ENT (Ear, Nose, and Throat) Department

Keeping in pace with rapid advancements in the field of ENT, Head & Neck surgery, Operating room is very well equipped with high end Leica Operating Microscope with 4k video recording and video streaming, Storz Image 1s Full HD endoscopy camera with video recording and streaming function, Zeiss operating microscope with attached teaching aid, adult and Paediatric Storz HD 0 degree and 70 degree rigid endoscopes, Medtronic Xomed microdebrider (IPC) and M4 handpiece and high speed drill system. Operating room is equipped with instruments to perform all major surgical procedures including lateral skull base, anterior skull base, Rhinoplasty and Micrlaryngeal surgical procedures.

Department of ENT, Head & Neck surgery provides comprehensive outpatient services. Apart from management of routine ENT, Head & Neck disorders, department conducts speciality clinics such as Head and Neck cancer clinic, allergy clinic, vertigo clinic and headache clinic. Audiology and speech therapy services are available daily. Outpatient services also include Nasal endoscopy, video laryngoscopy, Oto microscopy, Biopsy, Minor surgical procedures, intra tympanic injections, allergy testing, immunotherapy and vestibular testing.

The ear is a complex organ responsible for hearing and balance, and the ENT department at SMCRI provides care for a wide variety of ear-related conditions, including:

• Hearing Loss: Full range of Audiology services are available for diagnosis and treatment of all the types of hearing loss in adult and paediatric population including hearing aids and hearing reconstruction surgeries.
• Ear Infections: Treatment for acute and chronic otitis media (middle ear infections), otitis externa (swimmer's ear), and mastoiditis, including antibiotic therapy and surgical drainage when needed.
• Tinnitus: Management of tinnitus (ringing in the ears) through counselling, Tinnitus retraining therapy and medications.
• Earwax Blockage: Removal of excessive earwax (cerumen impaction) using safe methods such as irrigation, suction evacuation or manual extraction.
• Eustachian Tube Dysfunction: diagnosis and treatment for dysfunction in the Eustachian tube, which can lead to ear fullness, discomfort, and hearing problems.
• Balance Disorders: Evaluation and treatment of vertigo, dizziness, and other vestibular disorders, including vestibular rehabilitation therapy.

The nose and sinuses are crucial for breathing, filtering air, and maintaining overall health. The ENT department offers specialized care for:

• Sinusitis: Treatment for acute, chronic, and recurrent sinusitis, including medical and surgical management with antibiotics, nasal steroids, and saline irrigation, and surgical intervention (functional endoscopic sinus surgery, or FESS)
• Deviated Septum: Correction of a deviated nasal septum (septoplasty) that may cause breathing difficulties, chronic sinus infections, and snoring.
• Nasal Polyps: medical and Endoscopic treatment of nasal polyps
• Allergic Rhinitis: Management of allergic rhinitis (hay fever) through antihistamines, nasal steroids, immunotherapy (allergy shots) and surgical procedures such as submucous diathermy or posterior nasal neurectomy
• Nasal Obstruction: Treatment for conditions causing nasal blockage, such as enlarged turbinates or chronic congestion.
• Epistaxis (Nosebleeds): Management of recurrent or severe nosebleeds, including cauterization, nasal packing, and endoscopic surgery for structural abnormalities.
• Nasal Tumors: Management of benign and malignant tumors with advanced endoscopic procedures.
• Nasal deformities: Cosmetic and functional correction of nasal deformities by Rhinoplasty

The throat is involved in speech, swallowing, and breathing, and the ENT department provides treatment for a variety of throat-related conditions:

• Tonsillitis and Adenoiditis: Treatment for acute and chronic inflammation of the tonsils and adenoids, including medical management and tonsillectomy or adenoidectomy when necessary.
• Voice Disorders (Dysphonia): Diagnosis and treatment of voice-related issues, such as hoarseness, vocal cord paralysis, and nodules. Treatments may include voice therapy, surgical interventions (Phonosurgery), and medications.
• Swallowing Disorders (Dysphagia): Evaluation and treatment of swallowing difficulties due to conditions such as esophageal disorders, neurological issues, or structural abnormalities.
• Laryngopharyngeal Reflux (LPR): Management of acid reflux affecting the voice box (larynx) and throat, often presenting as hoarseness, sore throat, or chronic cough.
• Throat Cancer: Early diagnosis and treatment of throat cancers (laryngeal and pharyngeal cancers), including surgery

The head and neck region includes various structures such as the salivary glands, thyroid, and lymph nodes. Common treatments include

• Thyroid Disorders: Diagnosis and management of thyroid diseases, including thyroid nodules, goiter, hyperthyroidism, and hypothyroidism. Surgery for thyroid problems may involve thyroidectomy (partial or total removal of the thyroid gland).
• Salivary Gland Disorders: Treatment for salivary gland infections, stones, and tumors, including salivary gland surgery (parotidectomy, submandibular gland removal).
• Neck Masses or Lumps: Evaluation and management of lumps or swellings in the neck, such as enlarged lymph nodes, cysts, or benign tumors, with surgical biopsy or excision if necessary.
• Oral Cancer: Early detection and management of oral cancers, including surgery,
• Head and Neck Tumors: Surgical and non-surgical management of benign and malignant tumors of the head and neck region.

