Ears Nose and Throat Surgeon UK

The nose continues to develop in both its cartilaginous and bony components. It does so via a numer of different growth centres that have a dedicated blood supply. The growth continues significantly until at least 16-17 years of age.

Surgery to the nasal septum and nasal bones disrupts the blood supply to these growth centres and as a result most patients aged below 17 would not be considered for a nosejob before this age. This is not to say that it should not be done as sometimes if there is a trauma causing a significant injury to the nose and distortion of shape it is better to correct this rather than let the nose continue to grow in the wrong fashion for the rest of the deveoment of the nose.

or further information about nosejobs please look at the website http://www.myentsurgeon.com/septorhinoplasty.html

A change in voice is an important symptom. It can be important to an individual because of the fact that the person requires their voice for their job or they are a professional voice user. It can also be important because this symptom can herald the early onset of a laryngeal cancer. There is however, a wide mix of diagnoses related to this symptom.

If a change in voice persists greater than 4 weeks than it does warrant an ENT examination. An ENT surgeon will take a careful history and perform a thorough examination to elicit the cause of the change in voice http://www.myentsurgeon.com/ears-nose-throat-consultation.html

It is important to bear in mind risk factors for cancer in the form of smoking and drinking and clearly patients with these and a change in voice should not delay in seeking a specialist opinion.

Nosebleeds also referred to as epistaxis are a common phenomenon. It occurs in all age groups, both sexes and thankfully most of the time is fairly self limiting. However, as an ENT surgeon I see the more troublesome end of the spectrum and always treat them seriously as every year in this country a few people die as a consequence of a nosebleed.

It is important to take a full history to look for any causes of a tendency or cause for nose bleeds. A careful examination of the nose is important to look for a cause.Occasionally blood tests are undertaken to look for a bleeding tendency and if there is a mass in the nose special XRays may be organised.

Treatment is dependant upon the cause. The commonest cause is related to bleeding from the nasal septum where there are some fragile blood vessels. These can be easily cauterised even in the younger age group. Occasionally nasal packing or even surgical intervention is required to stem a brisk nosebleed.

Patients should be seen for a significant nosebleed or recurrent nosebleeds.

A septoplasty is an operation undertaken by ENT surgeons to straighten the midline cartilage of the nose and is often combined with minor surgery to the fleshy turbinate tissue in the nose. It is aimed at improving nasal obstruction.

If patients are carefully selected then the operation can be extremely successful. However, patients should be aware that on occasions if the cause of their nasal obstruction arises from the lining of the nose then the operation may not be a success as this does not change.

A careful examination of the nose often revels the deflection of the nasal septum, that can obstruct both sides of the nose if the cartilage is in a S shape. If this deflection is noticed and nasal obstruction is the main symptom without significant other nasal symptoms then septoplasty carries a high chance of success.

Just be warned that immediateley following a septoplasty the nose is blocked significantly as the operation causes swelling and inflammation. This takes approximateley 10-12 days to start settling and then the patient starts to feel the benefit of surgery.

Prominent ears are a reasonably common phenomenon that are troublesome to children because of teasing that occurs at school but that can be treated very well with surgery.

Prominent ears are noticeable from birth and in the first few weeks of life the cartilage of the ear is malleable and certain proprietary brands of splints can actually be used with some success. What is commonly seen though is the prominent ears do not become a problem until teasing starts at schooling age.

Many different techniques of surgery are used to correct these deformities but it is key to understand the anatomic problem with development that has caused the prominence and then to correct it.

Correction can make a massive difference in the quality of a childs life and can be a hugeley beneficial operation. Parents are often nervous about undertaking an operation for essentially a cosmetic operation but anaesthesia in children is significantly safer than it ever has been and the benefits of surgery outweigh the risks in most circumstances.

The facial nerve is very important as damage to it can cause assymetry in the ability to blink, wink, smile and chew food. The facial nerve unfortunateley lies in the middle of the parotid gland and in a formal parotidectomy is found and preserved.

Thankfully the majority of parotid surgery is performed for benign lesions and so the facial nerve is not significantly at risk. Malignant parotid disease is quite different as often the facial nerve function may have already been affected by the disease process and there may be a need to sacrifice part or all of the nerve.

When looking for the nerve typically the surgeon should have experience with parotid surgery as this will allow him to find it with certainty using normal anatomical landmarks he or she is used to. Once the main trunk is found the nerve should not be handled if at all possible as the less it is touched the less of a chance of weakness postoperativeley will develop.

