ENT Treatments

Following are some procedures that ENT specialists especially perform to treat different types of ENT disorders:

Sinus surgery

This surgery is used by healthcare providers for the treatment of chronic sinusitis, removal of polyps from the sinuses, and for treating other conditions. Most patients undergo sinus surgery because of severe sinus problems that medications can’t resolve. Sinus surgery involves removal of a part of sinus tissue, bones, or polyps. Several types of sinus surgeries have been designed, which are minimally invasive and require less recovery time.

Sinus surgeries are of several types including:

Functional endoscopic sinus surgery (FESS): It is the commonest type of sinus surgery that is performed to widen the drainage passages between the nose and the sinuses. A part of bone or infected tissue is removed so that the mucus trapped inside the sinuses evacuates.

Balloon sinuplasty: Balloon Sinuplasty is a minimally invasive procedure that does not involve cutting or resection of nasal tissues or bones. The time taken for recovery is quicker, and the scar heals fast. Due to these reasons, balloon sinuplasty is emerging as the procedure of choice for the severe or chronic form of sinusitis unresponsive to other medical treatments, including nasal decongestants, antibiotics, rinses, and nasal and oral corticosteroids.

If you are not the right candidate for balloon sinuplasty, you may be considered for endoscopic sinus surgery, a minimally invasive procedure that is also used for the treatment of sinusitis. Your doctor will evaluate your thoroughly and then discuss the right treatment options with you.

If not treated at the right time, inflamed and clogged sinuses can adversely affect normal breathing and lead to development of symptoms including headache, jaw ache, and insomnia.

Millions of people have CRS or chronic rhinosinusitis. Conservative treatment like antibiotics can ease the symptoms of most people. However, if your symptoms continue for more than three months, your doctor might recommend endoscopic sinus surgery or balloon sinuplasty. The symptoms of chronic rhinosinusitis include congestion, facial pressure, stuffy nose, loss of sense of smell, and runny nose.

Every patient who can benefit from balloon sinuplasty is not a candidate for the procedure. Ideal candidates for balloon sinuplasty include those who:

• Have a mild form of sinusitis
• Do not have nasal polyps or tumours
• Can tolerate the procedure under local anaesthesia
• Have an affected area in specific sinuses, including those in the forehead (frontal sinuses), cheeks (maxillary sinuses), or back of the nose (sphenoid sinuses)

• Caldwell Luc surgery
  Doctors may use this surgery when traditional approaches have not resolved the sinus problem. During this procedure, doctors create a new opening from the maxillary sinus (the cavity that lies behind the cheek) to the nose so that mucus can drain out of the sinus cavities.
• Snoring/sleep disorder surgery
  If the snoring problem is mild, the doctor may prescibe a nasal spray to reduce the swelling of the lining of the nose. Some dental appliances or nasal strips may also be recommended. If the problem is more severe or causes obstructive sleep apnea, continuous positive airway pressure or surgical procedures may be recommended.
• Continuous positive airway pressure (CPAP)
  It is a treatment modality that involves wearing of a mask over the nose and/or the mouth while sleeping. The mask is attached to a machine delivering continuous air flow into the nostrils. The pressure of the air that flows into the nostrils helps to keep the airways dilated so that breathing is not interrupted. Other PAP machines including BiPAP and VPAP are also available. BiPAP has two levels of air pressure and VPAP has varying levels of air pressure.
• Surgery for snoring disorders
  Surgery may be required to rectify a physical disorder that is leading to snoring. The surgical options include:
• Somnoplasty
  It is a minimally invasive procedure performed to reduce the soft tissue at the back of the throat or in the upper airway.
• Tonsillectomy and adenoidectomy
  Resection of the adenoids and/or tonsils may be required to prevent snoring.
• Palate surgery
  Your healthcare provider may recommend resection of some tissues of the soft palate that may be interfering with your breathing pattern.
• Upper airway stimulator
  This device is helpful for people with obstructive sleep apnea. It comes with a small pulse generator that is placed in the upper chest beneath the skin. A breathing sensor electrode is then implanted surgically on the side of the chest by the ribs. It detects the natural breathing pattern of the person using it. Another wire that goes up to the jaw delivers mild stimulation to the nerves that regulate the functioning of the airway muscles, keeping those open. A healthcare provider can program the device externally through a remote. Also, the user can turn it on before bed and off upon waking up in the morning with the help of a remote.
• Septoplasty
  Septoplasty is a surgical procedure that is performed to straighten a deviated septum. The nasal septum is around 7 centimetres long in adults. It consists of bone and cartilage and separates the inside of the nose into two nostrils or chambers. A deviated nasal septum is one that is bent or crooked instead of straight. It can interfere with the airflow by blocking one or both the nostrils. It can be deviated as a result of an injury, but people can even be born with it.
  
