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K.T.P.
SURGERY |
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Surgical Procedures |
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 The
LASER is the acronym for light amplification by stimulated emission
of radiation. It is an intense, parallel beam of pure single
wavelength in which all light waves are of same length and travel
in phase in the same direction.
A lens can focus this laser beam into a small spot producing
extremely high energy levels that can cut, coagulate or vaporize
the tissues.
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Lasers in Ear,
Nose and Throat Surgery |
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The laser is now universally accepted as technologically
the most advanced tool in various specialities of surgery. However
the properties of all lasers are not alike and the field of
ear, nose and throat surgery has advanced significantly with
the introduction of the K.T.P.-532 laser. The wavelength corresponds
to the absorption peak of haemoglobin(blood pigment) offering
the most bloodless surgery available today. The laser is especially
suited for ENT work and finds application in various aspects
of surgery in the ear, nose, larynx, neck etc. The quality of
ENT surgery using this laser improves significantly on the results.
The Vikram ENT Hospital is the first hospital in the country
to acquire and perform various new techniques with the K.T.P.laser.
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Advantages in
K.T.P.Laser Surgery |
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1. Precise
Surgery |
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As in all surgery, precision is of utmost
importance. In ENT surgery a lot of work, especially operation
on the ear and vocal cords are undertaken under the microscope.
The microscope provides a well-illuminated and magnified, operative
field in which the bright red laser is positioned with great
accuracy the laser beam can have precision upto even 0.1 mm
or less, facilitating super fine work during surgery. |
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2. Bloodless
Dissection |
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The laser beam will seal off all small blood
vessels automatically as it cuts during surgery. This is of
great importance as the blood loss is minimised, avoiding the
need for blood transfusion and associated risks. |
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3. Minimal Instrumentation
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The KTP laser can be delivered through a 200
million flexible fiber. This is of vital importance where access
is limited as in children and in small operating areas such
as ear and voice surgery. |
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4. Reduces
Spread of Cancer |
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By its property of sealing of blood vessels
and lymph vessels immediately, the spread of cancer cells during
operation is significantly reduced. Many open major surgeries
can be avoided when the cancer is treated with the laser. |
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5. Quicker
ecovery |
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The laser beam works by instant vaporization
of the tissue. This reduces the postoperative swelling and therefore
means a quicker recovery with less pain for the patient. |
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Applications
of the KTP-532 Laser in ENT Surgery : |
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ENDOSCOPIC
SINUS SURGERY |
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 The
treatment of Nasal and Sinus diseases has been revolutionized
by the introduction of the nasal endoscope. The pioneering work
of Messerklinger has lead to an understanding of the physiology
of the nose and sinuses and also recognising the mucocillary
transport mechanism of the nose and sinuses. The mucocillary
transport of mucus etc. occurs in a definite genetically predetermined
pattern. The transport is always towards the natural ostium
and a dependent opening like the intranasal inferior meatal
antostomy does not necessarily help in drainage. Mucosal contact
between adjacent areas e.g., in the middle meatus arrests the
mucocillary transport leading to stagnation and subsequent infection.
This has shown that in most instances, the pathology is not
primarily in the larger sinuses but is secondary to impaired
drainage caused by diseases in the ethmoidal infundibulum blocking
their natural ostia in the middle meatus. |
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There are numerous narrow clefts
in the anterior ethemoidal cells and there are many anatomical
variations that can easily narrow these clefts thus predisposing
to recurring infections, firstly in the ethmoids and eventually
in the larger sinuses. The Messerklinger’s concept for
the treatment of diseases of the nose and sinuses is based largely
on the diagnosis of these areas of obstruction, by the use of
Diagnostic Nasal Endoscopy and CT scans. Once the cause of the
problem is identified clearly, treatment can be directed at
these critical areas in the ethmoidal clefts and not at the
larger sinuses. |
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With
the Messerklinger’s technique, the advantages are : |
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Radical procedures
can be avoided and |
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Even in case of
massive diseases, limited procedures usually prove sufficient
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However, it is now increasingly
obvious that the principles of Functional Endoscopic Sinus Surgery
and the Messerklinger’s technique i.e., attempting to
reverse pathophsiological processes by conservative surgery
in defined areas dictated by disease are applicable only in
chronic sinusitius and acute recurrent sinusitis. The Functional
approach is not applicable to all diseases of the nose and sinuses.
