Question 1

Adenoid Surgery

Accepted Answer

What is adenoid surgery?
Adenoid surgery or adenoidectomy is a procedure to remove the small glands in the throat, at the back of the nose.

Who does the operation?
All of our consultants carry out adenoidectomies. This takes place under a general anaesthetic and the operation takes approximately 45 minutes.
Before the operation

You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.

The operation
The operation takes place as a day case. You will be given the anaesthetic; you will have your adenoids removed through the mouth, which takes about ten minutes. You will then go to recovery and then back to day case. You are normally discharged the same day.

After the operation
It is recommended to allow one week for recovery after the procedure. You may feel like you have a blocked nose, or you are talking through your nose or that your voice sounds different. This is perfectly normal and should settle in a week or so. Your throat may also be sore. Use painkillers for the first few days, following the guidance on the label. You may also feel like you have sore ears, again this is normal.

Is a follow up appointment required?
A follow up appointment is required 6 weeks post-op to check on progress.  An appointment letter will be sent out to you.

Question 2

Chronic Rhinitis

Accepted Answer

ClariFix® Cryotherapy for Chronic Rhinitis
ClariFix® is a minimally invasive treatment designed to provide lasting relief from chronic rhinitis, a condition characterised by persistent nasal congestion, rhinorrhoea (runny nose), and post-nasal drip. These symptoms are often caused by overactivity of the posterior nasal nerves, which regulate nasal secretions and congestion.

Using a small cryotherapy device, ClariFix® delivers targeted cold therapy to these overactive nerves at the back of the nose. The procedure takes only a few minutes and can be performed under local anaesthetic, with minimal discomfort and no surgical incisions.

Clinical Benefits:

• Evidence-based treatment for both allergic and non-allergic rhinitis
 • Quick procedure with minimal recovery
 • Reduced reliance on nasal sprays or medications
 • Long-lasting symptom improvement in many patients

Most individuals are able to resume normal activities shortly after treatment, with symptom improvement typically noticed within a few weeks.

If you experience chronic nasal symptoms that have not responded to conventional treatments, ClariFix® may be an appropriate option. Contact us on 01761 422262 to book an appointment.

Question 3

Fess (Functional Endoscopic Sinus Surgery)

Accepted Answer

About the Sinuses
Your sinuses are air filled spaces at the front of your skull, between your eyes and above your upper jaw that are connected to the inside of your nose. Sinusitis is an infection of the mucous membrane that lines your sinuses and causes symptoms of pain, blocked nose, discharge, reduced sense of smell and feeling of mucus at the back of your nose or throat. In some patients, an operation to improve drainage of the sinuses into the nasal cavity is helpful. This operation is known as a FESS (Functional Endoscopic Sinus Surgery).

Who does the operation?
All our consultants are able to carry out FESS procedures. They take place under general anaesthetic, the operation takes approximately 1 hour.

Before the Operation
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.

The Operation
The operation is performed through your nostrils and does not result in any facial scars or change in the shape of your nose. Using a telescope, the surgeon will examine your nasal passages, remove any polyps and widen the passages from your sinuses into your nose. You may have some nasal packing inserted at the end of the operation to control bleeding. This is usually removed by the nursing staff a few hours after the operation.

After the operation
After the procedure you may experience some pain and the nursing team will give you pain medication to help control this. You may experience bleeding after the procedure. Vigorous nose blowing should be avoided for the first week after the operation, as this may cause a nosebleed. Rinsing the nose with saline will help to clear the blood and mucous – your surgeon will explain how to do this. You must not drive, operate machinery or do any potentially dangerous activities (including cooking) for at least 24 hours. Do not sign any legal documents or drink alcohol for at least 24 hours.

Is a follow up appointment required?
A follow up appointment is normally required but if your consultant feels that you need a follow up appointment then he will send an appointment letter out to you.

Question 4

Grommets

Accepted Answer

Grommets are a surgical procedure that’s carried out either under local anaestheic in the clinic or general anesthetic in the theatre.