  Septoplasty is usually a minor, low-risk procedure. Recovery typically takes only a few days and. However, like with any surgical procedure, it is associated with some risks including infection, bleeding, and numbness. Apart from patients with deviated nasal septum with nasal obstruction, septoplasty may be performed to treat chronic sinusitis, remove nasal polyps, address other conditions blocking the nasal airway, and stop recurrent nosebleeds.
• Tonsillectomy
  Tonsillectomy is the surgical removal of the tonsils. Tonsils are the round, fleshy masses that lie in the back of the throat. You have a pair of tonsils - one on each side of the throat. While tonsillectomies are usually performed to treat children, adults can also benefit from it. During tonsillectomy, usually all portions of the tonsils are removed. However, some patients may only require a partial tonsillectomy.

Doctors recommend tonsillectomy procedure for two main reasons:

To decrease the risk of infection in patients with chronic or frequent tonsillitis.

To treat sleep disorders related to breathing, such as obstructive sleep apnea.

Getting a tonsillectomy has many benefits including fewer risks of infections, better sleep quality, and overall improved quality of life.

Adenoidectomy

Adenoids are glands that lie behind the nose and above the roof of the mouth. They appear as small lumps of tissue, and perform an important function in young children. They form a part of the immune system and protect the body against bacteria and viruses. Adenoids start shrinking at around the age of 5-7 in children and can be almost gone completely by the teenage years. A surgery aimed at removing the adenoids is called adenoidectomy.

While adenoids help protect the body against bacteria and viruses, they get swollen and enlarged or chronically infected sometimes. This can occur as a result of allergies, infection, or other reasons. Some kids may even be born with adenoids that are abnormally large. When a child's adenoids are too large, those can result in problems by blocking their airways partially. When this occurs, children can face breathing problems, infections of the ear, or other complications, leading to snoring or more serious conditions like sleep apnea. Chronic congestion, nasal drainage, and sinus infections can also be seen. Enlarged adenoids can also interfere with the return of ear infections and collection of chronic fluid in the ear, resulting in temporary loss of hearing.

Tympanoplasty

It is a surgical procedure used to treat ruptured eardrums. The eardrum or tympanic membrane is a tissue that separates the ear canal from the middle ear. When the eardrum is ruptured, a hole is created in the tissue. This hole keeps it from vibrating, affecting the normal breathing pattern. Most of the time, the ruptured ear drum is treated with antibiotics or ear drops. However, if the eardrum doesn’t heal with these treatment modalities, a tympanoplasty surgery may be needed to prevent problems like chronic infections, hearing loss, and dizziness.

The surgeon performs tympanoplasty surgery by accessing the eardrum and patching the hole. The surgery has been shown to successfully treat ruptured eardrums in more than 90% of people who undergo the surgery.

Ruptured eardrum can occur if:

• You poked your eardrum while trying to clean your ear with a bobby pin, cotton swab, pencil, or some other object.
• You have a middle ear infection (otitis media).
• You suffer from ear injuries due to a fractured skull, a loud explosion, or taking a hard hit on the side of your head.
• You suffer from barotrauma, a condition that occurs when the eardrum is affected by sudden air pressure changes.

Before tympanoplasty, the doctor will examine the middle ear and hearing. Following are some steps he might take:

• Examine your head and neck
• Examine your eardrum and middle ear with an otoscope or microscope so as to know the size and location of the rupture, if there are signs of inflammation, and whether the eardrum is discharging fluid or is dry.
• Employ tests like audiometry, that are used to check whether or not you can hear different pitches and sounds and tympanometry, which determines how well the middle ear functions.
• Ask you to complete a questionnaire to understand how the ruptured ear influences your day-to-day life.
• The healthcare providers use this information to find out which tympanoplasty technique will suit your condition the best.

