Tonsillectomy & Adenoid Surgery Specialists Sydney

Tonsil Removal in Sydney at Norwest ENT

Tonsillectomy (also known as tonsil removal) is a very commonly performed procedure in Australia. The current indications (circumstances or signs that the procedure should be performed) for tonsillectomy are as follows.

1) Recurrent tonsillitis
2) Snoring and sleep disordered breathing in children and adults
3) Chronic tonsillitis
4) Tonsillar abscess
5) Unusual appearing tonsil

About the procedure

Tonsil removal at our Sydney clinic is carried out in hospitals by expert surgeons with several years’ experience in this procedure. We minimise risk wherever possible, although this procedure inevitably comes with standard risks of complication from ENT surgery such as infection, bleeding, and breathing difficulty. You will be fully informed of these risks during your pre-surgery consultation appointment/s.

Depending on your individual circumstances and your doctor’s advice, you should be able to return to school or work within a week or two, although it may take longer to be able to eat solid food and return to normal activities. Technically, complete healing from tonsil removal can take around a year.

Dr Tobias Pincock is an expert in child and adult tonsillectomy. If you have any specific concerns or questions, he will be more than happy to address them.

Appointments

Please call (02) 8883 0744 to make an appointment for you or your child if you think they may require a tonsillectomy. For more information on tonsillectomy, please contact us.


The Blocked Ear and Cholesteatoma Talk at the National GP Conference in Sydney

Dr Nirmal Patel, Ear Surgeon, gave a talk at the National GP Conference in Sydney on the Blocked Ear and Cholesteatoma. The meeting was attended by over 6000 delegates.
Nirmal’s talk focused on the common symptom of a blocked ear and how this may represent potentially serious conditions such as cholesteatoma and acoustic tumours. A PDF summary of the talk is here:
Blocked_Ear_Cholesteatoma_Nirmal_Patel_Sydney


The Blocked Ear and Cholesteatoma Talk at the National GP Conference in Sydney

Dr Nirmal Patel, Ear Surgeon, gave a talk at the National GP Conference in Sydney on the Blocked Ear and Cholesteatoma. The meeting was attended by over 6000 delegates.

Nirmal’s talk focused on the common symptom of a blocked ear and how this may represent potentially serious conditions such as cholesteatoma and acoustic tumours. A PDF summary of the talk is here:

Blocked_Ear_Cholesteatoma_Nirmal_Patel_Sydney


Snoring in Children Affects Brain Development and Behaviour

Snoring affects 10% of the pediatric population and can be associated with obstructive sleep apnoea.  Recent work has demonstrated two significant findings in children that snore – adverse brain performance and behaviour.

Firstly, children who snore appear to have increased risk of poor neurocognitive development and performance.  Recent work by Hogan et al demonstrated reduced cerebral blood flow velocity and cognition in children who snore, which significantly improved following adenotonsillectomy [1].  This impact on brain development seems to be greatest in preschool and early school aged children, but can affect children well into adolescence.  Episodic hypoxia and sleep fragmentation that occurs with snoring and sleep disordered breathing children has a profound effect on the developing central nervous system [2].  In large metanalyses these poor cognitive outcomes seem to reverse with adenotonsillectomy in up to 90% of children.

Secondly, snoring children have demonstrable poor behaviour that is often correctable by adenotonsillectomy [3-5].  Improvements in behaviour following adenotonsillectomy are marked in the first 6 months but still present in long term follow up studies [6].  Children following adenotonsillectomy showed improvement in the behavioural assessment system for children as well as reduced inattention, depression and hyperactivity subscales following the surgery [5].  Studies of children with attention deficit hyperactivity disorder (ADHD) and snoring show that adenotonsillectomy reduces the use of methylphenidate (MPH) and may completely obviate the use of the drug, potentially “curing” the child of ADHD [7].

Certainly not all children who snore have large adenoids and tonsils that are obstructing the airway.  A small percentage of snoring children have other areas of airway obstruction such as a deviated nasal septum, large nasal turbinate, micrognathia (small mandible) and a large tongue.  Furthermore, a subset of children may suffer from hypotonia of the oropharyngeal musculature along with poor coordination that may contribute to snoring and sleep disordered breathing.  Current best practice recommends, that all children who snore continuously for more than 3 months, should be assessed by an ENT surgeon to correct this potentially significant problem.

