport Hospital.


A check-up from the neck up could save your life

Vicki Mahoney, 57, of Oxford, has dealt with thyroid issues most of her adult life. Thyroid disorders run in her family, so she wasn’t surprised when she was diagnosed with Hashimoto’s thyroiditis at age 18.

According to the American Thyroid Association, Hashimoto’s thyroiditis is the most common cause of underactive thyroid, or hypothyroidism, in the United States. Because the thyroid becomes inflamed gradually, the affected person may not recognize any symptoms early on. 

“Some patients have no symptoms, but their primary care doctor feels a nodule, or a lump, during an exam,” explained Bridgeport Hospital and Northeast Medical Group otolaryngologist and head and neck surgeon Sara Richer, MD. “Other people can experience difficulty swallowing or pressure on their airway, depending on the size of their thyroid.”

As hypothyroidism progresses, a patient may experience fatigue, constipation, weight gain, dry skin, depression, increased sensitivity to cold, muscle aches and reduced exercise tolerance. Women may also have irregular menstrual periods.

Vicki took medication for years and had annual follow-ups with an endocrinologist. At the time, she didn’t experience any of the typical symptoms of Hashimoto’s, but her thyroid was visibly large. She didn’t have trouble swallowing or eating. She wasn’t overly tired and her routine blood work was normal.

But then her condition started to change.

“In 2017, one of the nodules grew and it was obvious, especially to my sister,” said Vicki.

Her younger sister Cindy Kowalski, a nurse in SurgEase, the outpatient surgical suite at Bridgeport Hospital, urged Vicki to have her thyroid checked. When the biopsy came back as inconclusive, Cindy insisted Vicki see Dr. Richer. 

“I trust my sister with my life, so I took her advice and made an appointment,” commented Vicki. After a consultation with Dr. Richer, Vicki and her husband agreed with Dr. Richer’s recommendation to remove Vicki’s thyroid.

“There are a few reasons to have thyroid surgery: cancer, a nodule that we cannot determine if it is cancer without removal, an overactive thyroid or a thyroid is simply too large,” said Dr. Richer. “Vicki’s thyroid was large. There is only so much space in the neck and if you have a large thyroid, it can push other things, such as the esophagus or airway, out of the way.”

In Vicki’s case, Dr. Richer suggested a total thyroidectomy at Bridgeport Hospital. The surgery revealed that Vicki’s thyroid was encroaching in her chest cavity. With the pathology report in hand, Dr. Richer called Vicki and explained that cancer was found in her thyroid. Vicki underwent radioactive iodine therapy in November. A posttreatment scan recently confirmed the cancer was gone, and Vicki received a clean bill of health.

Coincidentally, Vicki’s spouse of almost 25 years was experiencing his own thyroid issues. Kevin, 60, had a history of developing fatty tumors, or lipomas. After Kevin had an ultrasound to evaluate a lipoma on his neck, the physician found a nodule on his thyroid. When his nodule biopsy returned as indeterminate and a genetic test revealed a chance of cancer, doctors decided Kevin needed surgery.

Both Kevin and Vicki were stunned. “Vicki and I had been relatively good with our health and now this?” he said. 

Without hesitation, Kevin scheduled his surgery at Bridgeport Hospital with Dr. Richer.

“I wasn’t nervous when I got to the hospital, and that usually is not the case for me when I go to doctors,” said Kevin. “The whole staff was very kind and accommodating. I knew I was in good hands.”

Due to the nodule placement and size, Dr. Richer removed half of Kevin’s thyroid. The nodule, however, was benign, or noncancerous.

Other head and neck diseases

Otolaryngologists are trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT) and related structures of the head and neck.

These ENT physicians focus on diseases of the sinuses, larynx (voice box), oral cavity and upper pharynx (mouth and throat), as well as structures of the neck and face. 

Cheryl Curwen, 57, of Fairfield, developed a chronic cough and headaches. In addition, she experienced a globus sensation, the feeling that something was stuck in her throat. At times, she had trouble breathing. Cheryl felt such severe pain that she was taking acetaminophen daily.

“The coughing was constant and lasted for years. It started when I woke up in the morning, lasted all day and into the night,” explained Cheryl. “Sometimes I was caught off guard and could not breathe.”

Cheryl visited her primary care physician, along with various specialists. She was diagnosed with asthma, but the prescribed inhalers weren’t easing her symptoms.

Through a specialist’s referral, she sought the care of Heather Osborn, MD, a head and neck surgeon with Yale Medicine. Out of fear and frustration, she put her affairs in order and stopped planning for her future, expecting the worst from her scheduled appointment.

Dr. Osborn performed a nasopharyngoscopy, an in-office procedure in which, after numbing the patient’s nasal passage, the physician passes a flexible scope into her nose and down into her throat.

The procedure revealed two cysts inside Cheryl’s throat, which were removed during a scheduled surgery with Dr. Osborn at Bridgeport Hospital in January 2018.

“From the moment that I woke up from the surgery, I could breathe,” said Cheryl.

Dr. Osborn noted that symptoms of laryngeal cysts are trouble swallowing, a chronic cough and feeling as if something is stuck in your throat.

“Laryngeal cysts are fairly common,” explained Dr. Osborn. “The majority are benign, but we often remove them either because they are causing symptoms, or to get a pathologic diagnosis. Cheryl’s cysts were benign, but since she was experiencing such severe symptoms, we removed them.”

Since their respective surgeries, Vicki, Kevin and Cheryl are back to their everyday lives and thankful.

“I did tell Dr. Richer and her staff that as much as I love them, I hope I don’t have to see them again,” laughed Vicki. “I really wanted to write a letter to thank everyone at Bridgeport Hospital. I feel like everything happened the way it was supposed to. I could have gotten a biopsy sooner, but then we may not have met Dr. Richer. We feel very lucky and grateful.”

Cheryl shared Vicki’s sentiments. “I have a new lease on life,” she exclaimed. “I am so thankful to Dr. Osborn and Bridgeport Hospital. I tell everyone to go there.”

For more information on otolaryngology or head and neck surgery, visit bridgeporthospital.org. To find an expert ENT physician near where you work or live, go to bridgeporthospital.org or call our Physician Referral Service toll-free at 888-357-2396.