What are grommets and why are they used?
Grommets are small plastic tubes that are inserted across the eardrum to create a deliberate small hole. This allows air to pass across the eardrum.  It can help restore hearing in a condition called ‘glue ear’, and can help with recurrent ear infections, retracted (sucked in) eardrums, or other pressure related ear problems.  In glue ear thick, sticky fluid collects behind the eardrum and prevents transmission of sound.Glue ear is common in childhood and typically follows the common cold, but can also occur in adults. Adults may also require grommets- either for middle ear fluid, or to treat a deformity of the eardrum. Grommets are usually temporary, and fall out into the ear canal after 6-12 months. The hole then usually heals over. In some patients the fluid behind the eardrum may then return. If this occurs one option is to insert a long-term grommet of a different design.

Who does the operation?
All of our consultant surgeons are able to carry out grommet insertion. They take place under local or general anaesthetic, and the operation takes approximately 45 minutes.

Before the Operation
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.
Before the operation you will need to have an up to date hearing test (audiogram).
 
The Operation
The surgeon will make a small hole in your eardrum and remove the fluid using suction. The grommet will then be placed in the hole. The grommet design depends on how long the grommet should stay in place.
After the operation

Patients are discharged from hospital on the day of the operation. Placing a grommet in your ear is not usually painful. Sometimes the ear can discharge fluid for a few days following the procedure. Try to keep the ear dry when bathing for the first 2 weeks. Swimming should be avoided for 6 weeks following the operation, and deep diving (greater than 2 metres depth) should be avoided for the duration that the grommet is present in the eardrum.

Is a follow up appointment required?
A follow up appointment at 3 months post-op preceded by a hearing test is the usual plan.

Question 5

Mastoid Surgery and Tympanoplasty

Accepted Answer

What is mastoid surgery?
Mastoid surgery or a Mastoidectomy is a procedure usually carried out to remove a pocket of skin called a cholesteatoma that has grown into the middle ear and mastoid bone.

Who does the operation?
Mr Thomas Mawby and Mr Arthur Henderson, carries out the procedure under general anaesthetic.

Before the operation
We need to ensure you have an up to date hearing test, ideally within 8 weeks.
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.

The operation
The operation takes place as a day case.  The consultant will discuss the operation with you during the consultation. The exact details of the operation depend on the severity and extent of the disease. Surgery may take between one and three hours.

After the operation
You will go home with a little ointment in your ear – this will be removed in the out-patients, usually after 4 weeks.

We recommend one week off after the operation. Take care not to get the ear wet. You should be able to wash your hair after a week but try not to get water inside of your ear.

Is a follow up appointment required?
A follow up appointment is required 4 weeks post-op to check on progress and remove the ointment from the ear. Longer term follow up is usually required to ensure the ear heals well and the disease does not return.

Question 6

Microlaryngoscopy and Panendoscopy (throat endoscopy)

Accepted Answer

What is the operation and why would it be necessary?
Both these operations are formal examinations of your throat under a full, general anaesthetic. They both involve passing rigid metal tubes through your mouth to look at your throat. They are typically den to further investigate or treat something your surgeon has seen during your outpatients assessment.

A microlaryngoscopy is where a powerful microscope is use to help the surgeon examine your voice box (larynx) carefully. Whilst doing this, small lesions can be delicately removed and/or sampled. It can also be an opportunity to inject steroid, fillers or botox into the larynx if necessary.
A panendoscopy is similar but involves looking also into the top of your food pipe (your oesophagus).
 
Who does the operation?
In our team, Mr Andy Carswell and Mr Stuart Gillett offer this surgery. 
 
Before the operation
As with any surgery, you can take steps to improve your health and enhance your recovery before the operation; stopping smoking at least 4 weeks before, trying to maintain a healthy weight and taking regular exercise.
 
The operation
Whilst you are asleep, the surgeon will pass a rigid metal tube carefully into your throat. Your teeth will be protected. Do highlight any particular concerns about your teeth to our surgeons. It will take around 45 minutes to an hour.
 
