General ENT Surgeries

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Click here for a General Preoperative Instruction Sheet

Click here for information on Herbal Medications, Nutritional Supplements, and Medications That May Inhibit Ability to Clot Blood

Skin Cancer Surgery with Reconstruction

The most common procedure used to treat skin cancer in any of its various forms is surgery. Skin cancer surgery generally consists of the removal of the cancerous lesion, and an examination of the surrounding tissue to ensure that the cancer was removed entirely. The site is then repaired by standard stitches.

For cases with large affected areas, your doctor may take skin from a another site and apply it to the wound in order to promote healing. This is called skin grafting.

If the cancer is more advanced, alternate treatment options may be suggested, such as chemotherapy and radiation therapy.

Click here for a tip sheet for patients having Skin Surgery

Click here for general Postoperative instructions on Plastic Surgery of the skin

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Uvulopalatopharyngoplasty (UPPP)

A uvulopalatopharyngoplasty is a procedure used to tighten the soft palate and remove the uvula. The tonsils must be removed for this procedure. As a result, the procedure will be somewhat shorter if the patient has had a previous tonsillectomy. Patients are sedated and are "put to sleep" for the duration of the procedure.

The surgery consists of pulling back the uvula in order to identify a wrinkle line. The line is used to locate the mucous membrane that will be removed. The uvula is then removed as well. Your doctor will then sew the margins of the incisions together using a dissolvable suture called Monocryl. The suture takes 1-3 weeks to dissolve completely.

Click here for Postoperative instructions on uvulopalatopharyngoplasty.

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Tympanoplasty

Tympanoplasty is an elective, ambulatory microsurgical procedure performed to close a perforation in the tympanic membrane (ear drum) when non-surgical methods are ineffective.  Perforations may be caused by infections, injuries, flying with a cold and cotton swabs; symptoms include drainage or bloody discharge from the ear, hearing loss, dizziness when water enters the ear and frequent ear infections. 

Surgery may not be recommended for very young children or patients with chronic sinus or nasal problems such as severe allergies, acute infection in the sinuses or nose, or poorly controlled diabetes or heart disease.

Tympanoplasty can require either local or general anesthesia and may be performed in conjunction with mastoidectomy if infection is present there.  An incision is made either in the ear canal or behind the ear, depending on the size and depth of the perforation.  The damaged ear drum is lifted and the perforation located; skin from behind the ear or from the ear lobe (tragus) is removed, thinned, dried and applied to the ear drum. 

The bones of the middle ear are examined for damage.  In a supplemental procedure known as ossicular reconstruction, the damaged or eroded bones may be bridged with a bone or cartilage graft, re-shaped using an operating microscope, or strengthened by the implantation of an artificial bone strut made of hydroxy apatite to reduce risk of rejection.  Another, rarer ossicular reconstruction procedure called malleus fixation involves the reshaping of the malleus bone (“hammer”).

The incision is then closed.  Stitches beneath the skin will be required if the ear was opened.

Patients often return home in about three hours after tympanoplasty or the next morning if ossicular reconstruction is performed, and may return to work within the week.  Swimming and showering without ear plugs may be resumed in three to four months.  Antibiotics or Tylenol usually relieve any post-surgical pain.  The graft is checked at ten days and again at three weeks, with a hearing test performed after four to six weeks.  The perforation heals properly in over 90% of cases.  Failure may result from immediate infection, water getting into the ear or displacement of the graft after surgery.

Complications are uncommon but may include temporary dizziness, tinnitus, loss of taste on one side of the tongue, facial nerve injury and further hearing loss.

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