ENT Management

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Cochlear Implant is a medical device/implant for those patients who have severe difficulty in hearing or are profoundly

Highly Reputed ENT Surgeons in India

Our teams of selected world-class ENT surgeons in India have gained expertise and are leaders in the field of cochlear implantation in India. Their dedication and commitment to patients have been instrumental in giving success rates at par with the global standards.

NABH and JCI accredited world class hospitals having state of the art facilities.

Rehabilitation

The patient is trained to get accustomed to the cochlear implant and its features. All queries regarding rehabilitation post the procedure is handled during this time. The patient’s post discharge will also be on a regular follow-up with the doctor, in order to achieve smooth recovery.

Rehabilitation

The patient is trained to get accustomed to the cochlear implant and its features. All queries regarding rehabilitation post the procedure is handled during this time. The patient’s post discharge will also be on a regular follow-up with the doctor, in order to achieve smooth recovery.

Rehabilitation

The patient is trained to get accustomed to the cochlear implant and its features. All queries regarding rehabilitation post the procedure is handled during this time. The patient’s post discharge will also be on a regular follow-up with the doctor, in order to achieve smooth recovery.

Rehabilitation

The patient is trained to get accustomed to the cochlear implant and its features. All queries regarding rehabilitation post the procedure is handled during this time. The patient’s post discharge will also be on a regular follow-up with the doctor, in order to achieve smooth recovery.

Ent Management

Ent Management

Cochlear Implant is a medical device/implant for those patients who have severe difficulty in hearing or are profoundly deaf. The condition could also be congenital(Birth defect). People can become deaf because their sensory hair cells in the inner ear (also known as cochleas) are damaged. This implant is most useful for such patients. Even though the quality of natural hearing is different, the implants can ensure sufficient hearing and a better understanding of the speech. The implant has the power of transforming people’s lives.

A cochlear implant is an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants bypass the damaged hair cells of the inner ear (cochlea) to provide sound signals to the brain. Many people suffer hearing loss because their hair cells in the inner ear or (or cochlea) are damaged. The cochlear implant enables the sound to be transferred to your hearing nerve and enables you to hear.

COMPREHENSIVE RANGE OF ADVANCED SERVICES OFFERED BY HEALTH & HOLIDAYS

Our staff is sensitive to the needs of the patients and stand with you every step of the way.  They are capable to deliver assistance 24*7 in case of emergencies.

  • Pre-arrival, no-obligation free quote for your medical condition along with consultations and selection of best doctor/hospital

  • Dedicated case manager as one-point contact for all your needs while you are here with us,also responsible to help you get the best price for your procedure

  • Complimentary Airport Pick-up/Drop, Translation,Interpretation services and assistance in choosing the best accommodation.

  • Complete assistance in making the right decisions when choosing the best procedure and full support during your stay at the hospital

Pre-Surgery

The most informed patient is considered as the best patient. We try to clear all your doubts and dissipate your fears even before you travel. Whatever questions you may have even then are answered on your arrival. In this case, as the primary reason for surgery is hearing loss, extreme care and precaution is required post operatively, all steps of which are explained before the procedure. The doctor schedules a full pre surgery investigation, which includes various hearing tests, blood investigations,etc followed by an anaesthetist checkup. The patient is evaluated to be fit for surgery on the basis of results of these examinations. Once he/she is declared fit the surgery is scheduled as per patient’s choice.

Post- Surgery

After the cochlear implant surgery is done, the patient is observed in the ward for 1-2 days before discharge. The patient might feel a little pain / pressure or discomfort in the ear the implant is done but this settles down in a few days to a weeks. The bandages also might be there for a few days and usually get removed on the first follow – up day with the doctor. The patient does not start hearing immediately after the surgery, as the external device is still not turned on. It is usually switched on after a week or so post surgery. This allows the incisional area to heal. The patients are always advised to be extra cautious in the initial stages till the time they get used to the device.

Laryngology

What is Laryngology?

Laryngology can be defined as a branch of drugs which has sicknesses and injuries of the cartilaginous structure, typically noted because the larynx. Laryngology similarly addresses voice treatments and disorders. The cartilaginous structure is found within the neck and homes the vocal cords. The cartilaginous structure is crucial within the body’s generation of sound.

 

What will a laryngologist do?

A laryngologist could be a doctor with a selected interest in sicknesses of the cartilaginous structure and voice disorders. Laryngology could be a subspecialty of otology that relates to the treatment of the ears, throat, and nose. Laryngologists, and Otolaryngologists area unit usually known as as ENT (ear, nose, and throat), doctors.