The Norwest ENT Group surgeons, Nirmal Patel and Tobias Pincock have a particular interest in children’s ENT disorders in particular children’s snoring, ear infections and hearing loss.  The Norwest ENT group surgeons use the latest technique of coblation adenotonsillectomy, which removes the tonsils at 40 to 70 degrees, as compared to 400 degrees for convention diathermy removal.  The reduced heat dispersion of Coblation adenotonsillectomy is said to translate into less pain for the child with quicker return to eating and quicker healing times.  For more information on snoring in children please visit: http://www.norwestent.com/Tonsils_Adenoids.htm#sleep_disorder

References:

1.            Hogan, A.M., et al., Cerebral blood flow velocity and cognition in children before and after adenotonsillectomy. Pediatrics, 2008. 122(1): p. 75-82.

2.            Gozal, D., Obstructive sleep apnea in children: implications for the developing central nervous system. Semin Pediatr Neurol, 2008. 15(2): p. 100-6.

3.            Owens, J.A., Neurocognitive and behavioral impact of sleep disordered breathing in children. Pediatr Pulmonol, 2009. 44(5): p. 417-22.

4.            Ericsson, E., I. Lundeborg, and E. Hultcrantz, Child behavior and quality of life before and after tonsillotomy versus tonsillectomy. Int J Pediatr Otorhinolaryngol, 2009. 73(9): p. 1254-62.

5.            Mitchell, R.B. and J. Kelly, Behavioral changes in children with mild sleep-disordered breathing or obstructive sleep apnea after adenotonsillectomy. Laryngoscope, 2007. 117(9): p. 1685-8.

6.            Wei, J.L., et al., Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing: long-term follow-up. Arch Otolaryngol Head Neck Surg, 2009. 135(7): p. 642-6.

7.            Huang, Y.S., et al., Attention-deficit/hyperactivity disorder with obstructive sleep apnea: a treatment outcome study. Sleep Med, 2007. 8(1): p. 18-30.


High Tech Sydney University Cochlear Implant Research Facility Opens

The Northside Cochlear Implant Clinic, is a specialist adult cochlear implant clinic servicing Northern Sydney, the Northern Beaches, Northwest Sydney and greater NSW.  The Northside Hearing group prides itself on high quality outcomes.  As part of Northside’s commitment to high quality outcomes the clinic involves itself in evidence based research of cochlear implants.  The Northside Cochlear Implant Clinic in Sydney is proud to announce the opening of the Kolling Deafness Research Centre at the University of Sydney.

The Kolling Deafness Research Centre (KDRC) has a mandate to promote hearing health research and deafness alleviation.  The centre is located at the University of Sydney’s centre of research excellence the Kolling Building in the Northern school campus.  The Kolling Building is Australia’s largest and most advanced research centre located on a hospital campus. The KDRC’s research focuses on improving cochlear implant electrode insertion, to reduce damage to the inner ear.  The Centre also focuses on hearing alleviation by providing funds for under privileged patients requiring cochlear implants and NSW aboriginal ear health promotion.

The Kolling Deafness Research Centre has deductible gift recipient charitable status and accepts tax deductible donations over $2.

For more information on how to donate, sponsor or get involved with the centre please follow the link and donate to “Sydney Deafness Research Centre”:

http://www.kolling.com.au/forms/Donation_Form_Kolling_Deafness_Research.pdf


Northside Cochlear Implant Clinic in Sydney offers a Brand New Cochlear Implant (Cochlear Nucleus 5)

The Cochlear Nucleus 5 cochlear implant was launched at the Sydney Powerhouse museum in November 2009.  The newest version of the Cochlear corporation hearing implant brings to the market the world’s thinnest and strongest bionic ear.

The cochlear Nucleus 5 is made of titanium and is significantly lighter than previous models, providing increased comfort for the end user.  Other Cochlear Nucleus 5 features include water resistance (allowing the implant to still work when caught in the rain) and two microphone adaptability ( for improved speech understanding in noise).