The ENT department at SMCRI provides specialized care for children with ENT issues, including:

• Recurrent Ear Infections: Management of recurrent otitis media (middle ear infections) in children, including myringotomy (ear tube placement) for chronic cases.
• Pediatric Snoring and Sleep Apnea: Diagnosis and treatment of snoring and obstructive sleep apnea (OSA) in children, often related to enlarged adenoids or tonsils.
• Congenital Ear Abnormalities: Evaluation and treatment of congenital conditions such as microtia (underdeveloped ear) and ear deformities in children.
• Speech and Language Delays: Assessment of speech and language delays related to hearing loss or other ENT conditions.
• Adenoid and Tonsil Surgery: Tonsillectomy and adenoidectomy for children with recurrent throat infections or breathing difficulties during sleep.

The ENT department at SMCRI is equipped with the latest surgical tools and technologies to treat various ENT conditions through minimally invasive or traditional surgical methods. Some of the common ENT surgeries include:

• Functional Endoscopic Sinus Surgery (FESS): A minimally invasive surgery to treat chronic sinusitis and other nasal conditions using endoscopes and specialized instruments.
• Septoplasty: Surgical correction of a deviated nasal septum to improve nasal airflow and alleviate breathing problems.
• Tonsillectomy and Adenoidectomy: Surgical removal of the tonsils and/or adenoids in cases of recurrent infections or obstructive sleep apnea.
• Myringotomy and Tympanostomy Tube Insertion: Surgical procedure to drain fluid from the middle ear and place ear tubes in children with recurrent ear infections or chronic fluid buildup.
• Stapedotomy: Surgical procedure to treat otosclerosis
• Head and Neck surgeries: Thyroidectomy, Parotidectomy, Submandibular gland excision, composite resection of oral cancers, Neck dissections, laryngectomy, sistrunks operation for thyroglossal fistula, branchial cyst/sinus excision.
• Adenoidectomy and Tonsillectomy: Removal of enlarged adenoids and/or tonsils in children with chronic infections or obstructive sleep apnea.
• Extended endoscopic transnasal surgeries: CSF leak repair, Angiofibroma excision, Trans-sphenoidal approaches to skull base tumors, Endoscopic medial maxillectomy, Choanal atresia repair, Septal perforation closure, Endoscopic adenoidectomy, Endoscopic orbital decompression, Optic nerve decompression, Endoscopic dacrocystorhinostomy.
• Facial plastic surgeries: Rhinoplasty, Extra-corporeal septoplasty, Nasal bone fracture reduction
• Endoscopic ear surgeries: Endoscopic underlay/interlay tympanoplasty, Endoscopic mastoidectomy, Endoscopic stapedotomy.
• Emergency surgical procedures: Tracheostomy, Repair of cutthroat injury, Surgery for deep neck space abscesses, Foreign body removal
• Laryngeal procedures: Endoscopic and Microscopic laryngeal surgeries for vocal nodule, vocal cord cyst, cordotomy.

• Ear keloid excision
• Excision of mucous retention cyst
• Ear lobe repair
• Ear/Nose piercing
• Deroofing of pseudocyst of pinna
• Chemical cauterization for epistaxis
• Nasal packing for epistaxis
• Nose/Ear foreign body removal
• Intratympanic injections
• Incision and drainage
• Biopsy for oral and nasal lesions
• Cerumen removal

• Allergy Testing and Management: Skin prick tests and blood tests to identify allergens, followed by allergy management strategies such as medications, nasal irrigation, or immunotherapy (allergy shots).
• Hearing Tests: Audiometric assessments, tympanometry, and audiograms to evaluate hearing function and identify any hearing impairments.
• Speech Therapy: Specialized therapy for patients with speech and voice disorders, including those resulting from neurological conditions or vocal cord issues.
• Multi-disciplinary comprehensive management of Headache and vertigo

• Role of labyrinthine sedatives in the treatment of residual dizziness after successful Epley maneuver
• Audiological evaluation among chronic kidney disease patients undergoing hemodialysis
• Role of reflux finding score and reflux symptom index as potential predictor for PPI response in patients with globus pharyngeus

• Posterior nasal neurectomy by coblation in management of intractable allergic rhinitis
• Emerging trends in antibiotic resistance in cases of acute otitis externa
• Clinical and audiological outcome of endoscopic interlay tympanoplasty