 

What areas unit a number of the sicknesses that touching the larynx?

Many disorders of the cartilaginous structure could also be as a result of injury or strain to the vocal cords by means of speaking too low or too loudly, smoking, throat clearing, singing, excessive talking, screaming, or coughing. Finally, regular vocal misuse and abuse vocal cords will result in lasting changes in vocal perform and doubtless the loss of voice.

 

Disorders as a result of overuse, abuse, or misuse are:

  • Vocal wire palsy
  • Laryngopharyngeal reflux unwellness (LPRD)
  • Laryngeal cancer
  • Vocal wire polyps
  • Vocal wire hemorrhage
  • Expert voice disorders
  • Laryngeal stricture
  • Dysphagia
  • Vocal wire nodules
  • Laryngitis
  • Laryngeal papillomatosis
  • Spasmodic speech disorder

 

How the sicknesses of the cartilaginous structure diagnosed?

  • To diagnose conditions of vocal misuse like nodules, polyps, or cyst a laryngologist can even examine the vocal cords employing a scope. any tests which can be dispensed to diagnose problems with the cartilaginous structure area unit MRIs and CT scans.

 

  • Illnesses of the cartilaginous structure area unit typically by AN ENT man or laryngologist. The person can initiallydo a physical examination that features a scope& take a look at to see the cartilaginous structure throat and cartilaginous structure. Supported your symptoms, different examinations can seemingly be needed.  In bound eventualities, they could similarly order a speech organ diagnostic technique (LEMG), to assess the nerve input to the speech organ muscles and should supply prognostic and diagnostic info regarding the recovery of vocal cord performance.

 

How are the sicknesses of the cartilaginous structure treated?

  • Treatment for sicknesses of the cartilaginous structure vocal cords and cartilaginous structure vocal cords area unit extremely personal, supported a profession, condition, and age. Your doctor can take of these into issues to create a private treatment arrange.
  • Chemotherapy, radiotherapy or surgery or a mix of them may notcure speech organ cancer. Surgery could also be required to treat a cyst, nodules, or polyps.
  • Treatments for sicknesses that have an effect on the cartilaginous structure disagree supported your designation. Treatment for sicknesses led to by vocal overuse, abuse, or misuse, could be as straightforward as resting the voice. Singing or voice medical aid may additionally  be suggested. this can be done by a speech-language medical specialist.

 

What can be done to stop sicknesses of the larynx?

  • It is crucial to recollect that several conditions touching the cartilaginous structure area unitis curable if you obtain medical attention once you initially notice your symptoms. Failing to try to to therefore would possibly imply lasting injury to the cartilaginous structure and voice.
  • Taking correct care to not strain the voice by means of an excessive amount of misuse or use might stop sicknesses like nodules and polyps. this can be notably very important for singers or individuals like lawyers and lecturers, UN agency pay most of their day talking.

Maintaining shape, taking the time to rest your voice, and manage irritating factors like reflux or hypersensitivity reaction might facilitate lots in preventing these sicknesses.

  • Stopping smoking and reducing alcohol consumption would possibly facilitate preventingspeech organ cancer.

Septoplasty

What is Septoplasty?

It is a type of surgery that is carried out to correct a deviated nasal septum. A deviated septum arises when the cartilage, which separates your nostrils, is out of position. This may lead to breathing issues, and nosebleeds.
What is a septum?

The septum is the wall of cartilage and bone, which separates your nose into two separate nostrils. A deviated septum happens when your septum is moved to one side of the nose. Few people are born with a deviated septum; however, it can as well be brought about by an injury to your nose. Many people with a deviated septum have one nasal passage, which is smaller unlike the other. This may lead to facial pain, trouble breathing and regular nosebleeds. A surgical procedure is the only solution to repair a deviated septum.
Getting ready for a septoplasty

  • Your physician might ask you to avoid certain medications fourteen days before the operation. These medications can include ibuprofen, aspirin, and other blood thinners. They do this to lessen your risk of excessive bleeding during and after the surgery. Remember to tell your doctor if you’re allergic to you are allergic to particular medications or if you have a background of bleeding issues.
  • Your physician may take images of your nose before the surgery. Comparing pictures from before and after the surgery may help you see how your nose has changed.
  • Sometimes, people have a septoplasty under local anesthesia that numbs the area to stop the pain. But many people have the operation under general anesthesia, meaning they are asleep during the surgery. Do not drink or eat anything after midnight the night prior to the operation if you are to be under general anesthesia. This helps stop you from choking and vomiting should you be nauseated from the anesthesia during the procedure.