Inevitably some weakness can ensue even with benign disease and even when the facial nerve is deemed completeley intact at the end of the operation. This sometimes relates to minor trauma to the nerve during the operation and often returns in the few months postoperativeley. One does notice clinically the older a patient is the more sensitive the facial nerve is to this transient weakness postoperativeley and this may be related to a deterioration in the blood supply to the nerve with age. If a nerve is sacrificed the surgeon should be planning or know what to do in this eventuality and it may involve grafting the lost portion of nerve or hitching part of other cranial nerves to the damaged facial nerve for some residual stimulation.

Most importantly for a good result both clinically and for the facial nerve, if a patient is to be operated on for a parotidectomy the surgeon should be well practiced in this surgical technique ie a surgeon with an interest in Head and Neck Surgery.

This is an exciting, developing area of Head and Neck Cancer treatment. Up until more recent years the mainstay for treatment of laryngeal cancer included options such as radiotherapy, total or partial laryngectomy (removal of the voice box) or a comination. The use of the laser has now added an extra option to the treatment arms available to a patient and as it does not require a major open operation can be very attractive to the patient.

The laser is a precise cutting tool that can be used with an operating microscope for magnification to accurately excise a cancer in the larynx. The benefit of this can be that a relatively simple procedure can be used to excise a laryngeal cancer in one or two visits to the operating theatre.

The patient must however, be carefully counselled with regards to the chances of success of resection and the complications that can ensue from the operation. Clearly removing part of the larynx can have an effect on voice production, if the cancer is small this effect is not often too significant but equally so for these cancers treatment with radiotherapy can also have an effect on voice. Which is better for voice is being investigated at the present time by a number of institutes around the world. Too much of a resection in the larynx may also affect the protective function of the voice box (increase the risk of aspiration) it is for this reason that discussion with a speech and language therapist is always prudent.

Whatever, the risks and benefits, transoral laser surgery is certainly an option of treatment for a laryngeal cancer that should not be overlooked and with the increasing development of robotic surgery this area of Head and Neck Cancer surgery could improve even further.

This condition can be a severely painful acute condition and a nuisanceful chronic recurring problem. Whatever, careful attention should be taken to aural hygeine advice http://www.myentsurgeon.com/ear-care-advice.html

It is imperative to contact your general practitioner to commence early treatment in addtion to the ear care advice. If the ear canal is not too swollen then the instillation of antibiotic and steroid drops can help reduce the symptoms of the condition rapidly. Unfortunateley, some patients rapidly develop a swollen ear canal or alternativeley have a predisposition to the condition because of narrow ear canals and as a result require intervention by an ENT surgeon in the form of splinting the ear canal open with a ‘wick’. This keeps the ear canal open whilst allowing for the delivery of the antibiotic and steroid drops.

Despite all medical intervention the strict adherence to the advice on aural hygeine is the key to success in the management of this condition and occasionally people will require regular follow up in the clinic just to maintain patency of the ear canal.

Snoring is a common phenomenon and has an increased incidence with age. Certain physical attributes such as weight and alcohol consumption can worsen the effect of snoring. The symptoms and complications associated with snoring cover a number of specialities and it is therefore imperative that there is a working relationship with these other specialities if the correct management is to be offered to patients.

If a patients Epworth Sleepiness score (see website) is high then this implies that the snoring is significantly affecting the quality of sleep and this may be best assesed by a physician with the ability to undertake a sleep study.

If a patient is not overweight and does not drink excessively together with a low scoring Epworth Sleepiness score, it is not unreasonable to offer snoring surgery. The patient should be advised carefully as to the success and more importantly the long term effect of this success. They also must be aware of the complications associated with this sort of surgery.

Ultimately, surgery for simple snoring is not an unreasonable treatment option as long as the patient has been assesed correctly in the Out-Patient setting and is given realistic expectations for the future

This is a huge issue in the UK with local areas being split up into cancer networks and cancer services being delivered with varying levels of expertise and allied health care support. Thankfully this is being regulated by a process called peer review.

The very best treatment for a patient is not just centered around the surgery or the radiotherapy a patient receives. These are very important but there are many more things that are offered to patients in a premier Head and Neck Cancer Centre.

In our Head and Neck Cancer Centre we have excellent surgical staff experienced and trained both nationally and internationally. Our oncologists offer conventional radiotherapy and state of the art IMRT a form of radiotherapy to allow for more accuracy in complicated areas of the Head and Neck. Very importantly however we have world class radiology and cytopathology together with superb histopathology support. In addition we have nursing staff on the ward dedicated to the post operative care of Head and Neck Cancer patients, we have clinical nurse specialists supporting the patients both whilst in hospital and when they leave and we have specialised Speech and Language as well as dietietic services purely attached to the Head and Neck Service alone.

It is clear therefore that the service that can be offered to the Head and Neck Cancer patient from a holistic view point is significantly improved with this dedicated service.