ENT & Audiology Services
In polyclinical part of “Nairi” Medical Center acts out – patient ENT Service, which is carried out by “MEDLOR” Ltd., where the following methods of diagnostics, conservative treatment and patients’ control with ENT pathologies are used.
With using rigid and hard endoscopes from Karl Storz company, with videoregistration system Sopro Imaging are carried out:
- videoendoscopic diagnostics of nasal cavity and anastomosis of paranasal sinuses – endoscopic examination of the structures of nasal cavities and nasopharynx,
- videoendoscopic sinusoscopy – endoscopic examination of paranasal sinuses,
- videoendoscopic fibrorhinopharyngolaryngoscopy – endoscopic examination of nasal, nasopharyngeal, pharyngeal and laryngeal cavities.
Using otoscope from Karl Storz company and microscope from Karl Zeiss Opmi Pico, with videoregistration system Sopro Imaging, in the Department there is also carried out videoendoscopic otoscope – endoscopic examination of acoustic meatus, tympanic membrane, tympanic cavity (on steady perforation).
After general construction of Nairi Medical Center, starting from 2003, in ENT Department we started using high – technology methods of diagnostics, conservative and surgical treatment of patients with congenital or acquired pathologies of nose, throat, head and neck.
In the Department adult patients receive a modern medical aid as well as children from the age of 1, thanks to the high qualification of the Head of the Department, colleagues of the Department and clinical basis, anesthesiologists, who had multiple trainings and licenses in the leading clinics in the Europe.
The department is a clinical basis of ENT Diseases Department of Yerevan State Medical University, where the students get their Bachelor Degree and Master Degree, get specialization, the clinical residents, post -graduated students carry out scientific – practical activity.
Implementation and application of the newest methods of diagnostics and treatment in the Department using optical systems, with video control and archiving the data, allow to carry out not only high – accuracy diagnostics, but also to perform clinically grounded treatment of the patients as well as under the optical control, which increases the percentage of treatment positive results for 40-50%.
The Department staff widely uses all diagnostics facilities of ENT pathologies of R – study as well as multispiral CT, MRI with 1.5 Tesla resolution from Siemens and ultrasound examination.
In the polyclinic part of Nairi Medical Center acts an out-patient Service “MEDLOR” Ltd., where are used the following methods of diagnostics, conservative treatment and control of the patients with the ENT problems.
In the polyclinic part of Nairi Medical Center works auditory apparatus and hearing aid room, where are also performed on the high level all necessary modern listening examinations, which allows to plan the optimal treatment already on the early stage of diseases. Here are carried out:
In the Department are developed and implemented into practice the newest methods of endoscopic and microsurgical correction of intranasal structures deformations, chronic inflammation of paranasal sinuses, solid lesions (polyps, cysts etc.) in nasal cavities and paranasal sinuses with maximum safety for healthy tissues and structures, which allowed to significantly increase the treatment quality, decrease complications and to cut the time of patients’ stay at the hospital.
In the ENT Department are invented into the practice and carried out the following methods of surgical treatments using the optical endoscopes with fields of view 00, 300, and 700 from Karl Storz (Germany), with video equipment from Karl Storz (Germany) and Stryker (USA):
- endoscopic septoplasty – microsurgical intervention on the nasal septum during its deformation, perforations,
- endoscopic interventions during congenital, including new-born, and iatrogenic atresias of choana,
- endoscopic interventions on nasal turbinate using radio surgical device form Johnson&Johnson USA, bipolar radio frequent coagulation from Coblator (France) used during chronic hypertrophic, allergic and vasomotor rhinitis,
- rhinoplasty – surgeries during congenital, acquired, and also secondary deformations of external nose and intranasal structures,
- endoscopic treatment of chronic purulent rhinosinusitis – endoscopic sparing microsurgical intervention with the correction of intranasal structure, anastomosis accessory sinuses during their different pathologies, which leads to the development of chronic inflammation in the nasal cavity and paranasal sinuses,
- endoscopic interventions during foreign bodies in the nasal cavity and paranasal sinuses, including of odontogenous origin, intrusion into the maxillary cavities of filling material and different parts of dental implants,
- endoscopic treatment of polypous rhinosinusitis – endoscopic sparing opening of affected by polypous process nasal cavity, paranasal sinuses and their sanation,
- endoscopic treatment of cysts in accessory nasal sinuses – endoscopic sparing opening of affected by cystic process of nasal sinuses and their sanation.
Modern concept of endoscopic surgery means a full removal of unhealthy tissues from the sinuses and maintenance of nasal cavity functions that is especially important during polypous sinusitis, because this approach leads to the stable remission of the disease.
Due to endoscopic functional surgeries on accessory nasal sinuses in ENT Clinic of our Medical center, there are implemented one stage interventions during deformation of external nose and intranasal structures in combination with non – purulent affection of paranasal sinuses -, to be exact if there are polyps and cysts. In these cases, we perform rhinoseptoplasty with one moment endoscopic sanation of paranasal sinuses. This allowed to exclude traditionally accepted multistage surgical treatment of the mentioned type patients.
In ENT Department the traditional ENT surgeries are improved and:
- endoscopic adenoidectomy – removal of adenoids under the visual control with using the special instruments and mono – and bipolar radio frequent coagulators Coblator (France), which allowed to significantly decrease the percentage of relapses,
- tonsillectomy with radio surgical device Johnson&Johnson (USA) and bipolar radio frequent coagulation from Coblator (France).
