Chapter 10 : Ear, Nose, Throat and Thyroid Surgery
Ear, nose, and throat surgery is the surgical treatment of diseases, injuries, or deformations of the ears, nose, and throat areas.
ENT Surgery includes:
Topics covered in this snack-sized chapter:
- Removal of bone in the Middle Ear.
Removal of all or part of a bone in the middle ear (called the stapes) is known as Stapedectomy.
Stapedectomy is a surgical procedure in which the innermost bone (stapes) of the middle ear is removed, and replaced with a small plastic tube surrounding a short length of stainless steel wire.
- Endoscopic Sinus Surgery.
During a Stapedectomy
- An incision is made in the skin of the ear canal, the skin and eardrum are lifted to expose the stapes bone, and the stapes bone is removed.
- An incision is made above the ear and the tissue is removed.
- The tissue is used to cover the opening created by the stapes bone removal.
- Prosthesis has put in place where the stapes bone had been and the eardrum and skin of the ear canal are laid back in place.
- The ear canal is then packed.
Following are the risks associated:
Sinuses are air-filled spaces in the bones of the face and head.
They are connected to the inside of the nose through small openings.
Sinusitis is a condition in which the sinuses swell and become clogged, causing pain and impaired breathing.
Endoscopic sinus surgery is a procedure used to remove blockages in the sinuses.
Endoscopic sinus surgery is a procedure designed to increase the amount of air flowing through the sinuses and allow mucus to drain properly out of the nose.
The procedure can:
- Improve the sense of smell and taste.
A thin, lighted instrument called an endoscope is inserted into the nose.
The endoscope beams light into different parts of the nose and sinuses allowing the surgeon to see what is causing blockages.
Surgical instruments can be used along with the endoscope to remove the blockages and improve breathing.
The tonsils are the part of the lymphatic system and protect from infection by trapping germs that may enter through nose or mouth.
A tonsillectomy is a surgical procedure to remove the tonsils in the back of the throat.
The tonsillectomy procedure is often combined with an adenoidectomy, which is the removal of an additional set of glands that are also in the throat.
Removal of either the tonsils or the adenoids requires a general anesthesia.
The mouth is held open to expose the tonsils.
The tonsils are grasped with clamps and pulled toward the middle of the mouth.
The tonsils are removed by gentle dissection of the surrounding tissues.
Bleeding is controlled, once the tonsils and potentially the adenoids are removed.
A thyroid disease is a medical condition impairing the function of the thyroid.
Some medical problems may require removal of all or part of the thyroid gland that are:
- Overactive Thyroid Gland (Hyperthyroidism).
Hyperthyroidism is a condition in which the thyroid gland becomes overactive and secretes excessive amounts of the hormone thyroxin.
- Diffuse enlargement of the thyroid (Goiter).
Removal of the thyroid gland (thyroidectomy) is rarely used to treat hyperthyroidism.
An anti-thyroid drug which works to decrease the amount of hormone is preferably used.
Radioactive iodine treatment involves taking a radioactive form of iodine that causes the permanent destruction of the thyroid.
Goiter is the enlargement of the thyroid gland which leads to difficulty breathing and/or swallowing.
The thyroid can be enlarged due to generalized enlargement of the thyroid or nodules within the thyroid.
Many symptoms include:
- A swelling, ranging in size from a small nodule to a massive lump.
- A feeling of tightness in the throat area.
Treatment options depend on the size of the enlargement, symptoms, and the underlying cause.
Treatments typically include:
- Radioactive iodine to shrink the gland, particularly if thyroid is producing thyroid hormone.
- Small doses of potassium iodine solution if the goiter occurs due to iodine deficiency.
- Surgery is reserved for the following situations:
- Large goiters with compression.
Thyroid cancer is a disease when abnormal cells begin to grow in thyroid gland.
- When other forms of therapy are not practical or ineffective.
- A lump or nodule in front of the neck.
- Hoarseness or difficulty speaking in a normal voice.
- Difficulty swallowing or breathing.
- Pain in the throat or neck.
Removing all or most of the thyroid (Thyroidectomy).
Removing lymph nodes in the neck.
- Surgery to remove the entire thyroid is the most common treatment for thyroid cancer.
Thyroidectomy is used to treat thyroid disorders, such as:
- When removing thyroid, the surgeon may also remove enlarged lymph nodes from the neck and test them for cancer cells.
- Noncancerous Enlargement of the Thyroid (Goiter)
Thyroidectomy includes following steps:
- Overactive Thyroid (Hyperthyroidism)
- The operation will be performed under general anesthesia.
- A cut is made across the front of your neck.
- Some or the entire thyroid is taken out.
- Great care is taken to avoid damaging the nerves that control voice.
- The surgeon also avoids the nearby glands (parathyroid glands) that control blood calcium salts.