What does the field of ENT entail?

ENT is (in my opinion) the most interesting field in medicine. We deal with all the diseases in this region, and ENT includes the subspecialist fields of head and neck surgery, paediatric ENT, otology, rhinology, laryngology and facial plastic surgery. The field of ENT also has overlap with the surgical specialties of neurosurgery, ophthalmology and cardiothoracic surgery, amongst others. Together with the multiple advanced technologies we utilize to make a diagnosis, we can operate using microscopes and endoscopes, or do open surgery with surgical loupes.

What should I bring along for my first consultation?

If possible, please bring your referral letter from your GP or your specialist if you’ve been referred. If you’ve had previous assessments by audiologist, please also bring copies of these, or ask the audiologist to email the results to the practice.

What can I expect during my first consultation?

Once you arrive at the practice you’ll be assisted through every step and filling of forms by the receptionists. You may also fill in the patient form on the website. After you’ve enjoyed the amazing view and a coffee, the consultation will involve history taking, and examination of the ears, nose, throat and neck. I may perform microscopy of the ears or video assisted endoscopy of the nose and throat. Thereafter, I’ll discuss the provisional diagnosis and we’ll plan a way forward, albeit be medical management, surgery, or referral.

What are tonsils and adenoids?

Tonsils and adenoids are part of the Waldeyer ring of lymphoid tissue. As tonsils and adenoids are the first site of encounter with inhaled and ingested micro-organisms, they are considered the first line of defense against exogenous aggressors. When young children enter their kindergarten years, tonsils and adenoids may get chronically inflamed or lead to upper airway obstruction necessitating adenotonsillectomy.

Do all children require their tonsils and adenoids removed with an adenotonsillectomy?

Luckily not. The common indications for an adenotonsillectomy are recurrent tonsillitis meeting the Paradise Criteria and/or worrying upper airway obstruction causing snoring, nasal obstruction or recurrent sinusitis. Other indications include severe tonsillitis with febrile seizures, or if complicated with a deep neck space abscess.

What are the risks and concerns involved with an adenotonsillectomy?

The main concern is the post-operative pain. Your child may have up to two weeks of pain after the operation which will be alleviated by pain medication prescribed by me or the attending anaesthetist.

The other main risk is for post-operative bleeding in the immediate post-operative period up until two weeks after the operation. If a worrying bleed occurs, your child will be taken to theatre to find and cauterize any bleeding vessels.

I have a hoarse voice which has persisted for more than two weeks. What now?

Please make an appointment as this may be due to early cancer of the vocal cords. During the consultation I will do a flexible laryngoscopy video exam to exclude any abnormalities and plan further management.