Paideia International Hospital has highly-qualified otolaryngologists, or ENT specialists, who treat ear, nose and throat conditions, from examination to the management and treatment of the most serious conditions requiring hospitalisation and possible surgery. For head and neck conditions, themultidisciplinary approach ensures an efficient and a comprehensive study of the patient’s problem. Paideia International Hospital is equipped with the latest technology to support physicians in delivering the best services of prevention and diagnosis.
Otorhinolaryngology, the main conditions treated:
- Ear diseases, such as otitis media, perforation of the eardrum, exostoses, vertigo, labyrinthitis and tinnitus
- Throat diseases, such as tonsillitis (especially if chronic), fibropapillomatosis, abnormalities of the palate and problems such as sleep apnoea and snoring
- Larynx diseases, such as vocal cord paralysis, nodules, polyps, cysts and laryngeal stenosis
- Salivary glands diseases, for example salivary sialadenitis and salivary stones
- Inflammatory diseases of the nose, such as sinusitis, adenoiditis, polyposis and turbinate hypertrophy
- Malformations of the nose and septum
- Otosclerosis
- Hearing loss
- Head and neck tumours
Nose and sinus disorders
Sensation of nasal obstruction, may be experienced on only one side of the nose, sometimes both. There are three common explanations for this problem:
- Deviated septum: the septum is located in the middle of the nose and divides the nostrils into left and right. Its normal position is in the middle of the nose, but otherwise, it is known as a deviated septum.
- Turbinate hypertrophy: turbinates.
- Pathologies of the paranasal sinuses such as sinusitis or nasal polyps, which are growths of tissue in the lining of the nose or sinuses. They occur most commonly due to inflammation of the nose from sinus infections; however, in rare cases they may be associated with neoplasms.
Treatments
Sometimes it is best to manage the symptoms with systemic or topical medical treatment, which helps reduce swelling inside the nose.
Deviation of the nasal septum. When merely managing symptoms is not enough, a septoplastyis recommended, using up-to-date techniques and a tamponade with “open” devices, best splint, which allows the flow of air through the nasal passages.
Turbinate hypertrophy. In some cases, surgery(turbinoplasty) is recommended to reduce the size of the turbinates, performed using a minimally invasive technique, under endoscopic vision, under local anaesthesia without tamponade using current technology (Radiofrequency-Coblation-Macan) in a day-hospital setting.
Sinonasal Polyposis. Endoscopic sinus surgery is usually performed using a video-assisted procedure. It does not involve cutting the skin, because it is performed entirely through the nostrils.
Selected sinusitis. Balloon Sinuplasty, a minimally invasive technique, is used to treat chronic, recurrent sinusitis or sinus infections when medical treatment has not provided sufficient relief. During this procedure, surgeons use a small balloon, inserted through the nose, to dilate the sinus openings. People eligible for balloon sinuplasty include those who do not have nasal polyps or tumours.
Voice disorders
People develop vocal problems for many reasons. Physicians specialising in ear, nose and throat disorders and speech pathology specialists help to diagnose and treat voice disorders. Treatment depends on what is causing the voice disorder, but may include rehabilitation therapy (speech therapy), medication or surgery.
Treatments
Microlaryngoscopy to remove non-cancerous lesions (polyps and cysts) on the vocal cords. The physician can remove non-cancerous, pre-cancerous and cancerous lesions, including recurrent respiratory papillomatosis, white spots (leukoplakia), using microsurgery, state-of-the-art digital microscopes, and also laser surgery where indicated.
Sleep disorders
Obstructive sleep apnoea syndrome is the most common sleep-related breathing disorder. It causes the sufferer to stop breathing repeatedly while sleeping. There are several types of sleep apnoea, but the most common is obstructive sleep apnoea syndrom (OSAS). This type of apnoea occurs when the oropharyngeal throat muscles relax intermittently during sleep and block the airway. An obvious sign of obstructive sleep apnoea is snoring.
Obstructive sleep apnoea is considered a serious medical condition.
Complications may include:
- Daytime fatigue and drowsiness. Due to the lack of restorative sleep during the night, people with obstructive sleep apnoea often experience severe daytime sleepiness, fatigue and irritability.
- Difficulty concentrating and finding themselves falling asleep at work, while watching TV or even when driving. Children and young people with obstructive sleep apnoea may perform poorly in school and commonly have attention deficit or behavioural problems.
