Spectrum of Services
The basic directions of treatment:
Diseases of the nose and paranasal sinuses:
- Alignment of the nasal septum
- Reduction of turbinates
- Endoscopic surgical treatment of paranasal sinuses (functional endoscopic surgery of the paranasal sinuses (FESS))
- Correction of the external shape of the nose (rhinoplasty)
Diseases of the skull base:
- Surgical treatment of diseases of the skull base
- Diseases of the ear and vestibular apparatus
- Diagnostic audiological (hearing evaluation)
- Microsurgery to improve hearing
Diseases of salivary glands
- Surgical treatment of diseases of the salivary glands
- Surgical treatment of diseases of the submandibular salivary gland
Thyroid disease
- Surgical treatment of thyroid diseases
- Surgical treatment of diseases of the parathyroid gland
Diseases of the neck and throat
- Removal or reduction of the Palatine and pharyngeal tonsils
- Removal of lymph nodes, cysts and other mass lesions
- Operation to improve the voice
- Surgical treatment of diseases of the larynx
- Surgical treatment of diseases of the trachea
- Surgical treatment of diseases of the soft tissues of the neck
Diseases of the lacrimal ducts and eye orbits
- Surgical treatment of diseases of lacrimal ducts and eye orbits
Cancer in the head, neck and skin
- Cancer treatment across the region of the head and neck
- A full range of services in the surgical treatment of tumors of the head and neck
- Organ-saving operations
- Plastic reconstruction
- Brachytherapy
- Photodynamic therapy
Others
- Diseases of the upper respiratory ways and the digestive tract
- Childhood diseases
- Plastic and aesthetic surgery of the face
- Laser therapy
Diagnostic – Acoustic neuromas
Acoustic neuromas are benign tumors i.e. they grow slowly without penetrating the nearest tissues. They also do not develop into secondary tumors (metastases). They are most often found in the internal acoustic meatus area (Meatus
acusticus internus). Therefrom, they usually invade between the cerebellum and the pons varolii, a component of the brain stem. This area is called a pontocerebellar trigone. Therefore, the acoustic neuroma is also called a tumor
of the pontocerebellar trigone.
Diagnostics
Firstly, an ENT specialist will carefully examine the ear. The ear will be examined with an ear speculum or ear mirror to exclude other causes of the hearing loss (e.g. foreign body in the ear or inflammation). This will be followed
by ear tests to assess the loss of hearing, as well as the so-called brainstem evoked response audiometry (BERA) to localize the loss of hearing.
In addition, the doctor will also examine the sense of equilibrium. The doctor makes the final diagnosis based on the skull/brain magnetic resonance imaging. This imaging review may help to accurately determine the tumor size and
location, which plays an important role in further treatment. Also, this method can be used to diagnose very small neurinomas.
What treatment options exist?
Small acoustic neuromas of less than 3.5 mm diameter that do not cause symptoms should be monitored and measured every six months using MRI. Thus, tumor growth and change can be detected. No significant tumor growth has been found
in 60 percent of older patients since the diagnosis is established. Spontaneous tumor regression is also possible.
The growing acoustic neuroma should be removed surgically, if possible. Surgery for smaller tumors in the acoustic meatus or inner ear area is usually performed by an ENT specialist. Larger tumors and those that are deeper in the
pontocerebellar trigone shall be removed by a neurosurgeon through the hole in the calvarium. Frequently, both ENT specialists and neurosurgeons take part in the surgery. Surgeons seek to securely remove the tumor without damaging
brain tissue, nerves, and blood vessels. Alongside general surgical complications, such as haemorrhage, infection and increased risk of thrombus formation, brain interventions pose additional risk of temporary or permanent damage
to the nervous system. For acoustic neuroma, especially in the case of very large tumors, impairment or even loss of hearing may occur after the surgery.
Disturbance of the sense of equilibrium (dizziness) or damage to the facial nerves is also possible.
For patients who cannot undergo surgery for other medical reasons, such as if they suffer severe heart disease and may not survive anesthesia, special radiation therapy, known as gamma knife therapy, can be used as an alternative
to surgery. The radiation used here causes cell damage, after which healthy cells recover faster than tumor ones.