Ear, nose, and throat surgery is the the surgical treatment of diseases, injuries, or deformations of the ears, nose, throat, head, and neck areas.
The purpose of surgery to the ears, nose, throat, head, and neck is to treat an abnormality (defect or disease) in these anatomical areas. An anatomical deformity is a change that usually occurs during embryological development, leaving the affected person with the apparent defect. A disease in this area usually develops later in life, such as head and neck cancer. Additionally, the specialty known as otorhinolaryngology (ears [ oto ], nose [ rhino ], and throat [ laryn ], referring to the larynx or throat) also includes surgical intervention for diseases in the head and neck regions. Most ears, nose, and throat (ENT) surgeons in the United States are referred to as otolaryngologist and the specialty as otolaryngology. Ear surgery is usually performed to correct specific causes of hearing loss. Nose surgery can include different types of procedures necessary to treat sinus problems (sinus surgery). Throat surgery can include complicated procedures such as cancer of the larynx ( laryngectomy ), or more simple procedures such as surgical removal of the adenoids ( adenoidectomy ) or tonsils (tonsillectomy ). Head and neck surgery may be necessary to remove a tumor or reconstruct an area after disfigurement from trauma or injury.
Typically, ear surgery is utilized to correct defects causing hearing loss or impairment. Such procedures include stapedectomy(removal of all or part of a bone in the middle ear called the stapes), tympanoplasty (reconstruction of the ear drum), andcochlear implants (implantation of a device to stimulate nerve ends within the inner portion of the ear to enable hearing). Surgery of the ear also includes myringotomy (insertion of ear tubes to drain fluid in persons with chronic ear infections).
Common surgical procedures of the throat include removal of tonsils (tonsillectomy) or adenoids (adenoidectomy). The tonsils (either side and in back of the throat) and adenoids (higher up the throat behind the nose) are masses of lymph tissue that play an active role in body defenses to fight infection. The tonsils and adenoids can get chronically infected, in which case surgical removal is usually indicated to relieve breathing problems and infection recurrence. Furthermore, chronic inflammation of the adenoids can cause repeated middle ear infections that can ultimately impair hearing.
Surgery of the nose can include procedures that treat sinus diseases (sinus surgery). Advanced endoscopic surgery for sinus and nasal disorders can eliminate the need for external incisions and greater surgical precision. Other common surgical procedures include correction of a deviated nasal septum ( septoplasty ) and for chronic nasal obstruction (congestion).
Surgery of the neck region can commonly include tracheotomy (a surgical procedure in which an opening is made in the trachea or window). Tracheotomy is indicated for a person who is unable to deliver enough air (oxygen) to the lungs. Additionally, ENT surgeons perform complicated surgical procedures for the treatment of malignant head and neck cancers. In addition to tumor removal , when indicated, ENT surgeons may perform an operation called radical neck dissection , during which the ENT will remove cancer that has spread via lymphatic vessels to regional neck lymph nodes. Neck dissection is also useful since specimens can be removed for pathological examination, which can provide important information concerning metastasis (spread) and can direct the treatment plan (i.e., radiation therapy and/or chemotherapy may be recommended for aggressive cancers). ENT surgeons also treat sleep-related disorders such as sleep apnea and excessive snoring; a procedure called laser-assisted uvula palatoplasty (LAUP) will remove tissue to allow for unobstructed airflow.
Other ENT procedures include surgical reconstruction of ear deformities (otoplasties), special surgery for diseases in the inner ear, and skull-based surgeries (neuro-otology). As well, ENT surgeons can surgically treat abnormalities near the eye, perform oral surgery for treatment of dental and jaw injury, and remove skin cancer within the head and neck region. ENT surgeons also perform special surgical techniques that can preserve nerve and blood vessel function ( microsurgery ) and reconstruction of bone and soft tissue.
A careful history and physical examination of the ears, nose, throat, head, and neck is a standard approach during initial consultation. Different instruments with light sources (i.e., otoscope for ear examinations) enable ENT surgeons to quickly visualize the ears, nose, and throat. Visualization of these areas can reveal the severity of the disease or deformity. The head and neck area is inspected and the neck and throat area is typically felt with the surgeon's hands (palpation). Special technological advancements have enabled ENT surgeons to further visualize deep internal anatomical structures. Nasal endoscopy allows visualization of the upper airway to detect anatomical problems related to sinuses. Videostroboscopy can be used to visualize the vocal cords, and triple endoscopy (laryngoscopy, esophagoscopy, and bronchoscopy ) can diagnose and stage head and neck cancers. Preparation before surgery is fairly standardized and includes blood work-up and instructions to have nothing to eat or drink after midnight of the night before the procedure.
All these procedures/surgeries with advanced diagnostic tools are routinely carried out in our hospital.
Dr RAJESH VALAND
M.B.BS, MS (E.N.T), DORL
FULL TIME CONSULTANT
GLOBAL HOSPITAL AND RESEARCH CENTRE , ANDHERI WEST.