After the operation
Once you are awake you will be cared for on the ward for a couple of hours. You may be asked to rest your voice, particularly after a microlaryngsocopy. Resting your voice means trying to talk as little as possible and to avoid any shouting or whispering. Whispering puts more strain on the vocal cords then using your normal conversational voice. You should  twoor three days off work after the surgery to recovery. Remember you can usually not drive for 24 hours (your anaesthetist will confirm this for you on the day of surgery).

Is a follow up appointment required?
A follow up appointment will be made with your consultant to discuss any results from the operation and to monitor your recovery.

Question 7

Myringoplasty

Accepted Answer

Myringoplasty is a procedure carried out under general anaesthetic
What is a myringoplasty?
A myringoplasty is an operation to repair a hole in your eardrum. The hole may have been caused by an infection in your middle ear that burst through your eardrum, or by some form of trauma. Often perforated eardrums do not cause any problems, but repeated ear infections and poor hearing can occur.

Who does the operation?
Mr Thomas Mawby and Mr Arthur Henderson are our Consultant Surgeons who carry out this procedure. They take place under general anaesthetic and the operation takes about 90 minutes. Usually patients are discharged from hospital on the day of the surgery.

Before the Operation
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.
Before the operation you will need to have an up to date hearing test (audiogram).
 
The Operation
In almost all cases we will aim to perform this procedure endoscopically.  This means we will use a camera down your ear and not make any cuts to the back or front of the ear.  Your surgeon will use a graft (piece of tissue) to cover the hole.  Your eardrum will be lifted, the graft placed underneath it and supported with a dissolving sponge. A dressing may be placed in your ear canal, and a bandage may be used around the ear.

After the operation
For the first 24 hours after a general anaesthetic, you should not drive, sign any legal documents, operate machinery or do any potentially dangerous activities (including cooking). Alcohol should also be avoided for 24 hours. After the procedure you may be in some pain and the health team will give you pain medication to help control this. If the ear is bandaged, this is usually removed the day after the surgery.

You will need 1-2 weeks off school / work after this procedure. The ear should be kept dry until your surgeon has checked that the graft has fully healed. This usually takes about 6 weeks but can take longer. Vigorous exercise should be avoided until after the first post-op check.

Is a follow up appointment required?
A follow-up appointment is typically arranged a fortnight after the operation.

Question 8

Palatoplasty

Accepted Answer

What is the operation?
A palatoplasty is an operation to alter the shape of the palate. This is the floppy soft part of the back of your mouth. 
 
Why would someone need this operation?
Changing the shape of the palate can help with snoring. If you see one of our consultants about snoring, they will assess your nose, mouth and neck. It may be that this operation is deemed appropriate to improve your airway. Typically, this operation is offered if your palate is long and narrowing the space through which you breath. This procedure can be combined with nasal surgery (eg septoplasty) and often tonsil removal as well.
 
Who does the operation?
In our team, Mr Andy Carswell and Mr Stuart Gillett offer this surgery. 
 
Before the operation
As with any surgery, you can take steps to improve your health and enhance your recovery before the operation; stopping smoking at least 4 weeks before, trying to maintain a healthy weight and taking regular exercise.
 
The operation
You will come into the hospital as a day case admission. On the day, the team will confirm your consent and check you in. The actual procedure will take around an hour. Afterwards you will be cared for on the ward until you are ready to go home. Remember you cannot drive for 24 hours after a general anaesthetic.
 
After the operation
This operation is painful during your recovery. You will be given advice on regular pain relief and anti-inflammatories when you are in the hospital. You will need pain relief for at least ten days and we would recommend taking two weeks off work to recover. Some people find it easier to eat a diet of soft food while the palate is healing.
 
Is a follow up appointment required?
Normally we would offer and arrange a follow up appointment to monitor your recovery.

