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Procedures

Surgical

Ear

Ear drum repair (Myringoplasty)

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Hearing restoration (ossiculoplasty and stapedotomy)

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Combined approach tympanoplasty (surgery for chronic ear disease)

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Endoscopic ear surgery and laser

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Grommets (adults and children)

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Mastoid reconstruction / obliteration

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SENTIO (bone implant hearing aid)

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OSIA (bone implant hearing aid)

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BAHA (bone anchored hearing aid)

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Bonebridge (bone implant hearing aid)

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Soundbridge (middle ear implant)

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Cholesteatoma surgery

Transtympanic injection of steroids for Meniere's

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Surgery for problematic or discharging mastoid cavities

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Surgery for otosclerosis (Stapedotomy)

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Nose

Adenoidectomy

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FESS (functional endoscopic sinus surgery)

 

Throat

Excision of lesions on the skin of head and neck

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Tonsillectomy (adults and children)

 

Outpatient

Ear

Ear and mastoid cavity dewaxing (micro suction)

 

Nose

Flexible telescopic fibre-optic nasolaryngoscopy

Patient Advice and Links

Ear

  • Acidifying agents

    Available over the counter and / or on repeat prescription

    Otinova: https://www.otinova.co.uk/

    Ear Calm: https://www.tevauk.com/patients/our-therapy-areas/consumer-healthcare/earcalm/

     

    Aural (Ear) Steroids

    Lower potency: Prednisolone Sodium Phosphate 0.5% drops (Adult and child)

    2-3 drops every 2-3 hours for 7 days

     

    Higher Potency: Betamethasone 0.1% drops (Adult)

    2-3 drops every 2-4 hours for 7 days

    Reduce frequency when relief obtained

  • Vestibular migraine

    Consider: Hydration- 2-3 litres water per day, 7 hours good quality sleep per day, gentle exercise (e.g. freestyle swimming [not breast-stroke], yoga…)

    Take: Magnesium glycinate 600mg 1/day with food, Riboflavine (B2 vitamin) 400mg 1/day, Co-enzyme Q10 (Kaneka formulation) 100mg 3/day.

    https://migrainetrust.org/understand-migraine/types-of-migraine/vesibular/

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    https://www.menieres.org.uk/information-and-support/symptoms-and-conditions/migraine-associated-vertigo

     

    Meniere’s disease

    https://www.menieres.org.uk/information-and-support/symptoms-and-conditions/menieres-disease

     

    DVLA and driving advice

    https://www.gov.uk/dizziness-and-driving

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    https://www.entuk.org/patients/conditions/4/glue_ear_otitis_media_with_effusion_ome

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    Otovent: https://otovent.com/children/

  • To minimise discomfort when flying with Eustachian tube dysfunction (ETD), focus on equalising pressure during takeoff and landing. Use methods like Valsalva manoeuver, swallowing, yawning, and chewing gum to help open the Eustachian tubes. Consider using decongestant nasal sprays or drops about 30 minutes before takeoff and landing, and avoid flying with a cold or ear infection.

     

    Detailed Advice

    Pre-Flight Preparation:

    • Nasal Decongestants: Use a nasal decongestant spray or drops (like Otrivine or Sinex) about 30 minutes before takeoff and landing. Avoid using them for more than a few days as they can worsen congestion. 

    • Antihistamines: If allergies are a contributing factor, consider taking an antihistamine  before the flight, especially if they include a decongestant ( such as Sudafed) 

    • Stay Hydrated: Drink plenty of fluids to prevent dehydration, which can thicken nasal mucus and make it harder to equalise pressure. 

    • Avoid Alcohol, Tea, and Coffee: These can dehydrate you and worsen congestion. 

     

    During the Flight:​

    • Swallowing and Yawning: Encourage frequent swallowing and yawning, especially during takeoff and landing. Chewing gum or sucking on hard candy can help stimulate swallowing. 

    • Valsalva Manoeuver: Gently pinch your nostrils, close your mouth, and gently blow as if blowing your nose. Repeat this several times, particularly during descent. 

    • Earplugs: EarPlanes or similar earplugs designed for pressure equalisation can be helpful, but avoid solid earplugs as they can trap pressure. 

    • Stay Awake: Avoid sleeping during takeoff and landing, as swallowing frequency decreases during sleep. 

    • Keep Kids Comfortable: If traveling with children, encourage them to drink, suck on a bottle or pacifier, or breastfeed during these critical times. 

     

    Consider alternatives:

    • If you have severe ETD and experience significant discomfort during flights, explore alternative treatments like myringotomy and grommet, or tuboplasty.

  • https://www.entuk.org/patients/conditions/5/grommets

     

    Post-operative Care

    • No school or work for 24 hours. You can return to school or work after 24 hours.

