A large part of our practice involves taking care of a myriad of ear problems.
Common ear complaints include
If you have an ear problem that you need diagnosed and treated, contact us today. We can help you get the relief you crave.
It may be something you have not done in a long time -- breathe easily through your nose. Many of our patients have lived with the problem for many years and simply deal with it as a natural part of their lives. In fact, they often cannot even remember the last time they breathed well through their nose.
Nasal obstruction and congestion can have one or several causes
External nasal deformities
Enlarged nasal turbinates
Dr. Ludwick manages a wide array of nasal problems and surgeries, including
Repair of external nasal deformities
Nasal allergies and congestion
Septum repair and straightening
Repair of the broken nose
Management of nose bleeds including Endoscopic Sphenopalatine Artery Ligation
Endoscopic treatment of Inverted Papilloma
Treatment of Sinonasal Tumors
Rhinophyma as a complication of Rosacea
Whatever the cause, one thing is certain: Dr. Ludwick will carefully explain your diagnosis and available treatment options. In the end, breathing easily through your nose will no longer be a thing of the past.
If you have nose problem that you need diagnosed and treated, contact us today. We can help you get the relief you crave.
As a Board Certified Otolaryngologist, Dr. Ludwick is a surgical expert of the upper aerodigestive tract. This includes all structures from the tip of your lips to the lungs.
Common complaints in these areas include
Foreign body sensation of the throat
Tonsillitis and peri-tonsillar abscesses
Salivary Gland Problems
Masses, lesions, lumps and bumps of the mouth and throat
Hoarseness lasting more than two weeks should be evaluated. We offer in-office video laryngoscopy so you can see your own examination and results.
Some common causes of hoarseness include
Acute and chronic laryngitis
Vocal cord polyps
Vocal Cord Paralysis
At high risk for possible laryngeal cancer include those who smoke and have chronic hoarseness and/or associated throat pain. In this patient group, early diagnosis is associated with the best outcomes.
Foreign Body Sensation in the Throat
One of the most common throat complaints Dr. Ludwick evaluates is a sensation that something is stuck in the patient’s throat. A thorough head and neck evaluation including laryngoscopy is indicated to determine the cause. Often this is secondary to undiagnosed reflux disease, nasal allergy, or occasionally a mass or tumor is the culprit. West Houston ENT and Sleep Center offers in-office video laryngoscopy so you can view your own examination and results.
Tonsillitis and Peri-tonsillar Abscess
Dr. Ludwick manages complicated tonsil infections and infections leading to abscess formation. Known as a peri-tonsillar abscess, it requires surgical drainage. Typically, this can be done in the office. Delayed treatment of a peri-tonsillar abscess can lead to serious, life-threatening upper airway compromise and hospitalization.
The vast majority of tonsil infections can be effectively managed by your primary care physician. However, if your symptoms are not improving within 36-48 hours after initiating therapy, you should make an appointment with Dr. Ludwick for an evaluation.
If you have enlarged cervical lymph nodes that persist for more than a few weeks, you should be evaluated for diagnosis and treatment. Known to most as “glands”, enlarged lymph nodes can be caused by infection or cancer. Causes of enlarged lymph nodes include:
Reactive enlargement due to local bacterial or viral infections
System viral infections such as HIV or Infectious Mononucleosis
Direct bacterial infection called Lymphadenitis
In addition, lymph nodes themselves can become involved in a cancerous process such as:
Salivary Gland Problems
Pain or swelling that occurs right in front or just below your ear or below the jaw bone can be caused by your salivary glands. We have three major paired salivary glands including the parotid, submandibular, and sublingual glands. Tumors, infection, and salivary gland duct stones can cause enlargement of these glands. As a board-certified ENT physician, Dr. Ludwick can evaluate and resolve salivary gland problems.
Does it feel like food or pills are getting stuck in your throat on the way down? The medical term is dysphagia. The problem likely stems from an issue with upper esophagus. Dr. Ludwick can evaluate and treat all of the causes of dysphagia relating to the upper esophagus such as:
Enlarged thyroid gland
Diverticulum of the Esophagus
Cricopharyngeal muscle spasm
Cervical spine osteophytes
Dr. Ludwick has worked at the Harris County’s Level I Trauma Center, Ben Taub Hospital, for over 10 years. He has performed numerous surgeries on patients with extensive facial trauma resulting from both blunt and penetrating injuries. These include:
Dr. Ludwick has extensive experience in facial bone reconstruction as well as repair of mandible fractures.
For help with your facial trauma, contact us today.
Thyroid Tumors and Goiter
Successful surgical removal of the thyroid gland requires more than just getting the gland out. It requires preservation of important motor nerves to prevent hoarseness or need for tracheotomy as well as the adjacent parathyroid glands to prevent post-operative low calcium levels. Dr. Ludwick is a seasoned thyroid surgeon having performed hundreds of successful thyroid surgeries and has treated:
Metastatic neck disease
Most patients recover quickly from the procedure and require only an overnight hospital stay.
