Department of ENT / Head and Neck Surgery
Head of Department Petr Jirák, MD
Activities of the Department
The Department of ENT / Head and Neck Surgery specializes in diagnostics and conservative and surgical treatment of the ear, nose and throat diseases.
Similarly as in previous years, surgical procedures carried out in 2017 covered a whole range of head and neck surgery – surgeries of thenose and paranasal cavities (mostly as endoscopic interventions), comprehensive surgery of the thyroid and parathyroid glands, microsurgery of the vocal folds and larynx, cophosurgical interventions (ear surgeries), interventions to treat sleep apnea syndrome and rhonchopathy, as well as corrective surgeries in the area of the head and neck, operations on the soft tissues of the head and neck, surgeries for injuries of facial bones and ENT surgical oncology. Skull base surgery was intensively developed in collaboration with the Department of Neurosurgery.
Within the Na Homolce Hospital, the Department cooperates with neurologists in the treatment of balance disorders and has at its disposal a unit with the state--of-the-art equipment - Leksell gamma knife - for the treatment of auditory nerve tumours. In cooperation with oral surgeons and neurosurgeons, it performs demanding operations of the facial skeleton and skull base. We cooperate inter alia with experts in allergy and immunology, especially when dealing with chronic rhinitis or chronic sinusitis. One of the key areas is treatment of patients with cancer. The Department provides a detailed diagnosis, surgical treatment and follow-up care, in collaboration with oncologists.
The program of temporomandibular joint treatment has further continued. In 2017, the treatment of diseases of the temporomandibular joint was mainly conservative and minimally invasive (arthrocentesis under local anaesthesia
and arthroscopic surgeries).
Surgical treatment of rhonchopathy and sleep apnea syndrome is also very common, with the use of radiofrequency method that reduces healing time and postoperative discomfort for patients. The success rate of the treatment is regularly monitored by feedback from patients obtained through questionnaires. We established very close cooperation with the Centre for Sleep Disorders which is part of the Department of Neurology of the Na Homolce Hospital to treat patients with sleep breathing disorders.
In the field of thyroid surgery, the Harmonic scalpel has been increasingly used which significantly reduces the length of surgical procedures. In indicated cases, minimally invasive procedures to remove thyroid tissue by the MIVAT method (minimally invasive video-assisted thyroidectomy) are used. At the same time, the Department carries out a whole range of operations, ranging from partial up to extensive interventions, including removal of the entire gland and surrounding lymph nodes. It provides comprehensive postoperative care in cooperation with endocrinologists. In addition to that, the Department closely cooperates with the Department of Nuclear Medicine of the Teaching Hospital in Motol in the follow-up care of patients with thyroid cancer.
Close cooperation with dental surgery has continued. Together, we indicate and operate on patients for whom the combination procedure is an advantage.
In 2017, the outpatient unit of the Department of ENT / Head and Neck Surgery provided comprehensive services, including specialized consultancy services in oncology, otoneurology, cophosurgery and otoprosthetics, outpatient interventions for rhonchopathy, outpatient unit for corrective head and neck surgery, phoniatry, joint outpatient unit (temporomandibular joint), and a specialized outpatient unit for the treatment of salivary glands using endoscopic technique for diagnosis of salivary gland ducts (sialoendoscopy).
The outpatient centre for sleep and snoring disorders (rhonchopathy) accounts for a large part of our outpatient care and cooperates with the Department of Neurology and the Laboratory for Sleep Disorders. The Department also has an ENT paediatric specialist working in the outpatient unit of the Department of Paediatry. The Department continues to successfully develop an aesthetic program of corrective surgery of the head and neck which primarily includes procedures on auricles, eyelids, external nose, and laser operations.
As standard, we use an NBI diagnostic method (narrow band imaging) which allows us, both in the outpatient setting and during surgeries under general anaesthesia, an earlier and more precise diagnosis of early stages of serious diseases of ENT mucosa, particularly disorders of the vocal folds and larynx.
Since 2015, we have been using a FEES (fiber-optic endoscopic evaluation of swallowing) assessment method of swallowing which has been further developed in cooperation with a clinical speech therapist.
Outlook for 2018
- The Department will continue to provide comprehensive ENT diagnostics and treatment. The aim is to further improve the professional standard and quality of provided health care, with focus on interventions necessitating shorter hospital stays.
- The program of functional corrective surgery and rhonchopathy has an increasing trend.
- We have introduced a drug-induced sleep endoscopy (DISE) in patients with the sleep apnoea syndrome.
- We will focus on further development of thyroid surgery – newly also under grant support.
- We will continue our close cooperation with dental surgery in performing combined ENT / dental surgical procedures.
- Within the neuroprogram, close cooperation will continue with the Department of Neurosurgery, particularly with regard to the skull base surgery.
- Within the cardiac program, the Department will continue to be involved in preparation of patients for cardiac and vascular surgeries.
- As every year, the Department plans to organize a workshop on thyroid disorders, with a focus on operative techniques and thyroid surgery, also in 2018.
- We will hold a seminar for practitioners on diagnosis and treatment of ENT patients coming to practitioners’ outpatient units.