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Other Treatments

Ear

A large part of our practice involves taking care of a myriad of ear problems.

Common ear complaints include

  • Ear pain
  • Ear infections
  • Ear fluid
  • Hearing loss
  • Dizziness and Vertigo
  • Tinnitus
  • Draining ears
  • Eardrum perforations
  • Foreign body removal

If you have an ear problem that you need diagnosing and treated, contact us today. We can help you get the relief you crave.

Nose

It may be something you have not done in a long time -- breath 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

Nasal allergies

Deviated septum

External nasal deformities

Nasal polyps

Enlarged nasal turbinates

Enlarged adenoids

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

Sinus surgery

Management of nose bleeds including Endoscopic Sphenopalatine Artery Ligation

Endoscopic treatment of Inverted Papilloma

Treatment of Sinonasal Tumors

Rhinophyma is 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 a nose problem that you need diagnosed and treated, contact us today. We can help you get the relief you crave.

Throat

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

Hoarseness

Foreign body sensation of the throat

Tonsillitis and peri-tonsillar abscesses

Swollen glands

Salivary Gland Problems

Difficulty swallowing

Masses, lesions, lumps, and bumps of the mouth and throat

Throat pain

Hoarseness

Hoarseness lasting more than two weeks should be evaluated. We offer in-office video laryngoscopy so you can see your examination and results.

Some common causes of hoarseness include

Acute and chronic laryngitis

Vocal cord polyps

Reflux

Throat cancer

Vocal Cord Paralysis

Voice Abuse

Trauma

Aging process

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 examination and results.

Tonsillitis and Peri-tonsillar Abscess

Dr. Ludwick manages complicated tonsil infections and infections, leading to abscess formation. Known as a peritonsillar 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.

Swollen Glands

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

Tuberculosis

In addition, lymph nodes themselves can become involved in a cancerous process, such as:

Lymphoma

Leukemia

Metastatic cancer

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.

Difficulty Swallowing

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

Reflux

Tumors

Strictures

Facial Trauma

Dr. Ludwick has worked at the Harris County’s Level I Trauma Center, Ben Taub Hospital, for over ten years. He has performed numerous surgeries on patients with extensive facial trauma resulting from both blunt and penetrating injuries. These include:

  • Motor vehicle accidents
  • Aggravated assaults
  • Gunshot wounds
  • Knife wounds
  • Sports injuries

Dr. Ludwick has extensive experience in facial bone reconstruction as well as repair of mandible fractures.

  • Orbital Floor Fractures
  • ZMC Fractures
  • Zygoma Fractures
  • Midface Fractures including LeForte I, II, and III fractures
  • Nasal Fractures
  • Nasal-Orbital-Ethmoid Complex Fractures
  • Frontal Sinus Fractures

For help with your facial trauma, contact us today.

Thyroid Disease — Thyroid Tumors and Goiter / Parathyroid Surgery

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:

Large goiters

Thyroid nodules

Thyroid cancer

Metastatic neck disease

Most patients recover quickly from the procedure and require only an overnight hospital stay.

Parathyroid Surgery

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 normalize 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.

Neck Masses

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.

Head and Neck Cancer

Dr. Ludwick has over ten 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.

Skin Cancer

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

Ear

Lower lip

Scalp

While the 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.

Salivary Gland Tumors

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 jawline, 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.

Pediatric — Snoring

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 your child snores nightly, they likely have chronic upper airway obstruction caused by one of the following:

Pediatric Snoring — Nasal Congestion

Pediatric Snoring: Nasal Congestion — Nasal Allergies

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:

Allergy testing

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.

Pediatric Snoring: Nasal Congestion — Enlarged Nasal Turbinates

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.

Pediatric Snoring: Nasal Congestion — Adenoid Hypertrophy

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.

Pediatric Snoring: Nasal Congestion — Septal Deformity

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.

Pediatric Snoring: Nasal Congestion — Chronic Sinus Disease

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.

Adenotonsillar Hypertrophy

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

Snoring

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.

Sleep Apnea (OSAS)

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:

Restless sleep

Loud snoring

Witnessed apneas, cyanotic episodes, or gasping during sleep

Hyperactivity

Daytime sleepiness

Aggressive or defiant behavior

Growth/developmental delay

Pediatric — Recurrent Ear Infections

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 severe 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 a sterile, mucous-like fluid that sits between the eardrum 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.

Pediatric — Speech or Language Delay

Hearing loss can be as simple as an impacted ear canal wax to malformations of the hearing organ. At West Houston ENT and Sleep Center, we provide a thorough evaluation to correctly 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.

Pediatric — Surgery and Other Pediatric ENT

Additional conditions treated by Dr. Ludwick include:

Congenital neck masses

- Branchial cleft cysts -

- Lymphangiomas -

- Venous malformations -

Enlarged lymph nodes

Reflux

Laryngomalacia

Stridor

Croup

Hoarseness

Laryngomalacia

Recurrent respiratory papillomatosis

Foreign body removal involving ears, nose, windpipe, 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 lumps, bumps, and conditions. He also evaluates children for voice and breathing problems and is proficient in laryngoscopy and bronchoscopy.

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