The stand out feature for elderly patients (who now form the bulk of cochlear implant recipients) is a remote control device.  The remote control device allows adjustment of critical cochlear nucleus 5 features such as volume, acoustic environment changes and adjustment of bilateral implants with the one device.

The cochlear implant (or bionic ear) is now a well established technology for adult deafness.  When patients are not hearing well with their regular super powered hearing aids, then they may be good candidates for a cochlear implant.  Our clinic will be implanting our first patient with the new Cochlear 5 on November 19th 2009.  For further information on the cochlear implant process visit the Northside Cochlear Implant Clinic, in Sydney at:


Dr Nirmal Patel wins prestigious award for Cochlear Implant Research in Sydney

Dr Nirmal Patel recently won the prestigious Kolling Foundation’s Hearing Impairment Grant for $150 000 in funding.  The funds will be used at the new Kolling Deafness Research Centre, at the University of Sydney, Northern Clinical school campus at the Kolling Building (http://www.kolling.usyd.edu.au/).  The research involves studying better ways of atraumatically inserting cochlear implant electrodes at the University of Sydney main campus and Kolling building.  Dr Nirmal Patel will be supervising two full time Master of Surgery students in understanding better ways of inserting new cochlear implant electrodes.  The Sydney Deafness Research Centre also studies better ways to deliver hearing health care to our NSW aboriginal population.

All donations of $2 and above are fully tax deductible as the research centre has full DGR (deductible gift recipient status).  To donate to the Kolling Deafness Research Centre please follow the link below:

Sydney University Cochlear Implant Research (KDRC)-nirmal-patel


Northside Cochlear Implant Clinic in Sydney offers relief for Single Sided Deafness

Single sided deafness occurs for a number of reasons including trauma, viral infections, artery blockage and unknown causes. Approximately 1 in 10 000 people will have a sudden deafness that may leave them with a permanent deafness on one side.  Although a person can still function reasonably with single sided deafness, there is good research evidence that it may impact dramatically on social and work interaction.  Furthermore, single sided deafness can leave a patient feeling very isolated in social situations, leading to depression.

The two problems that most trouble a person with single sided deafness are loss of sound directionality (that is working out where sound comes from) and understanding of speech in background noise.  The Cochlear Baha Bone Anchour Hearing implant often provides an excellent solution to these problems.  The Cochlear Baha is a titanium implant that is inserted on to the deaf side and sends sound via bone conduction (vibrations through the skull) to the good ear.  The cochlear baha has a very high sound fidelity, in fact one of our patients is in the sydney symphony orchestra and she says it sounds better than her normal ear!  The Cochlear Baha is said to improve speech understanding in noise by 50%, compared to the unaided situation.

A new Cochlear Baha hearing implant the Cochlear Baha BP100 has just been launched.  The device is significantly smaller, easier to use and provides superb connectivity to other devices such as your ipod, TV and computer.  The Cochlear Baha BP 100 is said to improve speech understanding in noise by 25% more than the older bone anchoured devices.  Norwest ENT Group offers the cochlear baha device through either Norwest Hearing (Bella Vista) or the Northside Cochlear Implant Clinic, based in the lower north shore of Sydney.  For more information on our Cochlear Baha implant services, please visit:

http://www.norwestent.com/BAHA.htm

http://www.northsidehearing.com.au/


Sydney Tonsillectomy & Adenoid Surgery Specialists

Tonsillectomy is a very commonly performed procedure in Australia. The current indications for tonsillectomy are as follows.

1) Recurrent tonsillitis

2) Snoring and sleep disordered breathing in children and adults

3) Chronic tonsillitis

4) Tonsillar abscess

5) Unusual appearing tonsil

Dr Nirmal Patel and Dr Tobias Pincock are experts in children and adult tonsillectomy. Please call 02 8883 0744 to make an appointment for you or your child if you think they may require a tonsillectomy.  For more information on tonsillectomy in Sydney visit:

http://www.norwestent.com/Tonsils_Adenoids.htm

http://www.norwestent.com/pdf/Tonsils_Norwest_ENT_Group.pdf


Botox now offered at the Norwest ENT Group

Botox is the name for botulinum toxin A, which is a purified neurotoxin that is produced naturally by the bacterium clostridium. It paralyses muscles temporarily.

