Monday, June 21, 2010

Otolaryngology (ENT)

Otolaryngology (ENT)

ENT Specialists Treat:

Ears : Treatment of ear disorders involve both the medical and surgical treatment of hearing, ear infections, balance disorders, ear noise (tinnitus), nerve pain, and facial and cranial nerve disorders.

Nose : ENT Specialists care for the nasal cavity and sinuses. This includes allergies and a person's sense of smell, as well as the appearance of the nose and a person's ability to breathing through the nose.

Throat : ENT Specialists are experts in managing diseases of the larynx (voice box) and the upper aero-digestive tract or oesophagus, including voice and swallowing disorders.

Head and Neck : ENT Specialists treat infectious diseases in the head and neck area. Some diseases include both benign and malignant (cancerous) tumours, facial trauma, and deformities of the face. ENT Surgeons perform cosmetic, plastic and reconstructive surgery. We have a fully equipped and staffed ENT department.

All types of ENT services are offered by us, including:

1. Audiogram : An audiogram is a graphical representation of how well a certain person can perceive different sound frequencies.

2. Free Field Audiometry: Free-field audiometry is a versatile diagnostic tool, in the diagnoses of children and in evaluating the fitting of hearing instruments using functional gain. Today, its most important clinical use is the assessment of work-related noise injuries.

3. Audiogram with SISI & TD & RECR

4. Tympanometry (also called Impedance Audiometry): It is a test that can be performed in most physician offices to help determine how the middle ear is functioning. It does not tell if the child is hearing or not, but helps to detect any changes in pressure in the middle ear. This is a difficult test to perform in younger children, however an early detection of hearing abnormalities in children can help a great deal.

5. Brain Stem Evoked Response Audiometry:
The brainstem auditory evoked response (BAER) test measures brain wave activity that occurs in response to clicks or certain tones. The test is performed to help diagnose nervous system abnormalities and hearing losses (especially in low birth weight newborns), and to assess neurological functions.

6. Cochlear Mapping

7. Speech therapy for all types of voice disorders.

We also have a dedicated ENT theatre, equipped with state-of-art instruments.

throat

Types of ENT Surgeries performed : T H R O A T

1. Tonsillectomy: A tonsillectomy is a surgical procedure in which the tonsils are removed. Sometimes the adenoids are removed at the same time.

2. Adenoidectomy:

Adenoidectomy is the surgical removal of the adenoids. They may be removed for several reasons, including impaired breathing through the nose and chronic infections or earaches. The surgery is common. It is most often done on an outpatient basis under general anethesia.

Post-operative pain is generally minimal and prevented with an abundance of icy or cold foods (ex. Popsicles, ice cream). Procedure can sometimes be combined with a tonsillectomy if needed. Recovery time is 2 to 3 days.

3. Micro-Laryngeal Surgeries: A problem in the vocal chords or a voice disorder is something that can be cured and corrected through the Micro Laryngeal Surgery. Being a Minimally Invasive Technique, Micro Laryngeal Surgery is a process that helps in the correction of the voice disorder or problem in the larynx. It involves the removal of the unwanted and unnatural growth in the larynx. Micro Laryngeal Surgery is a kind of minor surgery that involves the use of endoscope, which is inserted in the larynx area through the mouth and involves no incisions.

4. Uvula – Palatoplasty: Snoring is noisy breathing through the mouth or nose during sleep. Severe snoring causes sleep deprivation for both the snorer and the sleeping partner. Sleep deprivation leads to daytime sleepiness, poor mental and emotional health, decreased productivity and unclear thinking. In addition, snoring causes reduced oxygen flow to the brain, which can lead to premature death, High blood pressure, Hypertension, Stroke and Cardiac diseases. Uvula – Palatoplasty allows treatment of snoring by removing the obstruction in your airway in an outpatient setting under local anesthesia. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures. It requires up to five treatments spaced four to eight weeks apart (although one to three are usual). Improvement is noted by the reduction in or disappearance of your snoring.

5. Pharyngoplasty: When we speak, air comes up from our lungs, through our voice box, and we then use our plate, tongue, lips and teeth to make the air into speech sounds. For some people, during speech the palate does not close off the back of the nose sufficiently, this leads to impaired speech. A Pharyngoplasty is an operation carried out by a plastic surgeon to help repair the speech. This operation helps speech by stopping air from escaping down the nose during speech.

6. Laryngofissure: Laryngotomy is the surgical operation of cutting into the larynx, possibly with specialized equipment such as a laryngotome. The surgical creation of a permanent opening in the larynx is referred to as laryngostomy. Laryngotomy is an important procedure in assisting respiration when the upper part of the airway has been obstructed.

7. Tracheal Surgeries Throat: Tracheal surgeries are commonly performed to remove benign or malignant tumors that have grown from the lungs into the trachea or from within the trachea. Surgical procedures may also be required to remove scarred areas of the trachea that have abnormally constricted due to a prior surgery in the trachea. Surgery of the trachea is a very delicate surgery and requires careful coordination between the surgeon, anesthesiologist, and operating team. Endoscopic techniques and laser surgery is frequently used allowing for faster recovery.

