Documents

Before every operation it is necesarry to fill out certain documents. In these documents you will find information about procedures and general anesthesia. You can download them here or you will get them at the reception at Modřany.

Procedures in general anesthesia

For the below stated procedures please fill out the particular document and also the Informed consent of the patient with treatment in general anesthesia, which you will find below. Please bring all filled-out documents to the attending physician afterwards.

LASER ADENOIDECTOMY

Endoscopic, laser-assisted removal of the pharyngeal tonsil

PLASMA ADENOIDECTOMY

Endoscopic removal of pharyngeal tonsil with plasma coblation

MIDDLE EAR DRAINAGE

Puncturing the eardrum with a laser or lance blade 

MYRINGOPLASTY

Perforation of ear drum due to fluid in middle ear

GROMMET EXTRACTION

Grommet/stipula removal 

OTOPLASTY

Ear pinning surgery

FRENULECTOMY

Removal of lingual or labial frenulum with laser

RHINOSEPTOPLASTY

Plastic surgery of nose and nasal septum

UVULOPALATOPLASTY (LAUPP)

Removal of the tissue on the back of the mouth and upper throat that causes snoring

FESS, FEELS SURGERY

Functional endoscopic surgery of paranasal sinuses,
laser- or plasma-assisted endoscopic nasal polypectomy

SEPTOPLASTY + MUCOTOMY

Surgery of nasal septum + excision of the mucous membrane

REPOSITIONING OF NASAL BONES

Straightening broken bones in the nose under anesthesia

CORRECTION OF NASAL SEPTAL PERFORATION

Surgical coverage of perforated nasal septum 

EXOSTOSIS

Removal of bony growtha on the ear canal with micro miller

EPISTAXIS

Laser, radiofrequency or bipolar therapy for nosebleeds

MICROLARYNGOSCOPY

Removal of pathologies on the vocal cords

TONSIL CRYPTOLYSIS

Laser of plasma treatment of tonsillar plugs 

TUBOPLASTY

Auditory Tube Dilation – Balloon Tuboplast

RHINOPHYMA

Surgery of enlarged nasal tip 

Adult patients

If the patient is an adult, please fill out the following documents.

Informed consent of the patient with treatment in general anaesthesia + pre-operative examination

Recommendations before and after general anaesthesia

Child patients

If the patient is a child, please fill out the following documents. 

Informed consent of the patient with treatment in general anaesthesia
+ anesthesiology questionnaire

Blood clotting screening questionnaire
+ pre-operative examination

Recommendation before and after general anaesthesia of a child

For all the above procedures EXCEPT adenoidectomy

Recommendation before + after general anaesthesia (adenoidectomy)

Special instructions for adenoidectomy

Operations in local anaesthesia

For the operations listed below, you only need to complete the document listed for the procedure. 

You will then hand it in to the attending physician.

MUCOTOMY

Laser or radiofrequency volume reduction of the inferior turbinate

FRENULECTOMY

Removal of lingual or labial frenulum with laser

MIDDLE EAR DRAINAGE

Puncturing the eardrum

OTOPLASTY

Ear pinning surgery 

EPISTAXIS

Laser, radiofrequency or bipolar therapy for nosebleeds 

EXCISION OF A SKIN OR MUCOSAL LESION

Removal of fibroid or other benign or suspicious formation

SUTURING OF EARRING CANALS

Ear piercing in acue otitis media in the outpatient clinic

Contact us

In case of any other questions regarding surgical procedures you can contact us through this contact form or you can visit us personally at the doctor’s office in Modřany.

Contact information

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