Healthcare Innovations • Sunday 26 July 2020
Specialist clinics • 47
Stay as safe as possible with private ENT consultations and sleep studies
During these challenging and difficult times, there’s a lot of anxiety surrounding safe and secure environments for medical consultations and assessments
Professor Bhik Kotecha is available for private consultations at the new West- land Medical Centre in Hornchurch, Essex, as well as at his consulting rooms at 17 Harley Street in London. Great care has been taken in imple-
menting all the relevant safety meas- ures, including adequate PPEs. Te facilities provided include consulta- tions for all disorders in relation to ear, nose and throat problems and sleep-related breathing disorders such as snoring and sleep apnoea. All necessary precautions have been
taken in order to provide endoscopic evaluation of nose and throat, micro- suction for wax removal and provision of ambulatory home sleep study. Te ambulatory home sleep studies
are particularly useful for screening patients who have problems with snoring and may be suffering from obstructive sleep apnoea. Te patient would be offered a comprehensive upper airway evaluation with a fibre- optic endoscope after taking a full clinical history and offered ambu- latory home sleep study equipment,
which can even be provided on the same day. Snoring is an extremely common
problem affecting both males and females, and up to 40% of the popula- tion. It can disrupt the quality of sleep of both the patient and their partner. About 10% of these patients may have a condition known as obstruc- tive sleep apnoea, whereby they have breath-holding episodes in their sleep, which can cause oxygen deprivation. Tis can result in poor sleep, morning headaches and daytime sleepiness. If sleep apnoea is left untreated then the chances of developing other disor- ders, such as ischaemic heart disease, diabetes, memory problems, dementia and stroke can increase. In addition to having higher risks of developing the above problems, intrusive snoring can play a detrimental role in relation- ships and many of these patients are experiencing marital disharmony. Snoring occurs as a result of a
turbulent airflow and can affect both children and adults. Te commonest cause in children is due to enlarged tonsils and adenoids and there’s plethora of evidence in medical litera- ture to demonstrate that the removal of tonsils and adenoids in these chil- dren dramatically improves their quality of sleep — as well as their cognitive function. In adults, the problem could be
ENDOSCOPIC EVALUATION WITH FIBRE-OPTIC ENDOSCOPE
due to an obstruction in the nose as a result of a deviated nasal septum or nasal polyps, but more commonly it’s the redundant, floppy soft palate in the throat that may be the culprit. Certain lifestyle factors such as increased alcohol intake or obesity could aggravate the symptoms.
NASAL CAVITY BEFORE SURGERY
NASAL CAVITY AFTER RADIOFREQUENCY SURGERY AMBULATORY HOME SLEEP STUDY EQUIPMENT Evaluation of these patients would
include full assessment of the nose and throat with an endoscope and a sleep study (which can be performed in the home setting). Treatment options include oral
appliances such as mandibular advancement device or nasal CPAP (continuous positive airway pressure). Medical treatment with nasal sprays and antihistamines may help patients with allergic rhinitis by improving breathing through the nose and thus improve snoring. Patient compliance with medication and appliances can be poor and therefore surgery in care- fully selected patients could offer a good alternative. Minimally invasive surgical procedures using radiofre- quency thermal ablation for nasal congestion can be performed under
Professor Bhik Kotecha MBBCh.,
M.Phil., FRCS consultant ENT surgeon.
snoringmanagement.com Westland Medical Centre, Westland Avenue, Hornchurch,Essex RM11 3SD T: 01708 205149
17 Harley Street, London T: 01277 695653 Nuffield Hospital Brentwood, Essex T: 01277 695695 Spire Hartswood Hospital, Brentwood, Essex T: 01277 232525
local anaesthesia in the clinic and good improvement in nasal breathing can be attained.
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