ENT Clinic in Sarjapur Road, Bangalore

When to Visit an ENT Specialist?

Visiting an Ear, Nose, and Throat (ENT) specialist, also known as an otolaryngologist, can be crucial for diagnosing and treating conditions that affect the ear, nose, throat, and related structures of the head and neck. Here are scenarios and symptoms that warrant a visit to an ENT specialist:

Persistent or Recurrent Ear Problems

• Hearing Loss

• Ear Pain in or around the ear.

• Frequent ear infections

• Tinnitus - Constant ringing, buzzing, or other noises in the ear

• Vertigo - Frequent dizziness or problems with balance 

Nasal or Sinus Problems

• Chronic Sinusitis 

• Persistent stuffiness or difficulty breathing through the nose

• Allergic Rhinitis

• Blockage or sinus infection due to nasal polyps

• Major shifts in smell or taste abilities

Throat or Voice Issues

• Chronic sore throat or feeling of a lump in the throat that doesn't improve

• Problems or pain when swallowing

• Long-lasting huskiness, changes in voice, or loss of speech

• Sleep apnea symptoms, i.e. loud snoring interrupted with periods of stopped breathing

Head and Neck Symptoms

• Neck Masses: Swelling or lumps in the neck that persist or grow.

• Facial Pain or Headaches: Constant pain in the face or head, mostly from sinus problems.

• Thyroid Issues: Signs of an overactive or underactive thyroid, like weight shifts, energy changes, or neck puffiness.

• Problems with Salivary Glands: Issues like swelling, pain, or troubles linked to salivary glands.

Treatments and Procedures

The ENT department at Manipal Sarjapur Clinic provides a wide variety of treatments and services for ear, nose, and throat problems. Our services range from simple check-ups and tests to specific treatments. 

1. Unilateral and Bilateral Ear Wax Removal 

When ear wax, or cerumen, builds up and causes issues like not hearing well, discomfort, ear ringing, or feeling dizzy, it needs to be taken out. By removing this built-up ear wax, we can hear better.

Types of Removal

• Unilateral: Removal from one ear only.

• Bilateral: Removal from both ears.

How It's Done

• Ear-wax drops: These are solutions that soften or dissolve ear wax, making removal easier

• Irrigation: This involves using water or saline to flush out the ear wax. It is less effective than manual removal but is commonly used.

• Microsuction: This is done under visualisation, often with specialised instruments, and is considered more effective than irrigation.

Before the Procedure: 

• The patient's history is taken, and the ear canal is examined.

• Cerumenolytic ear drops may be prescribed for days before softening the wax.

During the Procedure 

• The method of removal is carried out, which may include irrigation, manual removal under visualisation using micro-suction or other instruments, or a combination.

• Care is taken not to perforate the eardrum.

After the Procedure

• The ear canal is re-examined to ensure complete removal of wax.

• Follow-up instructions are given, which may include the use of antibiotic ear drops if the canal skin is irritated.

• Further follow-up may be scheduled to ensure no residual wax re-accumulates.

Advantages of Ear Wax Removal

• Improves Hearing

• Prevents Infections 

• Relieves symptoms like dizziness, tinnitus, and earaches associated with impacted wax.

• Maintains Ear Health

Follow-Up Care After Ear Wax Removal

• Use earplugs or protected cotton wool when showering for 4-5 days to avoid infection.

• You can avoid ear wax problems with simple olive oil drops. 

• Keep an eye out for any discomfort, dizziness, or abnormal fluid from the ears. If you spot these signs, make sure to get medical help. 

• After any ear procedure, don't go for heavy workouts and swimming for a day or two.

• Regular check-ups for your hearing can also ensure your ears stay healthy.

Doing this as soon as possible can prevent serious problems later on, such as infections, hearing loss, or damage to your ear or eardrum.

2. Removal of Foreign Bodies: Ear, Nose, Throat

Prompt removal of foreign bodies from the ear, nose, and throat is a critical procedure to prevent serious complications such as infection, hearing loss, aspiration, throat obstruction or perforation.

Techniques and Instruments

• Direct Instrumentation: Using forceps or hooks to grasp and remove the object.

• Positive Pressure for nasal obstruction: Forcing the foreign body out with the patient's breath.

• For throat obstruction, endoscopy using various tools to grasp and retrieve the object is the primary removal method.

• Suction for ear canal obstruction: Effective for soft or crumbly objects.

Before the Procedure

• Preparation with the necessary instruments and knowledge of various techniques.

• Assessment of the type, location, and potential risks associated with the foreign body.

During the Procedure

• Removal is categorised as emergency, urgent, or nonurgent based on the object's characteristics.

• Restraint and cooperation of the patient are important for successful removal.

After the Procedure

• Ensure no additional foreign bodies are present.

• Monitoring for any signs of oesophagal injury or remaining foreign bodies.

Advantages

• Removal of foreign objects from the ear, nose and throat as soon as possible avoids further complications and potential emergencies such as hearing loss or aspiration.

• Removal of objects from the ear can often be performed in an outpatient setting.

Follow-up

• Observation for any signs of complications or retained foreign bodies.

