ENT surgery is an option for many types of head and neck related conditions.
Ear, nose, and throat (ENT) surgery is rarely the first attempt at treating head and neck problems unless there is a severe injury, advanced condition, or deformity involved. The goal with most types of ENT surgery is to restore function and/or appearance, as may be the case with an abnormally shaped ear that’s also affecting the ability to hear clearly.
Many of the ENT procedures discussed below are now routinely performed with less invasive methods when possible.
Middle ear infections are common in children, but rarely reason enough to perform surgery. However, if medication isn’t helpful, a procedure called a myringotomy may be performed to allow fluid to drain. Traumatic injuries and eardrum tears or ruptures often require surgical correction. Surgery on one or both ears might also be necessary to
- Restore hearing with cochlear implants
- Release thick liquid in the middle ear (“glue ear”)
- Remove acoustic tumors
- Replace the stapes with an artificial part if a buildup of bone is causing hearing loss (otosclerosis)
If something is blocking a nostril or one of the sinus cavities, a lighted tube with an attached camera (nasal endoscope) is often used to determine the source of the obstruction. With severe blockages, surgery may be necessary. Another common reason for nose surgery is what’s termed a deviated septum, which refers to one side of the nasal passage being smaller in size than the other one. A procedure known as a septoplasty is often performed to straighten and reposition the nasal septum when an imbalance is affecting breathing abilities. Nose surgery may also involve:
- Nasal polyp removal
- Removal of sinus or nasal tumors
- Surgery to reduce the size of tiny structures within the nose (turbinates)
- Repairing a nose that’s broken or deformed
- Sinus surgery to open pathways and/or clear blockages
Throat and Neck Procedures
Surgery to remove the tonsils and/or adenoids is a common procedure performed on children. Removing chronically irritated or inflamed tonsils and adenoids at the same time is sometimes necessary to improve breathing and reduce issues with recurring infections. Swallowing disorders that aren’t responding well to medication and other conservative treatments are sometimes corrected with vocal fold (cord) injections or laryngeal framework surgery, which involves the use of an implant to add bulk or reposition the vocal cord. If the throat and upper esophagus becomes narrow after tumor removal, a pharyngoesophageal dilatation may be recommended to stretch the narrowed area with a balloon or a flexible rubber cylinder. Commonly performed throat and neck procedures also include:
- Soft palate repair (palatopexy)
- Uvula removal for obstructive sleep apnea
- Removal of part or all of the thyroid (thyroidectomy)
- Cancerous throat/neck tissue removal
- Skull base surgery to remove benign or cancerous growths
ENT surgery sometimes involves facial reconstruction procedures. In some instances, such procedures are done for cosmetic and functional purposes – e.g., to correct abnormalities of the nose (rhinoplasty) that may also be affecting the ability to breathe properly. Other times, reconstructive surgery is needed to repair droopy eyelids or restore facial and/or neck appearance following surgery for a specific type of head or neck cancer.