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WHAT DO WE DO


MEDICAL EXAMINATION OF EAR

SURVEYES
In ENT examination of ear, nose, and throat is always complete, and it’s not  separating due to many conditions and diseases which manifest in all these organs. However, to illustrate it better now, we separate them.
When examining the ear, we use following methods.

mikroskopija uha-Standard-otoscopy, which is performed by using funnels and frontal lighting and mirrors is now considered classical method of ear examination, which is slowly taking place of modern methods.

-Elektroscopy that performs with various types of electrootoscops devices with magnifying glass and its own light source and which is particularly suitable for orientational examination but also for examination of children as well as defining some specific conditions and diseases of the ear. 

-Pneumatic otoscopy by Siegel. Excerpts with the original Siegel otoscope which registers the movements of the eardrum. It belongs to the classical methods of investigation

-Otomicroscopy is the best method found for examination of ear with the help of a microscope so it gives opportunity for appropriate intervention in the same procedure with the survey by controlling the color change of light to work with the laser. In modern otorhinolaryngology there is no quality review of your ear without this method.

-Fiberoptical-otoscopy as a complementary and optional method for diagnosis, but it helps in some states where the ear is needed view from a certain angle. 

-Acumetry as a method of testing hearing using the sound forks is a classic method that helps in some cases to resolve some diagnostic dilemmas.

audiometrija-Audiometry as a must-classical method of registering the threshold of hearing is performed by  contemporary digitized audiometer in a quiet room or with isolated-antifonic headphones. It also provides the ability to record mechanical and electronic, ie nervous hearing disorder.

-Timpanometry as an important complementary method for registering the flow of air in the ear and middle ear function which is very important in children's diseases of the ear. The appliance monitors the state of pressure in the middle ear and the auditive tube function and the acoustic reflex (IPSI and contralateral) which are specific tests for facial nerve function.

-Vestibulometry-testing method is the center of balance, which is implemented in several ways. We use the calorisation procedure using water- Fitzgerald-Hallpke's method. With varioterm apparatus and with the help of Frentzelovih spectacles and in the horizontal supine position of,the patient, it takes 30 to 40 minutes. During the test, is not required any interactive relationship from patient and no special preparation is necessary for it.

-Aspiration-tualet of  ear is performed under the control of the microscope and with aspirational  pump with aspiration canals. In contemporary Otology  it’s indispensable method of preparation of ear for examination that may follow a diagnostic so as therapeutic procedures.

-Polypectomy from the ear is small interventions that can continue with the histological analysis of the material and if it is judged that it’s necessary . Performed in otomicroscopy with or without local anesthesia. 

-Removal of foreign bodies from the ear with or without anesthesia is also performed in otomicroscopy. The same can be done using special instruments or with flushing ...  Drug-application in the ear as a method of placing medicinal liquids, powders, creams are also conducted more frequently in otomicroscopy. 

slusni aparati-Determination of hearing aids means the process of determining the threshold of hearing in a patient on the basis on which to determine which device is best suited for this particular case. The process is computer-programmed into the modern NOAH program and with the help of HI PRO BOX digital test equipment provides high accuracy in this process. 

Paracentesis of the tympanic membrane with or without insertion of ventilation tubes is performed under local anesthesia and under the microscope and in some cases with LASER and is denoted as Laser Asisted Myringotomy. We describe in the subtext of this chapter no. 1.

-Immediate repositioning of traumatic rupture of the eardrum, is penetration or rupture of the rupture, under local anesthesia and no incisions and the technique of otomicroscopy.If it’s done promptly, this method gives good results. With the knowledge that such violation in most cases and spontaneous good repair, however, experience has shown that one can not predict the ultimate outcome and it is24 always possible complications of this injury, and persistent bad result. So do not wait to get the process done, we do it as soon as we can, without leaving anything to chance.

-Aesthetic otoplastyor correction of protruding or protruding ear shell is performed under local anesthesia by choosing a technique that is appropriate for this case. Requires no special preparation. We do it by the author's own method and  it gives very good results… and more in the subtext below titled otoclysis no.2.