Septoplasty procedure

  • A septoplasty requires between 30 to 90 minutes to finish, based on the complexity of the problem.
  • You will be under either local or general anesthesia, considering what you and your physician decide is the most suitable for you.
  • You may require stitches to hold the membrane and the septum in place. But packing the nose with cotton at times is enough to keep them in position.

Recovery :– This implies that you will be able to go home on the same day as the surgery, as soon as the anesthesia has worn off. Septoplasty is frequently done as an outpatient procedure except if major complications emerge. Your nose will be painful, swollen, and full of cotton to control bleeding. The cotton can be taken out a day or two after the procedure. Your doctor will even prescribe pain medication as required. -Your doctor will probably ask you to refrain from ibuprofen, aspirin, and other medications, which thicken the blood. This is done to decrease the risk of hemorrhage issues after the surgery. -You must also minimize your physical activity for some weeks after the procedure to reduce inflammation and boost healing. These activities may increase your blood pressure and result in heavy bleeding.

Risks: Most people require a second surgery if they are displeased with the outcome. Other risks related to a septoplasty are uncommon, but they may include: bleeding, scarring, perforation of your septum which takes place when a hole forms in your septum, a reduced sense of smell, a discoloration of the nose, an altered nose shape.

After care :-Elevating your head at night to keep the swelling down -Not blowing your nose for at least three days after the procedure -Wearing shirts, which button up in the front so you will not have to pull garments over your head.

 

Tympanoplasty

What is Tympanoplasty?
Tympanoplasty is also called as Eardrum repair. It is a surgical procedure that repairs the perforated eardrum, named tympanic membrane. Tympanoplasty aids in restoring normal hearing that may have been damaged due to chronic infection or injury to the eardrum.

Depending on the demand, Tympanoplasty may also include ossiculoplasty (reconstructing the bones located at the back of the tympanic membrane).
What are the different types of Tympanoplasty?

  • Type I Tympanoplasty
    This type of procedure is named myringoplasty, and involves repairing only the perforated eardrum by grafting.
  • Type II Tympanoplasty
    This method includes repairing the pierce tympanic membrane that has malleus erosion with grafting on top of the incus or remnants of the malleus.
  • Type III Tympanoplasty
    this procedure includes destroying two ossicles by keeping the states undamaged and movable.Grafting is done on top of the stapes to provide protection.
  • Type IV Tympanoplasty
    Grafting is done on top of or around a movable footplate of the stapes. This procedure involves ossicular destruction along with partial or complete stapes arch.
  • Type V Tympanoplasty
    This is performed when the footplate of the stapes is immovable.

How is Tympanoplasty Performed?

 

  • A gelatin sponge that is absorbable is positioned beneath the eardrum to hold the graft.
  • The incision is put in beneath the remaining parts of the eardrum, which is folded black to close the perforation.
  • To stop it from coming out of the ear when the patient sneezes, the sheeting that is placed on the graft is made very thin.
  • An operating microscope is used to magnify the view of the structures inside the ear.
  • If the incision is made behind the ear, it is then closed with dissolvable stitches, and a sterile patch is place outside the ear canal.
  • The residual eardrum is raised away and forward of the ear canal.
  • In case of very large perforations or those that are too far to be viewed, an incision is made behind the ear.
  • Any scar tissue is removed with laser or by using micro hooks.
  • The tissues from behind the ear, the tragus or a vein are taken.
  • The remaining parts of the hole eardrum are turned forward and the bones are examined.
  • The graft tissues are then thinned out and dried.
  • An incision is made in the ear canal.

How to prepare for Tympanoplasty?

 

  • If the patient suffers from any allergies or illnesses, the doctor should be informed.
  • The patient’s ear is fully examined using various diagnostic tests including audiogram, hearing loss history, facial weakness and vertigo.
  • A microscopic examination of the ear is also done.
  • Otoscopy is executed to examine the mobility of the tympanic membrane and the malleus.
  • If the patient has a history of dizziness or minor eardrum perforation, a fistula test is done.
  • Certain medication that the patient is taking may need to be stopped, including herbs and vitamins.
  • If the patient needs to take medication, it can be taken with a small sip of water.
  • Any condition that is affecting the other throat, ear or nose is first treated prior to tympanoplasty.
  • Blood and urine tests are conducted.

 

 

Duration of procedure/surgery :2 to 3 hours

Anesthesia :Local or general anesthesia is used, depending on the type of tympanoplasty.

Recovery :

– The patient can go home after two to three hours of the surgery.

