Overview

At the Otolaryngology Department, we generally provide treatment for a wide range of diseases like sinusitis, allergic rhinitis and other diseases of the nose, chronic otitis media, cholesteatoma of the middle ear, and other diseases of the ears, tonsillitis, vocal cord polyps and other diseases of the throat, as well as benign tumors of the head and neck, and dizziness (vertigo). We proactively perform nasal surgery using an endoscope for the treatment of deviated nasal septum, etc., and tympanoplasty using a microscope to treat chronic otitis media, cholesteatoma of the middle ear, etc. We are also ready to admit emergency patients, e.g., those with acute infections who need intravenous treatment under hospitalization, those with sudden hearing loss, and those who develop a facial nerve palsy, etc.

Diseases and Expertise

1. Ears
   • Diagnosis, treatment and surgery for chronic otitis media, cholesteatoma of the middle ear, and chronic otitis media with cholesteatoma
   • Diagnosis, treatment and surgery for otitis media with effusion (especially persistent pediatric cases)
   • Early diagnosis, treatment and surgery for hearing impairment (sudden hearing loss, Meniere’s disease and perilymph fistula)
   • Diagnosis and treatment for dizziness (vertigo)
   • Diagnosis, treatment and surgery for facial nerve palsy
   • Diagnosis and treatment for patulous (patent) Eustachian tube
   • Diagnosis, treatment and surgery for congenital diseases like aural fistula
   • Hearing aid outpatients (Tue./Wed. afternoons, by appointment)
2. Nose
   • Diagnosis, treatment and surgery for chronic sinusitis
   • Diagnosis, treatment and surgery for allergic rhinitis
   • Diagnosis, treatment and surgery for deviated nasal septum and hypertrophic rhinitis
   • Diagnosis, treatment and surgery for broken nose (nasal fracture), orbital blow-out fracture, and other kinds of facial trauma
   • Diagnosis, treatment and surgery for smell disorders and pediatric sinusitis
3. Throat
   • Diagnosis, treatment and surgery for chronic tonsillitis
   • Diagnosis, treatment and surgery of the adenoids and enlarged tonsils
   • Diagnosis, treatment and surgery for snoring and sleep apnea
4. Larynx
   • Diagnosis, treatment and surgery for vocal cord polyps
   • Diagnosis and treatment for recurrent laryngeal nerve paralysis
   • Diagnosis and treatment for dysphagia
   • Diagnosis, treatment and surgery for foreign objects in the trachea/esophagus
5. Head and neck
   • Diagnosis, treatment and surgery for inflammation or stones of the salivary glands
   • Diagnosis, treatment and surgery for thyroid masses
   • Diagnosis, treatment and surgery for lymphadenitis of the head and neck
   • Diagnosis, treatment and surgery for benign tumors of the head and neck
   • Diagnosis of malignant tumors of the head and neck (patients are referred to a specialized medical institution for treatment after a diagnosis of cancer is made. )

Hospital Admission

• You can schedule an operation date at the time of registration.
• We aim to provide emergency hospitalization for neurological disorders of the Otolaryngology department such as acute inflammation, dizziness, sudden deafness and facial nerve palsy.
• All patients (except pediatric patients) will be hospitalized in a private room (with an extra charge). This is so that patients can have a quiet stay and to reduce the possibility of any hospital-acquired infections.
• We strive to shorten hospitalization periods as much as possible. Generally, hospitalization will begin on the day prior to the operation.

Operations

Characteristics

1 Sinusitis

For sinusitis diseases, an endoscopic treatment is conducted. In the past, gums under the upper lip or facial skin were incised to conduct sinusitis surgery. However recently, operations using an endoscope through the nose have made surgeries without incision possible. Equipment used for surgery has also been modified, dramatically improving operation results.

