Ear, Nose and Throat
ENT is the medical specialty that involves the diagnosis, management and treatment of ear, nose and throat disorders and diseases as well as related parts of the head and neck.
At Berkshire Independent Hospital we provide the very best ENT care for your individual needs and offer the latest techniques as appropriate. Whether you need a simple investigation for an ear, nose or throat problem or complex endoscopic sinus surgery, we’ll look after you throughout from diagnosis to treatment.
Conditions we care for include: hearing loss and balance, nasal and sinus problems, voice and swallowing issues, snoring and sleep apnoea, ear diseases (otology), nose diseases (rhinology) and head, neck and facial cancers. Our ENT surgeons, also known as otolaryngologists, offer a full range of ENT services for adult and child ENT patients. They are supported by a consultant audiologist, radiologists and nurses.
Tonsillectomy is a surgical procedure to remove your tonsils. It can be performed if you have recurrent tonsillitis whereby your tonsils become inflamed and you have a sore throat. A tonsillectomy is the only reliable way to stop tonsillitis that keeps coming back. Your ENT surgeon will discuss the criteria for a tonsillectomy with you.
You have two oval-shaped tonsils at the back of your throat. They are part of a group of lymphoid tissues (glands in your neck) that help defend your body from germs that are breathed in or swallowed.
Tonsillectomy is normally carried out as an outpatient procedure so you’ll go home the same day. It takes about half an hour. You’ll be under general anaesthetic and your tonsils will be removed through your mouth. There are a number of ways to perform a tonsillectomy including using a scalpel or a surgical tool that uses heat, laser or ultrasound.
Surgical treatment for hearing loss
Hearing loss can be divided into two types:
- Sensorineural - damage to the hair cells within the cochlea and/or the hearing nerve causes a problem with the transmission of nerve impulses from the inner ear to the brain. It’s difficult to treat but hearing aids and cochlear implants may help.
- Conductive – sounds can’t pass freely to the inner ear. It can usually be medically or surgically treated to correct or improve your hearing.
Conductive hearing loss is often due to a blockage in the outer or middle ear such as ear wax, fluid or infection. It can also be due to an abnormality in the structure of the outer ear, ear canal or middle ear such as abnormal growths of skin, bone or tumours or a perforated or collapsed ear drum.
Surgeries we perform for conductive hearing loss include:
- Tympanoplasty – surgical repair of ear drum for collapsed ear drums.
- Myringotomy – repair of a perforated ear drum caused by otitis media (middle ear fluid or infection).
- Stapedectomy – restore of hearing loss caused by otosclerosis (disease of bone surrounding the inner ear and abnormal bone forms around the stapes causing a reduction of sound to the inner ear).
- Cholesteatoma removal – removal of an abnormal growth of skin in your middle ear.
- Ossiculoplasty - repair of damaged or discontinued ossicles of the middle ear (ossicular chain).
- Perilymph fistula (PLF) repair – repair of a channel that has formed that connects your inner and middle ear allowing perilymph (fluid) to leak into your middle ear.
- Translabyrinthine surgery – removal of tumours such as a growth on a nerve called acoustic neuroma.
Tinnitus is the hearing of sound in your ears or head such as whistling, buzzing, ringing, hissing, humming or roaring, that isn’t due to an external source. The sound can be in one or both of your ears. It may start gradually over time or suddenly depending upon its cause. Tinnitus can occur occasionally or regularly and at night causing a reduction in a person’s quality of life.
Treatment may focus on the management of the condition or treatment if an underlying cause is known such as the removal of earwax build up or surgery for otosclerosis.
Self-help remedies such as relaxation, listening to music, distraction through hobbies, regular sleep patterns and support groups may help.
Treatment options to manage tinnitus on a daily basis may include: sound therapy (fill silence with neutral sounds to distract you from your tinnitus sound), counselling (offering coping strategies), cognitive behavioural therapy (aimed to reduce anxiety around tinnitus and help change the way you think about it so it becomes less noticeable) and tinnitus retraining therapy (retraining your response to tinnitus so that you can tune out and become less aware of it).
Sinus disease, or sinusitis, is an inflammation or swelling of your sinuses, which are small air-filled cavities found behind your forehead and cheekbones. Blocked and fluid-filled sinuses can grow germs and cause infection. Symptoms of sinusitis include: pain, discharge, blocked nose, fever and headache.
Often sinusitis clears up after a few weeks but if you develop chronic sinusitis you should seek medical advice. Treatment can include self-help remedies, medical help or surgery.
Surgery aims to unblock your sinuses and improve your mucus drainage. Functional endoscopic sinus surgery (FESS) is often recommended and uses a thin, flexible telescope called an endoscope to see inside your sinuses. Your ENT surgeon will then insert surgical instruments to remove bone and mucus membrane to unblock your sinuses. FESS is typically performed under general anaesthetic.
Balloon sinuplasty is another sinusitis surgery carried out under general anaesthetic. It involves your surgeon inserting a small, flexible tube into your sinus and inflating a balloon on the end of it to unblock your sinus.
Sleep apnoea is also called obstructive sleep apnoea (OSA) and occurs when the air passage in your throat narrows or collapses causing a total blockage for ten seconds or more whilst you’re asleep. Sleep apnoea occurs because the muscles in your mouth, nose and throat relax too much during sleep. Your brain will wake you so you can take in air. These episodes can be repeated frequently during the night and can make you feel extremely tired.
Treatment of sleep apnoea depends on the severity of your symptoms, your health and preferences. Often your consultant will suggest lifestyle changes such as: losing weight, stopping smoking, reducing your alcohol consumption and avoiding sedatives.
If you’ve mild sleep apnoea a mandibular advancement device (MAD) may be recommended. A MAD is a dental appliance that you wear over your teeth whilst you're sleeping. It’s designed to hold forward your jaw and tongue so that you’ve more space to breathe.
Continuous positive airway pressure (CPAP) is often the first line of treatment for moderate to severe sleep apnoea. Pressurised air is blown into your upper airways, through a mask whilst you’re asleep, that keeps your airways open.
Surgical options may be recommended and include: the removal of tonsils or adenoids, the insertion of a tube into your neck to allow you to breathe freely or weight loss surgery if you’re obese.
Snoring is a coarse sound made by vibrations of the soft palate and other tissue in the mouth, nose and throat. When you sleep the muscles in this area relax and your airways can sometimes narrow or even close up.
Snoring isn’t harmful but it can affect the people around you and may be a sign of sleep apnoea.
Lifestyle changes are normally initially recommended and include: losing weight, exercising, reducing alcohol and giving up smoking.
Anti-snoring devices may prevent you from snoring, such as mouth guards or nasal strips.
Surgery may be recommended if anti-snoring devices haven’t helped. There are a number of options that normally involve removing the soft tissue that causes snoring, or preventing the tissue from vibrating by causing it to tighten. If you’ve obvious anatomical problems that contribute to your snoring, then the appropriate surgery to correct this will be advised. For example, if you’ve large tonsils, then a tonsillectomy will be recommended.
The following Consultant offers ENT procedures at Berkshire Independent Hospital