– 10 days after the surgery, the packing is taken off and the ear is examined to check the graft.
– Usually patients resume work and normal activities after five or six days.

– The patient may incident a pulsing sensation or hears a popping sound or other strange sounds after the surgery.
– The patient may feel sharp pains and feel as if the ear is filled with liquid after the surgery.
– Pain medication and antibiotics are provided.
– Patients who perform strenuous physical labor need to wait for two to three weeks.
– The complete packing is entirely removed after three weeks and the success of the graft is then determined.
– A complete hearing examination is conducted four to six weeks after tympanoplasty.

Risks :– Bleeding
– Infection
– Difficulty in breathing
– Adverse reactions to medications
– Injury to the facial nerve or nerves affecting the sense of taste
– Middle ear bones damage leading to loss of hearing
– Vertigo or dizziness
– Incomplete repair of the eardrum perforation
– Loss of graft
– Graft healing failure causing repeated eardrum perforation
– Ear canal stenosis
– Worsening of hearing or loss of hearing
– Tin nitus

After care :

– The patient should keep the ear dry and water should not get inside the ear.
– The patient should avoid blowing the nose and care should be taken while sneezing.
– The patient should avoid swimming and air travel.
– Antibiotics and decongestants may be prescribed by the doctor if the patient has a cold or allergies.

– Any ear drainage should be wiped off carefully and ear drops may need to be applied during the first week of recovery.
– The patient should stay away from crowded areas and from people with cold symptoms.

Tonsillectomy

What is Tonsillectomy?
Tonsillectomy is a type of surgical procedure to remove the tonsils. Tonsillectomy helps in removing recurrent throat infections. It is often performed along with adenoidectomy, which is a surgical procedure to remove the adenoid glands. It lessens severe throat infections for a minimum of two years.

How is Tonsillectomy performed?

  • The tonsils are removed with a surgical instrument.
  • The cuts do not require stitches.
  • A small tool is inserted into the mouth to keep it open.
  • The tongue is depressed to view the throat.

How to prepare for Tonsillectomy?

  • Any bleeding disorder should be controlled before the surgery.
  • If the patient has acute tonsillitis, it should be treated before tonsillectomy. Tonsillectomy may be delayedfor three to four weeks in this case of treatment.
  • The patient will be asked to take certain medication about 10 days before surgery.
  • If the patient needs to take medication, it can be taken with a small amount of water
  • The patient will go though a complete physical examination.
  • The patient will need to do some blood tests.
  • The doctor should be informed about any medication that the patient is taking, including herbs and vitamins.

Days admitted :Tonsillectomy is generally done as an outpatient procedure. On rare occasions children may be kept overnight in the hospital for observation.

Anesthesia :General Anesthesia.
Sometimes adults may be given local anesthesia.

Recovery :
– The patient will be affected with a sore throat for several days.
-The patient is taken to the recovery room and kept there until the effects of anesthesia wears off.

– White scab will form in the throat for five to 10 days after the surgery.

– The patient’s vital signs are monitored.
– A complete recovery will take approximately one to two weeks.
– The patient is made to lie down on the side to avoid any chance of aspiration of blood into the lungs.

Risks :– Bleeding
– Nasal sounding voice
– Risks of anesthesia such as untimely reaction to medication and breathing difficulty

– Infection
– Injury to the uvula
After care:

– The patient should avoid strenuous physical activities for about 10 days.

– The patient should stay away from sick people to avoid chances of infection.

– Antibiotics and pain medication should be taken to relieve sore throat.
– The patient should take liquid food or food that is soft for 24 hours after the surgery.
– The doctor should be informed if the patient has bleeding, Earache or fever for more than three days.

 

Thyroplasty

What is Thyroplasty?
Thyroplasty is a type of procedures which includes a collection of surgical procedures to treat voice disorders by changing the cartilages of the larynx that surrounds the vocal cords. Thyroplasty helps in restoring the voice after paralysis or altering the pitch of the voice. It is also called as laryngeal framework surgery.

What are the types of Thyroplasty?

  • Type I Thyroplasty
    During this procedure, the vocal cords are placed near each other to reduce the results of the abductor spasms.
  • Type II Thyroplasty
    During this procedure, the vocal cords are spread apart by a shim, which separates the vocal cords and does not bring them in contact during the spasms.

How is Thyroplasty performed?