Dr. Ludwick is adept at the surgical management of parathyroid adenomas and four-gland hyperplasia. If you have persistently elevated blood calcium levels caused by an enlarged parathyroid gland, surgical removal of the gland will normalizes your calcium level. Kidney failure patients have chronically elevated calcium levels. Typically, this is managed with medications. A sub-total parathyroidectomy can restore calcium homeostasis when medications are no longer effective.
New onset of a neck mass should raise concern and prompt you to seek an immediate evaluation. The range of diagnoses for neck masses is extensive, including benign, reactive lymph nodes to metastatic cancer. Dr. Ludwick is very experienced in the diagnosis and surgical management of head and neck masses. He will ensure you receive an accurate diagnosis that you understand fully, along with positive surgical results.
Dr. Ludwick has over 10 years experience diagnosing and treating cancer and understands how this diagnosis can affect the patient and family. He takes the time to provide the compassionate support needed during this difficult time. Head and neck cancer treatment usually requires multiple modalities including chemotherapy, surgery, and radiation therapy.
The head and neck are the most frequent sites of skin cancer due to their high exposure to the sun. Basal cell carcinoma, Squamous cell carcinoma, and Melanoma are the most frequent types of skin cancer. The most common sites include:
Nasal tip and dorsum
While the first priority is complete tumor removal, it is also of paramount importance to put the tissues back together in the most functional and cosmetically acceptable manner after excision. It is our priority to ensure we achieve this balance with our procedures.
Tumors involving the major glands such as the parotid, submandibular, and the sublingual can present as a swelling in front of the ear, below the jaw line, or under the tongue, and may be benign of malignant. Dr. Ludwick is experienced in the management of these tumors including their removal and necessary post-operative treatments.
Chronic snoring among children is not considered normal. Certainly, if he or she has a cold or upper respiratory infection and develops temporary nasal congestion, snoring is not unusual. But if you child snores nightly, they likely have chronic upper airway obstruction caused by one of the following:
Trying to manage your child’s allergy symptoms can be a daunting task given the vast array of allergy medications available at your local drug store. Parents are left in a difficult situation, often asking:
Which medicine or medicines does my child even need?
How much medication should I give?
Is this medication safe for my child?
Is there another problem besides just nasal allergies?
We provide our patients complete nasal allergy and sinus care, including:
Customized medical treatment regimen
Needleless immunotherapy to cure nasal allergies
To learn more about the Allergy Treatment and Testing options offered by West Houston ENT and Sleep Center, visit the Allergy and Sinus section of this website.
When it comes to children, large adenoids or tonsils are not always the cause of their nasal congestion or obstruction. Nasal turbinates are structures suspended from the outside wall of our nose that allow our nose to warm and humidify the air. These structures dramatically increase the surface area inside our nose like the radiator of a car cooling system. As air passes over these structures, warm water evaporates.
Turbinates are suspended by a thin sheet of bone and wrapped with erectile tissue that can swell due to inflammation caused by nasal allergy, a common cold, or from dependent blood flow as when lying down to sleep. Ever notice one side of your nose or the other becoming obstructed or congested, only to change if you roll over in bed or stand up?
A chemical turbinate reduction is done whenever you give your child oral or topical decongestants, such as Sudafed or Afrin. Simple, safe, and painless turbinate reduction procedures are available to permanently reduce the size of the turbinate, thereby improving nasal breathing and congestion.
Adenoid tissue, the sister to tonsils that sits in the back of the nose, can become enlarged to the point of obstructing the back of the nose. It can mimic nasal allergy, causing not only nasal obstruction but congestion as well.
We rule out adenoid hypertrophy in the office using nasal endoscopy that our patients and parents can view with Dr. Ludwick.
While adenoidectomy requires general anesthesia, there is very little post-operative discomfort and children resume a normal level of activity the next day.
A deviated or malformed septum can dramatically impair your child’s nasal airflow. Dr. Ludwick can correct septal deformities with a relatively short, outpatient surgical procedure. Post-operative pain is mild and your child will return to work or school in just a couple days.
The nasal septum is the wall that divides the inside of your nose into a right and left side. It is made of bone and cartilage, and should be centered and basically straight. However, due to trauma or abnormal growth, this wall can become bent or deformed leading to chronic nasal obstruction. When the deformity is so crooked that it blocks the nasal passage, an out-patient procedure called Septoplasty can be performed to restore clear breathing. It is typically performed through a centimeter-long incision hidden inside the nose. Unlike a “nose job” there is no facial bruising or swelling. More severe deformities may require other surgical approaches.
Dr. Ludwick has successfully performed hundreds of Septoplasty procedures. A Septoplasty is performed in a surgical setting under general or local anesthesia with sedation. On average, on average surgery takes 20-40 minutes and recovery time is 3 – 4 weeks.
Chronic swelling of the mucosal lining our sinus cavities can also lead to the feeling of nasal congestion. Termed chronic sinusitis, relief from this source of congestion may not respond to medical therapy.