Types of ENT Surgeries performed : N O S E

1. Cauterisations for Epitasis

2. Septoplasty:

Septoplasty is a corrective surgical procedure done to straighten the nasal septum - the partition between the two nasal cavities. Ideally, the septum should run down the center of the nose. When it deviates into one of the cavities, it narrows that cavity and impedes airflow. Nasal obstructions caused by serious deviations frequently lead to chronic sinus problems.

3. Septorhinoplasty: A surgical procedure done on the nose and the nasal septum, the wall within the nose separating the left and right sides. Septorhinoplasty is related to rhinoplasty and is performed for patients who also have nasal obstruction. Septorhinoplasty not only improves the appearance of the nose, but it removes any internal obstructions that may be blocking breathing through the nose.

4. Functional Endoscopic Sinus Surgery: It is an operation for chronic sinus disease and, is called functional because it aims to return the working of the sinus to normal. The operation is tailored to suit the individual patient. What exactly is done will be decided based on examination of your nose in the clinic and usually also a CT scan of the sinuses.


5. Trans Nasal Neuro Surgeries

7. Optic Nerve Decompression: Surgical optical decompression and optic nerve decompression (OND) are reasonable and reported treatments for traumatic optic neuropathy. New evidence suggests that initial visual acuity (IVA) of no light perception is the most significant determinant of outcome in traumatic optic neuropathy. Patients with IVA of no light perception treated surgically within 7 days of injury had a better improvement degree than patients managed medically. Various surgical approaches for decompression of the optic canal include transfrontal craniotomy, extranasal transethmoidal, transnasal ethmoidal, lateral facial, and endoscopic procedures. An intranasal endoscopic approach is favored because of the proximity of the optic nerve to the sphenoid sinus and Onodi cell. Advantages of this approach include lack of external scars, preservation of olfaction, decreased morbidity, and faster recovery time.

ear

Types of ENT Surgeries performed : E A R

1. Myringotomy: Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum, so as to relieve pressure caused by the excessive buildup of fluid, or to drain pus. Myringotomy is often performed as a treatment for otitis media. Myringotomy with tube insertion is performed for the relief of otitis media. Although this very brief microsurgical procedure can be performed on an outpatient basis, without the need for a general anaesthetic in co-operative adults, children require a short general anesthetic for tube insertion.

2. Tympanoplasties: It is a surgical correction or repair of defects or injuries in the eardrum or the bones of the middle ear. In most cases, the operation relieves pain and infection symptoms completely. Hearing loss is minor. The outcome may not be as good if the bones in the middle ear need reconstruction along with the eardrum.

3. Stapedectomy: A stapedectomy is a surgical procedure of the middle ear performed to improve hearing. If the stapes footplate is fixed in position, rather than being normally mobile, then a conductive hearing loss results. The results of this surgery are generally most reliable in patients' whose stapes has lost mobility because of otosclerosis. Nine out of ten patients who undergo the procedure will come out with significantly improved hearing.

4. Mastoidectomy: Mastoidectomy is an operation to remove disease from the bone behind the ear, when medical management is inadequate. There need not be drainage or ear pain for mastoid disease to exist. Sometimes a mastoidectomy is required in order to gain better exposure to the middle ear and attic.

5. Sac Decompression

6. Facial Nerve: The facial nerve extends from the base of the skull, winds around the ear, passes through the salivary gland, and divides into many branches that connect to various facial muscles, the tear gland, and the tongue. Sometimes the facial nerve becomes compressed, usually behind the ear, due to inflammation from a viral infection, tumors, or injury. If the nerve sustains damage as a result of such compression, symptoms including facial weakness, paralysis, spasms, and twitching can manifest. Other consequences may include inability to properly close the eye, excessive tearing, drooling, and inability to taste certain foods. Different procedures may be performed depending on the cause of compression, location of damage, and other factors.

7. Cochlear Implant:

A cochlear implant (CI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf or severely hard of hearing. The cochlear implant is often referred to as a bionic ear. Unlike hearing aids, the cochlear implant does not amplify sound, but works by directly stimulating any functioning auditory nerves inside the cochlea with electrical impulses. External components of the cochlear implant include a microphone, speech processor and transmitter.
Under the appropriate conditions, an implant can give a deaf person a useful auditory understanding of the environment and/or hearing and help them to understand speech, although post-implantation therapy is usually required.

8. Orbital decompression: Orbital decompression surgery is a procedure that may be necessary for patients with visual loss due to compromise of optic nerve function or for patients whose Grave’s disease has caused significant disfigurement. In orbital decompression, the surgeon creates fractures of the thin bones of the orbital walls, allowing the orbital contents to be displaced into the sinuses. This permits a significant diminution of proptosis, i.e., the bulging eyes fall backward into the orbit creating a more natural appearance.