  • Local anesthesia along with intravenous sedation is applied on the patient.
  • An incision is made on the neck crease.
  • The soft tissues and muscles are put apart to reach the framework of cartilage of the larynx.
  • Topical anesthesia is applied in the nose and fiberoptic laryngoscopy is performed to view the vocal cords.
  • The patient may be asked to speak during the procedure to test the voice improvement while adjustments are being made on the vocal cords.
  • Steroids are usually used to reduce swelling, as swelling can make it difficult to make accurate estimates about the size of the implant and placements. Swelling may also damage the airway.
  • The incision is then closed and covered with a dressing.

How to prepare for Thyroplasty?

  • The patient’s vocal cords are examined.
  • The patient goes through voice tests.
  • Laryngeal stroboscopy may be performed to study the vocal fold closure and vocal fold pliability.
  • The patient’s airway is examined according to the patient’s particular aerodynamic requirements.
  • After a thorough examination of the patient’s requirements, the type of thyroplasty needs to be selected.

Duration of procedure/surgery :1 to 2 hours

Days admitted :1 day

Anesthesia :Local anesthesia with intravenous sedation

Recovery :– The patient is taken to the recovery room after thyroplasty.
– The dressing should be kept on after the surgery and can be removed the following morning if instructed by the doctor.
– Antibiotics are prescribed to avoid infection.
– The patient will be able to use the voice normally after the surgery site heals.

Risks :– Swelling
– Discomfort

After care :

– Voice should not be strained during the recovery period.
-The patient should limit the usage of voice for a week after thyroplasty.

– Strenuous physical activities should be avoided.

– Coughing should also be prevented.
– The surgery site should be kept dry until it heals. It should be cleaned gently with the prescribed ointments.

The patient should contact the doctor if the following symptoms occur:
– Severe swallowing difficulty
– Chest discomfort
– Bleeding, drainage or redness from the surgery site

– Breathing difficulty
– Heavy coughing
– Fever that is higher than 101
– Palpitation

 

Snoring

Treatments options for snoring

  • Behavioral changes
    • Stop taking alcohol before going to bed
    • Limit the use of certain medication like sedatives before sleeping
    • Making changes in the lifestyle can help in treating snoring. However, making these changes can be challenging. Some of these changes are to:
    • Quit smoking
    • Lose weight if the person is overweight
    • Sleep on the side rather than the back
    • Use decongestants to clear a stuffy nose that may be making the snoring worse
  • Natural Remedies
    Using various natural remedies can be beneficial to reduce snoring.

    • Acupressure and acupuncture can also be beneficial.
    • Herbal pills are available
    • Natural anti-snoring sprays may be available over-the-counter.
    • Exercises to tone the muscle of the upper airway passage may also help in alleviating snoring.
  • Dental Devices
    Dental devices known as mandibular advancement splints, which hold the jaw and tongue forward can be used to treat snoring. In 70% – 90% snoring cases, dental devices have proved beneficial. These devices should be made by the dentist for an accurate fit. This is also valuable in treating mild to moderate sleep apnea.
    Dental devices can cause excessive salvation and gum irritation. Furthermore, dental devices are quite expensive. They can also worsen temporomandibular joint (TMJ) problems.
  • Nasal Devices and Medications
    Nasal devices can be used by people who snore due to constricted nasal passages caused by colds or upper respiratory infection. Nasal sprays may help in reducing nasal mucosal swelling caused by allergies. Nasal saline irrigation sprays help in cleaning and keeping the nasal lining moist. Nasal breathing can be improved by using nasal steroid sprays which reduce swelling caused by minor allergies.
  • Nasal CPAP
    Continuous Positive Airway Pressure (CPAP) is a device that is helpful in treating snoring among patients who suffer from sleep apnea. CPAP provides a continuous enhanced air pressure that avoids the narrowing of airway during breathing. The patient needs to wear a mask that is joined by a tube to a pump that maintains a higher than normal level of inspired air. The air pressure can be adjusted according to individual requirements based on sleep study.

    CPAP machines cause much noise and are bulky. They might be difficult to be worn by patients throughout the night.

  • Uvulopalatopharyngoplasty
    Uvulopalatopharyngoplasty may be used to correct snoring. This surgery expands the airway by taking out tissues of the uvula and pharynx.
    Uvulopalatopharyngoplasty has risks of side effects. Formation of scar tissue in the throat is a major risk.
  • Radiofrequency ablation
    Radiofrequency ablation (RFA) is another surgery for snoring. Radiofrequency ablation uses radiofrequency heat and energy to scar the tissue of the soft palate and uvula. After healing, the surgical site becomes stiff. This reduces snoring; however, it does not entirely eliminate snoring.
  • Bipolar radiofrequency ablation
    Bipolar radiofrequency ablation (used in coblation tonsillectomy) is also used as a surgical treatment for snoring.
  • The Pillar Procedure
    The Pillar Procedure is a minimally invasive procedure. It uses strips or pillars that are inserted into the soft palate, which makes the palate more rigid and thus reduces snoring and sleep apnea.
  • Turbinate Coblation
    Turbinate Coblation is a minimally invasive procedure that is used to treat snoring caused by nasal obstruction due to enlarged inferior turbinates.