-Removal of atheromas or tumor from the earor near the the ear which is also done  appropriate to request  of situation of each patient individually whether classical or laser …

-1th Myringotomy with LASER
Myringotomy or paracentesis is technick of to macke perforation of eardrum, which is currently the case under a microscope for certain conditions and diseases of the ear. Here we talk about the latest Myringotomy that is performed by laser and local anesthesia. Anaesthetic drops are used eardrum which the patient holds in his ear just before the intervention. It's about making holes using a laser on the eardrum, which leads to the introduction of air into the middle ear and allows sometimes to ill secretions out of the ear. Also, depending on the target set can be an indication of that hole uvuditi medicated solutions.
Indications are:
-SOM Or secretory otitis media in children
-acute otitis with vestibulocochlear complications that acute otitis media, which spreads
       the organ of hearing and balance
  -akutna tube dysfunction auditive Eustahi as sharp and long lasting blockage of the ear
- Barotrauma, ie. Injury ear blast pressure or high volume
-therapy of acute hearing loss or deafness, which can occur for various reasons
             such as disorders of blood circulation, some autoimmune processes, an unknown
              or unresolved state
--therapy tinnitus or noise in the ear so that the hole give healing solutions
Therapeutic ventilation to surgical Myringotomy that only cutting the eardrum is inadequate because the incision heals within a day or two. The length of the wound can be moved by inserting a tube for ventilation, ie. Ventilation tubes, which have an average duration of four to six months. Such a method has certain disadvantages: some patients may develop chronic otorrhea; tube; since can lead to permanent perforation, timpanoskleroye and atrophic scar and even cholesteatoma.
CO2 laser is the choice of the eardrum. Other clinical lasers, such as argon, and Nd: YAG, not suitable for use on the eardrum due to the depth of penetration into the tissue.
  Laser Myringotomy with local anesthesia can result in rapid and immediate relief of symptoms of acute dysfunction auditive tube kodi barotrauma.
CO2 Laser Myringotomy is a new method in the surgical treatment of disorders of ventilation of the middle ear. This relatively painless outpatient procedure that can be performed under local anesthetic, even in children, is often replaced by the insertion of ventilation tubes, self-healing m perforation that allows adequate ventilation cavity of the ear.

-2th OTOCLYSIS or otoplasty
Operation which improves the aesthetic appearance of protruding earlobes usually called 'otokliza', however, is more appropriate to use the term 'otoplasty' particularly because it embodies the concept of modeling the earlobe which includes work on the possible variations and malformations that includes not only the form of protruding ears and often are associated ...

We're talking about the problem of protruding ears that can handle some of the anomalies of lower degree such as protruding and large uvula, cleft uvula, cleared the ridge (anthellix) ear, the presence of Darwin bumps, zavijenost top (cup) ear lesser degree, etc. ... Express anomalies of the ear such as zavijenost cupula ear greater degree (klaphor), curled and insufficient upper half of the ear, curled and / or insufficient parts of the whole ear (mycrotia) or lack of parts or even the entire ear (anotia), an operations require special procedures and they are not talking because they belong to the section of real physical anomalies.

Development and growth of the ear reaches about 80% of the total growth somewhere in the age of 6. That's why we say that the operative correction of protruding ears as possible from that age onwards anytime. Does not have a suitable age or climatic periods that are recommended and are mainly guided by the fact that the operation was done better before that favorably before the start of school for psychological reasons, and of course mostly on school holidays when school children and youth the highest demand and when free from school work. This is important because premature operations can disrupt the growth of ears and thus cause even worse disorders ...

The operation is performed under local anesthesia and in general and in younger children and those who require it, or when there is an allergy to local anesthetics. Work with local anesthesia may not last long so average that is considered beneficial to the one that lasts about 20 minutes on each side. But that does not mean that the speed may damage some of the segments of the ear ...

There are many techniques of surgery and has published more than a hundred of them but all give into three groups. This issue with the division of the group's operations and also to describe their personal techniques of this author, published in 1990 in the list of 'Symposia otorhinolaryngologica Iugoslavica' vol. 25 no. 1-3 p. Zagreb 73-80, 1990, entitled 'A stitch through the three-point-new approach in combination otoplasty' (Suture throuth three cholesterol-a new approach in combined otoplasty ') Prlja Vladimir, Department of Ear, Nose and Throat University Center, Sarajevo. I want to mention that this personal technique and the knowledge of the author, was accepted and made from several operators from the region with favorable results, according to the author records for these about 25 years ago there was witchcraft in the ears protruding position or other significant deficiencies, so that it can be words that the operation runs under 'warranty'.

Before the accession of the operation the patient and physician examination and interview obtained knowledge about the desired results and the ability to achieve them. At the same time, the doctor informs the patient with details of the preparation process and the operation itself.

-3th Aeration INSTALLATION PIPES IN THE TREATMENT OF CHILD hearing damage, ie secretory otitis
SOM, Secretory otitis media or serous otitis media is a disease of children aged adults, although sometimes I have this condition. For the occurrence of this disease blamed on inadequate function of the middle ear through the ventilation tube Eustachi which is normally in charge of air from the nose carry inside, and secretions from the ear throw out the nose. The most commonly cited the following conditions:

-Enlarged And ill third tonsil (adenoids) that their size does not allow the passage of air into the ear, and when he came down to their infectious and toxic effects caused by the islands of the channel and the poisoning of hearing. Note that in this sense palatal tonsills in the throat Him impact on this disease and are not the target of treatment, especially if it's twisted and allergies that are not recommended palatal tonsil surgery without evidence of their illness.