    • You can resume normal activities after 24 hours.

    • Keep your ears dry during showering or bathing by placing cotton wool smeared in Vaseline into the bowl of your ear. Do this for 2 weeks. After 2 weeks you can shower or bathe normally without ear protection.

    • Avoid swimming for 2 weeks. After 2 weeks you can resume swimming without ear protection.

    • You can fly straight after your operation.

    • If you develop an ear infection (usually in the form of an ear discharge), you will need a prescription for antibiotic ear drops (not oral antibiotics) for 1 week. Please inform either Ms Neumann or your doctor. 

    • Your first post-operative visit with Ms Neumann will be at around 6 to 8 weeks following the operation. A hearing test will usually be performed at this time.

  • There is a small risk of bleeding and infection and you may experience loss of hearing, dizziness or tinnitus (exceptionally rare complete loss of hearing an balance), altered taste, facial weakness, or recurrent disease (and need revision surgery). Please find below some more detailed information about the surgery.

     

    https://www.entuk.org/patients/conditions/9/hole_in_the_eardrum_myringoplasty_update

     

    Post-operative Care

    • Your ear has been packed with a medicated dressing. This must remain in your ear until it is removed in the clinic. 

    • A head bandage may have been placed around your head. This can be taken off the morning after surgery and thrown away.

    • A Vaseline impregnated gauze has been placed into the bowl of your ear. This may be soaked with blood after the operation  and can be replaced on the morning after surgery with a dry clean cotton ball.

    • Do not wash your hair until seen in clinic for post-operative visit. You can use dry shampoo but make sure that none of it goes inside your ear.

    • Your stitches are dissolvable and will not need to be removed.

    • No school or work for up to 2 weeks. You can return to school or work after 1 week if you feel up to it.

    • No lifting, pushing, bending, stooping, or use of a reclining chair for 2 weeks after surgery. From 2 to 6 weeks after surgery, do not lift anything heavier than a carton of milk. No strenuous exercising, and no activities that require straining for the first 6 weeks after surgery.

    • Do not blow your nose for 6 weeks; if you must blow your nose, do so gently. If you have to sneeze, pinch your nostrils and make sure that you sneeze with your mouth open.

    • Avoid swimming for 6 weeks,  and check whether this is OK for you at your  first pre-operative visit. 

    • You can fly 6 weeks after the operation.

    • If you develop an ear infection (usually in the form of an ear discharge), you will need a prescription for antibiotic ear drops (not oral antibiotics) for 1 week. Please inform Ms Neumann via her secretary.

    • Your first post-operative visit with Ms Neumann will be at around 2 to 4 weeks following the operation.

    ​

    After your first post-operative visit
    Keep your ears dry during showering or bathing by placing cotton wool smeared in Vaseline into the bowl of your ear for 4 more weeks. 

    • Avoid swimming for 4 more weeks.

    • You can shower, bathe and swim normally after 4 weeks. 

    • Your next clinic appointment will be at around 3 months, at which point a hearing test will be performed.

  • There is a small risk of bleeding and infection, and you may experience deterioration of hearing (including both conductive or sensorineural loss), dizziness or tinnitus, altered taste, facial weakness, tympanic membrane perforation, prosthesis displacement or extrusion, inner-ear damage leading to vertigo or perilymph leak (rarely complete hearing loss), or recurrent disease—and you may require revision surgery.

     

    Post-operative Care

    • Your ear has been packed with a medicated dressing. This must remain in your ear until it is removed in the clinic. 

    • A head bandage may have been placed around your head. This can be taken off the morning after surgery and thrown away.

    • A Vaseline impregnated gauze has been placed into the bowl of your ear. This may be soaked with blood after the operation  and can be replaced on the morning after surgery with a dry clean cotton ball.

    • Do not wash your hair until seen in clinic for post-operative visit. You can use dry shampoo but make sure that none of it goes inside your ear.

    • Your stitches are dissolvable and will not need to be removed.

    • No school or work for up to 2 weeks. You can return to school or work after 1 week if you feel up to it.

    • No lifting, pushing, bending, stooping, or use of a reclining chair for 2 weeks after surgery. From 2 to 6 weeks after surgery, do not lift anything heavier than a carton of milk. No strenuous exercising, and no activities that require straining for the first 6 weeks after surgery.

    • Do not blow your nose for 6 weeks; if you must blow your nose, do so gently. If you have to sneeze, pinch your nostrils and make sure that you sneeze with your mouth open.

    • Avoid swimming for 6 weeks,  and check whether this is OK for you at your  first pre-operative visit. 

    • You can fly 6 weeks after the operation.

