Otorhinolaryngology

Otorhinolaryngology

Otorhinolaryngology is a field of medicine dedicated to diagnosing and treating ear, nose and throat (ENT) diseases. In their everyday work, otorhinolaryngologists, also called ENT doctors, tests patients for balance and hearing, and perform different surgeries and procedures. Otorhinolaryngology includes also head and neck surgery to remove and treat tumors in these body regions. Below we describe some of the main and most debated ENT diseases and their treatment options.

Inflammatory conditions of the paranasal sinuses

As rhinitis is probably the most frequent disease in the world, its various aftermaths and complications are also very common.
One very common disease is otitis media in which the tympanic membrane, also called the eardrum, and the mucous membrane of the middle ear are inflamed. Acute otitis media is caused mostly by bacteria, but sometimes by viruses as well. Although antibiotics are the main treatment method, sometimes it is necessary to perform paracentesis of the eardrum. During this procedure, first the eardrum is rendered numb and then a tiny hole is made in the eardum to drain the pus. In case of persistent and/or recurrent inflammations, small plastic drainage tubes are inserted in the eardrum which serve as an exit for the pus. In some rare cases when the eardrum fails to heal after the removal of the tube, myringoplasty (surgical restoration of the eardrum) is performed.

Another disease with a similar etiology is sinusitis or an inflammation of the paranasal sinuses, which leads to the accumulation of mucus or pus in these cavities. Other sinuses may become inflamed as well, but maxillary sinuses are affected most often. In case of recurrent disease, one of the treatment options is surgical, called functional endoscopic sinus surgery (FESS). During this procedure, the maxillary sinuses are widened and cleaned to prevent the recurrence of the disease and improve ventilation.

Tonsils and adenoid

Palatine tonsils, often called simply tonsils, are pinkish lumps of tissue located on the left and right sides at the back of the throat. Although the function of the tonsils is to fight against pathogens, certain bacteria may cause the tonsils to become inflamed, a condition called tonsillitis. If the acute inflammation becomes frequent or is not treated adequately, chronic or permanent inflammation may develop. As a result, inflammatory agents and toxic products may leak from the tonsils to the blood and damage the heart, kidneys, joints and other organ systems. In that case it is advisable to remove the tonsils by means of an operation called tonsillectomy.

There is another tonsil – nasopharyngeal or pharyngeal tonsil – which is usually called adenoid. The adenoid plays an important role in the function of the immune system and protection against pathogens. Adenoid enlargement is a problem that more often affects children and more seldom adults. It may cause snoring, sleep disturbances, sleep apnea, headaches, coughing fits at night, and in children even speech problems and maldevelopment of the facial cranium. Enlarged adenoid may also lead to frequent otitis media. The only effective treatment is the surgical removal of the adenoid, called adenoidectomy.

Breathing and sleep problems

There are other conditions that may cause breathing and sleep problems, such as deviated nasal septum, nasal polyps, and sleep apnea.

Nasal septum deviation is usually caused by a trauma, such as nasal bone fracture. Its characteristic symptom is difficulty breathing through one or both nostrils. Quite often it also causes chronic rhinitis. Here as well the only effective treatment is surgical. During the operation, called septoplasty, the nasal septum is straightened.

Nasal polyps are growths or swellings of the lining of the nasal passages or sinuses, probably caused by allergic and chronic rhinitis. In most cases, polyps arise from the ethmoidal air cells and maxillary sinuses. When polyps get bigger, they start to fill the nasal passages and may cause persistent obstruction and loss of sense of smell. Treatment options include local steroid treatment or surgical removal.

(Obstructive) sleep apnea is a breathing pause during sleep, lasting over 10 seconds, caused by the collapse of the upper airway. For diagnosing a disease, a person has to have over five apnea episodes per hour. Its main symptom is loud snoring during sleep. Other, not so evident symptoms include restless sleep, morning headache, daytime sleepiness, recurrent airway inflammation, high blood pressure etc. To alleviate symptoms, mostly nonsurgical treatment is used (including eliminating risk factors). One of the minimally invasive surgical methods is called coblation, whereby excessive soft tissue is removed by using thermal energy.

Services:

    • Adenoidectomy

      44 clinics

      Adenoidectomy is an operation to remove adenoids, performed under general anesthesia. During the procedure, lymphatic tissue called adenoid, located behind the soft palate at the back of the nose, is removed via the mouth. Usually this operation is performed in the day surgery unit. This procedure is indicated for children whose enlarged adenoid causes mouth breathing and snoring, leading to sleeping problems or frequent upper airways infections or inflammations of the middle ear (otitis).

