Foreign body Oesophagus

Foreign body  Oesophagus
This is a Meat Bone which was stuck in the food pipe of an elderly gentleman. Such Foreign bodies are common in the elderly as their chweing and swallowing ability makes them more suscepitble to such accidenst. This elderly gentleman came to Bangalore from kerala where he had been advised a neck exploration and removal of the Foreign body . Fortunatley we were able to remove the Foreign body using endoscopic methods.
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Foreign body Bronchus

Foreign Body Bronchus
Foreign body bronchus
This is another Foreign body from the bronchus. This was a young lady from Maldives who accidentally inhaled this hairpin.This was an especially dangerous Foreign body !
Dr Sonia S V
ENT Surgeon , Bangalore

Ask ENT Doctor

You may ask questions or guidance to ENT Surgeon here by writing a comment below this post.Please mention your age and details of the problem .
I would be glad to help you through this blog if i can.However it will not serve as a substitute for a direct consultation with an ENT Surgeon as in ENT as in any other field of medicine physical examination and direct one  to one interaction is essential in arriving at a proper diagnosis and successful treatment.The purpose of this ASK a Question to ENT Doctor is to guide you .
Please note : We do not encourage telephonic consultation .
In majority of the cases I would urge you to Visit an ENT specialist in your locality for treatment
Click here If you wish to consult ENT Surgeon Dr Sonia S V

Throat Cancer

Throat Cancer
Throat cancer
The photograph is a laryngo-pharyngoscopy picture of a Pharyngeal cancer [ marked in red arrows].The white U shaped structure is the epiglottis .
What are the symptoms of Throat cancer?
Throat pain
Difficulty swallowing
Pain on swallowing
Blood in spit or sputum
Lump feeling in the throat
Breathing difficulty
Voice change
Unexplained One sided Ear pain
Swelling in the neck- this is due to involvement of Lymph nodes and hence any swelling in the neck in an adult needs to be promptly evaluated
How is throat cancer Diagnosed?
Diagnosis of throat cancer involves a thorough head and neck evaluation including a laryngoscopy or Laryngopharyngoscopy.A Laryngopharyngoscopy such as shown below shows the extent of the tumour and helps to plan the treatment.Here the tumour is extending from the area at the sides and back of the mouth down to the sides of the voice-box.
Pharynx cancer
If your ENT Surgeon suspects a cancer he or she will advise a biopsy.
What is a Biopsy and Why is a Biopsy performed?
A biopsy is a procedure to remove a small piece of tissue for examination under the microscope.It is performed to rule out the presence of cancer and also to know the type of cancer as further treatment will depend on the exact type of cancer.A biopsy from the suspected area can many times be done in a well equipped ENT Surgeon's Clinic itself .In some situations for a biopsy and further detailed Endoscopic examination may be required under General anesthesia in the operation theater.
The most common type of cancer in the pharynx is called a Squamous Cell Carcinoma.Other less common varieties include salivary gland cacners and lymphomas.
What investigations may be required in a patient with Throat cancer?
Biopsy- to prove presence of cancer and know the type of cancer
Xrays -of Chest,Neck,Panorax - depending on the Individual case
CT scans- special Contrast enhanced CT scans are required for cancer spread evaluation
MRI scan- In certain situations an MRI provides additional information required for treatment decisions
PET scan-Is a sophisticated New generation scan to detect cancer recurrence,cancer spread
Not all patients require all these tests.Your ENT Surgeon will discuss with you what is best for you.
What is the treatment of Throat cancer?
Treatment of throat cancer depends on several factors such as

  • Age and General Condition of the Patient
  • Type of Tumour
  • Extent of tumour
  • Spread of tumour to other parts of Body
  • Stage of the Cancer - the stage of cancer depends on the findings of clinical examination,Endoscopy and Radiological Investigations.
Treatment may be
  • Surgery
  • Surgery followed by Radiotherapy
  • LASER Surgery
  • Radiotherapy- External or Internal [Brachytherapy]
  • Chemotherapy
  • CT-RT is combined Chemotherapy- Radiotherapy
    An experienced  ENT Head &Neck Surgeon will discuss with you the best options in an individual case and help you make a choice regarding the treatment.

