ENT Treatments offered at Ashtead Hospital in Surrey

Ear, Nose and Throat Treatments

Cardiology

Tonsillectomy

Tonsillectomy is surgery to remove your tonsils. The tonsils are two oval-shaped pads of tissue at the back of your throat and are part of a group of lymphoid tissues (glands in your neck) that help to fight off infection from germs breathed in or swallowed.

Tonsillitis happens if the tonsils become infected. The main symptom is sore throat. A tonsillectomy may be recommended for a recurrent sore throat if certain criteria are met. Your ENT surgeon will discuss this with you.

Tonsillectomy is typically performed through your mouth as an outpatient procedure under general anaesthetic and takes about half an hour. Your ENT consultant will remove your tonsils and stop any bleeding. The procedure can be performed using a scalpel or a surgical tool that uses heat, laser or ultrasound.

Surgical treatment for hearing loss

There are two types of hearing loss:

  • Sensorineural - a problem with the generation and/or transmission of nerve impulses from the inner ear to the brain. This is difficult to treat. We offer hearing aids and cochlear implants that may help.
  • Conductive – a problem with the conduction of sound vibrations from your outer ear to your inner ear. This can usually be treated medically or surgically and your hearing can be corrected and improved.

Conductive hearing loss is caused by problems of the middle and external ear including: ear wax, fluid or infection, perforated or collapsed ear drum, abnormal growths of skin, bone or tumours, trauma and congenital reasons.

Surgeries we perform for conductive hearing loss include:

  • Tympanoplasty - surgical repair of the ear drum used for collapsed ear drums.
  • Myringotomy – repair of a perforated ear drum which may be caused by otitis media (middle ear fluid or infection).
  • Stapedectomy - surgery to restore hearing loss caused by otosclerosis (a disease of the bone surrounding the inner ear).
  • Cholesteatoma removal – cholesteatoma is 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, called the ossicular chain.
  • Perilymph fistula (PLF) repair – PLF is a channel that forms and connects your inner and middle ear and allows perilymph (fluid) to leak into the middle ear.
  • Translabyrinthine surgery – tumour removal such as acoustic neuroma (a growth on your nerve).

Tinnitus

Tinnitus is when you hear sound in your ears or head that isn’t caused by external noise. It can be in one or both ears and can happen suddenly or over time. It can range from occasionally happening to a serious problem that can severely reduce the quality of life for the sufferer.

There's no single treatment that directly cures tinnitus. If an underlying cause of your tinnitus is diagnosed your ENT surgeon will treat this which may help improve your tinnitus, such as the removal of earwax build up or surgery for otosclerosis.

Treatment often focuses on the daily management of tinnitus and may include: sound therapy (neutral sounds may distract you from the sound of tinnitus), counselling (understanding tinnitus and adopting coping strategies), cognitive behavioural therapy (help to change the way you think about your tinnitus so it becomes less noticeable) and tinnitus retraining therapy (retraining the way your brain responds to tinnitus to tune the sound out and become less aware of it).

Sleep apnoea

Sleep apnoea, also known as obstructive sleep apnoea (OSA), occurs when the air passage in your throat narrows or collapses during sleep and causes a total blockage for ten seconds or more.

It’s caused when the muscles in your mouth, nose and throat relax too much when you’re asleep. Your brain automatically wakes you momentarily so that you can take in air. These episodes can happen frequently during the night and leave you feeling extremely tired.

Treatment of sleep apnoea will depend on the severity of your symptoms and your individual circumstances and preferences. You may be advised to make healthy lifestyle changes such as: losing weight, reducing the amount of alcohol you drink, stopping smoking and avoiding sedatives.

For mild sleep apnoea a mandibular advancement device (MAD) may help. It’s a dental appliance, similar to a gum shield that’s worn over your teeth when you're asleep. It holds your jaw and tongue forward to increase the space at the back of your throat and reduce the narrowing of your airway.

Continuous positive airway pressure (CPAP) is the most effective treatment for moderate to severe sleep apnoea and involves using a machine at night that blows pressurised air into your upper airways through a mask creating air pressure to keep your airways open.

Surgery is normally recommended if the non-surgical options aren’t successful and includes: tonsillectomy, adenoidectomy (removal of enlarged adenoids that may be blocking your airway during sleep), tracheostomy (insertion of a tube into your neck to allow you to breathe freely) or weight loss surgery (reduction of stomach for severely obese people if obesity is suspected to be making the sleep apnoea worse).

Sinus disease

Sinuses are small, air-filled cavities found behind your forehead and cheekbones. Sinus disease, or sinusitis, is a common condition where the lining of your sinuses becomes inflamed and can become blocked. Symptoms include: pain, blocked nose, discharge, headache and temperature.

Often you’ll feel better after a few weeks but if it becomes chronic then you should seek medical advice. Your ENT specialist may advise self-help remedies, medical help or surgery.

Surgery will unblock your sinuses and improve mucus drainage. There are a number of different operations for this. Functional endoscopic sinus surgery (FESS) is most often recommended. It involves your surgeon using a thin, flexible telescope called an endoscope to see inside your sinuses. They will then use special instruments to remove bone and mucus membrane and unblock the sinuses. This is normally performed under general anaesthesia.

Balloon sinuplasty is an alternative whereby your surgeon places a small, flexible tube into your sinus and then inflates a balloon on the end of it to unblock your sinus. It’s also carried out under general anaesthetic.

Snoring

Snoring is a snorting or rattling noise when a person breathes during sleep. It happens when you try to breathe and the roof of your mouth and tissue in your mouth, nose or throat vibrates due to turbulence inside your airways.

Snoring is harmless, however it can cause distress to those around you and it can be a sign that you have sleep apnoea.

Initially, lifestyle changes are advised including: losing weight, exercising and stopping drinking alcohol and smoking. Anti-snoring devices are available such as mouth guards and nasal strips and they may help stop your snoring.

If you’ve had little joy from non-surgical techniques, then surgery may be recommended. There are a number of options and your ENT surgeon will discuss these in detail with you. They normally involve removing the soft tissue that causes snoring, or preventing the tissue from vibrating. If you’ve an obvious anatomical reason for your snoring, then surgery may correct this. For example, if you’ve large tonsils you may have surgery to remove them.

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