 

Sleep Medicine and Surgery

Sleep Medicine and Surgery

Sleep surgery is surgery done to treat sleep disordered breathing. Sleep surgery procedures are performed by surgeons specially trained in craniofacial surgery, oral maxillofacial surgery or otolaryngologist.
Indications for sleep medicine and surgery

  • Obstructive sleep apnea
  • Snoring
  • Nasal congestion
  • Upper airway resistance syndrome
  • Nasal congestion
  • Continuous Positive Airway Pressure (CPAP)
  • Oral appliances

Types of sleep surgical procedures include:

  • Uvulopalatopharyngoplasty (UPPP): This procedure involves removing excess tissue in the throat to make the airways wider. The excess tissue may be repositioned in the throat. The surgeon may trim down the uvula and soft palate, remove your tonsils and reposition some of the soft palate’s muscles. This procedure is also known as UPPP and if used alone, it is unlikely to cure severe sleep apnea. It can be merge with other surgeries that target other sites in the upper airway.
  • Radiofrequency Volumetric Tissue Reduction (RFVTR): it is also known as radiofrequency ablation. This treatment option is for people with mild to moderate sleep apnea. It involves applying controlled cauterization to the tonsils, tongue, and soft palate. This tightens and shrinks the tissues in the throat.
  • Septoplasty and Turbinate Reduction: Theseopen the nasal passage to improve the air flow. Septoplasty straightens a deviated or bent nasal septum (a divider which separates the two sides of the nose). Turbinate reduction removes or reduces the curved structures that stick out from the nose’s side. These can be enlarged for various reasons such as allergies.
  • Genioglossus Advancement: This procedure moves forward the major tongue attachment forward. This opens up space for breathing behind the tongue. It involves making an incision in the lower jaw and moving it slightly forward.
  • Hyoid Suspension: The hyoid bone is a U-shaped bone in the neck which has the tongue, epiglottis, and other throat structure attached to it. Hyoid suspension pulls the hyoid bone forward and secures it in pace. This enlarges the breathing space in the lower part of the throat.
  • Midline glossectomy and lingual plashy: These procedures involve making the tongue smaller by removing part of the back of your tongue. This prevents blockage of the airway in people with sleep apnea. However, these procedures are not common.
  • Maxillomandibular osteotomy (MMO) and advancement (MMA): This involves moving forward your upper and/or lower jaw. This enlarges the breathing space in the entire throat. This procedure is recommended for people with severe sleep apnea. It involves cutting the bones of your jaws. Your jaws may be wired shut for a few days and healing takes several months with your diet being limited for as long.
  • Palatal implants: This involves inserting small fiber rods into the soft palate. This stiffens the tissue and prevents blockage of the airway. This option may be ineffective for people with mild sleep apnea or snoring.
  • Bariatric surgery: This is a weight loss surgery which reduces sleep apnea. This is usually recommended for people who are obese.
  • Laser-assisted valvuloplasty (LAUP): This involves making an incision using a laser to scar and tighten the soft palate. It is not commonly recommended. The uvula is cut over some visits.
  • Tracheostomy: This option is very effective for treating sleep apnea. However, it is only used in rare cases. It involves placing a hollow breathing tube directly into your windpipe in the lower part of your neck. During the day, the tube can be plugged. This allows you t speak and breathes normally through your mouth and nose. At night, the tube is unplugged to allow you to breathe without any blockage.
  • Nerve stimulation: This involves implanting a device in the upper chest. The device sensesthe breathing pattern and then mildly stimulates the airway muscles to keep the airway open.

 

Rhinology and Sinus Surgery

What is Rhinology and sinus surgery?

This is a subspecialty that deals with nasal and sinus problems. These include common problems such as allergies, sinusitis, and nasal obstruction. Less common problems include tumors of the anterior skull base and of the sinuses.

Having this surgery may be the only means to get a badly blocked or infected sinus to drain properly. However, surgery does not always cure sinusitis. Some people may require a second surgery. The surgery is usually successful when combined with medicines such as antibiotics and home treatments to prevent the sinusitis from recurring.
What is the aim of the surgery?

