SURGICAL SERVICES
Dr Richard Kennedy – MBBS (Melb.), FRACS.
Ear, nose and throat, head and neck surgeon.
Ear, nose and throat disorders.
Surgical services for adults and children.
SURGICAL SERVICES FOR EAR, NOSE, THROAT, HEAD & NECK CONDITIONS
“My aim is to ensure you fully understand your diagnosis and treatment options and are treated in a compassionate, understanding and professional manner.
If you have any questions about the diagnosis or surgical procedures below please contact my rooms.
I’ll be happy to answer any of your questions – Call (03) 9495 6900.”
Dr Richard Kennedy – MBBS (Melb), FRACS.
Ear, nose and throat, head and neck surgeon.
EAR SURGERY
Acoustic Neuroma Surgery
An acoustic neuroma or vestibular schwannoma is a benign slow growing tumour that grows on the nerves that run from the inner ear to the brain. These are usually diagnosed with an MRI scan. If they are small they are frequently observed with serial MRI scans.
When they are larger or show signs of growth then treatment is required. This is either with radiotherapy to stop it growing or surgery to remove the tumour.
The operation is performed from behind the ear. Typically patients are in hospital for 7-10 days. Recovery is usually 6-12 weeks. The operation is usually done by an ENT surgeon and a neurosurgeon.
Ear Correction Surgery (Otoplasty)
Otoplasty is an operation performed to reduce prominent or bat ears. This often referred to as “pinning back of the ears”.
Surgery is performed via an incision behind the ear. Patients usually stay overnight after the surgery. A bandage is usually worn at home for several days and then a headband for various amounts of time for the next 4 weeks.
Myringoplasty/Tympanoplasty
A myringoplasty/tympanoplasty is an operation to repair a hole in the eardrum. A perforation or hole in the eardrum can cause repeated ear infections or loss of hearing.
The operation can be performed down the ear canal but more frequently requires an incision behind the ear. Most patients stay in hospital overnight after the operation.
Cochlear Implant Surgery
A cochlear implant is a device that is surgically inserted into a person’s inner ear to restore hearing. This may be an option when properly fitted hearing aids no longer allow people to understand speech.
The device is put in through an incision behind the ear. Wires from this device are placed inside the cochlear to stimulate the hearing nerves. An external device or speech processor (similar to a hearing aid) is worn behind the ear. It has a coil that sticks to the internal device across the skin via a magnet.
The device is progressively tuned up or mapped by an audiologist over the course of months to help improve speech understanding.
Grommets
Grommets or Ventilating Tubes are small plastic tubes that are surgically inserted into the eardrum to treat middle ear conditions. The operation is generally done under general anaesthetic as a day surgery case.
Most of the cases are done in children but adults do need grommets at times.
Grommets are generally done to drain fluid from the middle ear to improve hearing or prevent infections. They usually stay in for about a year and fall out on their own. They may need to be done multiple times if the problems come back after the ear has healed up.
Mastoidectomy
A mastoidectomy is a procedure that removes diseased mastoid air cells. Mastoid air cells are located behind the ear and usually are filled with air like honeycomb.
Typical reasons for a mastoidectomy are the removal of acute or chronic infection or for the treatment of cholesteatoma (an erosive skin cyst) in the middle ear or mastoid.
Exostoses Surgery
Stapedectomy
“Most ear conditions present with multiple symptoms that may require further tests to help formulate an accurate diagnosis. The management of the condition/s may be treated medically or surgically depending on your diagnosis.
I will ensure you understand the information in relation to your condition and your treatment options.
If you have any questions, please contact my rooms – Call (03) 9495 6900.“
Dr Richard Kennedy – MBBS (Melb), FRACS.
Ear, nose and throat, head and neck surgeon.
NASAL SURGERY
Nasal Surgery
Nasal surgery involves a series of different surgical procedures that are usually done in various combinations to try to help improve the function of the nose.
