The professional staff of Otolaryngology / Head and Neck Surgery diagnoses and treats both medically and surgically (including microscopic surgery) diseases in the following fields:
External and Middle Ear
Tympanoplasty – either injury or trauma can cause the perforation of the eardrum, leading to hearing loss. If the damage is minor, the eardrum can heal on its own. But in case of a major injury, tympanoplasty is the only way to repair the damage. Tympanoplasty involves surgically grafting skin from the patient's body and fashioning it into a membrane that replaces the damaged eardrum. If the damage extends to the stapes bones inside the ear, the surgeons might proceed to stapedotomy.
Stapedotomy is a delicate operation done on the tiny bones inside the middle ear. The ear is divided into three chambers, and any disorder that affects the ear, whether trauma or disease, may cause extensive hearing loss. Stapedotomy is performed on the Stapes, the tiny bone inside the ear that helps conduct sound to the inner ear. Sometimes, the three stapes get fused (otosclerosis), leading to hearing loss. Stapedotomy involves removal of the stapes and replacement with artificial "stapes" made of materials like Teflon. Stapedotomy results vary from person to person; so extensive consultation with the attending specialist is necessary before you can go in for surgery. In Israel, all the hospitals have ENT Departments that use the latest techniques in stapedotomy to minimize discomfort and reduce the recovery period.
Laser stapedotomy is a well-established surgical technique for treating conductive hearing loss due to otosclerosis. The procedure creates a tiny opening in the stapes (the smallest bone in the human body) in which to secure a prosthetic. The CO2 laser allows the surgeon to create very small, precisely placed holes without increasing the temperature of the inner ear fluid by more than one degree, making this an extremely safe surgical solution. The hole's diameter is predetermined according to the prosthesis diameter. Treatment can be completed in a single office visit
Cochlear implantation: a cochlear implant is a small electronic device that helps people hear. It can be used for people who are deaf or very hard of hearing. A cochlear implant is not the same thing as a hearing aid because it is surgically implanted and works in a different way. There are many different types of devices but they generally consist of several similar parts. One part of the device is surgically implanted into the temporal bone (the bone surrounding the ear). It consists of a receiver-stimulator, which accepts, decodes, and then transmits an electrical signal to the brain.
The second part of the cochlear implant is an external device. This consists of a microphone/receiver, a speech processor, and an antenna. This portion of the implant receives the sound, converts the sounds into an electrical signal, and transmits it to the internal portion of the cochlear implant.
Cochlear implants allow deaf people to receive and process sounds and speech. To a certain degree, they are devices that allow deaf people to "hear." However, it is important to understand that these devices do not re-establish normal hearing - they are tools that allow sound and speech input to be processed and transmitted to the brain.
The criteria used to select appropriate candidates for cochlear implants are changing over time - as both the technology changes, and our understanding of the brain's auditory (hearing) pathways improves.
Both children and adults can be candidates for implantation. They may have been born deaf or become deaf after learning to speak. Children as young as 1 year old are now candidates for this surgery. Although adult and pediatric criteria are slightly different, they are based on similar guidelines.
Surgery for inserting a cochlear implant is performed with the patient fully asleep. An incision is made behind the ear. Then a microscope and a bone drill are used to open the bone, allowing the insertion of the internal part of the implant.
The electrode array is then passed into the cochlea (inner ear). The receiver is placed into a "well" created behind the ear to help keep it in place, and to make sure it is close enough to the skin to allow transmission of electrical information from the external portion of the device.
After surgery, there will be stitches behind the ear, and you may be able to feel the receiver in its "well" behind the ear. The external portion of the device will be placed about 3-4 weeks after surgery, to give the incision time to heal.
Vocal Box and Larynx - Voice disorders, tumors etc.
Vocal folds vibrate so fast during sound production that this vibration is impossible to see with the naked eye, similar to the wings of a hummingbird.
Stroboscopy is a special method used to visualize vocal fold vibration. It uses a synchronized, flashing light passed through a flexible or rigid telescope to visualize vocal fold vibration. The flashes of light from the stroboscope are synchronized to the vocal fold vibration at a slightly slower speed, allowing the examiner to observe vocal fold vibration during sound production in what appears to be slow motion. This "slow motion picture" is an illusion, as the speed of actual vocal fold vibration is not changed by stroboscopy. This special viewing allows the voice care team to evaluate each vocal fold's vibration properties during the different phases of the vocal fold's vibration cycle.
Phonosurgery is the term of various surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (microsurgery of the vocal folds done through an endoscope), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection into the larynx of medications as well as synthetic and organic biologic substances), and the re-innervation (restoration of the nerve supply) of the larynx.
Laryngectomy refers to the surgical removal of the voice box, or larynx, in people whose larynx has been affected by cancerous tumor or any other trauma. Since a laryngectomy is a major surgery that affects the patient's ability to speak, the procedure also involves extensive rehabilitation program for the patient after surgery. ENT Departments in Israel offer the best treatment for neck and throat problems, including treatment for tumors and accidents that have damaged the larynx. However, if treatments like radiation and chemotherapy, as well as minor surgery, fail, then a complete laryngectomy is the only option. Israeli hospitals offer the best in terms of post operative care and rehabilitation. After Laryngectomy, patients may opt for the excellent speech therapy sessions available at the hospital plus thorough evaluation and treatment of disorders arising from conditions like hearing disorders and Laryngectomy.
Neuro-otologic surgery (facial paralysis and tumors)
Skull Base Surgery
Endoscopies of the aero-digestive tract, including diagnostic
procedures and extraction of foreign bodies
Laser surgery of the upper airway including treatment of
glottic, subglottic and tracheal stenosis and obstruction
Treatment and surgery for obstructive sleep apnea
Correction of swallowing problems
Nasal and facial plastic and aesthetic surgery
Endoscopic surgery of the paranasal sinuses and the skull base
Functional nasal surgery
Surgery and treatment of head and neck tumors including
diseases of the thyroid and parathyroid glands, salivary glands, larynx and pharynx
Most departments are fully affiliated to University Medical Schools, are involved in the education and training of medical students, and have a full residency program. Senior staff and residents are involved in research in several fields such as:
Vestibular function and vestibular evoked potentials
Biological markers of head and neck tumors
The mechanism and treatment of airway stenosis and injury
Genetics of deafness
The effect of a variety of drugs and substances on hearing on animal models