After the general reconstruction of the Nairi MC, since 2003, the high-tech technology and methodology was introduced at the ENT Department for diagnosis, as well as for conservative and surgical treatment of patients with congenital or acquired disorders of the nose, throat, ears, head and neck.
Due to contemporary medical equipment and high qualification of department’s staff that had been qualified and licensed in the leading European clinic, the children of 1 year old also able to receive specialized medical care.
At the ENT Department the Chair of ENT of Yerevan State Medical University is based. The undergraduate and postgraduate students pass their training on the base of the Department; get a specialization, and carries out scientific work.
The implementation and application of the latest technologies and methods of diagnostics and treatment with the use of optical and video-control systems and data archiving allow to carry out not only a highly accurate diagnosis, but also provide clinically substantiated treatment of the patients under the optical control, which increases the percentage of effective results of the treatment by 40 -50%.
In its Diagnostic activity the Department widely uses the diagnostic equipment of NMC: X-ray, CT scan, high resolution magnetic resonance imaging of Siemens Company and ultrasound examination.
In Outpatient Clinic the ENT Service provided by LTD MEDLOR, where the diagnostic methods, conservative treatment and monitoring of patients with ENT pathology are used.
With the use of the rigid endoscopes of Karl Storz Company, with video recording Sopro Imaging system the following services are provided:
- Video endoscopic diagnosis of nasal cavity and paranasal sinus fistulas - endoscopic examination of the nasal cavity and nasopharyngeal structures;
- Video endoscopic sinusoscopy - endoscopic examination of the paranasal sinuses;
- Video-endoscopic Fibro-rhino-pharyngo-laryngoscopy - endoscopic examination of the nasal cavity, nasopharynx, pharynx, larynx;
Using otoscopes of Karl Storz Company and microscope of Karl Zeiss Opmi Pico, with video recording Sopro Imaging system it is possible to provide video-endoscopic otoscopy - endoscopic examination of the auditory canal, tympanic membrane, tympanic cavity and discover persistent perforation or other diseases.
The outpatient Audiology Consulting аnd Examination Room provides also consultation and examination hearing and ear diseases including newborn. There are carried out:
- À threshold tonal audiometry, which is study the degree and type of hearing loss;
- impedansometry that study the functional state of the middle ear structures;
- registration of otoacoustic emissions (DPOAE) - the study of the functional state of the auditory receptors;
- Check the auditory potentials (ABR), which makes it possible to diagnose hearing loss in both adults and children, since the newborn period.
The Audiology Consulting аnd Examination Room provides also the high-tech hearing aid with the digital hearing devices from the Siemens Company.
At the Department the latest techniques and endoscopic microsurgical correction of deformities of intranasal structures, chronic inflammation of the paranasal sinuses, space-occupying lesions (polyps, cysts, etc.) in the nasal cavity and paranasal sinuses are introduced, with maximum preservation of healthy tissue and structures which have substantially improved the quality of care, reduce complications and reduce the hospitalization period.
In the ENT Department, the following methods of surgical treatment with the use of Karl Storz (Germany) optical endoscopes with the fields of sight 00, 300, и 700 and with videocontrol equipment of Karl Storz (Germany) and Stryker (USA) are introduced into the practice:
- Endoscopic septoplasty - microsurgical intervention in the nasal septum in case of its deformation, perforation;
- Endoscopic intervention in congenital, including neonatal, and iatrogenic choanal atresia;
- Endoscopic intervention in the nasal turbinated bone using radiosurgical device Ultracision Harmonic Scalpel (Ethicon Endo-Surgery, USA) (USA), the bipolar radiofrequency coagulation of Surtron company (LED, France), in chronic hypertrophic, allergic and vasomotor rhinitis;
- Rhinoseptoplasty is operation in congenital, acquired and secondary deformities of the external nose and intranasal structures;
- Endoscopic treatment of chronic suppurative rhinosinusitis - sparing endoscopic microsurgical intervention with the correction of intranasal structures, anastomoses of the sinuses in various diseases that leads to chronic inflammation in the nasal cavity and paranasal sinuses;
- Endoscopic intervention in the presence of foreign bodies of the nasal cavity and paranasal sinuses, including odontogenic origin (penetrated filling material, different parts of the dental implants into the maxillary sinus).
- Endoscopic treatment of polypoid rhinosinusitis - sparing endoscopic dissection of the nasal cavity and paranasal sinuses affected by polypous process, and their sanitation;
- Endoscopic treatment of cysts of the sinuses - endoscopic sparing dissection of the sinuses affected by cysts and their sanitation.
The modern concept of endoscopic intervention involves the complete removal of unhealthy tissue from the sinuses and nasal cavity function preservation, which is especially important in polypous sinusitis, because such an approach leads to a stable remission of the disease.
Due to the functional endoscopic surgery on the paranasal sinuses in the ENT Department of Nairi Medical Center the one-step intervention in the presence of deformation of the external nose and intranasal structures combined with non-purulent lesions of the paranasal sinuses in the presence of polyps and cysts is implemented. In these cases performed the rhinoseptoplasty with simultaneous endoscopic debridement of the paranasal sinuses. This permits to eliminate the conventionally adopted multistage surgical treatment of this patient population.