-Alergical Conditions in the nose is also affected by the same mechanism in the ear ventilation so that those in the population that are common and are the top causes of otitis ...

-position Auditive tube Eustachio in the skull is a common reason (and most difficult) for SOM. Specifically, in children this disadvantage a soft structure. Over time, they reinforce a position change for the better, it definitely ends with puberty. But the impact of long discharge damage your hearing because I can not wait for that time without treatment.

All the time of infection of the upper respiratory tract to be transferred to a tube and ear.
-Innatr Anomalies of the head and face (tears the throat, craniofacial ...) compromise the flow tube in almost 100% of severe cases ..
-second special rarer conditions

  It is no wonder that at the global level are maintained and entire conferences devoted to this complex subject. With us in Montenegro by the findings of our research every year around 5.ooo recruit new children all of whom are not of such a condition that it must spend more therapy. For such therapy takes about 5% of these patients, and about 1% remains as chronic ear patients in spite of all treatment methods. As there are no precise methods to determine which of these children will become chronically ill, we owe each new case thoroughly examined and treated in time. I also like the aspect of the development of the intellect with hearing loss. It is well known and the old Latin adage: Intelectum dat qui AUDITUM-intellect makes what we hear, which leads us to the realization that the builder of the intellect (not intelligence) are the most prevalent ear (no eyesight ...) and how it is known that the development of this falls in a period of 4 to 7 years, every absence of good hearing in this period was repaired later. That's why we insist on adequate therapy in this age.

Treatment of otitis media with effusion is initially always medically ie various types of antibiotic medications, nasal decongestant, thugs serves ... With this exercise is often recommended chewing and purging (by Valsalva maneuver and valves with balloons ..). In the end, when the most appropriate observation for at least 3 months and the end of therapy, without significant success, we approach the installation method of ventilation tubes that such a method still works well, and never damages under general anesthesia, and implies that the incision made ​​in the eardrum place a small tube (about 3 mm with a channel of about 1 mm), which at this point does not matter, but rather restores hearing immediately after waking up the child from the anesthesia. Length of pipe that is carrying a doctor determines that the emergence of a lasting improvement removes them. Therefore, there are some good division between permanent and temporary pipes, but chooses pipes that are not removed by the doctor but after watching the lining of the middle ear through a hole in a tube (so you need Knowledgeable installation of the pipe) and measuring tube function using tympanometry decide on the removal of the same, which if so selected may be removed without anesthesia because their structure allows it (slightly more expensive than standard tubes).

Thus, this method of installation of ventilation tubes is a sort of final "savvy" with SOM but also the most powerful at the same time harmless and without negative consequences, which we heartily recommend.

- 4th CANALOPLASTY outer ear
Canaloplasty outer ear ear is a surgical procedure that is done under general anesthesia. In fact, it is the expansion of the outer ear canal, which is popularly known by the fact that it accumulates ear resin (fat, earwax, ear wax resin, wax ...), which is often the target of cleaning or flushing the ear. Conditions to such a narrowing of the canal leading states are flourishing bones in it. This excrescence of bone occurs in two ways, and to the formation of exostoses or individual guka ie arms and the other form is hiperostosis that is as diffuse or totally bony canal narrowing. So it is always about the growing bone narrow channel to the extent that the ear can not be cleaned, leading to frequent infections and poorer hearing. The process is often mutual and surgery more often men. In the jargon, this state is referred to as 'swimmer's ear' because it is associated with states of the frequent bathing in cold water which are exposed to the swimmers. But this is not a rule but just an observation that in these situations often. Even though it is irritation or stimulation sometimes cause this condition, the real proof of that is no.
Patient after surgery remains a day in the hospital and tampons are removed gradually next ten days.

-5th Myringoplasty - eardrum surgery
Myringoplastica cum implantatio a tube aerators immediata
Operations on the middle ear cover with one hand, conservative and functional and the other radical or total procedure. These functional interventions aimed at eliminating the disease process in addition to also carry out the building and functional reconstruction of the ear and hearing what is actually the ideal process. On the other hand, radical changes have the primary goal is to eliminate the disease entirely, so that it does not save any functions or tissue so that hearing remains damaged but the patient is saved from a serious and often life-opesne disease.