- Cardiovascular problems. Sudden drops in blood oxygen levels that occur during obstructive sleep apnoea increase blood pressure and put a strain on the cardiovascular system.
- Depriving partners of sleep loud snoring can prevent those beside you from getting a good night's rest and put great strain on relationships. Some partners choose to sleep in another room. People with obstructive sleep apnoea may also complain of memory problems, morning headaches, mood swings or depression and the need to urinate frequently during the night.
Treatments
The approach to managing and treating patients with OSAS is multidisciplinary, with a team of specialists caring for all aspects of the patient’s condition.
The main examinations are:
Polysomnography. During this sleep study, the patient is connected to equipment that monitors heart, lung and brain activity, breathing patterns, arm and leg movements and blood oxygen levels during sleep.
Sleep Endoscopy. Procedure to assess the oropharyngeal anatomical sites that result in partial or total obstruction of airflow.
Medical treatment for central sleep apnoea with a central positive airway pressure (CPAP) device or similar machines. Oral devices that push air through the airway at the base of the tongue and pharynx.
Surgical treatment in patients diagnosed with obstructive apnoea caused by anatomical alterations that can be corrected surgically.
Ear diseases
Hearing loss normally occurs gradually with age and when it is unrelated to biological age, it is necessary to investigate the causes.
There are three causes of hearing loss: conductive, sensorineural, mixed.
Signs and symptoms of hearing loss may include:
- Muffling of speech and other sounds
- Difficulty understanding words, especially against background noise or in a crowd
- Difficulty hearing consonants
- Frequently asking others to speak more slowly, clearly and loudly
- Need to turn up the volume of the television or radio
- Withdrawing from conversations
- Avoiding certain social settings
- Painful infections
Treatments
Medicine: indicated for infections of the ear, often the middle ear, a virtual air-filled space behind the eardrum that contains the ear’s tiny vibrating bones.
Surgery: involves operations to manage and solve problems in the ear, from the tympanic membrane, to the ossicular-chain (hammer, anvil and stirrup), to the bone or mastoid bone. There are two major groups of surgeries: middle ear surgery, which includes surgery of the ossicular chain and mastoidectomy involving the bone; and reparative surgery of the tympanic membrane.
At Paideia International Hospital, operations are performed by our professionals using both electron microscope and endoscopy.
Pathology of the major salivary glands
We have three main pairs of salivary glands: parotid, sublingual and submandibular. Many problems can interfere with the function of the salivary glands or block the ducts so that they cannot drain saliva. Modern digital and traditional radiology enables rapid diagnosis and planning of appropriate treatment.
The most common salivary gland problems include:
- Sialolithiasis, stones, accumulations of crystallised saliva deposits.
- Sialadenitis: bacterial infection of the salivary gland, most commonly the parotid gland, which can occur when the duct in the mouth is blocked. The infection creates a painful lump in the gland and the unpleasant-tasting pus drains into the mouth.
Treatments
Medicine: bacterial infections are treated with antibiotics, NSAIDs, bromelain supplements and local manipulation to restore proper saliva flow.
Surgery: there are different types of salivary gland surgery, depending on the gland and the problem. A partial or complete removal of the parotid gland is called a parotidectomy. The removal of the submandibular gland is called a submandibular gland excision . A newer, minimally invasive treatment of salivary stones and recurrent infections of the parotid or submandibular glands is called a Sialendoscopy.
Precancerous lesions of the oral cavity
Oral cancer accounts for about 3% of all malignant tumours and is a major health problem worldwide. Most oral malignancies occur as squamous cell carcinomas (SCCs); despite significant advances in treatment methods, the 5-year survival rate has not improved significantly in recent decades and still hovers around 50-60%. Many squamous cell carcinomas of the oral cavity develop from premalignant conditions. A wide range of conditions have been implicated in the development of oral cancer, including leukoplakia, erythroplakia, palatal lesion from reverse cigar smoking, oral lichen planus, oral submucous fibrosis, discoid lupus erythematosus, and hereditary disorders such as dyskeratosis congenita and epidermolysis bullosa.
Management strategies for patients with precancerous lesions of the oral cavityfall into three categories: close observation, surgical removal and ablation, and medical treatments. The mainstay of therapy is observation through frequent clinical examinations. The frequency of examinations must be adapted to the patient’s individual factors such as the clinical appearance and stage of the lesion.
It is recommended to refer to a medical professional to decide the best screening programme for the prevention of oral cancer.
