1st ENT CLINIC, HEAD AND NECK SURGERY

COMMON ENT CONDITIONS

• Tonsil problems
• Adenoid hypertrophy
• Cystic enlargements
  1. Thyroglossal cyst
  2. Dermoid cysts
  3. Lymphangiomas
  4. Hemangiomas
  5. Ranula
• Branchial cleft cysts
• Laryngeal hernias
• Lipomas
• Cervical inflammations and abscesses
• Solid tumors

NASAL SINUS AND PARANASAL SINUSES CLINIC

Pathological conditions of the nasal sinus and paranasal sinuses are common. The new ENT Clinic, with its expertise in modern, innovative, endoscopic, imaging and surgical methods, provides personalized treatment to each patient. The pathological conditions treated include:

• Allergic rhinitis
• Nasal breathing difficulty and feeling of nasal congestion
• Nasal valve collapse
• Acute and chronic rhinosinusitis
• Nasal polyps
• Deviated septum
• Rhinorrhagias (chemical and electrical cautery, endoscopic surgical management)
• Nasal trauma
• Nasal and sinus cancer
• Inverted papilloma
• Juvenile angiofibroma
• Osteoma
• Paranasal sinus mucoceles
• Skull base tumors
• Cerebrospinal fluid outflow
• Aspirin Exacerbated Respiratory Disease (AERD)
  This syndrome is a chronic inflammatory disorder of the sinuses and lungs. People have an allergic-like reaction to aspirin and other Non Steroidal Anti-Inflammatory Drugs (NSAIDs).
  Symptoms include:
  
  • Nasal congestion (stuffy nose)
  • Rhinorrhea (runny nose)
  • Lacrimation (watery eyes)
  • Redness on the head and neck (flushing)
  • Coughing
  • Wheezing
  • Dyspnea (shortness of breath)
  • Thoracic pain (chest tightness)
  • Pruritus (itchy skin)
  • Nausea or stomach pain

Diagnosis - Treatment

Approximately 40% of patients with asthma, nasal polyps, or chronic sinusitis will develop AERD, which, in the past, was referred to as “Samter’s Triad”. Patients with this condition develop nasal polyps and, in most cases, exhibit persistent asthma.

Treating such patients is difficult and often requires the administration of oral corticosteroids and endoscopic sinus surgery (ESS) for the removal of nasal polyps. In many cases, the administration of multiple asthma medications may also be required to control this pathological syndrome.

DEPARTMENT OF AUDIOLOGY-NEUROTOLOGY-VERTIGO

Hearing loss, balance disorders and tinnitus significantly affect an individual's quality of life. Such disorders adversely affect both a person’s individual professional career and his/her ability to perform normal day-to-day activities. The Department deals individually with patients in different age groups in the evaluation and treatment of the whole range of otologic-neurotologic and surgical conditions, such as:

• Outer and middle ear infections
• Chronic otitis media
• Ventilation tubes in secretory otitis media
• Cholesteatoma
• Otosclerosis - conductive hearing loss
• Benign tumors of the ear such as auditory neuroma and paraganglioma
• Sudden hearing loss
• Cerebrospinal fluid otorrhea
• Malignant ear and skull base tumors
• Tinnitus
• Facial nerve dysfunctions
• Vertigo and balance disorders
• Benign paroxysmal positional vertigo
• Instability
• Ménière's disease
• Vestibular migraine
• Acoustic neuroma

For the diagnosis and investigation of the above diseases we carry out:

• Pure tone audiometry
• Tympanometry
• Acoustic reflex testing
• Electrically Evoked Auditory Brainstem Response

Inner ear function test

• Videonystagmography
• Posturography

Department of vertigo and balance disorders restoration

Balance disorders are a common problem that often affects the quality of life of patients. Given that many different conditions can cause balance disorders, an accurate diagnosis is necessary to help patients deal with their problems.

Tinnitus treatment

DEPARTMENT OF ONCOLOGY - HEAD & NECK CANCERS

Head and neck cancers, from the early signs of the oral cavity to the symptoms of thyroid cancer, constitute a very special group, as they affect a person's speech and expression as well as his/her sociality.

Traditional surgical techniques for head and neck cancers deliver good treatment outcomes; however, they cause dramatic changes in anatomical features such as in the tongue, lower jaw and larynx. Such changes cause patients to become isolated and depressed.

Nevertheless, newer minimally invasive surgical techniques have shown spectacular results not only in terms of a patient's physical condition but also in terms of his/her psychology. These innovative surgical techniques reduce skin scarring, maximize a patient's physical appearance and significantly improve his/her psychological behavior.