    • If you develop an ear infection (usually in the form of an ear discharge), you will need a prescription for antibiotic ear drops (not oral antibiotics) for 1 week. Please inform Ms Neumann via her secretary.

    • Your first post-operative visit with Ms Neumann will be at around 2 to 4 weeks following the operation.

     

    After your first post-operative visit
    Keep your ears dry during showering or bathing by placing cotton wool smeared in Vaseline into the bowl of your ear for 4 more weeks. 

    • Avoid swimming for 4 more weeks.

    • You can shower, bathe and swim normally after 4 weeks. 

    • Your next clinic appointment will be at around 3 months, at which point a hearing test will be performed.

  • There is a small risk of bleeding and infection and you may experience loss of hearing, dizziness or tinnitus (exceptionally rare complete loss of hearing an balance), altered taste, facial weakness, CSF leak, residual or recurrent disease (and a need for revision surgery)  or allergy to the ear packing material. Please find below some more detailed information about the surgery.

     

    https://www.entuk.org/patients/conditions/1/mastoid_surgery_cholesteatoma

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    Post-operative Care

    • Your ear has been packed with a medicated dressing. This must remain in your ear until it is removed in the clinic. 

    • A head bandage may have been placed around your head. This can be taken off the morning after surgery and thrown away.

    • A Vaseline impregnated gauze has been placed into the bowl of your ear. This may be soaked with blood after the operation  and can be replaced on the morning after surgery with a dry clean cotton ball.

    • Do not wash your hair until seen in clinic for post-operative visit. You can use dry shampoo but make sure that none of it goes inside your ear.

    • Your stitches are dissolvable and will not need to be removed.

    • No school or work for up to 2 weeks. You can return to school or work after 1 week if you feel up to it.

    • No lifting, pushing, bending, stooping, or use of a reclining chair for 2 weeks after surgery. From 2 to 6 weeks after surgery, do not lift anything heavier than a carton of milk. No strenuous exercising, and no activities that require straining for the first 6 weeks after surgery.

    • Do not blow your nose for 6 weeks; if you must blow your nose, do so gently. If you have to sneeze, pinch your nostrils and make sure that you sneeze with your mouth open.

    • Avoid swimming for 6 weeks,  and check whether this is OK for you at your  first pre-operative visit. 

    • You can fly 6 weeks after the operation.

    • If you develop an ear infection (usually in the form of an ear discharge), you will need a prescription for antibiotic ear drops (not oral antibiotics) for 1 week. Please inform Ms Neumann via her secretary.

    • Your first post-operative visit with Ms Neumann will be at around 2 to 4 weeks following the operation.

     

    After your first post-operative visit
    Keep your ears dry during showering or bathing by placing cotton wool smeared in Vaseline into the bowl of your ear for 4 more weeks. 

    • Avoid swimming for 4 more weeks.

    • You can shower, bathe and swim normally after 4 weeks. 

    • Your next clinic appointment will be at around 3 months, at which point a hearing test will be performed.

  • https://www.entuk.org/patients/conditions/14/otosclerosis_and_stapedotomy_update

     

    Post-operative Care

    • Your ear has been packed with a medicated dressing. This must remain in your ear until it is removed in the clinic. 

    • A head bandage may have been placed around your head. This can be taken off the morning after surgery and thrown away.

    • A Vaseline impregnated gauze has been placed into the bowl of your ear. This may be soaked with blood after the operation  and can be replaced on the morning after surgery with a dry clean cotton ball.

    • Do not wash your hair until seen in clinic for post-operative visit. You can use dry shampoo but make sure that none of it goes inside your ear.

    • Your stitches are dissolvable and will not need to be removed.

    • No school or work for up to 2 weeks. You can return to school or work after 1 week if you feel up to it.

    • No lifting, pushing, bending, stooping, or use of a reclining chair for 2 weeks after surgery. From 2 to 6 weeks after surgery, do not lift anything heavier than a carton of milk. No strenuous exercising, and no activities that require straining for the first 6 weeks after surgery.

    • Do not blow your nose for 6 weeks; if you must blow your nose, do so gently. If you have to sneeze, pinch your nostrils and make sure that you sneeze with your mouth open.

    • Avoid swimming for 6 weeks,  and check whether this is OK for you at your  first pre-operative visit. 

    • You can fly 6 weeks after the operation.

    • If you develop an ear infection (usually in the form of an ear discharge), you will need a prescription for antibiotic ear drops (not oral antibiotics) for 1 week. Please inform Ms Neumann via her secretary.

    • Your first post-operative visit with Ms Neumann will be at around 2 to 4 weeks following the operation.

    ​

    After your first post-operative visit
    Keep your ears dry during showering or bathing by placing cotton wool smeared in Vaseline into the bowl of your ear for 4 more weeks. 