The goal of having this surgery is to improve the sinuses drainage usually by draining the mucus and removing the blockage. This may involve removing:

  • Infected, damaged or swollen tissue
  • Bone, to create a bigger opening for drainage of mucus from the sinuses
  • Polyps (growths) inside the sinuses or nose
  • A foreign object that is blocking a nasal or sinus passage.

Indications for sinus surgery

  • If you have chronic sinusitis.
  • If you have followed ‘maximum medical treatment’ for 4-6 weeks. This treatment includes. A steroid nasal sprays, antibiotics and other prescribed medications
  • If after 4-6 weeks of treatment a CT scan shows the presence of nasal polyps

Types of sinus surgery

  • Endoscopic surgery:The doctor uses an endoscope (a thin lighted tool) to remove growths or small amounts of bone or material blocking the sinus openings. The endoscope is inserted through the nose to help the doctor see and remove any obstructions. Endoscopic techniques allow for better and more precise visualizations. They also eliminate the need for external incisions. As a result, there is less, bleeding, swelling and discomfort and recovery from the surgery is fast.
  • Sinus surgery:This is done when there is an occurrence of complications from sinusitis. These include infection of the facial bones, development of pus in a sinus or brain abscess. The doctor makes an incision from inside the mouth or through the facial skin. Sinus surgery involves removing diseased tissue as well as rerouting the existing sinus pathways.

When to call the doctor

  • Excessive bleeding
  • Fever greater than 38.6C (101.5F) that persists
  • Sharp pain or a headache that is unresponsive to medications
  • Increased swelling of the eyes or nose
  • Thin clear fluid draining from the nose

Risks :-Chronic nasal drainage. -Excessive dryness or crusting of the nose. -Need for allergy evaluation, environmental controls or treatments. -Damage to the eye and associated structures. -Damage to the skull base. -Permanent numbness of the face, palate or upper teeth. -Failure to control infection or polyps can lead to nasal obstruction. -Impaired healing, prolonged pain and the need for hospitalization. -Recurrence of sinus problems or polyps. -Failure to improve or resolve concurrent respiratory illness such as a cough, asthma or bronchitis. -Failure to resolve associated nasal or sinus headaches. The exact cause of the headaches can be difficult to determine and may have many various causes that are not sinus-related. -Worsening or failure to restore the sense of smell or taste.

 

Endoscopic Sinus Surgery

What is Endoscopic Sinus surgery?
The surgery is mainly performed using endoscopic methods for improved and accurate view. Endoscopic Sinus Surgery is a type of surgical method to remove unhealthy sinus tissue from the drainage channels, which helps in making way for the drainage of infected material from the sinus cavities. Endoscopic nasal sinus surgery is ready without external incisions and therefore there is very little bleeding, discomfort and swelling, which enables a fast recovery. The surgery is mainly performed using endoscopic methods for improved and accurate view. Endoscopic sinus surgery does not damage healthy tissues, requires less time and yields good results. Nasal sinus surgery needs post-operative care, therefore follow-up and aftercare should be given essential attention.

How is Endoscopic Sinus Surgery performed?

  • Any blockage in the ostium, situated close to the jaw is removed with a meatal antrostomy.
  • The ethmoid air cells are to improve ventilation, leaving the bone with the covering of mucous membrane.
  • A nasal endoscope is inserted through the nostrils into the nasal cavity. This allows the doctor to view the inside of the nose and sinuses.
  • The middle turbinate is located to identify and remove the uncinate process.

How to prepare for the Endoscopic Sinus surgery?

  • The patient may be required to take antibiotics and steroids to reduce swelling.
  • Patients who smoke are advised to stop or reduce smoking to help in recovery.
  • The doctor should be informed if the patient has fever or any illness before the surgery.
  • The patient’s medical history is reviewed by the doctor.
  • This includes herbs and vitamins.The patient requires to avoid taking certain medication that may worsen bleeding.
  • An ENT specialist will conduct diagnostic examination on the patient, which may involve fiberoptic endoscopy and CT scan.

 

 

Duration of procedure/surgery :60 to 90 minutes

Days admitted : This type of surgery is usually done as an outpatient procedure.

Anesthesia : Local anesthesia with intravenous sedation

Recovery :

– Swelling of the nose, around the eyes, and upper lip is noticed for several days.
– Complete recovery may take three to five days.

– The patient is taken to the recovery room where the patient’s vital signs are monitored.
– The patient may vomit once or twice after the surgery.

– Moderate bleeding from the nose after the surgery is normal.

