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dr. Gilles Van Haesendonck Make an appointment Graduated as a doctor from the University of Antwerp in 2016. Afterwards specialization in ENT and head and neck surgery at Antwerp University Hospital (UZA) and ZNA Middelheim. Special interest and ability in head and neck surgery: Thyroid: Swelling, nodule, or cyst of the thyroid gland. Benign and malignant tumors of the thyroid gland. Salivary gland: Swelling, nodule, or cyst. Benign and malignant tumors (parotid and submandibular salivary gland). Vocal cord pathology: vocal cord nodules, cysts, and cancer. Benign and malignant tumors in the head and neck area (mouth, tongue, tonsil,...) Surgical treatment of facial skin cancer. Disorders of facial movemen / facial paralysis or palsy. Also diagnosis, advice and treatment of: Voice and swallowing disorders facial paralysis Nasal congestion, nosebleed, runny nose, loss of smell and taste Functional Rhinoplasty / Septoplasty Tonsils and polyps Placing ventilation tubes Snoring and sleep disorders Hearing loss Hearing aid advice Dizziness and balance disorders BAHA surgery Also working at the Antwerp University Hopital (UZA Edegem) and AZ Sint Maarten (Mechelen) . Member of: Belgian Association for ORL EORTC Head and Neck surgical group Flemish Working Group for Head and Neck Tumors (VWHHT) Editorial board B-ENT

Home Make an appointment Nieuwe pagina About us Useful Documents FAQ Zoekresultaten More Information on septoplasty and conchaplasty Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Don't forget to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). What function does the nose have? The nose is certainly not only there for the smell, although this is of course an important part of the function. The nose is primarily a part of the respiratory organs. In the nose, the inhaled air is heated, moistened and cleaned. For example, more than 95% of the particles that pollute our air are filtered out through the nose and made harmless. The nose ensures the best possible breathing. In addition, the nose has an important function in voice formation and the drainage of tear fluid also runs through the nose. Finally, the external shape of the nose is also an important aspect; this determines a person's appearance to a large extent. Nasal function can be affected in many ways. For example, due to a cold as it sometimes occurs in everyone, or due to an allergy (hypersensitivity). Disorders in the function of the nose can often be made worse by an abnormal shape of the interior of the nose. The most common is a misalignment of the nasal septum (the septum), which separates the nasal halves. This abnormal shape of the nasal septum is very common and can lead to a wide range of complaints, such as a feeling of constipation, disturbed breathing or headache. This is an explanation for the fact that straightening the nasal septum (the so-called septal correction) is an operation that is common. The aim of this procedure is to improve nasal function. Septoplasty (septum correction) The purpose of the operation The aim of the operation is to correct deviations/crookedness of the nasal septum, so that it is straightened and there is therefore sufficient breathing space in the nose on both sides. The technical aspects of the operation Surgery is performed exclusively in the interior of the nose, so no visible scars are to be expected. During the operation, the cartilage and bone of the nasal septum is exposed through a small incision inside the nose, usually on the right side, a few millimeters past the entrance to the nose. After this, the partition is then straightened, ie protruding parts are removed, curved parts are straightened, etc. Immediate Effects The thus repaired nasal septum is then temporarily held in place by so-called splints inserted into the nose (silicone plates that are placed in the nose on both sides and that allow some breathing through the nose). In this way the septum is supported in the correct position on both sides, so that the mucous membrane, cartilage and bone can grow back together. The splints are removed after about 1 week. The sutures at the incision are removed after 1-2 weeks, if applicable. Late Effects The healing of the nasal mucosa takes several weeks. During this period, treatment with nasal rinses and/or vapors and/or nasal ointments may be applied. In rare cases, problems during healing can cause a misalignment of the septum or cause deformities that could negatively affect nasal breathing. Serious and/or exceptional complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Bleeding is always more or less to be expected, there are of course cases where the doctor will have to intervene