Laser or plasma coblation tonsillotomy (partial removal of tonsils)
Enlarged tonsils cause snoring and sleep disorders for children, which could negatively affect their development and wellbeing. Using laser or plasma to reduce the volume of tonsils improves the viability of respiratory and swallowing tract. For children who snore or suffer from apneic pauses we recommend only partial removal of tonsils by laser or plasma. Tonsils present an important part of the child’s immunity system; therefore it is not advisable to remove them entirely. However, in the case of recurring tonsillitis we recommend the removal of the entire tonsils (tonsillectomy). Unfortunately, due to the new statement of the Czech Society for ENT, we had to stop performing tonsillotomy at our clinic for the moment. It is necessary to ensure non-stop supervision of both ENT doctor and anaesthetist for 24 hours after surgery, which we are currently not able to provide. However, we can recommend or even arrange tonsillotomy and tonsillectomy at the ENT department of the General University Hospital at Charles squard
Laser frenulectomy (removal of lingua or labial frenulum)
This procedure is recommended by the child’s speech therapist in the case of incorrect pronunciation or by the breast-feeding consultant in the case of poor suction of an infant. Frenulum leads to stomatological problems and issues whilst swallowing. We evaporate the frenulum with a laser diode in general inhalational anaesthesia. More attached frenula are removed classically with a scalpel. Frenulectomy lasts approx. 10 minutes and the patient stays in the recovery room for 1-2 hours.
Laser or plasma cryptolysis (removal of tonsillar crypts)
Crypts on tonsils cause minor local infections and malodour. After implementing conservative methods such as gargling, rinsing or immunotherapy we recommend their smoothing with laser or plasma. By smoothing the tonsils by 10-20%, the crypts are obliterated. The rest of the tonsils are left in their position as an important part of the immunity system. This results in smoothed tonsils that return to full function and do not retain food particles and epithelial cells. Cryptolysis is performed under general anaesthesia and lasts approx. 20 minutes.
Microlaryngoscopy (operation of vocal folds)
Microscopic removal of benign structures on vocal cords, such as nodules, polyps, cysts or alternatively the procedure is performed when the vocal cords are swollen. Pathological state of vocal cords can be of benign or malign nature. To identify this, we must perform an excision of the lesion under general anaesthesia. The lesions can cause hoarseness, itchy throat, bleeding from respiratory tract or swallowing disorders. During microlaryngoscopy a special tubus is inserted into the oral cavity and larynx, which under the control of microscope removes the structures on the vocal cords and in their vicinity, with the possibility of injection of drugs into the vocal cords. The procedure lasts 1 hour and is performed under general anaesthesia.
Elimination of some of the snoring causes
Enlarged uvula, tonsils and possibly loosened soft palate cause snoring and the occurence of apneic pauses. During apnoeic pauses the brain and important organs are receiving poorly oxygenated blood increasing the risk of a stroke and heart attack. This condition results in sleepiness and can cause chronic fatigue syndrome. Laser uvulopalatopharyngoplasty (LAUPP) removes enlarged uvula from the soft palate in the oral cavity, which can cause snoring. The procedure is performed under local or general anaesthesia. Alternatively, radiofrequency somnoplasty can be implemented during which the soft palate is pierced using radiofrequency ablation. Subsequent scarring reinforces the soft palate and prevents vibrations that cause snoring. We also offer surgery performed with plasma coblation. Before the operation it is necessary to attend sleep disorders consultation, which is also available at our clinic.
prim. MUDr. Tomáš Fořt
MUDr. Vladimír Prokop
As. MUDr. Daniel Groh, Ph.D.
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