In this case, during the intervention, blood loss minimizes, the pain syndrome and risk for bleeding decrease during postsurgical period, which is especially important during children treatment.
The Department also deals with the snoring problem and with the disease of obstructive apnoe in the sleep. The surgical interventions are performed after the careful preliminary examination – sleep monitoring (plisomnography), endoscopy, and CT scan of respiratory tract. If there are clear indications and clarifications of obstruction level, then there must be used individually selected methods of plastic surgeries, that give us the possibilities really help our patients, to be exact, uvulopalatoplasty, also using radio surgical device from Johnson&Johnson (USA) and bipolar radio frequent coagulation from Coblator (France), if it is necessarily, in combination with surgical recovery of nasal respiration.
In the department a special attention is paid to the surgical treatment of vocal apparatus diseases: endoscopic surgery of vocal folds with full removal, or biopsy of neoformations of the larynx under the control of endoscopes and surgical microscope from Leica (Switzerland). The described method allows to perform a surgical intervention through natural tracts, without external cut, and as a result – minimum hospitalization and rehabilitation time, highest effectiveness.
Modern surgical interventions mean sparing methods with maximum safety of healthy tissues and structures. This became possible with using surgical microscopes from Leica (Switzerland). Multiple magnification and binocular vision allow to decrease a surgical trauma, perform adequate volume of the intervention, to be:
- myringotomy during acute otitis,
- myringotomy with bypass of tympanic cavity during exudative otitis,
- myringotomy with bypass of tympanic cavity during adhesive otitis, with special T-type bypass,
- myringotomy – restoration of tympanic membrane during its steadfast perforation with using the cartilage hircus of auricle.
In our Clinic we perform a surgical treatment of the patients with different congenital anomalies, and also with traumatic injuries of ENT, head and neck organs, to be exact:
- otoplasty for lop-ear and other restricted anomalies of auricle,
- otoplasty by Brandt – Negate – multi stage reconstruction of auricle by the cartilage from costal margin during congenital hypoplasia or traumatic injury of hircus,
- cheiloplasty – reconstruction of the upper lip during one – or two side cheiloschisis (cleft -hare's lip),
- uranius – uvuloplasty – reconstruction of soft palate during cleft palate,
- removal of the cyst of neck region of various localization: middle, lateral,
- removal of fistula of various localization: neck, ears, dorsum of nose.
Thanks to the collaboration with neurosurgeon, multidisciplinary team of surgeons carries out such combine complicated interventions as a pathology of cranium basis structures (hypophysis adenoma and others), as an endoscopic transnasal access through main sinus to the structures of cranium basis, closing of defects of cranium basis attendant with liquօrrhea.
In collaboration with plastic surgeons of multidisciplinary team of surgeons we perform simultaneous rhinoplasty with mammoplasty (decrease or prosthesis of mammary glands), or simultaneous rhinoplasty with abdominoplasty (plasty of anterior abdominal wall) and others.
For optimization of ENT Department activity during performance of complicated surgical interventions, because of multidisciplinarity of Nair Medical Center now it is possible to include into the multidisciplinary surgical team not only otolaryngologists, but also oncologists, plastic surgeons, neurosurgeons and other specialists.
Exceptionally, all surgical interventions are performed under the general anesthesia, using optimal allowance, which let our patients “not be present” on his/her own surgery, to be maximum safe from the surgical aggression, and the surgeon could perform his work on the high level of quality.
The above-mentioned technologies and surgical methods significantly decrease traumatic outcome of surgical treatment, risk of multiple complications, significantly improve the quality of treatment and decrease the terms of patient’s hospitalization.
Doctors of the Department carry out exit consultations and surgeries in Tavush and Armavir Marz (districts), and also in Stepanakert and Hadrut in NKR.
ENT Service of Nairi Medical Center is in close collaboration with the leading specialists and clinics of France, Germany:
- Prof. Erea – Noel Garabedian, Head of ENT Disease, Head and Neck Surgery Department of Children Hospital after Armand Trousseau, Paris, France,
- Jorje Tashjian, Doctor of Medicine, Assistance Professor of ENT Diseases Department, Head and Neck Surgery Department of Children Hospital after Armand Trousseau, Paris, France,
- Prof. Hilmar Hagedorn, Head of ENT Department of Helios Amper hospital, Dahau, Munich, Germany.
- Prof. Stephan Holtmann, Head of ENT Department of Arabella Clinic, Munchen, Germany,
- Prof. Lenartz and German auditory center, Hannover (DHZ),
- Prof. Lesinski – Scheedat, Hannover Medical School, Department of Otolaryngology.
Medical personnel of the Department constantly undergo the training in the best clinics of France, Germany, Russia.
- optical endoscope from Karl Storz with fields of view 00, 300 and 700 (Germany), ), with video registration rom Sopro Imaging,
- video equipment from Karl Storz Germany) and Stryker (USA),
- otoscopes from Karl Storz,
- microscope Karl Zeiss Opmi Pico, with video registration system Sopro Imaging,
- bipolar radio frequent coagulator Coblator (France),
- radio surgical device from Johnson&Johnson (USA),
- surgical microscope from Leica (Switzerland ).