Breathing and voice health significantly impact our daily functioning and overall quality of life. The nasal passages and throat facilitate proper breathing and clear speech. Conditions such as nasal obstruction, deviated septum, and nasal polyps can compromise these functions, leading to chronic breathing difficulties, sleep disruption and persistent discomfort. ENT specialists offer various procedural interventions that effectively address these issues, ranging from minimally invasive techniques to more comprehensive surgical approaches.

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What is Nasal Surgery?

Nasal surgery encompasses a range of specialized procedures designed to address structural abnormalities or pathological conditions affecting the nasal passages and sinuses. These interventions remove obstructions, repair damaged tissue, or restructure the nasal anatomy to restore normal breathing function. Septoplasty and Nasal Polyps Surgery represent two specialized interventions that address structural and inflammatory issues.

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Septoplasty

Septoplasty is a specific type of nasal surgery that addresses deviations in the nasal septum. The septum is a seven cm-long partition made of cartilage and bone that separates the left and right nasal cavities. When the septum becomes crooked or displaced, it can obstruct airflow through one or both nostrils, leading to breathing difficulties and chronic sinusitis. Unlike cosmetic rhinoplasty, septoplasty focuses exclusively on improving function rather than appearance.

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During septoplasty, an ENT surgeon makes precise incisions inside the nostril to access the deviated portions of the septum. The surgeon removes or reshapes the affected cartilage and bone before repositioning the remaining tissue in the proper midline position. The procedure typically takes 30-90 minutes and is usually outpatient. The patient will normally experience mild to moderate discomfort. Most patients experience significant improvement in nasal breathing within 2-3 weeks, but it may take several months to heal completely.

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Nasal Polyp Surgery

Nasal polyps are soft, painless, noncancerous growths in the nasal passages or sinuses lining. Enlarging or multiplying can obstruct the nasal airways and cause persistent congestion or pressure headaches.

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Corticosteroid nasal sprays and oral steroids can initially treat nasal polyps, but if they remain resistant, surgical intervention is necessary. Nasal polypectomy is the standard surgical procedure for polyp removal. It uses specialized endoscopic visualization and precise microsurgical instruments, such as surgical scissors or wire snares, to extract the polyps without damaging the surrounding tissue.

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For more complex cases involving the sinuses, balloon sinuplasty offers a less invasive alternative. This procedure involves threading a small balloon catheter through the nostril into the affected sinus passage, then inflating it to expand the opening and restore normal drainage. The surgeon can simultaneously remove accessible polyps during this procedure. Nasal polypectomy and balloon sinuplasty are typically performed under general anesthesia on an outpatient basis, with recovery times ranging from a few days to two weeks, depending on the extent of the procedure and individual healing factors.

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What is a Laryngoscopy?

Laryngoscopy is a diagnostic procedure that allows ENT specialists to examine the larynx (voice box), vocal cords, and surrounding structures in the throat. The larynx, positioned between the throat and trachea (windpipe), houses the vocal cords. These are delicate tissues that vibrate to produce sound when we speak. Visualizing these structures helps identify inflammation, growths, paralysis, or other abnormalities affecting breathing or voice abilities. There are three primary types of laryngoscopy, each with specific applications:

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Indirect Laryngoscopy

Indirect laryngoscopy is the most basic form of laryngoscopy. The specialist uses a small, angled mirror and light source at the back of the throat. Before the examination, the specialist applies a topical anesthetic spray to suppress the gag reflex. This technique provides a limited view but is suitable for detecting abnormalities within the surrounding throat area. This approach is used to initially screen patients with mild hoarseness or mild throat pain where major abnormalities are not suspected.

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Flexible Fiberoptic Laryngoscopy

This form of laryngoscopy is minimally invasive. It uses a thin, flexible endoscope with a fiberoptic camera inserted through the nostril and guided down to the throat. The procedure can be performed in an office setting with topical anesthesia. During speech and breathing, the vocal cords are visualized. This method is preferred for evaluating vocal cord movement disorders and assessing professional voice users with subtle voice changes or vocal fatigue.

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Direct Laryngoscopy

This is the most comprehensive form of laryngoscopy performed in the operating theater under general anesthesia. The surgeon inserts a rigid laryngoscope through the mouth, providing visualization and allowing for tissue sampling (biopsy) during the procedure. Direct laryngoscopy is necessary for cases requiring biopsy of suspicious lesions, removal of vocal cord polyps or nodules or when cancer is suspected and precise tissue examination is needed.

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Treatments Following Laryngoscopy

Laryngoscopy is primarily a diagnostic procedure which guides treatments for identified conditions.

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For inflammatory conditions such as laryngitis, treatments typically include anti-inflammatory medications to reduce stomach acid production. Patients can also improve hydration and eliminate cigarette smoke. If voice therapy and medical management are insufficient, structural abnormalities such as vocal cord polyps, nodules, or cysts may require surgical removal. Phonosurgery is a microsurgery of the vocal cords that preserves normal tissue while removing pathological structures.

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Easy Breathing and Speaking Through Advanced ENT Procedures

Advanced ENT procedures, such as nasal surgeries and laryngoscopic interventions, offer life-changing solutions for individuals struggling with breathing difficulties and voice disorders. These specialized techniques treat symptoms and address the underlying functional issues that impact daily quality of life. These procedures are generally minimally invasive, meaning a shorter recovery time and better patient outcomes. Opting for one of these procedures can ensure proper nasal airflow and vocal function, helping patients breathe and speak more easily.

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Sources:

1. Sinus Surgery. (2022). Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/treatments/15854-sinus-surgery-overview

2. Nasal Polypscopy. (2024). Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diseases/15250-nasal-polyps

3. Laryngoscopy and nasolaryngoscopy. (2023). Medline Plus. Available from: https://medlineplus.gov/ency/article/007507.htm

4. Laryngoscopy. (2022). Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diagnostics/22803-laryngoscopy