Question 9

Parathyroid

Accepted Answer

What is a parathyroid?  The parathyroid glands are four tiny glands that sit In your neck close to your thyroid gland.  They regulate your blood calcium levels.  If you have a problem with your blood calcium you should first see an endocrinologist for a full work up and diagnosis.  If you are diagnosed with primary hyperparathyroidism, they will commonly recommend parathyroid removal to cure the condition.
 
Who does the operation?  This procedure is carried out by our two specialist Head & Neck consultants: Mr Stuart Gillett and Mr Andrew Carswell.  The procedure is under a general anaesthetic and commonly takes from 1-2 hours.
 
Before the operation you can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.  Maintain a healthy weight and taking regular exercise.  Its important to inform our surgeons if you are taking any blood thinning tablets such as aspirin, warfarin, clopidogrel, apixaban, rivaroxaban and dabigatran.
 
The operation.  The recurrent laryngeal nerve (the nerve that moves your voice box) runs next to the parathyroid glands.  There is a small (approximately 5%) risk of causing a bruising type of injury to this nerve, resulting in a weak, hoarse or breathy voice.  If this happens it will usually get better over a few months.
 
After the operation you should take a week off work to recover.  We  would not recommend driving for 1 week and patients should ensure that they are safe/able to move their neck without pain before doing so.
 
Is a follow up appointment required?  A follow up appointment will be made with your consultant to discuss histology from the operation and to monitor your recover.

Question 10

Parotid

Accepted Answer

What is it a parotid?
The parotid is one of the large salivary gland that lies in the cheek area just in front of the ear. Its job is to produce saliva to help keep the mouth moist and aid the swallowing of food. Sometimes lumps can form within the parotid gland and need to removed for diagnosis and to prevent them getting larger. They are almost always benign.

Who does the operation?
This procedure is carried out by our two specialist Head and Neck consultant Mr Stuart Gillett and Mr Andrew Carswell. The procedure is under a general anesthetic and commonly takes from 2-3 hours.

Before the operation
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.
Its important to inform our surgeons if you are taking any blood thinning tablets such as aspirin, warfarin, clopidogril, apixaban, rivoroxiban and dabigatran.

The operation
The facial nerve (the nerve that moves the muscles of the face) runs through the middle of the parotid gland. The procedure starts by finding the facial nerve and following it to protect the nerve as the lump is removed – our surgeons are aided by machines that monitors the nerve. A small plastic drain is placed at the end of the procedure to remove any blood or fluid that may collect afterwards. Patients usually go home the same day.

Weakness to the nerve of the face is not common but can happen particularly if the lump is very large. It will almost always recover with time and permanent weakness is very rare. Saliva can sometimes collect under the skin forming a swelling – this will often settle in the space of a few weeks. The procedure is not overly painful – in fact most patients have numbness over the earlobe and side of face – this is common and does settle with time.

In time the scar heals very well, some patients notice an element of sweating on the side of the face when eating – something called “freys syndrome”. This is rarely problematic but can be dealt with if so.

After the operation
After the operation you should aim to take a week off work to recover. We would not recommend driving for 1 week and patients should ensure that they are safe/able to move their neck without pain before doing so.

Is a follow up appointment required?
A follow up appointment will be made with your consultant to discuss the histology from the operation and to monitor your recovery.

Question 11

Reduction Of Turbinates (Turbinectomy)

Accepted Answer

Reduction of turbinates is a procedure carried out under general anaesthetic
What is a turbinate?
The turbinates are bony shelves in your nose covered by glandular tissue rich in blood vessels and nerves. The turbinates help regulate the flow of air through your nose. Most of the air you breathe in moves between the lower (inferior) and middle turbinates.  The air is being filtered, warmed and moistened by the mucosa (lining tissue). The inferior turbinates can sometimes become permanently enlarged and block your nose.  In such cases surgery to reduce the turbinates can improve the nasal airway.

Who does the operation?
All of our consultants are able to carry out this procedure. They take place under general anaesthetic and the operation takes approximately one hour. Patients will usually go home on the day of the operation.