Diseases of the nose are most commonly treated with medicines first but if these don’t adequately fix the problem then surgical procedures are considered. Most surgical procedures require patients to stay the night in hospital after the operation and usually to take a week off from work.
Below are the descriptions of the common procedures that are done either on their own or more often in combination with some of the others depending on what is wrong with the nose.
Septoplasty
The septum is the bone and cartilaginous wall that separates one side of the nose from the other internally. It can often be crooked or deviated which can cause obstruction to breathing.
Septoplasty is the surgical correction of this deviation. It is done through the nostrils so there is no external scarring.
Turbinectomy
The inside walls of the nose have three long thin bones covered with a thin layer of tissue known as mucosa. These bones are known as turbinates.
The tissue on these can expand in response to various factors such as allergy or infection. This can lead to nasal obstruction. The lowest and largest of these, the inferior turbinate, is most frequently the cause of problems.
If treatment with medicines cannot reduce this then surgery to reduce this can be done. This is referred to as inferior turbinectomy and this is often done in combination with septoplasty.
Rhinoplasty
Rhinoplasty is the surgical correction of the outside part of the nose. It is mostly done as a part of a procedure to correct the function of the nose but can be done as a cosmetic procedure to just change the look of the nose.
The surgery is most often done through the nostrils so there is no external scarring. The bones of the nose usually need to be reshaped or broken so a splint is usually applied to the outside of the nose for 3 to 7 days. Bruising or black eyes are very common after this operation.
The skin on the outside of the nose if often stiff for several months after the operation and great care needs to be taken to avoid sun exposure in this time. Rhinoplasty is often performed with septoplasty and turbinectomy to correct associated nasal obstruction.
Sinus Surgery/FESS
The sinuses are hollow cavities in your cheeks, between your eyes, and in your forehead. They are usually full of air and connect to the inside of your nose through small openings. If they become diseased with infection or other causes of inflammation such as allergy then this can lead to symptoms such as nasal obstruction, nasal discharge, loss of smell and facial congestion and pain.
Treatment with medicines such as antibiotics and nasal sprays will frequently help these symptoms of sinusitis.
If medical treatment does not improve things the sinus surgery or FESS (Functional Endoscopic Sinus Surgery) can be done to help alleviate these symptoms. Surgery is typically done through the nostrils using telescopes and specialised instruments to open up the sinus openings so that they are less likely to be blocked.
Nasal Polypectomy
Nasal polyps are benign swellings that grow in the nose in some people’s noses. They often form in response to infection or allergy.
They can cause difficulty breathing, infections and loss of sense of smell and taste. Nasal polyps can be removed with surgery often as part of surgery on the sinuses and nose. This is usually done with sinus surgery using telescopes and specialised instruments through the nostrils.
Adenoidectomy
Adenoids are a type of tissue similar to tonsils that are present in the back of the noses of children. This tissue usually spontaneously shrinks when children are about 7 years old.
The adenoids however can cause nasal obstruction and increased nasal infections. They are located in what is known as the nasopharynx. The eustachian tubes which provide ventilation to the middle ears open into this space.
If the adenoids are enlarged or frequently infected it can lead to problems with the ears including recurrent infections and hearing loss.
Adenoidectomy is an operation that is done to help these problems. It is done through the mouth by reaching up behind the soft palate to remove them. If done on its own it is usually done as a day case. Often it is done in combination with other procedures such as tonsillectomy or grommets or other nasal procedures as mentioned above.
“Most nose conditions present with multiple symptoms that may require further tests to help formulate an accurate diagnosis. The management of the condition/s may be treated medically or surgically depending on your diagnosis.
I will ensure you understand the information in relation to your condition and your treatment options.
If you have any questions, please contact my rooms – Call (03) 9495 6900.“
Dr Richard Kennedy – MBBS (Melb), FRACS.
Ear, nose and throat, head and neck surgeon.
THROAT SURGERY
Microlaryngoscopy
Tonsillectomy
Uvulopalatopharyngoplasty (UVPPP)
This is a procedure that removes excess tissue in the back of the throat to make the airway wider. This is aimed to allow air to move more easily while you breathe in your sleep to reduce snoring and obstructive sleep apnoea.
