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Ear, Nose & Throat

Our ENT surgeon or Otolaryngologists Dr. Jason Guillot, M.D.  provides comprehensive medical and surgical care for adult and pediatric patients with diseases and disorders that affect the ears, nose and throat, the respiratory and upper alimentary systems, and related structures of the head and neck.

Some of the common ENT surgeries performed at Cypress Pointe Surgical Hospital are as follows:
  • Adenoidectomy
  • Functional Endoscopic Sinus Surgery (FESS)
  • PE Tubes (Ventilation Tubes)
  • Tonsillectomy

Adenoidectomy
An adenoidectomy is the surgical removal of the adenoids which are small lumps of tissue that lie in the back of the throat behind the nose. The adenoids are removed if they block breathing through the nose and if they cause chronic earaches or deafness. Between the ages of two and six, the adenoids can become chronically infected, swelling up and becoming inflamed. The swelling can also block the eustachian tubes that connect the back of the throat to the ears, leading to hearing problems until the blockage is relieved. Since adenoids are often associated with infected tonsils, they are often removed as part of a combined operation that also removes the tonsils, called a T&A (tonsillectomy & adenoidectomy).   Now, almost all adenoidectomies are performed on an outpatient basis unless other medical problems require hospital admission or an overnight stay. T&A is considered the most common major surgical procedure in the United States.

Functional Endoscopic Sinus Surgery (FESS)
Functional endoscopic sinus surgery (FESS) is a minimally invasive surgical procedure that opens up sinus air cells and sinus ostia (openings) by using an endoscope. The purpose of FESS is to restore normal drainage of the sinuses. All sinuses need ventilation to prevent infection and inflammation, a condition known as sinusitis. Sinusitis develops when there is a problem in the area where the maxillary and frontal sinuses meet near the nose or, occasionally, by dental infection.   Sinusitis is a very common condition, affecting 31 million Americans each year; 30% of the United States population has sinusitis at some point in their lives. The average adult has three to four upper respiratory
infections a year; 1% of these infections are complicated by sinusitis, accounting for 16 million visits to the doctor each year. FESS offers several advantages: It is a minimally invasive procedure. It does not disturb healthy tissue. It is performed in less time with better results. It minimizes bleeding and scarring. FESS is usually performed under local anesthesia with intravenous sedation on an outpatient basis with patients going home one to two hours after surgery. It usually does not cause facial swelling or bruising, and does not generally require nasal packing.

PE Tubes (Ventilation Tubes)
Why are tubes recommended or inserted?
Two most common reasons are:      
  1. Fluid that has not cleared for a long period of time, usually at least 3-4 months. The fluid, especially if on both sides, always causes some degree of hearing loss.    
  2. Multiple ear infections that have not been adequately controlled with medical treatment or that are particularily severe.
Other less common reasons include: severe retraction or distortion or the ear drum, pressure problems (barotrauma) - such as seen in patients undergoing hyperbaric oxygen treatment, or a "patulous eustachian tube".
 
What do tubes actually accomplish?
Since fluid is usually removed at tube placement, hearing is immediately restored. Most experts feel that the aeration of the ear reduces the likelihood of acute otitis media (ear infections). Infections become more reliably detected, since they will drain out through the tube and the infectious material can be cultured, if necessary.

How are they placed in the eardrum?
Because they are so tiny, PE tubes are placed directly through the ear canal into the eardrum using a microscope. The entire procedure takes only a minute or two. Children are general given a light general anesthetic, but adults are usually done right in the office.

What can I expect afterward & do they ever have to be replaced?
Insertion of the tubes is a virtually painless procedure. Hearing is improved generally right away and the frequency of middle ear infections should decline considerably, if not completely.   PE tubes generally remain in the ears about 6 to 12 months and will usually fall out by themselves. After this time the inflamed membranes in the ear and Eustachian tube should have returned to normal. Nearly all children will get another ear infection at some point. Most children, however, won't need another set, but approximately 1 child in 5 will have to have them replaced.

Tonsillectomy
Tonsillectomy is a surgical procedure to remove the tonsils. The tonsils are part of the lymphatic system, which is responsible for fighting infection.

A tonsillectomy is one of the most common surgical procedures among children. It is uncommon among adults. More than 400,000 tonsillectomies are performed each year in the United States. Approximately 70% of surgical candidates are under age 18.

Tonsils are removed when a person, most often a child, has any of the following conditions:       obstruction
  • sleep apnea (a condition in which an individual snores loudly and stops breathing temporarily at intervals during sleep)   
  • inability to swallow properly because of enlarged tonsils
  • a breathy voice or other speech abnormality due to enlarged tonsils
  • recurrent or persistent abscesses or throat infections  

A tonsillectomy is usually performed under general anesthesia. The surgeon depresses the tongue in order to see the throat, and removes the tonsils with an instrument resembling a scoop.

People are usually sent home the day of surgery. For at least the first 24 hours, individuals are instructed to drink fluids and eat soft, pureed foods. They are given instructions to call their surgeon if there is bleeding or earache, or fever that lasts longer than three days.



 

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