Saturday, 19 November 2011

Endoscopic Laser Turbinoplasty vs conventional Turbinectomy ... my view

1) larger inferior turbinate ( left ) before Laser surgery


2) 3 days post endoscopic Laser turbinoplasty
  • area of healing laser burn with reduction of the turbinate size

3) 3 weeks post Endocsopic Laser turbinoplasty ( with endoscopic laser septoplsty )
  • the 3 Dimensional reduction of the inferior turbinate
  • no amputation or excision of the turbinate



4) 3 weeks post Endocsopic Laser turbinoplasty ( PANORAMIC VIEW )
  • the 3 Dimensional reduction of the inferior turbinate
  • no amputation or excision of the urbinate
  • sufficient space for airway and for mucous flow


5) conventional method of turbinectomy ( excision of the inferior turbinate )
  • loss of volume causing nocturnal cough due to post nasal drip
  • airway obstruction due to negative pressure within the nasal passage ( due to large space in the middle of the nasal cavity )
  • potential empty nose syndrome



Monday, 14 November 2011

Hi everyone,
Guess I m quite late in continuing my blog, anyway I need to upload some photos soon.

Laser surgeries in Ent Head Neck, malaysia: Ent laser surgeries - 3 D reconstruction

Laser surgeries in Ent Head Neck, malaysia: Ent laser surgeries - 3 D reconstruction: ENT Laser surgeries , may sound new but has been around for very long. The question is,how much do we know about it. It is a very beautif...
LASER SURGERIES FOR THE NOSE

THIS TECHNIQUE WITH CO2 LASER IS A NON TOUCH TECHNIQUE
THE LASER PROBES HAVE SIDE PORTS AND STRAIGHT PORTS TO ENABLE THE LASER FIBRE TO FIRE THE LASER FORM A DISTANCE.

THIS TECHNIQUE ENABLES THE SURGEON TO WORK FROM A DISTANCE TO AVOID TRAUMA TO SURROUNDING TISSUE AND TO HELP GUIDE TO A FAR AWAY TISSUE WHICH NEEDS TO BE OPERATED UPON ( ADENOID, POSTERIOR PHARYNGEAL WALL OR EUSTACHIAN TUBE OPENINGS )
IT REDUCES ANY DIRECT INFECTION DUE TO PROBE CONTACT WITH THE NASAL MUCOSA

COMMON PROCEDURES PERFORMED BY ME IN TROPICANA MEDICAL CENTRE


1) LASER TURBINOPLASTY ( INFERIOR and MIDDLE Turbinates)


WHO NEEDS LASER ASSISTED TURBINOPLATY?

• CHILDREN
• ADULTS

WHY DO WE DO TURBINOPLASTY?

• RECURRENT NASAL BLOCK NOT RESPONDING TO NASAL SPRAY OR ORAL MEDICATION
• NASAL BLOCK LEADING TO SINUSITIS / RHINOSINUSITIS
• NASAL BLOK CAUSING RECURRENT EAR BLOCKAGE (EUSTACHIAN TUBE DYSFUNCTION)
• YOUNG CHILDREN WITH BAD NASAL SEPTAL DEVIATION, NOT ABLE TO BREATHE WELL, AWAITING FOR PERMANENT SEPTAL SURGERY AT LATER DATE ( AFTER AGE OF 18 YEARS)
-PEOPLE WHO DEVELOP FREQUENT BAROTRAUMA DURING FLIGHT OR DEEP SEA DIVING
-NASAL OBSTRUCTION CAUSING SNORING AND SLEEP APNOEA


WHAT BENEFITS DOES LASER ASSISTED TURBINOPALSTY HAVE?

• LESS PAIN
• FASTER RECOVERY
• SAFER THAN THE CONVENTIONAL METHODS
• WELL DEFINED SHAPING OF THE TURBINATES  (3'D' RECONSTRUCTION )
• LESS BLEEDING COMPARED TO CONVENTIONAL METHODS
• PRESERVING THE FUNCTION OF THE MUCOSA
• MINIMAL TRAUMA TO THE MUCOSA STRUCTURE
• NO EXTENSIVE NASAL  PACKING NEEDED POST SURGERY
• LOW INCIDENCE OF EXTREME NASAL PASSAGE DRYING (ATROPHIC RHINITIS) OR EMPTY NOSE SYNDROME )
• REDUCE SIGNIFICANT NASAL ALLERGY SYMPTOMS
-LESS USAGE OF ANTIHISTAMINE OR NASAL SPRAYS POST SURGERY

WHAT ARE THE RISKS INVOLVED?

• MINIMAL RISK
• LESS THAN THE CONVENTIONAL (OLDER) METHOD

WHAT IS A GOOD AGE?

-NO AGE LIMIT

PROCEDURE:

• DISCUSS WITH THE DOCTOR
- UNDERSTAND THE PROCEDURES IN DETAIL.
• DAY CARE PROCEDURE / ADMIT OVER NIGHT
• SURGERY DONE UNDER LOCAL OR GENERAL ANAESTHESIA
• PATIENT IS INTUBATED DURING SURGERY (AIR WAY TUBE PLACED FOR BREATHING)
• ALL LASER PRECAUTION TAKEN DURING THE PROCEDURES
• TIME TAKEN IS ABOUT 20 TO 30 MINUTES PER TURBINATE (TOTAL TIME NEEDED IS ABOUT 1 HOUR)


• POST SURGERY

 • ONCE THE PATIENT IS CONSCIOUS, PATIENT CAN EAT NORMAL DIET
• FOLLOW UP IS AFTER 5 DAYS TO 1 WEEK DEPENDING ON THE TYPE OF COMBINATION SURGERY DONE.
• PATIENT HAS TO SPRAY NASAL DECONGESTANT AND NASAL DOUCHING WITH SALINE TO CLEAR THE NASAL PASSAGE FOR ABOUT 1 WEEK TO 2
- RHINOWASH IS A GOOD NASAL CLEANSING  DEVICE
• BACK TO NORMAL DUTY ( SCHOOL OR WORK ) IN 1 WEEK


WHAT TYPE OF LASER IS USED?

CO2 LASER


FUTURE PLANS

TO START LASER TURBINOPLASTY AS A LOCAL ANAESTHESIA PROCEDURE