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ENT - Ear, Nose and Throat

ENT (Ear, Nose and Throat) is a commonly used term for the specialty called Otolaryngology. It is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. The full name of the specialty is otolaryngology-head and neck surgery. Practitioners are called otolaryngologists-head and neck surgeons, or sometimes otorhinolaryngologists (ORL).

ENT Procedures

Cochlear Implant (CI)


A cochlear implant is a small electronic device that helps people hear.

It can be used for people who are deaf or very hard of hearing.

A cochlear implant is not the same thing as a hearing aid because it is surgically implanted and works in a different way

 

cochlear implant

An implant has the following parts:


    * A microphone, which picks up sound from the environment.

    * A speech processor, which selects and arranges sounds picked up by the microphone.

    * A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses.

    * An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.


An implant does not restore normal hearing.


Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.

 

Working


In a normal ear, sounds are transmitted through the air, causing the eardrum and then the ossicles (middle ear bones) to vibrate.

This sends a vibratory wave into the cochlea (inner ear).

These waves are then converted by the cochlea into electrical signals, which are sent along the auditory nerve to the brain.


A deaf person does not have a functioning inner ear.

A cochlear implant attempts to replace the function of the inner ear by transforming mechanical energy (sound) into electrical energy,

which can then be used to stimulate the cochlear nerve (the nerve for hearing), sending "sound" signals to the brain.


Most cochlear implants operate using several similar components.

Sound is picked up by a microphone worn near the ear.

This sound is then transmitted to a speech processor worn on the body, usually on a belt.

The sound is then analyzed and converted into electrical signals, which are transmitted to a surgically implanted receiver behind the ear.

This receiver then sends the signal through an electrode array (wire) into the inner ear, where the electrical impulses are transmitted to the brain.

 

Cochlear implant differenct from  hearing aids.


Hearing aids amplify sounds so they may be detected by damaged ears.

Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve.

Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound.

Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn.


However, it allows many people to recognize warning signals, understand other sounds in the environment, and enjoy a conversation in person or by telephone.

 

Surgery


Surgery for inserting a cochlear implant is performed with the patient fully asleep.

An incision is made behind the ear, sometimes after shaving a portion of the hair behind the ear.

A microscope and bone drill are used to open the bone behind the ear (mastoid bone) to allow the internal part of the implant to be inserted.


The electrode array is then passed into the cochlea (inner ear).

The receiver is placed into a "well" created behind the ear to help keep it in place, and to make sure it is close enough to the skin to allow transmission of electrical information from the external portion of the device.


After surgery, there will be stitches behind the ear, and you may be able to feel the receiver in its "well" behind the ear.

Any shaved hair should grow back.

The external portion of the device will be placed about 3-4 weeks after surgery, to give the incision time to heal.


Tags: Cochlear Implant, Cochlear Implant Surgery, Cochlear Transplant, Cochlear Transplant Surgery

SEPTOPLASTY

Septoplasty, submucous resection of the septum, or septal reconstruction is a corrective surgery to straighten or repair a deviated nasal septum - the wall between the two nasal passages. Usually the septum is straight and upright, and runs down the center of the nose. A deviated septum occurs when the cartilage or bone of the septum is not straight, thereby narrowing the cavity into which is deviates making breathing difficult. This condition can lead to snoring and sleep apnea, and in certain serious deviations may frequently lead to chronic sinus problems. Septoplasty is necessary only when the problems associated with crooked nasal septum do not get better without surgery. The surgery may be done along with other procedures to treat chronic sinusitis, inflammation, or bleeding, or to correct sleep apnea. The procedure also may be done to allow access into the nose to remove nasal polyps.

DETAILS OF THE PROCEDURE

The procedure usually involves an excision or cutting of a portion of the cartilage and/or bone surplus. Under general or local anesthesia, the surgeon works through the nostrils, making an incision in the lining of the septum to reach the cartilage targeted in the operation. Often an "L" strut of cartilage in the dorsal and caudal areas (1cm width or more) is preserved for structural support. After excess cartilage and bone have been taken out, the septum may then be stabilized with small plastic tubes, splints, or sutures. The operation takes about 60-90 minutes.

AFTER THE SURGERY

Considerable swelling and bruising can be expected. The nasal cavities may or may not be packed, and a piece of gauze is taped underneath the nose to absorb blood. Postoperative care includes frequent changing of this gauze (roughly every hour or so) and after 1 to 2 days, the excess bleeding normally stops and the inner nasal packing may be removed. The following day, saline irrigations of the nasal cavities are often advised, and the patient may be allowed to gently blow their nose. After 1 to 2 weeks, patients are allowed to blow their nose normally. Patients typically regain about 80% of their energy one week after the surgery.

OTOPLASTY - COSMETIC EAR SURGERY

Otoplasty is a cosmetic surgery to change the appearance of a person's external ears.

Otoplasty may be done to:
•  set prominent ears back by bringing the ears closer to the head (often called ear pinning),
•  reduce the size of very big ears, or
•  reshape various bends in the cartilage.

Ear deformity results from distorted, damaged, or missing ear elements. Many otoplasties are performed not because of actual deformity, but because the individual is displeased with the shape of their ears. The operation is done on children between the ages of four and 14.

Otoplasty surgery, which is usually performed by either an oral and maxillofacial surgeon, plastic surgeon or ENT surgeon, can involve a combination of moving, reshaping, adding, or removing structural ear elements.

DETAILS OF THE PROCEDURE

Most otoplasty ear surgery is performed as a outpatient surgery, some requires a hospital stay. The procedure can take from two to five hours depending on the problem.

Either general anesthesia or local anesthesia with sedative will be administered before the surgery begins. The surgeon starts by making a small incision in the back of the ear to expose the ear cartilage. Then he sculpts the cartilage and bends it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete. In some other cases, he will remove the skin and use stitches to fold the cartilage back on itself to reshape the ear without removing cartilage.

In most cases, ear surgery will leave a light scar in the back of the ear that will fade with time. Surgery is usually performed on both ears, even when only one ear appears to protrude, for a better balance.

Following the surgery, the patient's head will be wrapped in a bulky bandage to promote the best molding and healing. Medication may be prescribed to relieve pain in the ears.

Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband. Stitches are usually removed, or will dissolve, in about a week.

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