Ear Nose and Throat Treatments in Cornwall | Duchy Hospital

Ear, Nose and Throat Treatments

Tonsillectomy

Tonsillectomy is a minor surgical procedure to remove your tonsils. It’s normally performed to prevent recurrent tonsillitis (when your tonsils are inflamed and you have a sore throat) coming back.  

Tonsils are oval shaped glands at the back of your throat that are designed to help defend your body against germs that you breath in or swallow.

A tonsillectomy is normally carried out as an outpatient procedure under general anaesthetic and takes about half an hour. Your ENT surgeon will remove your tonsils through your mouth. They may use a scalpel or a surgical tool that uses heat, laser or ultrasound.

Surgical treatment for hearing loss

Treatment of hearing loss is dependent upon its type. There are two categories:

  • Sensorineural - hair cells within the cochlea and/or the hearing nerve are damaged and cause a problem with nerve impulse transmission from the inner ear to the brain. Sensorineural hearing loss is hard to treat. Hearing aids and cochlear implants can help.
  • Conductive – sounds can’t pass freely to the inner ear. Often due to a blockage in the outer or middle ear (ear wax, fluid or infection) or an abnormality in the structure of the outer ear, ear canal or middle ear (abnormal growths of skin, bone or tumours or a perforated or collapsed ear drum). It can usually be treated to modify or correct your hearing.

Surgeries we perform for conductive hearing loss include:

  • Tympanoplasty – collapsed ear drum repair.
  • Myringotomy – perforated ear drum repair caused by otitis media (middle ear fluid/infection).
  • Stapedectomy – replacing stapes bone with a micro prosthesis to treat otosclerosis (condition in which spongy bone hardens around the base of the stapes).
  • Cholesteatoma removal – removal of abnormal skin growth in the middle ear.
  • Ossiculoplasty – repair of damaged/discontinued ossicles (bones that transmit sound) in the middle ear.
  • Perilymph fistula (PLF) repair – repair to stop perilymph fluid leaking into your middle ear.
  • Translabyrinthine surgery – tumour removal. Often used for acoustic neuromas.

Tinnitus

Tinnitus is the perception of sounds, such as whistling, buzzing, ringing, hissing, humming or roaring, in your ears or head that isn’t from an external source. Tinnitus may be in one or both of your ears, start gradually or suddenly and happen occasionally or regularly. It can impact on a person’s quality of life.

If an underlying cause is known, such as earwax build up or otosclerosis, then surgery will be performed to treat this.

You’ll be advised to try and relax more, listen to music, regular sleep patterns and support groups.

Treatment of tinnitus is often in the form of therapies:

  • counselling - talking about and considering coping strategies.
  • cognitive behavioural therapy (CBT) - finding different ways of responding to the tinnitus so it becomes less bothersome.
  • mindfulness - a meditation technique.
  • tinnitus retraining therapy - retraining your response to tinnitus to allow you to tune it out and become less aware of it.

Sinus disease

Your sinuses are air-filled spaces within the bones of your face, connected to the inside of your nose. Sinusitis is when the lining of your sinuses become inflamed and swollen. They can get blocked and close the openings that lead to your nose. Symptoms of sinusitis include: pain and a feeling of pressure, discharge, blocked nose, fever and headache.

Acute sinusitis clears up after a few weeks. Chronic sinusitis will take longer. Treatment can include self-help remedies, medical help such as antibiotics or surgery.

Surgery may be suggested if you’ve chronic sinusitis with severe symptoms. It aims to unblock your sinuses and improve your mucus drainage. Functional endoscopic sinus surgery (FESS) is usually recommended. Your ENT surgeon will use a thin, flexible telescope called an endoscope to see inside your sinuses and then insert surgical instruments to remove bone and mucus membrane to unblock your sinuses.

Balloon sinuplasty is an alternative sinusitis surgery that involves your surgeon inserting a small, flexible tube into your sinuses and then inflating a balloon at the end of it to unblock your sinus.

Sleep apnoea

Obstructive sleep apnoea (OSA) happens when the air passage in your throat narrows or collapses and causes a total blockage for ten seconds or more whilst you’re asleep. It happens because when you’re asleep the muscles in your mouth, nose and throat relax too much and then your brain momentarily wake you to take in air. Episodes can be frequent throughout the night and may result in extreme tiredness.

Treatment will be based on the severity of your symptoms, your health and your preferences. Losing weight, stopping smoking, reducing your alcohol consumption and avoiding sedatives may initially be recommended.

A mandibular advancement device (MAD) is often suggested for mild OSA. It’s a dental appliance worn over your teeth whilst you're sleeping. It holds forward your jaw and tongue so that you’ve more space to breathe.

Continuous positive airway pressure (CPAP) is often used for moderate or severe OSA. Pressurised air is blown through a mask, whilst you’re asleep, into your upper airways to keep them open.

Surgery may be proposed. It can involve: removing tonsils or adenoids, inserting a tube into your neck to allow you to breathe freely or weight loss surgery if you’re obese.

Snoring

Snoring is a coarse sound. It’s harmless but can bother people around you. It can also be an indication of sleep apnoea.

Snoring is due to vibrations of the soft palate and other tissue in your mouth, nose and throat. When you’re asleep the muscles in this area relax and sometimes your airways can narrow or close up.

Losing weight, exercising, reducing alcohol and giving up smoking are recommended initially. Anti-snoring devices such as mouth guards or nasal strips may help.

Surgery may be suggested to remove the soft tissue that causes snoring, or tighten it and stop it from vibrating. Any anatomical problems that contribute to your snoring may be corrected by surgery such as a tonsillectomy for large tonsils.

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