Before the Operation
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure. Maintain a healthy weight and taking regular exercise.

The Operation
The operation is performed through the nostrils and does not result in any facial scars or black eyes. Reducing the size of turbinates involves one of the following techniques:-
1. Diathermy – passing an electric current through a needle placed on the surface of the turbinate or inside the tissue;
2. Trimming – cutting away the lower or outer part of the turbinate. This can be done using a fine instrument called a microdebrider, under guidance of a surgical telescope.

Your nose may be packed with a dressing which is either absorbable or will be removed by nursing staff before you are discharged from the hospital.

After the operation
For the first 24 hours after a general anaesthetic, you should not drive, sign any legal documents, operate machinery or do any potentially dangerous activities (including cooking). Alcohol should also be avoided for 24 hours. After the procedure you may be in some pain and the nursing staff will give you medication to help control this. You may have some bleeding for up to 7-10 days following the procedure. Gently rinsing the nose with a saline solution can help clear blood clots and mucous- you will be given a leaflet to explain this in more detail. Do not do any strenuous exercise for the first fortnight as this could cause a nosebleed.

Is a follow up appointment required?
A follow up appointments will be arranged as required.

Question 12

Septal Perforations

Accepted Answer

Magnetic Nasal Buttons for Septal Perforations

A septal perforation is a hole in the nasal septum — the cartilage and bone that separate the two sides of the nose. This condition can lead to symptoms such as nasal crusting, bleeding, whistling, obstruction, and discomfort. In cases where surgical repair is not suitable or desired, a nasal septal button can offer an effective non-surgical alternative.

Magnetic nasal buttons are a modern development in septal perforation management. These customised prosthetic devices are designed to gently close the perforation by securing onto each side of the septum using paired magnets. They offer improved comfort, stability, and ease of insertion compared to traditional mechanical buttons.

Clinical Benefits:

• Non-surgical solution for managing nasal dryness, crusting, and obstruction
 • Custom-fit for improved comfort and nasal airflow
 • Magnetic design allows for secure positioning and easier handling
 • Can be used long term or as an interim measure before surgery

The button is typically fitted under local anaesthetic, and most patients experience immediate symptom relief.

If you have a septal perforation and are experiencing bothersome symptoms, a magnetic nasal button may be an appropriate treatment option.

To book an appointment, call on 01761 422262.

Question 13

Septoplasty

Accepted Answer

A septoplasty is a surgical procedure that’s carried out under general anaesthetic to fix a deviated nasal septum.

A deviated septum occurs when the cartilage that separates your nostrils is out of position. This can cause breathing problems, nosebleeds, and pain.
Why do you need a septoplasty?
A septoplasty may be required if you have a problem with your septum. Typically this causes a blocked or stuffy nose type symptom.  It can also cause problems with snoring.  Sometimes a septoplasty will be considered as part of your treatment for nose bleeds or sinus issues.

The septum is the cartilage and bone inside of your nose that divides your nose into two halves.  The septum is usually straight but it can be deviated or bent causing symptoms of a blocked nose.  A deviated septum may have been present since childhood or may be twisted by an injury.  This can happen to the cartilage, the bone or both.

Who does the operation?
All of our consultants are able to carry out a septoplasty. The operation takes place under general anaesthetic and takes about an hour. Patients normally go home on the day of the operation.

Before the Operation
You can help to ensure success of your septoplasty and avoid complications by following a few simple steps. Stop smoking (if you do) at least 4 weeks prior to the procedure.  Maintain a healthy weight and taking regular exercise.

The Operation
The septoplasty is performed through your nostrils and does not result in any facial scars or black eyes. The surgeon will make a cut in the lining of your nose over your septum.  They will lift the mucosa (lining tissue) away from the cartilage and bone. They will remove the parts of the cartilage and bone that are bent. They then put the rest back in the correct position. The cut will be closed with absorbable stitches which will fall out in a few weeks.