Typically the uvula and posterior part of the soft palate is removed as well as the tonsils if present. It is a painful operation and recovery is 10-14 days. It is often done with nasal surgery also to further improve the airway. Success depends on many factors and a full assessment of the upper airway including a sleep study is done prior to any surgery.
Pharyngeal Pouch Surgery
A pharyngeal pouch is a pocket that forms in the upper part of the oesophagus (gullet) just behind the larynx (voice box). Food may collect in the pouch rather than going down the oesophagus to the stomach causing difficulty swallowing and sometimes loss of weight. Food may regurgitate in the throat causing coughing and chest infections.
Most of the time the operation can be done down the throat through the mouth. In this procedure a stapler is used to open the wall of the pouch so that it no longer collects food. No incisions in the neck are required and the recovery from this is rapid and typically patients go home after 2 nights in hospital. If it is not possible to do it this way an incision can be done in the lower neck and the pouch can be removed. The recovery from this is more prolonged and the patient is in hospital for 5-7 days.
“Most throat conditions present with multiple symptoms that may require further tests to help formulate an accurate diagnosis. The management of the condition/s may be treated medically or surgically depending on your diagnosis.
I will ensure you understand the information in relation to your condition and your treatment options.
If you have any questions, please contact my rooms – Call (03) 9495 6900.“
Dr Richard Kennedy – MBBS (Melb), FRACS.
Ear, nose and throat, head and neck surgeon.
HEAD AND NECK SURGERY
Thyroglossal Duct Cyst
The thyroglossal duct is a potential space that runs from the back of the tongue down through the front of the neck to end in front of the trachea (windpipe) at the thyroid gland in the lower neck. It is the remnant of the path the thyroid gland follows as the human body is developing in utero.
Cysts (fluid filled lumps) can form anywhere along this tract and may need to be removed. They are removed through a small cut in the upper neck. An overnight stay is usually required after the operation and recovery is about a week.
Head and Neck Cancer Surgery
Neck Dissection
Neck dissection refers to the removal of lymph nodes and surrounding tissue from the neck for the purpose of cancer treatment. The extent of tissue removal depends on many factors including, the stage of disease, the extent and type of cancer.
The most common cancers removed from lymph nodes in the neck include head and neck squamous cell carcinomas, skin cancers and thyroid cancers. In general, the goal of neck dissection is to remove all the lymph nodes within a predefined anatomic area.
Thyroid Surgery (Thyroidectomy)
The thyroid gland is a butterfly shaped gland at the base of your neck. It produces hormones that regulate your metabolism including your heart rate and how quickly you burn calories.
A thyroidectomy is an operation to remove usually half or all of the thyroid gland. The operation is done through a small incision in the lower neck. Most frequently the operation is done to remove nodules from the thyroid gland to test if they are benign or malignant. It can also be done to remove very large thyroid glands or overactive thyroid glands.
Parotid Surgery (Parotidectomy)
The parotid gland is a salivary gland that is located in front of the ear and over the angle of the jaw bone. A parotidectomy is an operation to remove part or all of this gland.
Most operations are to remove tumours from the parotid gland. About 20 per cent of these will be malignant (cancerous). Sometimes the parotid gland is removed for chronic infections or stones.
The facial nerve which is the nerve responsible for helping the face moves runs through the gland and great care is needed to preserve the nerve and it’s function. Usually patients stay in hospital for 2 nights following surgery.
“Most head and neck conditions present with multiple symptoms that may require further tests to help formulate an accurate diagnosis. The management of the condition/s may be treated medically or surgically depending on your diagnosis.
I will ensure you understand the information in relation to your condition and your treatment options.
If you have any questions, please contact my rooms – Call (03) 9495 6900.“
Dr Richard Kennedy – MBBS (Melb), FRACS.
Ear, nose and throat, head and neck surgeon.