    Dr Sonia Suprabha Venugopal
    Consultant ENT Surgeon Head & Neck Specialist,Bangalore
    Dr Sonia & Dr Prateek's ENT Head Neck Center,Sahakaranagar, Bangalore

    Foreign Body Airways -Foreign body Bronchus

    Foreign Bodies in the airways are dangerous .
    Foreign Body Bronchus, Xray Chest
    A Foreign body  can obstruct the air passages and even produce instant death if large enough to completely obstruct the air passages.A Foreign body  which is aspirated may lodge in the larynx, trachea or pass lower down and obstruct the bronchi.A vegetable Foreign body  such as a groundnut can slowly swell over time and produce inflammation,ulceration and increasing airway obstruction.
    In children the common foreign bodies aspirated are
    toy parts
    Small children are especially vulnerable to Foreign body aspiration.The other category is the elderly.In the elderly,
    Loose tooth,dentures,poorly chewed food particles can all be aspirated.
    How do you suspect a foreign body aspiration?
    A sudden bout of coughing is an important clue. Breathing difficulty,Noisy breathing[termed Stridor or wheeze],Cyanosis[Bluish discoloration due to lack of Oxygen] can all occur slowly or suddenly.A neglected Foreign body  can present disguised as pneumonia .Pediatricians and general physicians should always keep a possibility of a Foreign body  in children especially with sudden coughing and even those with atypical symptoms.
    What is to be done if there is suspicion of Foreign body  aspiration?
    Immediately visit your Pediatrician or ENT Specialist Bangalore as early diagnosis and Removal as soon as possible is imperative to prevent complications and even death.
    How is a Foreign body  Bronchus diagnosed?
    Xray:-If the Foreign body  is radio-opaque it can be seen on the Xray.Sometimes if the Foreign body  has been present for some time the complications due to the Foreign body  will also be seen on the Xray of the chest such as Infection,Lung collapse etc.
    Laryngoscopy and Bronchoscopy: This is both diagnostic as well as therapeutic.Bronchoscopy involves direct visualisationof the air passages trachea and bronchi.
    How is the Foreign body  removed?
    In majority of the cases a Foreign body  can be removed by an ENT Surgeon using a Bronchoscope or even a laryngoscope if it is situated in the upper air passages.In some cases a Thoracotomy may be required.
    The photograph below is the Xray of an elderly gentleman who had aspirated a loose tooth.
    Closeup of the Xray Chest shows the tooth in the Right Bronchus
    The photograph below shows the tooth which was the aspirated Foreign body  in this gentleman.It was successfully removed using a Bronchoscope by Dr Prateek Nayak .
    Foreign Body Bronchus -Tooth
    Prevention of Foreign body  Aspiration

    • DO NOT feed young children Peanuts[groundnuts],small round candies,sausages.
    • DO NOT let small children play with coins,buttons,small objects
    • Scrutinize toys and children's dresses for possible small parts which they can pull off and put in their mouths or nose.
    • Always Impress on your young child to never put objects into the nose or ears.

    Dr Sonia Suprabha Venugopal
    Consultant ENT Surgeon Head & Neck Specialist,Bangalore 
    Dr Sonia & Dr Prateek's ENT Head Neck Center,Sahakaranagar, Bangalore

    LASER Tracheal Surgery

    LASER has considerable advantages in many surgeries in ENT.This is the case of a young man who was involved in a serious road traffic accident sustaining severe injuries .He was intubated in the emergency and required ICU stay and several days stay in the hospital.Even after recovering from his other injuries his breathing was affected.He had noisy breathing and poor exercise tolerance.A laryngoscopic examination revealed a narrowing of his airways just below his vocal cords-Medically termed as a Subglottic Stenosis.
    Subglottic stenosis
    Shown above is the Laryngoscopy picture of the airway narrowing.
    The Xray of his neck showed the band of tissue causing the Subglottic stenosis.
    LASER excision of the Subglottic stenosis was performed recreating a wide airway enabling him to breathe well.
    Tracheoscopy,LASER Laryngotracheal Surgery

