The ears, nose and throat perform some of the human body’s most important functions. The ears enable us to hear and maintain balance. Without our nose and throat, we would not be able to breathe the air we need to live. So when something goes wrong with these vital organs, it’s best to turn to a specialist in the field, an otolaryngologist.
Some of the most common surgical procedures are within the field of otolaryngology. Otolaryngologists, also known as Ear, Nose and Throat (ENT) doctors, represent the oldest medical specialty in the United States. They treat everything from hearing problems to allergies to voice and swallowing disorders. Texas Health Care/Privia North Texas has nine otolaryngologists on its team. Here’s a look at some of the more common surgical procedures they perform for their patients.
“An ear infection is miserable and it’s especially painful for young children,” says Dr. Tahir Ali. “When a child gets repeated ear infections, one of the most common ways to help solve the problem is by inserting tubes in the ears.”
Each year, more than 500,000 ear tube procedures are performed on young children. While most commonly associated with children, ear tubes can also be used for adolescents and adults.
Ear tubes are used when a patient develops chronic middle ear infections or experiences a buildup of fluid in the middle ear. The surgeon makes a tiny incision in the ear drum and then inserts a very small tube into the incision. This allows air flow into the middle ear, reducing the likelihood of infection and fluid buildup.
Recovery from this procedure is very quick. Depending on the type of ear tube used, they may fall out by themselves within six to eighteen months or require removal by the otolaryngologist.
Tonsils and Adenoids
Our tonsils and adenoids are integral parts of our bodies’ immune systems – they intercept and sample bacteria that enters our mouth. That’s the reason that they sometimes become infected and cause problems. Tonsils are roundish lumps in the back of the throat, while adenoids are located high in the throat.
For people who develop chronic infections of the tonsils (tonsillitis) or nose, removal of the tonsils and adenoids may be the recommended course of treatment if antibiotics have been ineffective at stopping the infections. Enlarged tonsils and adenoids may also interfere with one’s ability to sleep well; this can be another reason to remove them. In adults, a tumor or cancer of the tonsils, which is rare, would be cause for removal.
“When considering whether or not a tonsillectomy is appropriate, we have to make a determination if the tonsils are doing more harm than good. Since they are part of our body’s natural defense against bacteria, removing them is usually not the first option,” says Dr. John Fewins. “But if they are repeatedly infected or interfering with sleep, a tonsillectomy may be the best course of action.”
Tonsillectomies and adenoidectomies are fairly common procedures. In both cases, the patient will experience some pain in the days following surgery, but most people make a complete recovery relatively soon.
In cases in which an older child is having ear tubes inserted, especially for the second time, the otolaryngologist may recommend adenoid removal in the same surgery.
The nasal septum bisects the nasal cavity. Ideally, it would run straight down the middle of the cavity, but in as many as 80 percent of people, the septum is off center, meaning one side of the nasal cavity is bigger than the other. The deviation is not visible to the naked eye, and for most people, it doesn’t cause a problem. However, when the septum is significantly off center, the sinuses may not drain properly, resulting in chronic sinus infections -- this type of deviated septum may need to be repaired through surgery.
A deviated septum may occur on its own or be caused by a trauma to the nose. If you suffer frequent nasal congestion, especially on one side of the face, as well as sinus infections or headaches, your otolaryngologist may order a CT scan to get an image of your sinuses and septum.
If it turns out that the septum is deviated, your physician may recommend a septoplasty, which is surgery to straighten the septum. The septoplasty is performed entirely within the nostrils, which means there is no external bruising or incisions. It generally takes an hour or less, is performed under general anesthesia and is done on an outpatient basis. The patient is sent home with splints or packing on the inside of their nostrils that help to keep the repaired septum in place. This material is removed several days following surgery by the physician.
“Septoplasty can provide significant relief to a patient who suffers from chronic nasal congestion and frequent sinus infections,” says Dr. Todd Samuelson. “Correcting a deviated septum can do wonders for helping my patients breathe better.”
Sometimes, a septoplasty is combined with a rhinoplasty, plastic surgery commonly known as a “nose job.” Rhinoplasty can achieve a better-sized nose in proportion to the face, correct a drooping, upturned or bulbous nose, correct nasal asymmetry, as well as address other physical issues.
A septoplasty may also be performed in concert with sinus surgery.
Some people develop polyps in their sinuses that contribute to congestion and sinus infections. The sinuses can also swell, inhibiting their ability to drain mucus properly. This can often be effectively treated through use of a nasal steroid spray, which helps to shrink the sinus tissue and promote better drainage. Oral and injectable steroids are also possible treatments.
If these medications are ineffective, surgery to remove polyps may be an option. In this procedure, the surgeon inserts a small instrument through the nostrils and into the sinus cavity to remove polyps or other obstructions. If the opening from the sinus to the nasal passages is narrow, the surgeon may also widen it to promote better drainage.
“Sinus surgery can make a real difference for some people,” says Dr. Tahir Ali. “If I have a patient who has polyps or other obstructions in the sinuses that are not responding to medication, surgery may be the best opportunity to remove the obstruction, enabling the patient to breathe easier and experience less frequent sinus infections.”
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