At the ENT Department the traditional ENT surgery methodology with the use of contemporary equipment had been improved and optimized in accordance with existing international standards:
- Endoscopic adenoidectomy - adenoidectomy under visual control with the use of special tools and mono- and bipolar radiofrequency coagulator Surtron (LED, France), which made it possible to signifi cantly reduce the rate of recurrences;
- Tonsillectomy performance with the use of radiosurgical device Ultracision Harmonic Scalpel (Ethicon Endo-Surgery, USA) and bipolar radiofrequency coagulation company Surtron (LED, France). This allow to achieve the minimization of the blood loss during intervention, reduces pain and the risk of bleeding in the postoperative period that is especially important in case of children treating.
At the Department it is also performed the treatment of snoring and obstructive sleep apnea disease. Surgical procedures are carried out after a thorough preliminary survey: Sleep monitoring (polysomnography), endoscopy and computed tomography of the respiratory tract. If there is clear evidence of obstruction and after clarification of its level the tailor-made methods of plastic surgery such as uvulopalatoplasty is applied. It is performed with use of radiosurgical device Ultracision Harmonic Scalpel (Ethicon Endo-Surgery, USA) and bipolar radiofrequency coagulation of Surtron Company (LED, France). Sometimes this intervention is performed in combination with surgical recovery of nasal breathing.
At the Department the particular attention is paid to the surgical treatment of diseases of the vocal apparatus in the presence of various neoplastic diseases of the larynx -endoscopic surgery of the vocal pleats with the complete removal or biopsy of laryngeal tumors under the control of endoscopes and surgical microscope Leica (Switzerland). This very effective technique allows performing surgery through a natural airway, without the cuts or cession and as a result with consecutive minimization of hospitalization and rehabilitation period.
Contemporary otosurgical intervention meant the sparing techniques with maximum preservation of healthy tissue and structures. This became possible with the use of surgical microscopes Leica (Switzerland). Multiple zoom and binocular vision allows reducing the surgical trauma, to perform an adequate volume of intervention such as:
- myringotomy in the presence of acute otitis media;
- myringotomy to bypass the tympanic cavity in the presence of exudative otitis media;
- myringotomy to bypass the tympanic cavity in the presence of adhesive otitis media, special T-shaped shunt;
- myringoplasty - the restoration of the tympanic membrane in the presence of persistent perforation of the tympanic membrane, with the use of cartilage of the ear tragus.
The Department performs surgical treatment of patients with various congenital anomalies, as well as traumatic injuries of ENT, head and neck, such as:
- otoplasty in droopy ears and other limited anomalies of the ear.;
- otoplasty by Brendt-Nagato - multistage recovery auricular cartilage of the rib arch in congenital hypoplasia or traumatic injury of the ear;
- chiloplasty - the restoration of the upper lip with unilateral or bilateral cleft upper lip (cleft lip);
- uranouvuloplasty, - the restoration of the soft palate in congenital cleft palate (cleft palate);
- removal of cysts of various localization on the neck: medial, lateral;
- removal of fi stulas of diff erent localization: neck, ears, back of the nose.
Due to multidisciplinary profile of Nairi Medical Center it became possible to perform high complexity surgery with multidisciplinary surgical team such as ENT and neurosurgeons team and perform such complex joint intervention in the pathology of skull base structures (pituitary adenoma, etc.) through transnasal endoscopic access via the main sinus to the structures of the skull base, the closure of the skull base defects involving the flow of cerebrospinal fluid - liquorrhea.
In collaboration with plastic surgeons multidisciplinary surgical team such as ENT and plastic surgeons team perform the single-stage rhinoseptoplasty and mammaplasty (reduction or prosthetic breasts), or one-stage rhinoseptoplasty with abdominoplasty (plastic anterior abdominal wall), etc.
To optimize the work of the department of otorhinolaryngology in performing complex surgical interventions due to the multidisciplinary character of the Nairi MC, it became possible to include not only otorhinolaryngologists, but also oncologists, plastic surgeons, neurosurgeons and other specialists in the multidisciplinary surgical team.
It should be emphasized that all surgical procedures are performed under the general anesthesia.
The above-described technology and surgical techniques significantly reduce the invasiveness of surgical treatment, the risk of possible complications, significantly improve the quality of care and reduce hospitalization periods for the patients.
The department's doctors conduct field consultations and operations in the Tavush and Armavir marzes, as well as in Stepanakert and Hadrut of the NKR.
Partner and Sponsors
ENT Nairi MC service is in close cooperation with leading specialists and clinics in France, Germany:
- Prof. Erea-Noel Garabedian, Chief of ENT Diseases, Head and Neck Surgery Department of Children’s Hospital Armand Trousseau, Necker Paris, France
- Georges Tashjian, MD, PhD Associate Professor of Department of ENT diseases Head and Neck Surgery Department of Children’s Hospital Armand Trousseau , Paris, France,
- Prof. Hjalmar Hagedorn, Chief of ENT Department Helios Amper Hospital Dachau, Munich, Germany,
- Prof. Stefan Holltmann, Chief of ENT Department Arabela-clinikum, Munich, Germany
- Prof. Lenarz and German Hearing Center Hannover (DHZ),
- Prof. Lesinski-Scjiedat - Medical School Hannover Department of Otolaryngology
- Karl Storz optical endoscope with fields of sight 00, 300, and 700 (Germany), with video registration system Sopro Imaging
- Video equipment of Karl Storz (Germany) and Stryker (USA):
- Otoscopes of the Karl Storz
- Microscope Karl Zeiss Opmi Pico, with video recording system Sopro Imaging
- Bipolar radiofrequency coagulator Coblator (France),
- Johnson & Johnson Radiosurgery Unit (USA)
- Leica surgical microscope (Switzerland)