Method Myringoplasty falls into functional interventions mildest degree as it relates to the reconstruction of the eardrum. To put it simply it is a procedure that closes a punctured eardrum and the result is very good. Closing the hole prevents the eardrum to infect enters from outside and also water, or anything else, and thus prevent a nasty ear infection stednjeg that I normally follow these patients. More preferably favorable as it often improves the hearing.

Preparing itself for this operation includes examination, recording the pressure in the ear, Eustachian tube and simulate plastic drum with the anticipated effects of the surgery. Considering the results of these findings is undertaken at the most favorable type of surgery.
However, if there are adverse enters the assessment of the operation with the simultaneous installation of ventilation tubes in an eardrum which is called ``MYRINGOPLASTICA CUM implantatio tubii aeratati immediate``. This is done RECOVERY poorly functioning tube Eustachio and allows the healing and recovery of the ear. Achieved anatomical reconstruction and improvement of the hearing itself and tubes ensures that the implant may be lost while the diameter of the pipe will allow water to pass in and create inflammation because the pipe diameter is stronger than tension of water. This method is imposed as a lifeline for many of those cases that are inaccessible to the success of the classic operation.

The operation is performed under general anesthesia and usually does not require a stay longer than one day.
Less extensive cases do not require external incisions tend to have a more extensive incision behind the ear and the stitches are removed 7 days after surgery ...

-6th Tympanoplasty - MIDDLE EAR surgery
This operation is a classic functional operation in the middle of his illness (otitis media chronica) ear, which in addition to anatomical and functional reconstruction achieved by improving hearing. The method is profiled in mid-20th century by the German otosurgen Wullstain-and which is separate from the great esteem the author had the opportunity to personally meet and listen to the Course of cholesteatoma of the middle ear at the Inter-University Centre in Dubrovnik in 1982. Later this method was perfected and today could say that of those four original type 2 crystallized really applicable. We talk about the so-called method of tympanoplasty preserved wall or CWU (canal wall up) and the method of downed CWD wall (canal wall down). The first gives better results and is reserved for minor damage caused by disease of the middle ear (otitis media chronica).
As with miringoplasty and here you can set the aeration tube with the same aim and technique.
The operation is performed under general anesthesia with an incision just behind the ear, it stays in the hospital one day and the sutures removed 7 days after surgery ..

ILLNESS OF THE NOSE, SINUSES, ALLERGY

-Pharynx-front, or anterior rhinoscopy isthe classic way is a basic examination of the front of the nose. It is performed using a Killian's speculum and it’s not required from the patient any interactive relationship.pregled nosa

-Pharynx posterior, or rear rhinoscopy, which is also done by Michael's mirror is a classic method of examination and with a little cooperation of the patient gives a useful insight into the back of the nose, which is otherwise very difficult to see during examination.

-Fiberoptical rhinoscopy is done using a telescopic magnifying glass or a flexible fiberoptic rhinoskop is complement to classical examination of nose, and is particularly desirable during examination of functions of the soft palate and vocal help diagnose problems with night-time snoring or SAS that is choking during night.


-Ultrasound of the sinuses as a complementary method gives orientation if the fork or the frontal sinus that is going on a pathological disease process (inflammation, cysts or polyps) or finding is  neat, ie within the limits of normal. It is suitable for its simplicity and speed of obtaining results. It is also used as a referral method for examination during pregnancy..ultrazvuk sinusa

-Skin-prick tests for inhalation (respiratory) allergensthat are done on the skin surface. Test the patient does not require any previous preparation and no interactive relationship. Test duration is about 3 minutes for the reading of the results require a period of about 20 minutes. We do standard standard 10 probes, but it can be extended if doctor decide so.

-Endonasal-ablation (removal) of polyps from the nose either unilateral or bilateral is a classical method without surgical incisions. The procedure is done in a supine or semi-reclining position with use of local anesthesia-epimukosn (spray), a buffer in the nose stays fo 2-4 days. The process is particularly suitable for people who can not or do not want to get general anesthesia…

-Nasal packing for bleeding at nose, which is done using a tampon or a special rubber balloons indicated for emergencies..

-Rear-nasal packing with extensive bleedingat the nose as an emergency intervention for life-threatened patients and it’s carried out by placing a buffer or separate balloons in front and in back of the nose where it remains for several days.…

34-Removal of nasal foreign bodies in essence is a simple method, but until the moment when it starts to work improperly when they are possible complications of the same falling into the lower airways and possible suffocation. Therefore, the procedure requires expert medical approach.

-Coagulation of blood vessels in the nose bleeding is done by various chemical substances and does not require any special patient preparation or interactive relationship in the course of the proceedings. It is particularly convenient method for working with children who have such bleeding from the anterior segment of the nose commonly.

-Removal of tumors in the nose and the nose,(ENT region) allows histological analysis of tumor samples obtained to be done. It can be done by doing surgery or with CO2 laser.