1. Allergic Rhinitis
   This treatment is for perennial allergic rhinitis from house dust, ticks and seasonal allergic rhinitis, such as cedar and ragweed. Depending on the severity of the symptom and the patient’s sociality, we conduct either a conservative treatment (oral) or surgical treatment (ultrasonic scalpel). The ultrasonic scalpel treatment is a one day procedure. Endoscopic treatment is conducted on the mucous membrane so that an allergic reaction does not occur. Elementary school children can also receive this treatment. If swelling in the mucous membrane is severe, demucosation may be conducted upon hospitalization.
2. Nasal Septum Deviation
   Nasal septum deviation is a condition where the nasal cavity in the center of the nasal septum (which divides the right and left nasal cavities) is crooked. This may cause nasal congestion, snoring and sinusitis, requiring surgical procedures. A 7-8mm incision is made on the membrane about 1 cm from the entrance where an endoscope is inserted to remove deviated cartilage and bone. A week-long hospitalization is required.
3. Chronic Sinusitis
   Chronic sinusitis is the most common out of all paranasal sinus diseases. It used to be referred to as empyema. In the past, the mucous membrane in the gum under the upper lip was cut and a hole was drilled in the bone. Now, an endoscope and forceps are inserted through the nose and new equipment such as a scalpel is used to remove the sinusitis. Not only is it less of a burden for the patient, there has also been a dramatic improvement in operation results.
4. Cyst of Paranasal Sinuses
   There are four paranasal sinuses on each side of the nose(left and right). On each paranasal sinus, a cyst surrounded by bones may form. A surgical ciliated cyst is representative of a cyst that forms post-surgery. This disease can be treated by removing the pus from the cyst, and maintaining the hole that has been made.
5. Mucous Cyst
   Sometimes, a cyst may form on the mucous membrane of the maxillary sinus, located behind the cheek. Symptoms include cheek pain, discomfort, pain deep in the eye and yellow fluid flowing from the nose. Because its symptoms are rather light, operations were considered unnecessary, but for continuous symptoms, we conduct operations at our hospital. As for the operation method, an endoscope and a scalpel are inserted through 2 small holes to remove the cyst with a minimally invasive operation.
6. Mycosis of the Maxillary Sinus
   Mycosis of the Maxillary Sinus is a disease where mold grows in the paranasal cavity. Symptoms include cheek pain, foul smelling rhinorrhea and bloody nasal discharge. For these symptoms, a hole of roughly 3-4 cm is opened in the maxillary sinus from the inside of the nose to remove the mold.
7. Sinobronchial Syndrome
   Sinobronchial Syndrome is a complication of chronic sinusitis with chronic bronchitis, bronchiectasia or diffused panbronchiolitis. In most cases, the sinusitis develops first, and then influences the bronchitis with conditions such as nasal congestion, nasal mucus and choanal flow. Endoscopic surgery is conducted to improve nasal symptoms and bronchitis, and great results have been achieved.
8. Chronic Sinusitis due to Asthma Complications
   It is not uncommon for asthma complications to occur from chronic sinusitis, especially with the recent increase in people with allergies. Nasal polyp is especially common and is a symptom that combines asthma and chronic sinusitis. Prior surgical methods have not had good results, but by conducting an endoscopic surgery, nasal symptoms have improved and asthma symptoms have lightened due to the recovery of the function that protects the bronchi.
9. Blowout Fracture
   Blowout fracture is a condition that occurs when you hit your eye and a fracture the bone on the base of the eye. The orbital fat and muscles get caught in the fractured area and the lack of eye movement causes a person to see double. Three holes are opened to insert an endoscope and surgical equipment to treat this condition at our hospital.

2 Ears

1. Chronic Ear Infection
   Chronic ear infection is a condition when there is a hole (perforation) in the ear drum. When there is a hole, it is difficult to hear and also may cause repeated ear discharge. Tissue from the back of the ear is stuck to the perforated area to conduct an operation so that the ear drum can newly regenerate. When auditory ossicles lack movement, it is necessary to reconstruct the auditory ossicles in order to hear well. Five to seven days of hospitalization are required when the hole is large, but if the hole is small, one-day operations with local anesthesia or short-term 1 night hospitalization operations are available.
2. Middle Ear Cholesteatoma
   Middle ear cholesteatoma is when a part of the ear drum is indented inward and the outer skin layer grows like a cyst. It progresses inward breaking the bone and causes difficulty in hearing from auditory ossicles destruction. When an infection occurs, it causes discharge from the ears. In severe cases, it may cause dizziness or facial nerve palsy by destroying the semicircular canals, and if it progresses towards the head (base of the skull), it may cause meningitis.
   Surgery is conducted by cutting the back of the ear. A drill is used to scrape the bone to remove cholesteatoma. If there is damage in the auditory ossicles, a conchal cartilage is used to reconstruct auditory ossicles. In severe cases in which it has progressed over a broad range, 2 separate operations are conducted. The first operation is centered on cleaning (removing) the cholesteatoma and the second is conducted one year later to confirm if there are reoccurrences, and to reconstruct the auditory ossicles.
3. Secretory Otitis Media
   Secretory otitis media is a disease where water builds up deep in the ear drum (middle ear). It is common in children and is an inflammation in the middle ear membrane caused by adenoidal hypertrophy eustachian tube dysfunction due to adenoidal hypertrophy, and per tubam infection due to sinusitis and adenoid bacterial flora, and the secretion building up. In light cases, symptoms can be improved by taking antibiotics or sinusitis treatments but for severe cases, a tube must be placed long-term (about 2 years) to keep the middle ear well-ventilated. For adenoidal hypertrophy, it may be required to remove the adenoid at the same time.

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