Plasma adenoidectomy (adenoid removal)
The use of plasma coblation is currently the gentlest method of adenoid removal. The method is performed under general anaesthesia without the use of sharp surgical instruments. A plasmid sonde removes the swollen adenoid by creating a plasmatic field of only 40-70 °C and by method of denaturation (protein splitting) it breaks down the proteins contained in the hypertrophic tissue while also draining the tissue. This enables better removal of hypertrophic tissue of the adenoid in places where a standard curette or laser methods cannot be applied. This does not traumatize the base of the adenoid with sharp instruments and it also does not exert pressure on the cervical spine, resulting in a well-maintained base of the nasopharynx undamaged by heat. This minimalizes post-surgery risks of bleeding and pain resulting in a quick recovery allowing the patient to return to work or school after a week (the patient should refrain from physical activity for another week). The benefit of adenoidectomy is improved breathing through the nose, speech improvement and protection against frequent infections (rhinitis, middle ear infection).
Laser assisted adenoidectomy (adenoid removal)
Excessive hypertrophied tissue in the nasopharynx can cause sleep, speech and respiratory disorders. It can also cause malfunction of the Eustachian tube, which can cause frequent infection of the upper respiratory tract or the middle ear. This can even lead to partial deafness. During the laser assisted adenoidectomy we remove 90% of the hypertrophied tissue of the adenoid using curette followed by fiber laser, which vaporizes the rest of the hypertrophied tissue from the roof of the nasopharynx. This way we eliminate the risk of haemorrhage and relapse (recurrence of the problem). The procedure is performed under general anaesthesia by securing the respiratory tract (intubation) under optical control (endoscopy). It requires up to 30 minutes in the operating room.
FESS, FEELS surgery (functional endoscopic endonasal operation of paranasal sinuses)
Surgery of paranasal sinuses, endoscopic endonasal polypectomy or plasma-assisted. This procedure is performed on patients with a chronic infection of paranasal sinuses (sinusitis) and nose polyps. Nose polyps and swollen mucous membrane result in reduced ability to breath through the nose and they restrict its filtration function, which can cause breathing problems during sleep. They also cause a reservoir of infection in the upper respiratory tract. Nose polyps restrict the ventilating function of paranasal sinuses and lead to chronic infection. We remove the polyps gently with a shaver and subsequent cleaning is preformed with a laser or plasma. FESS and FEELS surgery is performed under general anaesthesia.
Septoplasty (modification of cartilage of the nasal septum)
Natural or a post-traumatic deviation to the nasal septum leads to poor viability of the nasal passageway, deteriorated air filtration, recurrence of sinus infection and snoring. Similarly, as a result of chronic allergies or a cold, the enlarged inferior nasal concha hinders nose ventilation and results in a dependency on nasal drops. The modification of cartilage of the nasal septum is performed under general intubated anaesthesia in order to improve nose breathing. In some cases we can combine septoplasty with a cosmetic modification of the outer nose (rhinoseptoplasty).
Laser treatment of nosebleed (epistaxis)
The method of coagulation is used to seal bleeding vessels in the nasal septum of children and adults. The procedure takes around 5 minutes and is performed in a short-term inhalational anaesthesia on children and local anaesthesia on adults. In isolated cases (when diagnosed with Morbus Rendu-Osler) we close the nasal septum by sewing skin together with the mucous membrane.
Mucotomy (volume reduction of inferior nasal concha)
Submucosal evaporation of enlarged tissue from the inferior nasal concha during chronic cold and worsened nasal passageway. Enlarged nasal concha causes a reduced nasal passageway, deteriorated air filtration, recurrence of sinus infection and snoring. Also, patients suffering from nasal congestions who overuse nasal drops create a dependency on them. Mucotomy can eliminate all these issues. The nasal passageway is clear approximately after two weeks of healing time without the need to use short-term nasal drops. The procedure is performed using radiofrequency, laser or plasma coblation methods.
Plastic operation of perforated nasal septum
Perforated nasal septum occurs after repeated nosebleeds, medical procedures, nasal drop overuse, drug overuse or other unknown causes. During surgery a healthy nasal mucous membrane is relocated onto the place of the perforation where it is supported by cartilaginous grafts from the auricle. The operation is performed under general anaesthesia.
Operation of cysts of maxillary sinuses
Cysts can cause chronic infections or headaches. They are removed by a minor endoscopic procedure using a laser or shaver under local or general anaesthesia.
prim. MUDr. Tomáš Fořt
Doc. MUDr. Jan Vokurka, CSc.
ENT dept. University Hospital of Umeå (Sweden)
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