-Laser ablation (decrease) in nasal shellswith difficulty of breathing through the nose but when other treatment methods are exhausted. Refers to the increased turbinate from a variety of reasons. This method with the CO2 laser has advantages over conventional surgical because it is performed under local anesthesia with the spray and the results of healing are better because they can not eliminate the entire turbinate, but are allowed to continue its function but with reduced mass…. more about it under number 8. Laser turbinolysis

-Jaw sinus surgery Calldwel-Luc's method, with or without the lower meatotomy and / or konhotomy and removing cysts, polyps ... It is done in classic way in general anesthesia No.9. surgery of jaw and ethmoid sinuses


Septoplasty-correction of the nasal septum involves the same procedure that is done in a particular order enesteziji rješenbja trouble breathing through the nose. more about it under no 10. Surgery of nasal septum

Rhinoplasty-and rinoseptoplasty as closed-or open decortication are the procedures in the interior and exterior of the nose that can work in anesthesia and are intended as internal and external correction function and esthetics-looking nose. more about it under no 11. Rhinoseptoplasty- nose surgery

-7th Ablation of nasal polyps
Nasal polyps do not yet have a clear explanation of the origin although they are frequently mentioned factors irritations, allergies, inflammation ... The patient has a primary obstacle to breathing through the nose to complete blockage. Treatment is surgical and that of the classical method of surgery to the auxiliary optical systems and the use of lasers. All these efforts aim to reduce the number of return polyps that does happen sometimes in a significant percentage. Many authors consider the advantages of some methods but must still conclude that the place of origin of most polyps. This is because the polyps originating from rešetastog (etmoidnog) sinuses usually vomit regardless of the method used to operate ...
The operation can be done under local and general anesthesia. Local anesthesia is possible in patients where the physician based on the findings (reviews, RTG ..) and general condition of the patient determines that it is possible. Often, patients who are at risk for general anesthesia or do not wish to receive it belong to those who operate it, of course, if a physician determines that it can have a good result. General anesthesia provides better comfort for the work of the doctor and the patient so that works whenever possible ... surgery under local anesthesia does not involve opening the sinuses while it is under general anesthesia is always possible, if necessary.
After surgery, the patient goes home with a tampon in the nose, which are removed 4 to 6 days later, depending on the type of surgery ...

-8thLASER TURBINOLIZA
Turbinoliza implies a reduction of nasal shells. Besides the classical operative removal of nasal conchs (conchotomia) work and laser surgery as well as radio frequency knife. Laser turbinolysisa is indicated for magnification nose clams that time performing obstacle in breathing through the nose and happiness to patients who sometimes have an allergy or condition thickening of chronic vasomotor type.
The procedure is performed under local anesthesia so that the laser beam is directed to the thickening of the nasal shells. Advantage of this procedure is that in functional terms does not harm the turbinates, which also retain their sensitivity essential to further function as a reduction in the volume of shells not at the expense of receprora and the mucosa. Usually a single session but sometimes repeated gives complete good result ...

-9th OPERATION jaw and ethmoid sinuses
When a pathological process that is sick (chronic inflammatory mucosal thickening, cysts, polyps, ...) located in the sinuses then surgically remove the same. If it is a simpler problem type cysts Sinusan same procedure can be done under local anesthesia and the extensive processes require general anesthesia. Except for the frontal sinus surgery is performed so that the cut does not see (under lip). Postoperatively not require a hospital stay and after 3 to 4 days tampons are removed and sutures also.

-10th OPERATION of nasal septum
The septum of the nose or the partition wall is located in the nose and that in the middle to divide the inside of the nose into two parts. Distortions and barriers called deviation of the septum. It involves several forms of which are commonly called 'S' form but there I like ridges (BC) or slippage (subluxation) ...
The operation is performed under general anesthesia with application specific so-called submucosal technique which gives good results.
As with most of these operations is not necessary stay in the hospital after surgery and usually it's one day and due to recovery from general anesthesia. Tampons are removed 5 to 7 days later and the stitches that are in the nose or self melting..

–11th Rhinoseptoplasty- nose surgery
Problems patients with breathing through the nose as well as deformities of the external appearance of the nose usually solve operations on the nose. Often the functional operations inside of the nose must be combined with external interventions that affect the appearance of the nose so that the most effective proven work on all structures of the nose which is then referred to as the Rhinoseptoplasty. Problems that are resolved in this way include about fifteen surgical techniques that combine in various ways so that there is almost no problem that is not solvable. It is always imperative that the account features no interference with the damage looked at each other just as they are at the expense of good looks will not damage the function of the nose. The following are just some of the problerma.

