Tonsillectomy is surgery to remove ’ of the palatine tonsils. And’ a routine procedure, safe, that is currently being carried out under general anesthesia.
The tonsils are removed or infectious diseases (Recurrent acute tonsillitis) or for airway obstruction problems or suspected malignancy.
The criteria that lead to a correct indication for tonsillectomy differ substantially between children and adults.
Rhinoplasty is the surgery that allows ’ aesthetic nose correction.
The shape of the nose is determined by its skeleton consists of bones, fibroadipose tissue and cartilage. The surgeon as a sculptor is able with numerous techniques to modify the shape of the “skeleton of the nose” changing the appearance of the nasal pyramid ’. And’ a complex surgical procedure that requires a great surgical skill and a good experience. Is done either by Otolaryngologists who by plastic surgeons, the former can combine l ’ switching to procedures to improve nasal breathing by correcting the nasal septum (septoplasty), reducing the thickness of the inferior turbinate mucosa (turbinoplasty) and endoscopic procedures for sinusitis (FESS).
And’ a surgery lasting about 2 hours, requires 1 night's shelter after ’ surgery. At the San Raffaele di Milano the placement of nasal tampons is absolutely awesome.
The procedure, being an aesthetic procedure, is not covered by the health system; some insurance companies may partially repay the cost of the surgical steps to improve ’ intervention covering nasal breathing (settoturbinoplastica).
Voluminous Wine Stain left vocal cord polyp, intraoperative vision before LASER microscopy excision
In healthy person, l ’ ’ organ of balance (vestibular system) It also plays a key role in ’ assist the brain in controlling eye movements so as not to lose the setting of an object despite abrupt head movements.
In pathology the vestibular system can cause abnormal eye movements called nystagmus.
L ’ careful evaluation of these movements is spontaneous that caused is essential to frame the dizziness and ’ instability. Being eye-movements controlled by the brain from the vestibular system it is important to try to exclude as much as possible, l ’ central task: It then tries to put the patient in a position not to see the ’ environment. To achieve this condition you can use goggles Frenzel with strongly miopizzanti that waste the patient lenses every visual reference.
L ’ technological evolution is represented by videonistagmografia: a mask with camera with Infrared Illuminator. Once worn the patient will be in complete darkness while l ’ examiner will investigate and possibly record the movements of eyes evaluating in a monitor.
Registering with videonistagmografia Rotary nystagmus, physiologic in healthy person Continue reading
Tinnitus (or tinnitus) are sounds perceived by patients but not in ’ environment. Their nature can relate to organic diseases (Otosclerosis, acoustic trauma, dell ’ VII acoustic nerve neurinoma, sudden hearing loss, hearing loss ototoxic agents, neurological diseases …) or, in most cases, from an unidentifiable cause.
Tinnitus involve a large number of subjects (until 15-18% of the population), may be constant or intermittent, unilateral or bilateral.
L ’ Tinnitus can be acute or severe tone, mild or very high. Can be very annoying, especially in quiet environments, situation in which it is perceived more.
Tinnitus sufferers know how this disorder can be a real handicap, making it difficult to sleep, increasing the State ’ anxiety and stress.
When evaluating ORL is essential to assess whether l ’ Tinnitus can have an organic cause or less, Once satisfied that the tinnitus is idiopathic ’ (do not have a known cause) The patient must understand that tinnitus is a nuisance (also important) but it is not and must not represent a health problem. Continue reading
L ’ outer ear physiologically produces ceruminose secretions that protect it from infection and microtrauma. Earwax is spontaneously spontaneously delivered from the skin to the outer ’ where will later be removed with normal hygiene. Earwax mingling to de-epithelialised skin can build up causing the dreaded Earwax plugs. Some people are very prone to the formation of earwax plugs, are known risk factors: l ’ hypersecretion of earwax, l ’ use of cotton buds (crushing Cerumen toward the eardrum), l ’ routine use of earphones, diseases that cause increased skin de ’ (keratitis, Psoriasis), narrow ear canal or shrink from osteomas and Exostosis. Also with age ear wax tends to be harder and so it is more prone to the formation of caps with ’ advancing years. Ear cerumen has a particular feature: is hygroscopic, namely swells when it's wet with water. And’ frequent that patients report feeling much less, suddenly, After taking a shower. Earwax plugs can give various symptoms: conductive hearing loss, autophony (hear their voices reverberate), Tinnitus, pain (ear pain) If they appear over infections. A simple otoscopy enables you to diagnose Cap. There are different techniques to remove plug of earwax. The simplest and the least disturbing to the patient is to resort to washing earphones: a jet of water ’ (at body temperature) sprayed in the external ear canal insinuates itself between the skin and Earwax him taking it off from. In the event that you suspect a ’ infection (already have pain) or there is a known perforation of tympanic basolateral or any other condition of ’ ears,or washing is however not recommended. You can remove the Earwax with hooks, Anse, spatulas, Hartmann's pliers or with suction under careful Visual inspection.
L ’ Otoscope is an instrument with a graft for disposable ear cones, a light and a magnifying glass.
Allows you to observe the external ear canal and tympanic membrane in a much smoother. And’ simply effectual a slight pull towards the external ’ and later on the ear and place the instrument.
And’ possible to exclude the presence of earwax plugs, of narrowing of the external ear canal (Exostoses and osteomas), exclude external otitis, evaluate the tympanic membrane integrity ’, exclude miringiti, acute otitis media and effusive.
The exam can be done easily in children.
Dysphagia, that is the difficulty in swallowing foods, can have many causes and may be caused by an obstacle or laryngopharyngeal level or oesophageal.
L ’ Otolaryngologist plays an important role in the evaluation of dysphagic patients, both in identifying the cause ’ that in ’ food standards setting to minimize risks due to dysphagia. In fact dysphagic patients have a higher risk of inhalation of foods: If swallowing is not effective foods may accidentally penetrate the Airways. L ’ inaction can cause serious lung infections.
The standard fiberoptic allows to evaluate l ’ Anatomy and the correct capacity of the larynx to prevent food from entering the trachea.
Also you can see the pharynx and larynx in real time while the patient ingests liquid foods and semi-solid colored. In this way you can have a clear idea of the level of dysphagia and introduce measures to minimise the risk of pneumonia.
All patients with snoring and obstructive sleep apnea syndrome (OSAS) should conduct an assessment ORL with fiberoptic.
In patients with snoring is initially made a standard fiberoptic in order to exclude anatomical issues that might affect or cause the pathology (nasal septum deviation, hypertrophy of lingual base, Palatal PTOSIS)
Then it is important to perform the maneuver of Muller: It requires the patient to a ’ forced inspiration keeping my mouth shut and nostrils plugged. The negative pressure that is created in the pharynx simulates pharyngeal collapse that occurs in sleep with reduced muscle tone.
This procedure allows to simulate, non-invasively, the collapse of the Airways that occurs during sleep.
Identify the anatomical problem that can affect your snoring can be set with the patient proper treatment plan
Below you can find some important rules to reduce gastroesophageal reflux and reflux and symptoms related to laringopatia. Respecting these rules, you can reduce the discomfort related to disease and even reduce or stop drug therapies. Continue reading
Scientific Association for
training, of care and solidarity
in Otolaryngology