Ear, Nose and Throat Surgery in Gloucestershire

Ear, Nose and Throat Treatments

Tonsillectomy

Tonsillectomy is the surgical removal of your tonsils. The tonsils are two oval-shaped lymphoid tissues at the back of your throat that help fight off infection caused by breathing in or swallowing germs.

Infected tonsils are diagnosed as having tonsillitis. The main symptom is a sore throat and if you have a recurrent sore throat a tonsillectomy may be recommended.

A tonsillectomy is carried out through your mouth using a scalpel or a surgical tool that uses heat, laser or ultrasound to take away the tonsils. It’s an outpatient procedure performed under general anaesthetic and takes about half an hour.

Surgical treatment for hearing loss

Hearing loss can be two types:

Sensorineural – when you’ve a problem generating or transmitting nerve impulses from the inner ear to the brain. Difficult to treat, hearing aids and cochlear implants may help.

Conductive – when you’ve a problem conducting sound vibrations from the outer to the inner ear due to middle and external ear issues such as: ear wax, fluid or infection, perforated or collapsed ear drum, trauma and abnormal growths of skin, bone or tumours. Medical or surgical treatment can improve or correct this type of hearing loss.

Surgical treatment we offer at Winfield Hospital for conductive hearing loss include:

Tympanoplasty - repair of a collapsed ear drum.

Myringoplasty – repair of a perforated ear drum. Often caused by infection such as otitis media.

Stapedectomy - restores hearing loss caused by otosclerosis (a disease of the bone surrounding the inner ear).

Cholesteatoma removal – removal of an abnormal growth of skin that can form in your middle ear.

Ossiculoplasty - repair or reconstruction of damaged or discontinued ossicles of the middle ear, known as the ossicular chain.

Perilymph fistula (PLF) repair – repair of a channel that forms and connects your inner and middle ear allowing perilymph fluid to leak into the middle ear.

Translabyrinthine surgery – removal of a tumour, for example the acoustic neuroma (a growth on your nerve).

Tinnitus

Tinnitus is the perception of sound in your ears or head when there’s no external noise. It can be in one or both ears, low, medium or high pitched and happen occasionally or continuously.

There isn’t a treatment that directly cures tinnitus. It may be that there’s an underlying cause of tinnitus such as earwax or otosclerosis and your ENT surgeon will treat this.

Often treatment will concentrate on managing your awareness of tinnitus and developing coping strategies. These include: sound therapy (use of neutral sounds to distract you from the tinnitus sound), counselling (to understanding tinnitus better and assume coping strategies), cognitive behavioural therapy (changes your thoughts about tinnitus so that it’s less noticeable) and tinnitus retraining therapy (retraining your brain’s response to tinnitus - tuning out and becoming less aware of it).

Sleep apnoea

Obstructive sleep apnoea (OSA) is when the air passage in your throat narrows or collapses whilst you’re asleep causing a total blockage for ten seconds or more. It happens because the muscles in your mouth, nose and throat relax too much when you’re sleeping. Your brain then automatically wakes you momentarily to allow you to take in air. If this regularly happens throughout the night, you’ll wake up feeling very tired.

Sleep apnoea treatment is dependent upon how severe your sleep apnoea is and your personal circumstances and preferences. Your consultant may recommend lifestyle changes such as: losing weight, reducing alcohol intake, stopping smoking or avoiding sedatives.

If you’ve mild sleep apnoea, a dental device called a mandibular advancement device (MAD) may be helpful. You’ll be advised to wear the MAD when you go to sleep. It will hold your jaw and tongue forward so that there’s more space at the back of your throat which reduces the narrowing of your airway.

If you’ve moderate to severe sleep apnoea, the most effective treatment is continuous positive airway pressure (CPAP). Whilst sleeping a machine will blow pressurised air into your upper airways through a mask which creates the air pressure required to keep your airways open.

If these aren’t successful, surgery will be advised. This may be: tonsillectomy, adenoidectomy (removal of enlarged adenoids blocking your airway during sleep), tracheostomy (insertion of a tube into your neck so you can breathe freely) or weight loss surgery (surgery for severely obese people if obesity is thought to make the sleep apnoea worse).

Sinus disease

Your sinuses are small, air-filled cavities behind your forehead and cheekbones. They can become inflamed and blocked, known as sinus disease or sinusitis. This is a common condition with distressing symptoms such as: pain, headache, blocked nose, discharge and high temperature.

Sinusitis may get better after a few weeks. If it doesn’t then you’ll need medical advice including self-help remedies, medical help or surgery.

There are a number of surgical options that will aim to unblock your sinuses and improve mucus drainage. Functional endoscopic sinus surgery (FESS) is the most common and uses a thin, flexible telescope called an endoscope to see inside your sinuses and, special instruments to remove bone and mucus membrane. It’s usually carried out under general anaesthetic.

Balloon sinuplasty is an alternative surgical treatment for sinusitis that involves inserting a small, flexible tube into your sinus and inflating a balloon at the end of it. It’s also performed under general anaesthetic.

Snoring

Snoring is often described as a snorting or rattling noise that can occur when a person breathes during sleep. It’s caused by vibrating of the roof of your mouth and tissue in your mouth, nose or throat when you breathe due to turbulence inside your airways.

It’s harmless but can cause anguish to partners and family as well as being an indication you may have sleep apnoea.

Lifestyle changes such losing weight, exercising and stopping drinking alcohol and smoking may help. You may be offered anti-snoring devices such as mouth guards and nasal strips.

If non-surgical methods aren’t working for you then surgery may be advised. Surgery will normally remove the soft tissue causing your snoring. If your snoring is due to an obvious anatomical problem then surgery will focus on correcting this, such as, if you’ve large tonsils, surgery may be recommended to remove them.

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