    Otomycosis Ear- Fungus in the Ear

    What is Otomycosis?
    Otomycosis means fungal infection in the ear.
    Otomycosis,Fungal Infection Ear

    Ear Drum Perforation and Fungal Ear Infection in Ear canal

    The picture above shows fungal infection of the ear canal.The ear drum of this particular patient is perforated and the black fungal spores can be seen in the floor of the ear canal adjacent to the perforated ear drum.
    What part of the ear does the fungus affect?
    Otomycosis commonly affects the outer ear canal.In case of an operated ear fungal infection can also occur in the cavity as in the case of a post-op mastoidectomy cavity.In case of an ear perforation the exposed middle ear can also become infected with the fungus.
    When and How does a fungal infection occur in the ear?
    It commonly occurs following water entry hence common in certain key situations such as
    Summer- more humid climate, more swimming ,more frequent showers
    Swimming in contaminated waters is one of the most common ways fungal infection occurs in the ear and for this reason  we see the maximum number of cases in summer months when swimming activities peak.
    Tropical Climate - hot humid climate encourages fungal growth.
    Otomycosis can occur following insertion of contaminated objects such as ear buds,pins etc into the ear canal in an attempt to" clean" the ear.
    Injury to the ear canal by any other means can also predispose to Fungal ear infections.

    What are the symptoms of Fungal Infection of the ear?
    Itching Ears - one of the most common symptoms of fungal infection in the ears is itching.
    Ear Discomfort
    Ear pain
    Ear discharge
    Ear fullness
    Ear blockage and Hearing loss
    Dizziness can occasional occur
    What is the management of Fungal Ear Infections?
    The treatment of the infection aims to completely clear the fungal infection.
    Topical anti-fungal ear drops are given.
    Suction cleaning of the fungal infection may be done under microscope by your ENT Surgeon .
    In cases of severe infection systemic anti-fungals may be required.
    Antihistamines are used to control the itching and Analgesics and anti-inflammatory medications are prescribed if there is pain.
    Super-added bacterial ear infection may need antibiotics to control the infection.
    Avoid water entry to ensure quicker healing and preventing reinfection
    What are the preventive measures for Otomycosis of the ear?
    DO NOT use ear buds to clean the ears.
    DO NOT insert pins, pen nibs or other objects into the ear canals.
    Avoid swimming in contaminated waters.

    Dr Sonia Suprabha Venugopal
    Consultant ENT Surgeon Head & Neck Specialist,Bangalore
    Dr Sonia & Dr Prateek's ENT Head Neck Center,Sahakaranagar, Bangalore