• Education for patients and caregivers on signs to watch for and when to seek medical attention.

3. Ear Piercing, Nose Piercing

Piercing is simply making a small hole in your body to insert jewellery. It's pretty common to see ear and nose piercings. They can show your style or represent your culture.

What are Some Piercing Choices?

• Ear Piercings: They range from simple ones in your lobe to the more complex types like in your helix. 

• Nose Piercings: You can get your nostril, septum, or bridge pierced.

How are they Done?

Piercings done by skilled professionals are safe and clean, reducing infection or other problems. 

• Ear Piercing: Most often, it's a lobe piercing, but it can be a complex cartilage piercing. A professional uses a clean needle or piercing gun to pierce. 

• Nose Piercing: This is normally done on the nostril, septum, or bridge. For these piercings, a sterilised needle typically provides the most accuracy and causes the least harm to the area.

Before, During, and After the Procedure

• Before the Procedure: Choose a reputable piercing studio and professional. Consider the type of piercing and jewellery. Ensure you're in good health before the procedure.

• During the Procedure: The area will be cleaned and marked for precision. The piercing is usually quick, but some discomfort or pain is normal.

• After the Procedure: Follow the piercer's aftercare instructions meticulously to prevent infection. This includes cleaning the piercing with saline solution and avoiding unnecessary touching.

Advantages of Piercing

• Piercings are a form of personal expression and can enhance one's aesthetic.

• For many, piercings are a way to connect with cultural heritage.

• Piercings offer versatility and the ability to change jewellery and styles.

Follow-Up and Care

Proper aftercare is crucial to ensure healing and prevent infection. This includes:

• Cleaning the piercing with saline solution.

• Avoiding swimming and activities causing excessive sweating.

• Do not change the jewellery until the piercing has fully healed.

We at Manipal Sarajpur Clinic provide professional ear and nose piercing in a clean environment to minimise any risk of infection. Piercings are done with precision technique and high-quality materials to promote healing and ensure the best placement.

4. Ear Lobe Repair

This method is meant for fixing torn or split earlobes, often caused by accidents or wearing heavy earrings for a long period. 

Why Ear Lobe Repair?

The earlobes are soft and pliable, making them susceptible to stretching, tearing, and other forms of damage. Reasons for seeking earlobe repair include:

• Split Earlobes: Often resulting from the gradual elongation of the piercing hole due to heavy earrings or accidental tearing.

• Stretched or Gauged Earlobes: Some individuals may wish to reverse the appearance of gauged earlobes, a style where the piercing is progressively stretched.

• Aesthetic or Functional Reasons: Repair might be sought to improve the appearance of the earlobes or to allow for the wearing of earrings again.

The Procedure

Fixing earlobes usually is done in one visit. Different methods may be used based on the level of damage. Common methods include removing the skin lining the split or stretched area and suturing the fresh edges together to allow natural healing. The process takes about 30-60 minutes per earlobe.

Before, During, and After the Procedure

• Before smoking, avoid certain medications. Your ear needs to be clean and infection-free.

• During Your surgeon will numb your ear, cut away scar tissue and reshape it. The cut is then closed with stitches.

• After: You can resume regular activities after a few days. Stitches come out after 1-2 weeks, and total healing takes a few months.

Follow-Up Care and Recovery

• Listen to your surgeon on how to clean the wound. Use antibiotic cream and keep it clean and dry.

• Heavy earrings or stress on the earlobes is a no-no while healing.

• Watch for signs of infection or complications. Contact your surgeon if you notice anything wrong.

We at Manipal Sarjapur Clinic offer surgical repair services that restore the earlobe's natural look with minimal scarring and recovery time.

5. Nasal Packing

It refers to placing packing material inside the nasal cavity, usually to control nosebleeds (epistaxis) that have not responded to initial treatment. It works by applying direct pressure to the bleeding vessels to promote clot formation.

Indications

• Severe or persistent nosebleeds that have not responded to conservative treatment, like pinching the nose

• After nasal surgery to support structures, control bleeding, and absorb drainage

Types of Packing Materials

• Non-resorbable gauze strips coated with petrolatum or antibiotic ointment, foam sponges, inflatable balloons

• Resorbable gelatin matrix, oxidised cellulose, polyurethane sponges, hyaluronic acid; dissolve over days to weeks

Technique

The nose is anaesthetised and decongested. Packing material is inserted along the floor of the nasal cavity, sometimes with a bayonet forceps. Layers are added until the cavity is filled. Packing may be secured with sutures exiting the nose. An anterior pack is always used for posterior bleeds.

Care and follow-up

Nasal packing is very uncomfortable. Pain management and monitoring for complications like infection are important. Packs are typically left in place for 1-3 days to prevent rebleeding. Patients need close follow-up to remove packs.

Complications

Pain, bleeding, infection, pressure injuries, toxic shock syndrome, syncope upon removal. Overall, complications are uncommon with proper technique and follow-up care.

6. I and D (Incision and Drainage)

This method treats infections. A small cut lets out pus or fluid. It reduces pain and speeds up healing. It also stops the infection from spreading. Local numbing brings the pain down.