1. the problem PROJECTIONS tip of the nose, which is perhaps one of the most important details of the nose that gives his seal so it is often said that the projection of the nose recognise skill of the surgeon.

2. the problems of the nose, which collectively is called a peculiar obstacle tip of the nose. These include deformities such as boxing nose, bulbous nose, hooked nose, wide nose, flattened nose, etc.. Often these problems are combined with other details without their solutions never satisfied, so these techniques are somehow turn out to be less important and in the end be necessary.

3. COMPLEX UPPER LIP- MEDIUM CARRIER TIP OF THE NOSE- TIP OF THE NOSE. This complex is important that breathing and for the aesthetic aspect of the mid face and is often correlated with developmental abnormalities faces. Work on this issue is highly demanding and sensitive to the effect of looking and breathing function of the nose.

4. the problems that call WIDE BASE WING NOSA is addressed resection of that part which reduces the width of the nasal wings. This requirement is not so common but gives good results.

5. area which is the most common motive for labor nasal surgery that solves TECHNIQUES IN CONNECTION KOŠTANOHRSKAVIČNOM or nasal hump and saddle. In any surplus or deficit on the part of the nose that is required for the work and as the center of the nose must be rationed to make any compensation or reduction techniques with their own tissue or plastic implants. Although it seems simple that part of this work involves additional techniques and sculpting around the nose.

6. problem related to the nasal septum, nasal turbinate and nasal valve valve. These deformities are found in the interior of the nose and make functional parts directly related breathing but also includes support for the nose and work on them still show that it is necessary to be good because insufficient work that leaves both functional and significant aesthetic shortcomings.

7. the problems of distorted-deviation nose. It is a common deformity of the older it is harder to solve, and almost always the result of an injury, which was repaired well or badly made result operation on the nose.

8. conditions that solve the SECONDARY AND REVISION RINOSEPTOPLASTY related to repeated or multiple DONE surgery. It actually includes everything that is not done well or not done at all and should be the first or the first operation. Therefore, it is undoubtedly the most difficult surgical treatment, and the most difficult task for the surgeon. There are, in general, for the four front, depending on the particular needs and to rearrange the structure of 1-and 2-tissue reduction or reduction of tissue and structure of the extension 3 and the structure 4-reconstruction of tissues and tissue structures.

A rough classification of these operations on the internal and external (decortication) . In particular, we point out that the technique of decortication here as a special and powerful technique used to solve many difficult requirements of these operations. The choice of the surgeon that he ultimately allows that both he and the patient are satisfied with the end result of their work ...

Such a complex problem and issued a number of aspects of the evaluation or evaluation and consideration of various scales and ratings of aesthetic and functional results rhinoseptoplasty. One of the appropriate scale implied by awarding 33 points for every 33 points or details of the nose from the point of view from the front, side and bottom so that the allocation of 1 or 0 points will be awarded a total score of 100 evaluated the details of the nose, or 100 points, which is the maximum success or proportionately less. Thus, the results from 80 to 100 points are considered excellent, 60 to 80 good and bad points below 60. This scale will introduce you to one of the next occurrence with a note that it can presentationi photographs and that the correspondence used by many rinosurgens. It can also serve as a way to objectify the results of this operation, which is indeed still subjective because it is like someone else does not have and vice versa, and that at the end tells us that at the top of the scale, however a single person who wears her beauty.

 

THROAT DISEASES, VOICE AND VOCAL CORD

37-Orofaringoskopy is a classic examination of the throat, which is done using the frontal reflector, or Fiberoptical magnifying glass, or microscope is used.

-Shower beads silver nitrate or appropriate fluids ismanipulation of the mouth and throat, which often treat aphthous changes.

-Removal of the tumor in the region of the mouthand throat either with surgery or CO2 laser, and a histological analysis of samples obtained in this way. The procedure is done in local anesthesia particularly desirable for mucosal papillomas as the best method for this type of tumor..

-Frenectomy in the mouth with the findings of short laces or the upper lip in children is done with surgery or CO2 laser.

-Odontotomy-in-canal ie. peritonsilar abscess near the tonsils under local anesthesiaas a beneficial method for now, with no alternative, is represents the classic method of treatment

-Laser surgery of the tonsils or tonsil ablation refers to the procedure for palatinal ie palatal tonsils, which are carried out under local or general anesthesia in adult patients with chronic tonsillitis. It has the advantage in reducing the pain and after surgery, reduced risk of bleeding ...

-Third tonsil surgery in children is under general anesthesia with or without the installation of ventilation tubes in the ears of one of the minor operation but with a pronounced positive effect .. It is conventional surgery,

-LAUP snoring with laser-assisted uvulopalatoplasty for snoring laser surgery is a method by which the intervention of the soft palate and uvula throat reduce snoring in adult patients. The procedure is suitable for local anesthesia but may work in general.

