Otorhinolaryngeal Surgery (Ear, Nose and Throat)

Otorhinolaryngeal

U.S. News and World Report ranks Beaumont among the top hospitals for complex surgery on the ear, nose and throat as well as related areas of the head and neck. Beaumont Otorhinolaryngologists (Ear, Nose and Throat surgeons) focus on treating disorders of the voice box (larynx), mouth, pharynx, sinuses, middle ear, front and side of the skull base. The use of minimally invasive and image guided surgical techniques allow patients to spend less time in the operating room, require less postoperative care and recover more quickly.

Beaumont offers the most sophisticated imaging capabilities for care of the ENT patient including: CT, MRI and PET scanning and the CT Landmarx system for endoscopic sinus surgery. ENT surgeons at Beaumont function as part of a large multidisciplinary team which includes Medical and Radiation oncologists, Radiologists, Nuclear Medicine specialists and Anatomic pathologists who participate actively in treatment planning through the Head and Neck Tumor Board. Plastic surgeons, Speech pathologists and nutritional specialists play an important role in the rehabilitation and recovery of surgical patients.

Special Procedures Offered

Our surgical team performs a range of otorhinolaryngeal surgical procedures including:

Head and neck cancer

  • Trans-oral endoscopic laser resections: oropharynx, hypopharynx and larynx tumors (organ preservation)
  • Resections of paranasal sinuses, oral cavity, oropharynx, hypopharynx and larynx lesions
  • Total laryngectomy with primary or secondary TEP puncture (voice prosthesis)
  • Hemilaryngectomy: vertical, supraglottic via external or endoscopic (minimally invasive approach)
  • Approaches to the paranasal sinuses for tumor resections: midface degloving, lateral rhinotomy, subfrontal
  • Neck dissections - radical, modified radical, functional and selective
  • Reconstructions - Pedicled flaps (pectoralis major), free flaps (fore-arm flaps etc), gastric pull up, and regional flaps (forehead, tongue flaps, skin flaps)

Middle ear

  • Tympanoplasties
  • Stapedectomies
  • Cholesteatoma surgery with/without mastoidectomies
  • Reconstructions of ossicles

Paranasal sinuses

  • Endoscopic surgery of maxillary, ethmoid, sphenoid and frontal sinuses - with or without Landmarx guidance
  • Orbital decompression
  • External approach to the sinuses - see above

Anterior skull base

  • Resections of skull base tumors in combination with subcranial resections by neurosurgery like sino-nasal carcinomas involving the skull base, estesioneuroblastomas
  • Transnasal endoscopic approach to the skull base for resection of pituitary gland tumors, meningeoma

Lateral skull base

  • Endoscopic lateral skull base surgery for acoustic neuromas
  • Translabyrintal, suboccipital resections for acoustic neuromas

Esophagus

  • Zenker's diverticulum or transoral endoscopic stapling
  • Esophageal dilatations

Voice

  • Laryngoplasty - Botox® and gelfoam injections for vocal cord paralysis
  • Thyroplasty - Goretex® implants for vocal cord paralysis
  • Arytenoidectomy
  • Laser excisions of nodules, polyps, Reincke's edema, web etc
  • Laryngo fissure - laryngocele
  • Secondary TEP fistula - voice prosthesis for laryngectomy patients

Facial Plastics

  • Reconstructions after resection of skin cancers, such as Moh's surgery
  • Rhinoplasties (nose)
  • Face lifts
  • Botox® injections

Fractures

  • Tripod fractures-mini-plating
  • Orbital floor fracture repair
  • Nasal fractures under local anesthesia (in-office) or under general Anesthesia depending on patient age and fracture complexity

Abscesses

  • Peritonsillar-transoral
  • Parapharyngeal-transoral/transcervical
  • Periorbital-Lynch incision
  • Mucocele, frontal sinuses-endoscopic/external via bicoronal flaps

Trachea

  • Tracheostomy under local or general anesthesia
  • Tracheal resections-tracheal stenosis

Thyroid

  • Hemithyroidectomy/total thyroidectomy for benign and malignant disorders

Special Techniques

Each patient is evaluated before and after treatment with a variety diagnostic tools:

  • For head and neck cancers - CT, MRI and PET scans
  • For sinus - CT with Landmarx, an system for operating endoscopically resulting in fewer complications
  • For larynx disorders - laryngoscopy and stroboscopy

Because patients with head and neck cancer usually receive a variety of treatments from surgery to radiation and chemotherapy, Beaumont's tumor board discusses every major case to broaden the basis for complex decisions. After treatment is complete, patients with neck cancer get repeated follow-up PET scans rather than neck dissections to reduce recurrence or spread of the disease.

Beaumont ENT surgeons often use simultaneous chemoradiation therapy or minimally invasive surgery to preserve organs, ENT surgeons and radiologists plan radiation dosing together. For years after treatment, Beaumont surgeons and radiation/medical oncologists continue to evaluate patients. When needed, Beaumont routinely involves speech pathologists after surgery for objective voice analysis and swallowing training and dieticians also consult with patients to optimize nutrition.