After appropriate and maximal medical therapy, a CT scan of the sinus can be performed to determine the health of the sinus mucosa. If evidence of chronic mucosal disease is present, surgical intervention may be warranted.
Endoscopic sinus surgery is an outpatient surgery performed through the nasal cavity without skin incisions, to improve sinus ventilation. This helps improve sinus mucosal health and relieve nasal congestion. The specific sinus procedures required are dependent upon each patient’s specific disease.
Tonsil and adenoid tissue generally cause problems when they get too large or they become infected on a recurring basis. When done for the right reasons an adenoidectomy and tonsillectomy can help children sleep better, breathe better, and get fewer infections after having their tonsils or adenoids removed.
We are often asked the role of adenoid or tonsil tissue. The exact role is not explicitly known. However, from an ENT perspective they cause:
Nasal congestion or obstruction
Recurring ear, throat, and sinus infections
Obstructive sleep apnea
Tonsil tissue, which sits in the back and to the sides of our throat, is composed of lymphoid tissue. Adenoid tissue is simply tonsil-like tissue located in the far back of the nose.
The American Academy of Otolaryngology—Head and Neck Surgery recommends that children who have three or more tonsillar infections a year undergo a tonsillectomy; the young patient with a sleep disorder should also be a candidate for removal or reduction of the enlarged tonsils.
Dr. Ludwick has performed thousands of tonsillectomies using coblation technology. Unlike traditional methods, coblation methods use radiofrequency (RF) to remove tissue. RF is a form of energy like radio waves, but with a higher frequency. Coblation-based surgical procedures use RF energy in a precise and controlled manner to remove affected tissue while causing very little harm to healthy tissue. Dr. Ludwick uses coblation technology to minimize post-operative discomfort and intra-operative bleeding.
Snoring may just be a noise your child makes when he or she sleeps due to chronic nasal congestion or obstruction. However, it can also signal a more serious medical problem, Obstructive Sleep Apnea. The treatment for most children for Obstructive Sleep Apnea is removal of the tonsils and adenoid tissue. In fact, sleep apnea greatly surpasses recurrent tonsillitis as the primary reason for performing adenotonsillectomy in children.
Symptoms of Pediatric Obstructive Sleep Apnea
We’ve all heard the saying, “sleeps like a baby.” The cliché conjures up thoughts of a very restful, peaceful, and restorative night’s sleep. So if you’ve ever had to give a second thought to your child’s sleep quality, something is likely amiss. If his sleep frequently appears restless or you note odd breathing such as gasping, choking, or pauses, your child may be suffering from Obstructive Sleep Apnea.
The behavioral symptoms of Sleep Apnea are a reflection of chronic sleep deprivation these children experience because of their poor sleep quality.
Signs and symptoms of Obstructive Sleep Apnea in children differ significantly from those of adults suffering with the same disease:
Witnessed apneas, cyanotic episodes, or gasping during sleep
Aggressive or defiant behavior
Recurring ear infections are usually caused by poor Eustachian tube function leading to chronic negative middle ear pressure and fluid accumulation. Enlarged adenoids, reflux, and poorly controlled nasal allergies are contributing factors. Speech delay, multi-drug resistant bacteria, and even serious complications including ear bone infection (mastoiditis) or meningitis can result if left untreated.
Chronic ear fluid is often a silent problem. You typically don’t know your child has it because they don’t complain of pain, don’t develop fever, and don’t have ear drainage. In fact, the unfortunate first sign can be a delay in speech development.
Chronic ear fluid is sterile, mucous-like fluid that sits between the ear drum and the hearing organ, the Cochlea. This fluid causes a significant hearing loss eventually resulting in speech delay.
Ear tube placement is a short procedure requiring no recovery that clears the fluid and restores hearing to normal levels.
If your child is being treated for more than three ear infections every six months, please bring them to West Houston ENT and Sleep Center. They would likely benefit from an evaluation with us. Contact us and let Dr. Ludwick help keep your child become ear infection free
Hearing loss can be as a simple as impacted ear canal wax to malformations of the hearing organ. At West Houston ENT and Sleep Center, we provide a thorough evaluation to properly and accurately diagnose your child’s hearing loss. We offer complete ear examinations and obtain comprehensive hearing tests to rule out hearing loss as a cause of speech delay. Dr. Ludwick takes pediatric hearing loss seriously and ensures his parents understand the cause and all available treatment options.
Additional conditions treated by Dr. Ludwick include:
Congenital neck masses
- Branchial cleft cysts -
- Lymphangiomas -
- Venous malformations -
Enlarged lymph nodes
Recurrent respiratory papillomatosis
Foreign body removal involving ears, nose, wind pipe and esophagus
In addition to managing allergies and performing tonsillectomies, Dr. Ludwick is well versed in head and neck surgery and routinely evaluates and treats children for an array of neck lump, bumps, and conditions. He also evaluates children for voice and breathing problems, and is proficient in laryngoscopy and bronchoscopy.