    • Tonsillectomy

      41 clinics

      Tonsillectomy is an operation to remove tonsils, performed under local anesthesia. During the procedure, both tonsils (oval-shaped pads of tissue at the back of the throat) are removed via the mouth. In people with a strong gag reflex, tonsillectomy should be performed under general, not local anesthesia. Usually it is necessary to stay in the hospital for 24 hours after the operation. The healing of the operated area takes 12–14 days. To lower the risk of bleeding, strenuous physical activity should be avoided during this period. Indications for the operation include peritonsillar abscess (accumulation of pus around the tonsils) and permanent enlargement of tonsils which causes chronic or recurrent acute tonsillitis.

    • Tonsillectomy under general anesthesia

      8 clinics

      Tonsillectomy under general anesthesia is an operation to remove tonsils, performed under general anesthesia. During the procedure, both tonsils (oval-shaped pads of tissue at the back of the throat) are removed via the mouth. Usually it is necessary to stay in the hospital for 24 hours after the operation. The healing of the operated area takes 12–14 days. To lower the risk of bleeding, strenuous physical activity should be avoided during this period. Indications for the operation include peritonsillar abscess (accumulation of pus around the tonsils) and permanent enlargement of tonsils which causes chronic or recurrent acute tonsillitis.

    • Tonsillectomy and adenoidectomy

      5 clinics

      Tonsillectomy and adenoidectomy is an operation to remove tonsils and adenoid, performed under general anesthesia. During the procedure, the two tonsils and the adenoid are removed via the mouth. The healing of the operated area takes 12–14 days. To lower the risk of bleeding, strenuous physical activity should be avoided during this period. This operation is indicated when the child has breathing or swallowing difficulties and frequent upper airways infections.

    • Polypectomy

      125 clinics

      Rhinoscopy is an examination of the nasal cavity, performed by means of a special thin tube-like instrument called rhinoscope. A rhinoscope is equipped with a lamp, so that the doctor can observe the nasal cavity. Usually rhinoscopy is performed in two stages – anterior rhinoscopy and posterior rhinoscopy. For anterior rhinoscopy, the rhinoscope is inserted through the left and right nostrils; posterior rhinoscopy is performed by inserting the rhinoscope via the mouth in order to examine the back of the nasal cavity from behind the soft palate.

    • Endoscopic sinus surgery (FESS)

      17 clinics

      The aim of this surgical procedure, the exact name of which is functional endoscopic sinus surgery (FESS), is to remove the soft tissue or bony structures that constrict the sinuses (air-filled spaces that surround the nasal cavity) in order to enlarge the sinuses. The procedure is performed under local anesthesia and usually the patient can go home after 6–24 hours. The indications for this operation include chronic drug-resistant sinusitis resistant to medical therapy, polyps in the nose and sinuses, sinus tumors etc.

    • Endoscopic sinus surgery (FESS; over 45 minutes)

      23 clinics

      The aim of this surgical procedure, the exact name of which is functional endoscopic sinus surgery (FESS), is to remove the soft tissue or bony structures that constrict the sinuses (air-filled spaces that surround the nasal cavity) in order to enlarge the sinuses. The procedure is performed under local anesthesia and usually the patient can go home after 6–24 hours. The indications for this operation include chronic drug-resistant sinusitis resistant to medical therapy, polyps in the nose and sinuses, sinus tumors etc.

    • Middle ear drainage

      40 clinics

      Middle ear drainage is a procedure to drain mucus and pus buildup from the ear. The fluid is suctioned out of the middle ear through a tiny opening made in the eardrum. If necessary, a tiny plastic tube is inserted in the opening so that the fluid can come out of the middle ear. The procedure is indicated in case of recurrent or persistent inflammations of the middle ear (otitis) or hearing loss due to mucus buildup.

    • Septoplasty

      13 clinics

      Septoplasty is an operation to correct a deformity of the nasal septum. During the procedure, the nasal septum is straightened by correcting the bones or the cartilage by means of special instruments. To support the operated area and to speed up healing, plastic plates are inserted in the nasal cavity. The plates are removed about a week later during the follow-up. This operation is usually performed under general anesthesia.

    • Pharyngoplasty (RFTT)

      18 clinics

      Pharyngoplasty or palatoplasty is a minimally invasive procedure to treat snoring. Treatment with low-frequency radio waves promotes the appearance of thin canals in the tissue of the soft palate. As a response to these structural changes, connective tissue starts to proliferate. As a result, the soft palate becomes harder, its ability to resonate decreases which, it its turn, will put an end to, or at least alleviate, snoring. The procedure is performed under local anesthesia and hospitalization of the patient is not necessary.

    • Otolaryngologist’s consultation

      191 clinics

      An otolaryngologist or ENT doctor is a specialist trained in the treatment and diagnostics of the diseases of the ear, nose and throat (ENT). This doctor can help you in case of an acute nose-ear-throat disease (e.g. ear infections, angina) or exacerbation of a chronic problem (e.g. chronic tonsillitis, hoarse voice). During the first appointment, the otolaryngologist usually examines the patient and prescribes necessary tests and analyses. The otolaryngologist also gives advice about nose-ear-throat disease prevention and plans subsequent treatment.