Ears Nose and Throat Surgeon UK

This is a very difficult question to answer as every patient is an individual.

I always say to patients not to get water in the ears until I see them at the first Out-Patients appointment. At that stage I reiterate that they have an artifically created hole in the eardrum by virtue of the fact the grommet is in place. I then suggest should they wish to swim they should use good ear seals to prevent water entering the ear canal. If children, I also suggest the headbands that can be worn to further prevent water from entering the ear canals.

Clearly if patients develop infections despite ear precautions as above I explain it is more appropriate to avoid putting the ears at risk with certain activities such as swimming.

It is not uncommon for people to come to me feeling a lump in the throat being present. It is a very common phenomenon that more often is benign but requires a careful ENT evaluation in the history and examination.

It is imperative to take a clear history in order to elicit high risk cancer association factors such as a smoking and or high alcohol intake. Safer aspects to the history include the ability to continue to eat and drink, no weight loss and if the lump sensation comes and goes.

It is essential that a thorough ENT examination is undertaken to visualise the upper aerodigestive tract and this can be undertaken using nasendoscopy. This allows a direct picture of the upper airway that cannot be undertaken by the patients General Practitioner. It is often for this reason that patients are referred for a specialist opinion.

A wide differential diagnosis exists for this symptom thankfully the majority of cases are related to a ‘globus’ phenomenon which may be related to reflux or stresses however, the high risk malignant conditions have to be excluded.

Sinus surgery has changed significantly over the years. The previous operations that were the norm such as a Caldwell Luc or inferior meatal antrostomies are unusual to perform nowadays. Our technique has been refined to encorporate the normal sinus drainage patterns which is what we refer to as ‘Functional Endoscopic Sinus Surgery’ or ‘FESS’.

What is interesting, when I teach General Practitioners who have had a good grounding in ENT Surgery, this newer approach to sinus surgery is not fully appreciated. This may be because it is simply a development that has occured since they had any formal ENT training so it is essential that we spread the word with this up to date form of treatment of the sinuses.

The treatment does not usually require any surgical scars and is performed through the nose using an endoscope, which is a thin rod that can allow the surgeon to visualise inside the nose and then instrument it. A variety of specialist instruments can then be used intranasally to open the natural drainage patterns of the sinuses and thus improve the symptoms of sinusitis by improving the natural drainage pattern and not creating an unnatural one.

Nasal polyps cause onbstruction of the nose and can be very symptomatic causing patients to suffer with nasal obstruction, snoring, decreased smell sensation and a runny nose.

Polyps are an inflammatory / allergic response of the nasal (sinus)mucosa that then prolapses and obstructs the nose. A large number of polyps can be treated with intranasal steroid sprays, but I often see patients who have tried these already. If the polyps are symptomatic then it is not unreasonable to remove the polyps surgically via an endoscopic surgical technique (no external scars). This gives the patient immense relief after the intranasal swelling goes down.

Whilst this removes the majority of the polyps there is a tendency for the condition to recurr as it is the sensitivity of the nasal (sinus) mucosa to swell and prolapse that causes them and this still remains. It is for this reason I will often treat people again with intranasal steroid sprays following surgery as the delivery is improved and it will decrease the chance and the need for further surgery.

Over the years tonsillectomy has had a bad press and this may be related to the fact that previously many people had their tonsils removed surgically without a correct indication.

As an ENT surgeon tonsillectomy is a satisfying operation as it is now performed with specific indications and the results therefore are gratifying for the surgeon and satisfying for the patient.

Clearly you will not die of tonsillitis but it is a huge problem to adults and children. However, when thinking about state services paying for operations, those that are deemed the most life saving will always be paid for and those deemed not serious may not be seen to be value for money (amongst the politicians). It is imperative to understand that tonsillectomy for reccurrent tonsillitis significantly improves an individuals lifestyle and whilst tonsillitis is not life threatening a tonsillectomy can significantly improve the quality of life of individuals.