procedures
Myringotomoy and ventilation tube (grommet)
Myringotomoy, with or without grommet insertion, is the most commonly performed ear operation and it is both extremely safe and effective.
The procedure takes about 15 minutes to perform and the patient is discharged on the same day. Complications are minor and usually take the form of infections that can be treated with antibiotics.
While it may be rejected sooner, a grommet usually remains in place for several months, sometimes even years. Care should be taken to avoid contaminating the grommet with water, particularly bath water. In very rare cases, the tympanic membrane fails to heal after the grommets have been extruded, and the resulting perforations may require repair. Hearing usually improves immediately after fluid has been removed from the ear and a lack of improvement may indicate a secondary problem in the middle or inner ear.
Tonsillectomy and adenoidectomy
The removal of tonsils or adenoids is one of the most frequent of all throat operations.
It has proven to be a safe and effective surgical method
for resolving breathing obstruction, throat infections and
managing recurrent childhood ear disease. The pain following
surgery, similar to that experienced during throat infections
(but often felt in the ears), can be controlled with medication.
Other side effects associated with the removal of tonsils
or adenoids include the possibility of post-operative bleeding
during the first seven to ten days. And because swallowing
is painful after surgery, fluid intake may be poor; if this
cannot be corrected at home, the patient may require intravenous
fluid replacement.
Uvulopalatophyringo plasty (uppp)
Uvulopalatophyringo plasty (uppp) is an operation to improve
certain sleep-disorder symptoms, such as obstructive sleep
apnoea and snoring.
Several discrete causes may be responsible for the symptoms,
however, so the procedure may only offer partial relief, based
on the relative importance of the soft palate and uvular size.
But the success rate in treating apnoea has been reported
to be higher than 50%, while more than 80% of patients can
expect a reduction in snoring. Bleeding after surgery and
localised infections are the most common side effects, while
the pain following surgery can be controlled with medication.
Some patients may also experience a hypernasal or hollow-sounding
voice as a result of the shortened palate no longer making
contact with the back of the throat.
Patients undergoing the procedure are required to remain
in hospital for 24 to 48 hours after the surgery.
Tympanoplasty
Tympanoplasty is the reconstruction of the middle-ear hearing
mechanism in order to rebuild the tympanic membrane (myringoplasty)
and/or the bones in the middle ear (ossicularplasty). Excellent
results can be expected in about 90% of cases.
The success of the procedure depends almost as much on the
ability of the body to heal and preserve the reconstruction,
as it does on the surgeon’s skill.
Fortunately, even those cases that are not initially successful
can be revised with the same expectation of good results.
On rare occasions, complications do occur, but hearing loss
is uncommon when the operation is limited to repairing the
eardrum, while injury to facial nerves as a result of the
surgery is extremely rare. Depending on the seriousness of
the condition before the procedure, however, complete success
in restoring hearing without complications is the rule.
Minor side effects that may occur include a temporary loss
of the sense of taste on the side of the tongue and mild dizziness.
The post-operative period is normally relatively pain-free
and the ear requires no more than a bandage. Patients remain
in hospital overnight and are discharged on the following
day.
Septoplasty
Septoplasty is an operation to correct a deformity of the
partition between the two nasal passages. Usually performed
to improve breathing, it may also be required to improve the
interior of the nose for the adequate treatment of polyps,
inflammation or bleeding. No pharmaceutical treatment can
correct a deformed nasal septum, making surgery the only solution.
Complications are uncommon in this procedure, but may include
septal perforation and the failure to completely improve breathing,
as a result of swollen membranes that are most commonly seen
in patients with allergies. The procedure calls for the patient
to remain in hospital overnight, during which time small plugs
remain in the nasal cavities; these are removed the following
morning, after which the patient is discharged.
Functional endoscopic sinus surgery
Endoscopic sinus surgery is performed intranasally and is
recommended only after it has been determined that medical
management of sinusitis has been unsuccessful.
Surgery, medical management and failure to intervene all
have risks including, as a group, post-operative bleeding,
orbital complications, intracranial extension, leakage of
cerebrospinal fluid, persistent or recurrent nasal obstruction
due to failure to manage the polyps, and recurrent nasal or
sinus infections. X-rays and endoscopic findings are considered
in conjunction with the patient’s clinical status following
medical evaluation and therapy, which will identify the appropriate
sinuses to treat. With modern endoscopic techniques, success
rates in long-term control of sinus symptoms are about 85%.
Post-operative pain is minimal and discomfort is limited
to the nasal plugs that remain in the nose overnight. The
patient is discharged from hospital after these are removed
the following morning, but it is essential that the patient
irrigates the nasal cavities regularly during the post-operative
period and also applies the appropriate topical spray.
Audiology and hearing-aid dispensing
The world is full of beautiful sounds that we seldom fully appreciate until our hearing starts to fail.
One in ten people suffers from hearing loss, yet up to 90%
of these cases can be helped by the expert diagnosis of an
audiologist, state-of-the-art surgery, or the correct use
and fitting of a hearing aid, which will restore your hearing
to a level that you may have thought impossible.
Mediscapes will be delighted to advise you on an appropriate
procedure for your particular hearing needs and then recommend
a specialist to dispense a technologically advanced hearing
aid … at a cost far lower than the amount you would
pay for the same services at home.
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