Patching of the eardrum is involved in all tympanoplasties. The techniques vary in how the doctor reaches the middle ear so that the eardrum can be repaired. Following is some information on each technique:

• Endaural
  The incision is made above the ear canal.
• Postauricular tympanoplasty
  The surgeon will make a curved incision behind the crease in the outer ear called auricle.
• Transcanal
  The surgeon reaches the middle ear via the ear canal. They may employ this technique if the hole of the eardrum is relatively small and lies in the back of the eardrum.
• Thyroidectomy
  Thyroidectomy refers to the surgical removal of a part of or whole of the thyroid gland. Thyroidectomy is the primary surgical treatment for thyroid cancers. It is also a treatment option for several other thyroid conditions including:
• Thyroid nodules
  Thyroid nodule is a lump in the thyroid gland that is composed of thyroid cells. These nodules are generally noncancerous or benign but they can even be cancerous or malignant. Thyroid nodules can sometimes release excess amounts of thyroid hormone, causing certain symptoms.
• Goitre
  Goitre refers to an enlarged thyroid gland that has or does not have thyroid nodules. If the size of the gland gets too large, pressure will be exerted on the oesophagus or trachea, making it more difficult to swallow or breathe.
• Hyperthyroidism
  Overactive thyroid or hyperthyroidism is a medical condition in which the thyroid gland produces more hormones than you actually need. There are several causes responsible for the condition and surgery is one of the main treatment options.

The types of thyroid cancer are follicular thyroid cancer, papillary thyroid cancer, anaplastic thyroid cancer, primary thyroid lymphoma, and medullary thyroid cancer. Metastasis to the thyroid gland from cancer elsewhere in the body can also cause cancer.

Thyroidectomies are of two main categories - partial and total. Partial thyroidectomy involves the removal of part of the thyroid gland. It's types include:

• Thyroid lobectomy or hemi-thyroidectomy
  The surgeon removed one half of the thyroid gland.
• Isthmusectomy
  The surgeon resects the thyroid tissue between two thyroid lobes. This surgery is performed especially for small tumours located in the isthmus.
• Open thyroid biopsy
  During this surgery, the surgeon directly removes a thyroid nodule. This surgery is rarely performed. A near-total or total thyroidectomy is the surgical removal of whole or most of the thyroid tissue.

The type of thyroid surgery you might need depends upon the diagnosis. For example, if your thyroid gland has a nodule on one side, you might require a hemithyroidectomy to get it removed. If you have a large malignant cancerous tumour or a goitre, you will require a total thyroidectomy to get it treated. Your surgeon and your endocrinologist will together determine the best surgical treatment plan for you.

Head and neck malignancies such as oral, laryngeal, and temporal bone cancers may require an ENT surgery. The procedure employed may entail micro-blood vessel or reconstructive surgery.

Other procedures like laryngoscopy and tracheotomy are also performed in the ENT department. A direct laryngoscopy could be performed for diagnostic or therapeutic purposes. A tracheotomy may be performed when someone has problems breathing. An opening is cut in the wind pipe so that air reaches the lungs.

The Department of ENT at Kokilaben Dhirubhai Ambani Hospital, Indore offers advanced treatment services and consultation for conditions of the ear, nose, and throat region. Equipped with state-of-the-art facilities and pioneering technology, ENT specialists from Indore perform both routine and complicated surgical procedures via conventional and endoscopic methods. Combined skull-base surgeries and micro ear and laryngeal surgeries are also performed in the department.

ENT surgeries are recommended by oncologists in malignancies of the head and neck, including those of the larynx and temporal bone. These surgeries involve reconstructive or microvascular procedures.

Other ENT procedures involve diagnostic or therapeutic direct laryngoscopy, adenoidectomy, tracheostomy, septoplasty, and tonsillectomy. Some of these procedures are more frequently performed on paediatric patients.

If you are looking for the best ENT doctor in Indore, you can visit Kokilaben Dhirubhai Ambani Hospital, Indore. The Department of ENT at Kokilaben Dhirubhai Ambani Hospital, Indore boasts a team of experienced otolaryngologists who work in collaboration with allied trained medical professionals to determine treatment plans best suited to the patient's condition.