-Laser-benign surgery on his vocal cords papillomavirus type return, Reinke edema, cysts ... require precise work that the laser is achieved. The procedure is done under general anesthesia and requires a laryngomicroscopy lying in the hospital.

-Laser surgery on his vocal cords and the surrounding area (nodules-polyps, dysphonia, and voice alteration)  regarding  the vote that fall within the so-called phonysurgery, and are particularly demanding for people who are professionally involved in voice. Also it is done under general anesthesia and a laryngomicroscopy code changes such as vocal nodules-polyps, dysphonia, and voice alteration that is hoarse and difficult speech ..

-Surgery of midle cyst  on throaththat is performed under general anesthesia, standard surgical manner, more often in children.

-12th Cryptolysis of tonsils in bad breath
One of the latest techniques in laser surgery under local anesthesia is particularly recommended for the occurrence of bad breath from tonsils. In fact, bad breath (halitosis), which is caused by chronic tonsillitis changes often encountered in patients who have frequent infections of the same but also for those who are suffering from inflammation. On the surface layer of the palatal tonsils are depressions or crypts that are different and often individually large and deep. They are going collision of everything that comes into their area and defensive body that besides identifying what goes into the mouth creates a primary defensaive. The result of this encounter was the dissolution of both sides of a whitish detritus normally be superseded and swallowed and does not create a local problem. However, in cases where this mechanism does not work well there is a retention of the breakup or detritus that has an unpleasant odor and creates bad breath. Our task is by viewing laboratory findings establish whether the tonsils, but bad in his office when they condemn the operation or functionally good but fail to remove detritus from themselves. In the latter case, it is suggested laser treatment that eliminates these centers and thus prevents further collection of detritus and the function of the tonsils remain tidy.
Patient after this procedure does not remain in the hospital and is able to continue work

-13th Third tonsil in children-adenoids
Is called adenectomy as the third professional title of adenoid tonsil. It is one of the most effective surgery to remove a third of the tonsil and its growth area closed end of the nose or their infectious and toxic effects bad for the environment. The third tonsil located at the bottom of the nose and behind the uvula and soft palate above the area that represents the crossroads of the nose and throat as a way to breathe. At the same time there are also the mouth of the tube or tubes that Eustachio ventilated and drain the middle ear. Any unfavorable disease process on the third tonsil and its size affect more or less a function of the Eustachian tube and which thus harms the function of the middle ear, contributing to disease and even his hearing loss. Ailing third tonsil is not only locally but its bad effects of poisoning affects the entire body, loss of appetite, etc., and it is known that most of the children after the surgery improved their appetite and growth and therefore it is considered beneficial. This phenomenon is also popularly known where various methods usually characterised by a lifting ~ ~ I'll come back trying to do a massage of the third tonsil with very young children. Of course, this medical procedure is not approved because of potential scattering and the complications it.
Parents on the condition warnings presence of nocturnal snoring child or breathing with an open mouth is not only in this state but is a call for examination and diagnosis. Also, the occurrence of repeated ear infections, poorer hearing too often bring the child to a doctor when it is concluded that the culprit third tonsil as to diseases called secretory otitis ...
Children mostly stand up well to this surgery and she runs a day without staying in the hospital, of course, under general anesthesia.

-14th Laser surgery in night SNORING
Night time snoring (snoring) is a known problem that monitors human society since time immemorial. It is essentially harmless and environmentally tedious problem until it is triggered by certain disease or condition until it grew into the night choking (SAS- blind appnea syndrome). There are many reasons for snoring. They refer to a standstill in the upper airways, ie the nose, the back of the nose and epipharynx, a long soft palate and uvula and the voluminous base of the tongue especially pronounced in thickness (obesity). This narrowing can make snoring phenomenon which is the same level used to make and vary. Problems of the soft palate and uvula is the most comfortable grip laser resolved that we call LAUP (laser assisted uvulopharyngopalatoplasty) and refers to the shortening and reduction of tension that part of the soft palate and uvula and tonsil area which increases airway space and reduces excessive flicker of these structures and the creation of snoring.
In the preoperative preparation other than the review of ENT doctors sometimes true and polysomnography recording that during the night recording functions of breathing, heart rate, brain function, supplying oxygenated blood ... .what has real health significance because snoring is not only an aesthetic phenomenon, but often has a health effect especially when developing and night choking ..
The procedure is performed under local anesthesia in the sitting position, does not require special leave nor stay in the hospital ...