extra. Cerebrospinal fluid leakage can occur after both nasal and sinus surgery (although it is extremely rare with septoplasty). If a leak does occur, it is not very noticeable and only becomes apparent late. Confusing in this regard, of course, is that any patient undergoing surgery on the nose or sinuses will always have some watery nasal discharge. If the nasal discharge is profuse or noticeably one-sided, it is best to inform the doctor. Nasal turbinate surgeries (conchaplasty or conchacoagulation) The purpose of the operation Especially the inferior concha (the lower turbinate) is mentioned in this context as it plays the most important role in nasal breathing. The concha media can also be surgically corrected, usually in conjunction with sinus or septal surgery, so that we only focus on the inferior concha here. Most procedures on the inferior concha are intended to reduce this structure and thus improve nasal breathing. The technical aspects of the operation In order of invasiveness we distinguish the RF conchaplasty, the conchacoagulation and the conchaplasty. In the RF conchaplasty, a needle is inserted into the concha (usually under local anaesthetic), which causes a controlled heating of the concha, after which the concha scars and shrinks. In the concha coagulation, this effect is achieved by burning the concha from the surface using electric current. This can be done under local or general anaesthetic. In conchaplasty, part of the conchamucosa is cut away, almost always under general anaesthetic. Many turbinate surgeries are done in conjunction with a septal correction or sinus surgery. Immediate Effects Bleeding is to be expected to a greater or lesser extent if a conchaplasty is performed. this is why a nasal tamponade is sometimes temporarily applied, which can then be removed after 1 or a few days. Late Effects Crust formation at the inferior concha occurs in the first weeks, as long as the mucosa is still in the healing phase. Nasal rinses and/or nasal ointment are usually used for this or nasal drops. Serious and/or exceptional complications There are, apart from the already mentioned bleeding with conchaplasty, no serious or exceptional complications from these operations.

Information on removal of the parotid sinus / parotidectomy Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams. The parotid gland (parotid gland) is located in front of and below the ear. There are 2 parotid glands, 2 under the jaw and 2 under the tongue. Together with numerous smaller salivary glands, they ensure saliva production. The parotid gland has a superficial and a deep lobe, between which runs the facial nerve (facial nerve). This ensures the mimicry of the face, the closing of lips and eyelids. When a tumor is found, it is best removed surgically. Most growths are benign. Purpose of the procedure When a tumor of the parotid gland needs to be removed, it is safe to do so after carefully locating the facial nerve to try to avoid facial paralysis. The technical aspects of the operation The operation is done under general anaesthetic. Through an incision, which runs in front of the ear and further into the neck, the parotid gland, the facial nerve and the tumor are searched for and the tumor is removed. Depending on the location and extent of the injury, the operation can take up to 4 hours. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By incising the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the area of operation. The numb area gradually becomes smaller and smaller. The immediate consequences Swelling usually occurs in the wound area for several weeks. There may be bleeding from the wound. This usually happens shortly after the operation. Sometimes it is necessary to find the source of bleeding again under anesthesia and to burn the bleeding vessel shut. A crooked face may occur after surgery due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The belated consequences There may be a collection of saliva previously visible at the bottom of the wound, which may need to be punctured. Frey's syndrome can develop after a few months. Then there is redness and perspiration of the skin of the operating area during eating. Serious and/or late complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Permanent facial nerve failure can occur but is extremely rare. Phlegmon or abscess formation in the neck area is rare. