Most sore throats are self-limiting, but a few signal a deep neck infection or airway threat. Trismus, a muffled voice, uvular deviation, drooling, inability to swallow saliva, stridor or neck swelling should prompt same-day ENT assessment.
In adults, a persistent unilateral sore throat or referred ear pain lasting more than three weeks, particularly in smokers or drinkers, needs examination to exclude malignancy.
- Refer the same day for trismus, muffled voice, uvular deviation or drooling
- Treat stridor or inability to swallow saliva as an airway emergency
- Examine any unilateral sore throat lasting over three weeks for malignancy
- Ask about referred ear pain, which often accompanies pharyngeal pathology
Why it matters
Deep neck infections and pharyngeal cancers are both missed when every sore throat is treated alike.
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