-15th LASER SUPPORT intervention on vocal cords
Changes in voice such as hoarseness, fatigue speech, inability performance of pure speech and singing, etc. usually have their origins in the emergence of a variety of conditions and diseases of the vocal cords. After examination and diagnosis often suggest surgery which removes called the changes. They are mainly in the form of various growths. Such changes are suitable for LASIK surgery include:

-Noduli Vocales (vocal cord nodules) or vocales canthatorum nodules (singers nodes) occur in response to conditions of chronic inflammation in the form of liquid spills on the typical meeting place of the vocal cords during speech and are usually bilateral,

-Polypus Plicae vocalis (polyp) are usually one-sided, and a variety of shapes and sizes for people between 20 and 50 years of age. Their occurrence is often associated with vocal trauma that improper use of the voice, with respiratory irritation, allergies, infections, tobacco and alcohol as well as certain hormonal disorders.

-papillomas or RRP ie recurrent respiratory papillomas (warts feedback ministering wit caracteristic to their obstruction to breathing turn into a malignant state) is more common in children and in adults arouses the suspicion of malignant disease. It is caused by HPV - human papilloma virus. Because of the tendency to relapse is a serious condition. The method of removing the laser is only adequate for now, because it does not leave scars and allows a deeper effect on the tissue ..

- Clean coil (baggy formations that are filled with fluid) and also are associated with chronic inflammation.

- Reinke's edema (thickening of the vocal cords jelly form that would not turn into a malignant state, and is often linked with a reduced activity of the thyroid gland) usually on both vocal cords and respond well to surgical treatment of a particular laser because it does not leave scars ..

-Chorditis Vocalis (chronic inflammation of the vocal cords) that is repeated in irritation and inflammation, and is manifested by thickening of the upper surface of the same ...

-Anterior Sinechiae glotidis (congenital front srasline vocal cords) are the birth and disrupt breathing a laser to remove without fear of re-coalescence which in conventional surgery can happen ...

-Granulomas vocal cords, vocal cord ulcers, scarring of the vocal cords, vocal cord hematoma (reactive inflammatory tissue that is sometimes difficult to distinguish from tumor tissue or airway narrowing) are often the result of constant inflammation or recovery of acid from the stomach injury, foreign body, or in the long intubation in anesthesia, ie after it.

  Of course, in addition to these benign tumors, it also includes malignant tumors of the vocal cords and the environment, but given that they are specially treated here are important to be sure to have the time to diagnose ...

The only symptom of this is that the loss of voice hoarseness. So there is no pain or visible swelling, no enlarged lymph nodes in the neck (except for malignant tumors). The general rule is that any hoarseness that lasts more than three weeks should undergo examination and diagnosis. Summary implies that the eye sees the area of the larynx, and that can be performed in several ways all of which are equally valuable in the diagnosis and;
-First, conventional indirect laryngoscopy (using a small mirror)
-Other, indirect microlaryngoscopy (also mirrors and the microscope),
-Third, direct microlaryngoscopy (for which we need a general nestezija and microscope) and

Schnoorviertel, Fibre Channel endoscopy (flexible optical instruments).
After examination establishes the diagnosis and make a proposal for treatment. If it is a surgical treatment, which is often the case then surgery on vocal cords running through the mouth in a patient under general anesthesia and without external incisions on the neck. In the larynx that the vocal is very desirable to work with less aggression and cutting the consequent defects are undesirable. Therefore, in ideal conditions using CO2 laser that has the effect of biological and non Leave scars and defects in microscopic technique that the procedure is called LMS- laryngomicroscopy laser. This method is highly accurate and gives the best results, and the biological value of the laser is immediately evident. In particular, it is worth to you and if there was a malignant cell in this change, a review of what could be seen, the laser cuts are made, as opposed to those made ​​with a knife, to prevent further spread tumors.Ova method is especially recommended for people who are professionally using voice. Damage to surrounding tissue are negligible and recovery is quick.
The whole procedure was conquered with us in Montenegro and unique on this site (including the public and private institutions) and emphasize that we are proud of the overall commitment to physicians and other staff, special equipment (laser, operating microscope) and adequate space .

-16th Medium-sized cyst of the neck
Cysts or water bags on the neck of the innate and the occurrence of the most common in children's age. The final diagnosis other than examination raises the ultrasound which is not different from other similar formations. Average or median neck cyst located in the middle of the neck between the Adam's apple and the hyoid bone as beads of various sizes. Usually will not give you problems until they burst and fester. Therefore, the operations are proposed to occur before the inflammation. How to change an innate means a congenital operation must break it stump cysts which can be achieved by resection of the body of the hyoid bone to the cyst does not return ..
The procedure is done under general anesthesia with an external incision in the neck and the child remains in the hospital one day after surgery and the stitches are removed 7 days later.