Incision and Drainage (I&D) is a common procedure in many different sectors of healthcare. Its main use is when abscesses and other conditions require fluid or pus to be removed to lessen discomfort and aid healing.

Types of I&D in ENT

Common I&D processes in ENT cater to conditions like:

1. Peritonsillar Abscess: A tiny cut is made inside the mouth in front of the infected tonsil to let the pus out.

2. Sinus Conditions: Functional Endoscopic Sinus Surgery (FESS) is a less invasive operation for severe sinus issues, possibly including I&D.

3. Auricular Hematoma: This procedure involves incision and drainage along with bolster dressing positioning on the ear.

Procedure

• Usually, an I&D operation cuts open the infected area or abscess to let out the pus or liquid. Then, they clean it and sometimes packed with sterile material. 

• They could use local or general anaesthesia for the surgery. The choice depends on the abscess size and place. Sometimes, they put in a drain to let more fluid out.

• Post-operation, they normally tell the patient how to look after themselves at home. This might mean they have to clean the area, take medicines that are ordered, and watch out for infection signs.

Advantages

• The primary advantage of I&D is the relief of symptoms and the promotion of healing.
• It is often curative, and antibiotics are seldom indicated.
• Patients should be instructed on home care and the importance of a recheck in approximately 2 days.

Follow-up 

Care after an I&D procedure is crucial to ensure proper healing and monitor for potential complications. This may include checking the wound, removing any packing or drains, and assessing the need for further treatment or procedures.

Risks and Complications

While I&D is generally a safe procedure, potential complications can include pain, bleeding, recurrence of the abscess, damage to nearby structures, and scarring. Inadequately drained abscesses can lead to the extension of the infection into adjacent tissues.

7. Cyst Excision

Cyst excision is a medical procedure aimed at the removal of cysts, which are enclosed pockets of tissue that can contain fluid, pus, or other material. Cysts can develop on any part of the body, including the skin, organs, and bones, but when referring to ENT (Ear, Nose, and Throat) practice, it often involves cysts located in the head and neck region, including the thyroid gland, salivary glands, and within the nasal passages or sinuses.

Why is cyst excision done?

• Symptomatic Relief: To alleviate symptoms caused by the cyst, such as pain, swelling, or obstruction of normal functions.

• Preventive Measure: To prevent potential complications that can arise from the growth of the cyst, such as infection or impact on nearby structures.

• Diagnostic Clarity: To obtain a definitive diagnosis through histological examination of the cyst, especially if there's concern about the nature of the cyst.

How is it performed?

• Preparation: Local or general anaesthesia is administered depending on the cyst's size and location.

• Incision: A small incision is made over the site of the cyst.

• Removal: The cyst is carefully excised, and it is ensured that it is removed entirely to prevent recurrence.

• Closure: The incision is closed with sutures, which may be absorbable or may require removal later.

What Types of Cysts Are Commonly Treated with Excision in ENT?

In ENT (ear, nose, and throat), we do cyst excisions for:

• Thyroglossal Duct Cysts: These are usual birth cysts found in the neck.

• Branchial Cleft Cysts: Cysts you're born with, often on the neck sides.

• Dermoid Cysts: You might spot these around an eyebrow, the scalp, or other head areas.

• Nasal and Sinus Cysts: This includes mucus-holding cysts in the sinuses.

Advantages

• Complete Removal: Excision typically removes the cyst entirely, reducing the risk of recurrence.

• Symptom Resolution: By removing the cyst, associated symptoms are often completely resolved.

• Diagnostic Benefit: Examination of the excised cyst can rule out cancer or other serious conditions.

Complications and Risks

• Infection: There's a small risk of infection at the incision site.

• Scarring: Any surgical incision can leave a scar, though efforts are made to minimise its appearance.

• Incomplete cyst removal can lead to its comeback, the idea behind "recurrence".

8. Minor Biopsy

This step removes a tiny sample of tissue for testing. This helps in diagnosing different issues like infections, swelling, or cancers. It has minimum discomfort and a fast recovery period. Types of Minor Biopsy:

• Shave biopsy: Shaves off the top layer of skin cells using a blade. No stitches are usually needed.

• Punch biopsy Uses a circular tool to extract a deeper skin sample. It may require 1-2 stitches. 

• Excisional biopsy Removes the entire growth/lesion using a scalpel. Requires stitches to close the wound.

• Incisional biopsy Removes only a piece of a larger lesion using a scalpel. It may require stitches.

Procedure

• The area is cleaned and numbed with a local anaesthetic. 

• The sample is removed using the chosen technique (shave, punch, etc).

• The sample is sent to the lab for analysis under a microscope.

Benefits

• It can diagnose many skin conditions to guide treatment.

• Relatively quick office-based procedure.

Risks and complications

• Bleeding

• Infection  

• Nerve damage

• Scarring

Aftercare

• Keep the area clean and bandaged.

• Stitches are typically removed in 3-14 days.

• Contact a doctor if persistent bleeding, increasing pain/swelling, pus, fever, etc.