    Preauricular Pit or Sinus

    Preauricular Sinus
    Preauricular pits or sinuses are present in front of the ear. they are small skin lined tracks that lead from the skin surface to deep within the tissues in front of the ear.Their track course can go into the cartilage or end in the skin tissue.
    Why does a preauricular sinus or pit occur?
    A preauricular sinus or preauricular pit occurs as a result of faulty fusion in the development of the ear while the child is in the womb so it is a congenital condition present from birth.
    What does a preauricular sinus signify?
    The presence of a preauricular sinus may be associated with
    • Other abnormalities of the Outer ear: Helix abnormalities, Asymmetry, Posterior Angulation, Small size, Absent Tragus, and Narrow external auditory meatus.
    • Syndromes-Branchiootorenal syndrome, Mandibulofacial dysostosis, Beckwith-Wiedemann syndrome [Pediatricians and ENT Surgeons should always rule out syndromes in a child with preauricular pits]
    Does a preauricular pit close by itself?
    No a preauricular sinus or pit does not close by itself.
    What complications can happen in a child or adult with a preauricular sinus?
    A preauricular sinus is lined by epithelium and can get blocked and infected at any time.Many persons may not have infection.But if infected it can lead to abscess formation and cellulitis.A pit can also accumulate material and become a cyst which is a swelling with a propensity to get infected.Hence Doctors advise to remove a preauricular sinus.
    What are the signs of an infected Preauricular sinus or pit?
    Parents of a child with a preauricular sinus need to look out for infection of the sinus tract
    • The preauricular pit can discharge yellowish pus
    • The area around the preauricular pit can become red
    • The preauricular pit and surroundings can become swollen
    • The area in front of the ear can become tender to touch
    • Reddish or Brownish tissue growth[granulation tissue] at the mouth of the preauricular sinus
    • Fever can occur
    The Cardinal Signs of Infected Preauricular Sinus are
    • Pain
    • Swelling
    • Redness
    • Pus Discharge
    What is the treatment of a Preauricular Sinus or Pit?
    • Rule out other Congenital abnormalities [syndromes] in children
    • Surgical Excision is the management of Choice
    • Infected Preauricular Sinuses are treated with antibiotics before surgical removal
    What type of Surgery is required to remove a Preauricular Sinus?
    Preauricular Sinus Excision Under Local Anesthesia

    In adults the surgical excision of a preauricular sinus can be performed under local anesthesia.The pictures shown below is that of a preauricular sinus surgical excision performed under local anesthesia [ by numbing the area].The duration of the procedure varies from 15 mins to 1 hour depending on the tract length and complexity.On an average it will take about 30 minutes.In young children it is done under general anesthesia.
    Will rest be required after the procedure to remove the preauricular sinus?
    No Generally ,no hospital stay is required and the person can resume normal activities.Care of the operated area involves keeping it dry and Dr Sonia or Dr Prateek Nayak will give you detailed instruction on the care of the area.

    Preauricular Sinus Removal

    Excised Preauricular Sinus Tract

    Dr Prateek Nayak
    Consultant ENT Surgeon Head & Neck Specialist,Bangalore
    Dr Sonia & Dr Prateek's ENT Head Neck Center,Sahakaranagar, Bangalore

    Ear Surgery For Hearing loss in Bangalore-Cochlear Implants-

    The cochlear implant is a device which is surgically fitted into the ear of a child or adult with severe Hearing loss .It can give tremendous benefit to a person with Hearing loss who has not benefitted from the conventional hearing aids.
    How does a Cochlear Implant work?
    The animation depicts the hearing mechanism and the action of a cochlear implant to directly stimulate the cochlear cells for a hearing experience.
    How is a cochlear Implant done?
    A cochlear implantation is a surgical procedure performed by trained ENT Surgeons using a microscope and micro-drill systems. It is a very precise high end surgery. ENT Surgeons have to be specially trained to perform a Cochlear Implantation. It is a procedure which is best done under general anaesthesia. Both children and adults with severe Hearing loss all over the world have benefited tremendously from this srgery. The photograph below is of one of our own patients a boy with severe Hearing loss who did not benefit from a hearing aid.In a country such as ours where the health awareness is a bit suboptimal as well as easy access to the best medical facilities often difficult Hearing loss in children is detected late and treated late.

    Dr Sonia Suprabha Venugopal
    Consultant ENT Surgeon Head & Neck Specialist,Bangalore
    Dr Sonia & Dr Prateek's ENT Head Neck Center,Sahakaranagar, Bangalore

    How Do we Smell- ENT Surgeon Bangalore

    How do we taste?
    How do we smell?
    Both are interlinked!
    Dr Sonia Suprabha Venugopal
    Consultant ENT Surgeon Head & Neck Specialist,Bangalore
    Dr Sonia & Dr Prateek's ENT Head Neck Center,Sahakaranagar, Bangalore
    Nova Medical Center,Sadashiv Nagar, Bangalore


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