Dynamic wrinkles that are caused by repetitive muscle contraction can be treated very effectively by botox

Botox has an extremely good safety profile and has been used for many years now for both cosmetic and non-cosmetic uses.

Please click the link here to learn more about botox, or dermal fillers such as juvederm, juvederm ultra, juvederm ultra plus or the new product voluma http://www.sydneyfacialplastics.com.au/injectables.htm


Dr Tobias Pincock presents at the AAFPS meeting in Queenstown

Dr Pincock recently travelled to Queenstown in New Zealand to talk to his colleagues about the latest techniques in facial plastic surgery. The meeting was the winter meeting of the Australasian Academy of Facial Plastic Surgery www.aafps.com.au

Dr Pincock spoke about the latest techniques in eyelift (blepharoplasty) and facial fat injections (lipostructures).

To make an appointment about any of these procedures please call 02 88833699 or visit www.drpincock.com


Norwest Allergy Clinic Opens

Norwest ENT Group has commenced their allergy clinic. We are testing for environmental allergies that lead to allergic rhinitis and rhinosinusitis.

We also offer oral desensitisation (immunotherapy) for appropriate patients.  This is where a small amount of allergen is placed under the tongue in increasing doses over months to years, so that your body develops a resistance to the allergen and you lose the allergic symptoms.

Please call 02 88830744 to make an appointment for allergy testing and densensitisation in Bella Vista.


Northside Cochlear Implant Clinic in Sydney offers help for high pitch hearing loss

High frequency hearing loss (Ski slope hearing loss) is a condition that usually affects patients over the age of 50. The condition derives its name from the appearance of the audiogram, looking like a ski slope (that is the hearing in the low frequencies is reasonable and rapidly drops off in the high frequencies). High frequency hearing loss is characterised by a loss of clarity in understanding speech in noise situations (for example a crowded restaurant). Typically patients with this type of hearing loss will require open fit hearing aids, a new generation of hearing aid that solves the problems of whistling and chewing noise that used to affect older type hearing aids.

In a small percentage of hearing aid users with high frequency “ski slope” hearing loss the hearing aids are not enough. These patients still struggle with hearing in noisy situations. When a patient is hearing only 40% of words correct in the bad ear and 70% in the good ear they may be a candidate for a brand new type of hearing implant called the Cochlear Hybrid device.

The Cochlear Hybrid has recently been launched and provides a hearing aid for the lower frequencies and a bionic ear for the higher frequencies, all in the one unit. The device is inserted much like a conventional cochlear implant however the external device has a hearing aid connected to it. The cochlear hybrid provides electric and acoustic stimulation to bring a new richness of sound to patients with “ski slope” hearing loss.

To learn more about cochlear implants and to discover simply better hearing, please visit the Northside Cochlear Implant clinic, a specialist adult cochlear implant clinic based in Sydney at:
http://www.northsidehearing.com.au/


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No Gap Cochlear Implants

Recent improvements in hearing implant technology have relaxed the indicators for hearing implant candidacy.  Most cochlear implant recipients are now adults whose hearing aids are not working well for them.

When your patient’s hearing aids are only allowing them to hear 70% of words in their better hearing ear and 40% of words in their worse hearing ear, then patients could be considered candidates for cochlear implants.

Our Norwest ENT Group ear surgeon, Dr Nirmal Patel is now the surgical director at the Northside Cochlear Implant Clinic, which is a specialist adult cochlear implant clinic servicing Northern Sydney, Northern Beaches, Northwest Sydney and greater NSW.

For patients that have appropriate private health insurance, once the Northside Cochlear Implant Clinic team are engaged for the implant service; the implant, surgery and one year of aftercare are completely covered by Medicare and health funds.

Sometimes, if your patient’s hearing aids are not working well and they are looking for an upgrade, it may be far more inexpensive for them to consider cochlear implantation than a new set of hearing aids!

For more information on the Northside Cochlear Implant Clinic, in Sydney and its cochlear implant services please visit:

http://www.northsidehearing.com.au/index.html