Parotidectomy - Removal of Parotid Gland

Parotid gland surgery for tumors is sometimes difficult due to the close proximity of facial nerve, damage to these nerves resulting in paralysis of the muscles of facial expression. Detection of early stages of a parotid tumor is extremely important in terms of postoperative prognosis.

Surgery for stones in the gland depends upon the site of the stone: if within the anterior aspect of the duct a simple incision into the buccal mucosa with sphinterotomy may allow removal; however, if situated more posteriorly within the main duct, complete gland excision may be necessary.

Parotidectomy is the operation to remove part of the parotid gland, which is situated below and in front of the external ear. An incision is made on the side of the face, alongside the ear. It is a laborious technique, because of relapses and incomplete previous treatment made in other border specialties. A superficial (lateral) Parotidectomy involves removing the entire gland superficial to the facial nerve, whereas in partial superficial Parotidectomy only the portion of the gland surrounding a tumor or mass is removed. In a partial superficial Parotidectomy, only some branches of the facial nerve are usually dissected, whereas in superficial Parotidectomy, the entire cervicofacial and temporofacial divisions are dissected. In total Parotidectomy, the superficial gland is dissected free of all of the facial nerve branches and the branches are then completely mobilized and portion of the gland is removed.

Immediate postoperative complications of superficial Parotidectomy include: Hemorrhage, hematoma, numbness around the ear and temporary facial weakness. Occasionally a salivary fistula develops, due to over-activity by the remaining lobe of the gland. It can be resolved by medication. Gustatory sweating is seen at the site of surgery in some cases which may resolve slowly.

All the removed tissues will be sent to the laboratory to be examined under a microscope so that the cause of the swelling can be identified.

Esophagoscopy - To visualise Oesophagus and remove foreign body

The foreign body in the esophagus causes edema of the mucosa, and the esophageal wall becomes weakened. The esophageal peristaltic activity may be inadequate result in retention of swallowed objects. Retention leads to temporary perforation. All foreign bodies retained in the esophagus should be removed as soon as diagnosed. Diagnosis includes the identification the type of object, the time since ingestion, the location of the object, and the likelihood of associated complications. The most commonly used method for removal of esophageal foreign objects is rigid esophagus endoscopy. Esophagoscopy uses a flexible endoscope and is inserted through the mouth or rarely through the nose into the esophagus. A charge-coupled device displays the magnified images on a video screen. This allows visualization of the esophageal mucosa from the upper esophageal sphincter to the esophageal gastric junction. It may also have a tool to take a biopsy. Transnasal esophagoscopy is a technique for screening for esophageal cancer and other disorders. Its wide lumen helps in manipulating and extracting the most foreign bodies and removing it, in one setting and without withdrawing the endoscope

Tonsils removal - Cobblator Tonsillectomy

Tonsillectomy is a surgery in which the tonsils are removed from the throat. An adenoidectomy is a similar surgery that removes the adenoids. The procedure is indicated for recurrent acute tonsillitis or adenoiditis, obstructive sleep apnea, nasal airway obstruction, diphtheria carrier state, snoring, or peritonsillar abscess. Most tonsillectomies are performed on children, although many are also done on teenagers and adults by separating and removing the tonsils from the sub capsular plane.

A heat driven process is used in most of the radiofrequency electrosurgical techniques to ablate or cut tissue. The tissue structures get explode at high temperatures resulting from the high amounts of energy discharged into tissue. During this process, the surrounding healthy tissue also gets adversely affected.

Coblation Tonsillectomy and Adenoidectomy is a gentler way in which tonsils and adenoids are removed. This innovative surgery results in very little pain and fast recovery for patients. The operation is performed through the mouth and there are no cuts made on the neck, hence no scarring following surgery. The Coblation process is a controlled, non-heat driven process. With Coblation technology, radio-frequency (RF) energy is applied to a conductive medium, usually saline, causing a highly focused plasma field to form around the energized electrodes. The surrounding tissues remain unaffected. There is decreased risk of bleeding and the patient can start eating and swallowing earlier.
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