    • Avoid swimming for 4 more weeks.

    • You can shower, bathe and swim normally after 4 weeks. 

    • Your next clinic appointment will be at around 3 months, at which point a hearing test will be performed.

  • Percutaneous skin implants

    BAHA: https://www.oticonmedical.com/uk/hearing-and-hearing-loss/new-to-bone-conduction/what-you-need-to-know-about-bone-anchored-hearing

     

    Intact skin implants

    Osia: https://www.cochlear.com/uk/en/home/products-and-accessories/cochlear-osia-system/osiaimplant

     

    Sentio: https://sentio.oticonmedical.com/

     

    Soundbridge: https://www.medel.com/en-gb/hearing-solutions/vibrant-soundbridge

     

    Bonebridge: https://www.medel.com/en-gb/hearing-solutions/bonebridge

     

    Cochlear implant

    https://www.guysandstthomas.nhs.uk/health-information/recovering-cochlear-implant-surgery

Nose

Throat

  • Adults

    https://www.entuk.org/patients/conditions/59/tonsillectomy_taking_out_your_tonsils_because_of_repeated_infections

     

    Post-operative Care

    • No school or work for 2 weeks. You can return to school or work after 2 weeks.

    • Get plenty of rest and avoid strenuous activity for up to 2 weeks.

    • Take your painkillers regularly as prescribed for the first 5 days regardless of whether you are in pain or not. Do not wait for the pain to come on. After 5 days you can then take them only when needed.

    • Keep well hydrated with lots of fluids.

    • Get back onto a regular diet as soon as possible (do not only eat soft foods like ice-cream and jelly, although these are allowed as well).

    • At the first sign of bleeding from the mouth or nose, go to your nearest A&E Department for further treatment

    • If you vomit up coffee grounds, go to your nearest A&E Department for further treatment.

    • Avoid public areas for up to 2 weeks to prevent contracting an infection from someone; this may lead to bleeding.

     

    Children

    https://www.entuk.org/patients/conditions/63/helping_you_decide_about_tonsil_surgery_for_your_child

     

    https://www.entuk.org/patients/conditions/65/after_your_childs_tonsil_surgery_tips_for_parents

     

    Post-operative Care

    • No school or work for 2 weeks. You can return to school or work after 2 weeks.

    • Get plenty of rest and avoid strenuous activity for up to 2 weeks.

    • Take your painkillers regularly as prescribed for the first 5 days regardless of whether you are in pain or not. Do not wait for the pain to come on. After 5 days you can then take them only when needed.

    • Keep well hydrated with lots of fluids.

    • Get back onto a regular diet as soon as possible (do not only eat soft foods like ice-cream and jelly, although these are allowed as well).

    • At the first sign of bleeding from the mouth or nose, go to your nearest A&E Department for further treatment

    • If you vomit up coffee grounds, go to your nearest A&E Department for further treatment.

    • Avoid public areas for up to 2 weeks to prevent contracting an infection from someone; this may lead to bleeding.

  • The most common complications of adenotonsillectomy, such as bleeding, generally occur in the immediate perioperative period but can develop up to 2 weeks postoperatively. Exceptionally, the bleeding can be life threatening. There is a small risk of damage to lips and teeth during anaesthetic and surgery. Some children develop an infection post-operatively manifesting itself with increased pain, high temperature and a smelly breath. This is usually treated with antibiotics. Rarely, children may have some fluid reflux through the nose post-operatively but usually that settles down within weeks. Long-term complications, such as nasopharyngeal stenosis, may appear months to years after surgery but they are rare.

     

    Post-operative Care

    • No school or work for 2 weeks. You can return to school or work after 2 weeks.

    • Get plenty of rest and avoid strenuous activity for up to 2 weeks.

    • Take your painkillers regularly as prescribed for the first 5 days regardless of whether you are in pain or not. Do not wait for the pain to come on. After 5 days you can then take them only when needed.

    • Keep well hydrated with lots of fluids.

    • Get back onto a regular diet as soon as possible (do not only eat soft foods like ice-cream and jelly, although these are allowed as well).

    • At the first sign of bleeding from the mouth or nose, go to your nearest A&E Department for further treatment

    • If you vomit up coffee grounds, go to your nearest A&E Department for further treatment.

    • Avoid public areas for up to 2 weeks to prevent contracting an infection from someone; this may lead to bleeding.

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    https://www.entuk.org/patients/conditions/86/your_voice_and_how_to_look_after_it

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Questionnaires

Once the required questionnaires are completed, either submit online/by email or print out and bring to your appointment with Ms. Neumann.

Need to Get in Touch?

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