Ear, Nose, and Throat Surgeries

The most common types of surgery performed on the nose are as follows:

Turbinate correction

This procedure aims to improve nasal breathing by reducing the size of the enlarged inferior turbinates. The surgery is performed under local anaesthesia using a radiofrequency device. The procedure takes approximately 10-20 minutes, and there is no need to stay in the hospital after the surgery.

The turbinates are located on the lateral wall of the nasal cavity, with three pairs running horizontally. Normal nasal breathing depends on the shape of the nasal septum and the size of the turbinates, especially the inferior turbinates. The turbinates are responsible for filtering, warming, and humidifying the air. The most common cause of nasal congestion, besides a deviated septum, is swelling of the inferior turbinates.

The most common causes of inferior turbinate enlargement are prolonged use of traditional nasal drops, allergic rhinitis, chronic non-allergic rhinitis, side effects of medications, deviated septum, reflux disease, or pregnancy.

Why might turbinate surgery be necessary?

If conservative treatment, such as the use of steroid nasal sprays, does not improve nasal breathing, and the prolonged nasal breathing complaint is caused by swelling of the inferior turbinates alone or in combination with other causes. As a result of the surgery, nasal breathing improves and the secondary consequences of nasal breathing disorders, such as prolonged upper and lower respiratory tract infections, sinusitis, chronic throat and pharynx disorders, ear tube dysfunction, acute and chronic middle ear infections, headaches, snoring, and sleep disorders.

Nasal septum plastic surgery

In cases of deviated septum, we help improve nasal breathing by restoring the midline position of the septum. The surgery can be performed under general or local anaesthesia and usually takes about 20 minutes. The patient can leave immediately after the surgery, but the nasal tampons need to be removed by a doctor after a few days.

Nowadays, we more often perform a more modern and much gentler surgical procedure, which is performed under general anaesthesia and is therefore painless. This is a so-called cartilage-preserving procedure, meaning that we do not remove large areas of cartilage and bone during the surgery. The cartilage is dislodged from its place, trimmed a little, then put back in place and sutured. Since we suture the cartilage and mucous membrane, there is no need for tight gauze packing. There is less scarring, the nasal septum remains intact, and its function is less impaired. In this case, we are talking about plastic reconstructive surgery.

After waking up, the patient can leave on the day of the surgery with a biodegradable tampon in their nose. This tampon does not need to be removed, but can be gently blown out after 2 days. There is no pain after the surgery, at most a slight discomfort due to nasal congestion.

Endoscopic sinus surgery, FESS surgery

Nasal polyps are non-cancerous, painless, teardrop- or grape-shaped growths on the mucous membrane of the nose or sinuses. Smaller nasal polyps may not cause any symptoms, but larger growths or clusters of nasal polyps can cause nasal congestion, breathing difficulties, loss of smell, and infections. They may be caused by asthma, allergies, drug sensitivity, or chronic or recurrent sinusitis due to certain immune disorders.

Nowadays, surgical treatment of the nose and sinuses is most often performed endoscopically, with some of the procedures being microscopic, thus minimising tissue damage.

During FESS (functional endoscopic sinus surgery) performed inside the nose, we use a small camera-equipped rhinoscope to visualise the sinus openings with minimal surgical intervention. Preserving the anatomical structure and healthy functions of the nose and sinuses, we enlarge the natural openings between the nasal cavity and the sinuses, remove nasal polyps, and restore the natural functions of the nose and sinuses, as well as sinus ventilation. During nasal polyp surgery, it is sometimes necessary to operate on the nasal septum and the inferior turbinate as well.

When is FESS surgery necessary?

Surgery may be necessary if inflammation of the nose and sinuses persists for at least three months, i.e., chronic sinusitis has developed and does not improve adequately with medication. Symptoms of chronic sinusitis may include nasal congestion, runny nose, facial pain, headache, recurrent lower respiratory tract infections, and bronchial asthma.

How is the surgery performed?

Endoscopic sinus surgery can be performed under local anaesthesia or general anaesthesia. Depending on the extent and duration of the procedure, it takes approximately 30-80 minutes and usually requires a 1-day hospital stay.