Forms and types of head and neck cancers treated in the ENT Clinic:

Cancers:

• Oral cavity (tongue, lips, hard palate, mouth, gums)
• Nose, paranasal sinuses and nasopharynx
• Oropharynx (tonsils, root of tongue, soft palate)
• Larynx
• Hypopharynx
• Salivary glands
• Thyroid gland
• Head and neck skin
• Cervical lymphadenopathies (of unknown primary site) and metastatic.
• HPV+ Head & Neck Cancers
  

  Tobacco and alcoholic beverages are the main cause of head and neck cancers. However, HPV (human papillomavirus) infection has recently become the major triggering factor for HPV+ head and neck cancers that occur in tonsils and other areas such as the base of the tongue.

  The good news is that HPV+ patients have excellent treatment outcomes. They also have better prognosis than other forms of head and neck cancers. Treating HPV+ patients with less aggressive chemoradiotherapy schemes has shown to be beneficial, as it reduces the side effects of therapeutic regimens without affecting the treatment outcome.

Minimally Invasive Surgical Techniques:

• Transoral Laser Surgery (TLS)
• Transoral Videopharyngolaryngoscopic Surgery (TOVS)
• Laser Clinic

Personalized Treatment:

This new therapeutic method involves the study of cells obtained from biopsies to detect for gene mutations, i.e. changes in genes that can be linked with the type of cancer a patient has. Certain chemotherapeutic drugs are more effective than others in cancers with specific mutations. Molecular analysis of a neoplasm can provide more treatment options to choose the most applicable and effective one for a patient. This is called genomic testing.

THYROID AND PARATHYROID GLANDS DISORDERS CENTER

The Center surgically treats thyroid and parathyroid disorders such as:

• Multinodular goiter - total thyroidectomy
• Thyroid nodules - partial and total thyroidectomy
• Graves' disease - total thyroidectomy
• Thyroid cancer - total thyroidectomy and neck dissection
• Parathyroid gland disorders, such as parathyroid adenoma.

DEPARTMENT OF SALIVARY GLANDS

The Department treats diseases of the parotid, submandibular and other salivary glands, such as:

• Sialolithiasis
• Sialadenitis
• Benign and malignant salivary gland tumors.

VOICE AND SWALLOWING CLINIC

The Department deals with the diagnosis and treatment of voice, speech, utterance, communication and swallowing disorders. More specifically, it treats conditions such as:

• Hoarseness
• Vocal cord paralysis
• Spasmodic dysphonia
• Dysphonia
• Dysphagia
• Zenker's diverticulum
• Neurologic disorders of the larynx
• Subglottic stenoses

To diagnose the above conditions the Department performs:

• Pharynx and throat endoscopy with flexible endoscope
• Stroboscopy
• Fiberoptic endoscopic evaluation of swallowing (FEES)

OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS) AND SNORING STUDY AND SURGERY CLINIC

A large part of the population suffers from sleep apnea due to partial or subtotal obstruction of the upper airway which, if not treated, can cause arterial hypertension and other cardiovascular diseases, headaches and memory problems.

The Clinic provides a global diagnostic approach to patients with sleep apnea syndrome and snoring who have failed a successful conservative therapeutic rehabilitation or are interested in being informed about available surgical methods to deal with their problem.

Treatment includes:

• Obtainment of detailed anamnesis, physical examination, and endoscopic study of the head and neck (sleep endoscopy).
• Nasal procedures: deviated septum, nasal turbinate reduction, nasal valve collapse restoration, and removal of nasal polyps.
• Palate surgery: uvulopalatopharyngoplasty, tonsillectomy, radiofrequency palatoplasty and palatal implants.
• Base of tongue surgery: lingual tonsillectomy, use of radiofrequencies at the base of tongue.

SECOND OPINION

The term second opinion is a valuable tool for patients who are in a difficult situation or have a dilemma about their treatment options. Also, depending on their place of residence and their ability to travel or move, patients may have limited access to specialized tertiary healthcare services.

The online second opinion program provides timely consultation on difficult pathologies of the head and neck (nose, ears, oral cavity, oropharynx, larynx). It helps avoid unnecessary, costly travels and accommodation away from a patient's place of residence.

The online second opinion program is easy to use and confidential. The procedure requires attending physicians to send their patient’s medical record online.

The medical file must contain the following:

• Recent medical history (obtained not earlier than 2 months)
• Imaging studies
• Lab tests

Oncological cases also require the sending of histological reports, possible initial treatment (e.g. chemoradiotherapy protocols, possible surgery report).

How the program works:

Typically, the online reply from the second opinion program takes seven working days following the receipt of the medical record. The use of the program includes:

• Detailed and thorough assessment and re-evaluation of the medical record by a highly specialized medical team.
• Assessing the diagnosis of a new cancer or metastasis thereof.
• Evaluating the overall condition of the patient or change of a diagnosis.
• Suggesting a new alternative treatment regimen to the attending physician.
• Managing and answering questions and queries of the patient.
• Ongoing communication with the patient and his/her attending physician, in order to render any and all suggested therapeutic regimens or referrals fully understood and perceived.

Attention:

• The online second opinion program does not apply to direct emergencies.
• In case of an emergency, contact your attending physician or visit your nearest hospital on duty.