Risks :

– Numbness
– Voice change
– Pain
– Nasal blockage

– Injury to the optic nerve, resulting in blindness
– Leakage of cerebrospinal fluid
– Orbital Hematoma
– Nasolacrimal duct stenosis
– Intracranial injury
– Smell and taste impairment

After care :

– The patient should avoid blowing the nose for about a week from the surgery.
– Dairy products may cause excessive mucous formation and should therefore be avoided.
– The nose dressing should be changed regularly as it becomes wet.
– The patient may need to wear a nose pack for a few days

– The patient should avoid smoking and should drink a lot of water.
– The patient should take all medication prescribed by the doctor.
– A follow up appointment is scheduled a week after the surgery.

– The patient should sleep with the head at an elevation.
– Pain medication should be taken only after consulting the doctor.
– The patient may need to use a saline spray for six to eight times a day to keep the nose moist.

– The patient will not be able to drive after the surgery due to drowsiness and disorientation.
– The patient should refrain from strenuous activities and physical recreational activities for a few weeks.
– Alcoholic beverages, caffeine, and spicy food should be avoided.
– Decongestant nasal sprays should not be used without consulting a doctor.

 

Adenoidectomy

What is an Adenoidectomy?

It is a quick operation to remove the adenoids – behind the palate, small lumps of tissue at the back of the nose. It takes about 30 minutes to perform and is carried out in hospital by an ear, nose and throat (ENT) surgeon.
What are adenoids?

  • They are only found in kids. They begin to grow from birth and are largest when your child is roughly 3 to 5 to years of age.
  • However, by age 7 to 8 they begin to reduce in size and by the late teens, are hardly noticeable. By adulthood, the adenoids will have vanished totally.
  • But by age seven to eight they start to shrink and by the late teens, are barely visible. By adulthood, the adenoids will have disappeared completely.
  • Adenoids are part of the immune system, which helps fight infection and protects the body from bacteria and viruses.

When do adenoids need to be removed?

 

  • It might be essential to remove the adenoids if they get inflamed or enlarged because of:
  • difficulty sleeping, especially if breathing issues result in sleep apnea and snoring
  • breathing issues, like frequently breathing through their mouth or shortness of breath

Symptoms of Enlarged Adenoids

Swollen adenoids block the airways and can cause the following symptoms:

  • difficulty breathing through the nose
  • habitual mouth breathing
  • obstructive sleep apnea, which involves periodic lapses in breathing during sleep
  • frequent ear infections
  • sore throat
  • difficulty swallowing

Symptoms of Swollen Adenoids

Swollen adenoids obstruct the breathing passages and can bring about the following symptoms :

  • recurrent ear infections
  • obstructive sleep apnea that entails periodic lapses in breathing while sleeping
  • Repeated middle ear infections due to swollen adenoids and clogged Eustachian tubes have serious implications, such as hearing loss, which can also lead to speech problems.
  • Recurring middle ear infections because of inflamed adenoids and blocked Eustachian tubes have severe consequences, like hearing loss that may as well cause speech issues.
  • sore throat
  • difficulty ingesting
  • difficulty breathing through the nose
  • regular mouth breathing

 

Your child’s physician might suggest an adenoid removal if your child has persistent ear or throat infections that:

  • happen over five or eight times annually
  • hinder your child’s education because of regular absences
  • do not respond to antibiotic treatments

 

Preparing for an Adenoidectomy

  • The day before surgery, your child should have nothing to eat or drink after midnight. If the doctor prescribes medicine to be taken before the surgery, give it to your child with a small sip of water.
  • The throat and mouth bleed more readily compared to other parts of the body, so your doctor might ask for a blood test to find out whether your child’s blood clots properly and if their red and white blood count is normal. Preoperative blood tests might help your child’s doctor make sure that there will not be too much bleeding during and after the surgery.
  • In the week before surgery, don’t give your child any medicine that can affect blood clotting, such as ibuprofen or aspirin. You may use acetaminophen (Tylenol) for pain. If you’re in doubt about which medicines are appropriate, talk with your doctor.

 

Risks :The procedure has very few risks. Removing the adenoids won’t put your child at greater risk of getting infection. The body’s immune system is well able to deal with viruses and bacteria without the adenoids. However, as with all surgery, there is a small risk of complications such as infection, bleeding, nasal discharge, or an allergic reaction to the anesthetic. But as with all operation, there is a small risk of complications like an allergic reaction to the anesthetic, bleeding, infection or nasal discharge. There might also be some short-term minor health issues like a blocked nose for some, sore throat or earache.

 

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