After the operation
For the first 24 hours after a general anaesthetic  you should follow some simple steps.  You should not drive, sign any legal documents, operate machinery or do any potentially dangerous activities (including cooking).  Alcohol should also be avoided for 24 hours. After the procedure you can expect to be in some pain.  The nursing team will give you pain medication to help control this. You may suffer bleeding for a week to 10 days after the operation. Your nose may feel blocked for up to 6 weeks. You must not blow your nose vigorously for the first few days. Do not exercise, have a hot bath or bend down for 1-2 weeks as this may provoke a nosebleed. Stay off work/school and away from groups of people for two weeks to prevent catching a cold. This could result in an infection. Maintain regular exercise as soon as you are able to.

Is a follow up appointment required?
A follow up appointment may be required within a few weeks of the operation to check how it is healing.  If one hasn’t been sent to you with a copy of your letter from the consultant, please contact the office

Question 14

Tonsillectomy (removal of tonsils)

Accepted Answer

A tonsillectomy is a procedure carried out under general anaesthetic
What is a tonsillectomy?
A tonsillectomy is an operation to remove the tonsils which are the lumps at the back of the mouth. Most common indication for tonsillectomy is recurrent tonsillitis, an illness causing pain, fever and difficulty swallowing. Tonsillitis usually gets better within 7-10 days. Antibiotics may help if the tonsillitis is caused by a bacterial infection but it is often caused by a virus and antibiotics do not help. The operation to prevent tonsillitis does not prevent all sore throats. Other indications for a tonsillectomy include snoring and sleep problems, or if the tonsils appear abnormal.

Who does the operation?
All of our consultants are able to carry out tonsillectomies. They take place under general anaesthetic and the operation takes about an hour.

Before the Operation
You can help to ensure success of your operation and avoid complications by following a few simple steps.  Stop smoking (if you do) at least 4 weeks prior to the procedure.   Maintain a healthy weight and taking regular exercise.

The Operation
The operation takes place as a day-case and usually occurs in the morning. Before the operation is booked, we must check that you live within 30 minutes’ drive of an A&E department due to the risk of bleeding following the operation. If you live further away, you may be required to spend the night in hospital. You must be accompanied home in a car or taxi and a responsible adult must stay with you for 24 hours.

A tonsillectomy can take place in a number of different ways which your consultant will discuss with you. These include:
 • Cold dissection technique which uses a steel instrument to remove the tonsil.
 • Diathermy technique which involves using heat to remove and cauterise tissue.

After the operation
For the first 24 hours after a general anesthetic, you should not drive, sign any legal documents, operate machinery or do any potentially dangerous activities (including cooking). Alcohol should also be avoided for 24 hours. After the procedure you can expect to be in some pain, which the nursing staff will give you medication for. The pain can last for up to two weeks and can worsen on day 4-5, particularly in the mornings. If you eat and drink normally, this will ease the pain and speed up the healing process, even though it may be difficult. It keeps the muscles at the back of your throat moving and if the muscles seize up the pain will get worse. Stay off work/school and away from groups of people for at least one week to prevent throat infections whilst your throat is healing. Maintain regular exercise as soon as you are able to.

Is a follow up appointment required?
A follow up appointment is sometimes required after the operation.

Why do a tonsillectomy?

Most commonly we recommend this operation for recurrent sore throats.  This is when we think the sore throat episodes are related to recurrent tonsillitis.  If you have more than seven episodes in the last 12 months or more than five episodes in each of the preceding two years, or three or more in each of the preceding three years, then you may well benefit from having your tonsils removed.  If these episodes are significant and related to your tonsils, then there is high quality medical evident to suggest your quality of life will be improved by having your tonsils removed.

There are other reasons why you may benefit from a tonsillectomy such as bad breath, tonsil stones and for a diagnosis of an enlarged tonsil.

Tonsil surgery may also be considered as part of our approach to snoring surgery if appropriate.

Less commonly, tonsillectomy can be recommended as part of your overall treatment for other conditions such as Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis Syndrome.

Surgical Procedures