In addition the horizons of nasal surgery have grown far beyond
FESS and now include various orbital and anterior skull base
procedures. The K.T.P. laser can actually go inside even the
difficult areas offering less blood loss and complete disease
clearance. The Microdebrider is used as an adjunct to this safe
technique to relieve patients of their long-standing sinus disease. |
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Cochlear
Implant Surgery |
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 Cochlear
Implant is an electronic device by which even profoundly deaf
children and adults can hear. The surgery at our center is performed
in a different way through a tiny 3cm incision and takes about
3hours. It has been 100% successful in all patients and we would
need to perform a MRI to confirm that the cochlea is developed.
Once the cochlea is developed, the implant is placed there.
The surgical part of it has been evolved to perfection and there
is no need to worry about any issues other than the age of implantation.
There is no head shave or large scar or prolonged healing time
of 6 weeks like conventional cochlear implant surgery. A child’s
speech area in the brain finishes developing by the age of 6.
So they can get their hearing at any age but would have to have
the implant early to benefit from it to stimulate their speech
area to grow. Young children get normal hearing and speech if
operated by the age of 2/3 or even until 6 or a few years later.
After that they will get the ability to hear the sounds but
discrimination would be less and speech is aided. |
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Earlier cochlear Implant surgery
was seen to be too expensive and too sophisticated to be available
even in most developed countries. Such developments are now
within easy reach of those children at VIKRAM ENT HOSPITAL due
to our commitment to provide all the latest available medical
and technical innovations. Our Cochlear Implant program is among
the most successful in the world with all candidates having
excellent results, some of whom are being documented internationally
for their successful outcomes. |
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Ballon Sinuplasty |
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A guide wire equipped with a tiny balloon was threaded into the nostrils and up to the blockage. The balloon was inflated about a quarter of an inch -- just enough to open the passageway. The balloon was then deflated and withdrawn. The result is a safe, effective, permanent widening of the critical areas leading into the sinuses while leaving the nose lining unharmed. In most cases, the sinus openings are significantly widened because the balloon has actually remodeled the delicate bones and spread them apart – all without pain. It allows for no incisions or cutting. There's no bruising or swelling and many people can return to normal activities within 24 hours.Mr.Born returned home the same evening after treatment.
Sinusitis affects 37 million people each year and is more prevalent than arthritis and hypertension and has a greater impact on quality of life than diabetes or congestive heart failure. Symptoms may significantly affect people physically, functionally, and emotionally. Patients suffer from allergies with blocked sinuses , breathing difficulty, recurring headaches, a feeling of constant "pressure" on the face, bad breath, cough and throat infections. We anticipate that this will give individuals the confidence to finally tackle their sinus problems. Many say they’ve been waiting for years for nasal surgery to improve. This procedure has made a huge difference in the life of thousands of patients worldwide with a final solution for their headaches and breathing problems. It is a simple outpatient procedure and is hailed as the most exciting medical advance in the field of sinus treatment in the last 15 years. The number of sufferers who can benefit from this treatment is huge. With sinusitis causing sufferers pain for months on end, Sinuplasty could finally offer a way to end those painful sinuses.
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Vibrant Sound Bridge |
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The vibrant sound bridge is designed to deal with mild to severe sensorineural hearing loss(nerve deafness).It is a boon for individuals who cannot wear hearing aids, or who are dissatisfied with them, or desire a cosmetically superior option. This system remedies the majority of issues that many patients have with acoustic hearing aids and offers the first real alternative treatment option for patients suffering from sensorineural hearing loss. The advantages include: |
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Improved sound quality without distortion. |
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Higher amplification levels. |
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No feedback |
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No occlusion effect. |
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Excellent speech comprehension especially in noisy environments. |
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Cosmetically superior. |
Vibrant sound bridge utilizes a hearing technology that directly drives the ossicular chain. It consists of two major componenets 1.the implant, called the vibrating Ossicular Prosthesis(VORP) and 2) the external amplification system, called Audio Processor. It is 100% digital and is programmed by an Audiologist or hearing aid acoustician eight weeks after the implant procedure to fit the user’s specific hearing loss. With nothing in the ear canal, the Sound Bridge is a particularly good treatment option for current hearing aid wearers who suffer from occlusion or feedback, and those who are looking for better sound quality or improved wearing comfort. The Sound Bridge is not a cochlear implant and it is not for conductive hearing.
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