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated. Symptomen van LPR De symptomen van LPR kunnen variëren, maar de meest voorkomende zijn: Heesheid of stemveranderingen De irritatie van het strottenhoofd kan leiden tot een schorre stem of veranderingen in de stemkwaliteit. Keelpijn of gevoel van een brok in de keel (globusgevoel) Veel mensen met LPR ervaren een continu gevoel van iets vastzitten in de keel. Chronische hoest Dit kan een gevolg zijn van irritatie van de keel en luchtpijp door maagzuur. Keelpijn of branderig gevoel in de keel Dit kan optreden na het eten of wanneer je 's nachts ligt. Wakker worden met een droge mond of een benauwd gevoel LPR kan zich verergeren wanneer je ligt, wat 's nachts tot klachten leidt. Slikproblemen Er kan sprake zijn van pijn of moeilijkheden bij het slikken van voedsel. Oorzaken van LPR LPR ontstaat wanneer de onderste slokdarmsfincter (de klep tussen de slokdarm en de maag) niet goed sluit. Hierdoor kan maaginhoud, waaronder zuur, via de slokdarm omhoog komen en in de keel terechtkomen. Factoren die LPR kunnen veroorzaken of verergeren, zijn onder andere: Overgewicht of obesitas Roken Alcoholgebruik Koffie en andere cafeïnehoudende dranken Vette of gekruide voeding Stress Hormonale veranderingen (bijvoorbeeld tijdens zwangerschap) Bepaalde medicijnen, zoals bloeddrukverlagers of pijnstillers Hoewel medicatie een belangrijke rol speelt bij de behandeling van LPR, kunnen levensstijlveranderingen een cruciale bijdrage leveren aan het verminderen van symptomen en het voorkomen van terugkerende klachten. In deze sectie leggen we de belangrijkste veranderingen in levensstijl uit die je kunnen helpen om LPR onder controle te krijgen. 1. Eet kleinere, frequentere maaltijden In plaats van drie grote maaltijden per dag, kun je proberen om kleinere maaltijden te eten die je lichaam gemakkelijker kan verteren. Dit helpt om de druk op je maag te verminderen en voorkomt dat er teveel maagzuur wordt geproduceerd, wat kan terugstromen naar je keel. 2. Vermijd eten vlak voor het slapen Probeer ten minste 3 uur te wachten tussen je laatste maaltijd en het moment waarop je gaat slapen. Dit geeft je maag voldoende tijd om de voeding te verteren en voorkomt dat er zuur omhoogkomt wanneer je horizontaal ligt. 3. Verander je dieet Er zijn bepaalde voedingsmiddelen die de symptomen van LPR kunnen verergeren. Het vermijden van deze voedingsmiddelen kan een aanzienlijke verbetering opleveren. Vermijd vette en gefrituurde voeding: Vetrijke maaltijden vertragen de spijsvertering en vergroten de kans op reflux Beperk gekruide en zure voedingsmiddelen: Tomaten, citrusvruchten, chocolade, en koffie zijn voorbeelden van voedingsmiddelen die de maag kunnen irriteren en de reflux kunnen verergeren. Vermijd alcohol en cafeïne: Zowel alcohol als cafeïne kunnen de spieren van de onderste slokdarmsfincter ontspannen, waardoor reflux waarschijnlijker wordt. Probeer een alkalisch dieet: Voedingsmiddelen die een alkalisch effect hebben op het lichaam (zoals groenten, noten, en havermout) kunnen helpen om de maag te kalmeren en refluxklachten te verminderen. 4. Stop met roken Roken is een van de belangrijkste risicofactoren voor het ontwikkelen van reflux. Het verzwakt de sluitspier van de slokdarm en verhoogt de zuurgraad van het maagzuur. Ook verstoort het de speekselproductie, die normaal gesproken helpt om de keel te beschermen tegen zuur. 5. Beperk alcoholgebruik Alcohol kan de slokdarmsfincter ontspannen en de zuurproductie verhogen, wat beide bijdraagt aan reflux. Ook kan alcohol de maagwand irriteren, wat de symptomen van LPR kan verergeren. 6. Gewichtsverlies Als je overgewicht hebt, kan het verminderen van je gewicht helpen om de druk op je maag te verlichten. Overgewicht vergroot de kans op reflux, omdat het de buikdruk verhoogt, waardoor zuur omhoog kan stromen naar de slokdarm en keel. 7. Slaap met je hoofd omhoog Probeer je bed iets te verhogen, zodat je hoofd hoger ligt dan je buik. Dit kan helpen om te voorkomen dat zuur 's nachts omhoog komt in de slokdarm en keel. Gebruik bijvoorbeeld een kussen of een speciaal kussen dat het bovenste deel van je lichaam ondersteunt. 8. Stressvermindering Stress kan een belangrijke rol spelen bij het verergeren van refluxklachten. Het kan leiden tot een verhoogde zuurproductie en het verergeren van spierspanning rondom de maag en slokdarm. Technieken zoals ademhalingsoefeningen, meditatie, yoga of regelmatige lichaamsbeweging kunnen helpen om stress te verminderen. Hoewel LPR soms moeilijk te behandelen kan zijn, kunnen de meeste mensen hun symptomen beheersen met de juiste combinatie van medicatie en veranderingen in levensstijl. Het is belangrijk om geduldig te zijn en samen te werken met je arts om een behandelplan te vinden dat voor jou werkt. Wanneer naar de arts? Als je regelmatig symptomen van LPR ervaart, zoals keelpijn, stemveranderingen, of chronische hoest, is het raadzaam om een arts te raadplegen. Vroege behandeling kan helpen om verdere schade aan de keel en het strottenhoofd te voorkomen en de kwaliteit van je leven te verbeteren. Conclusie Laryngo-pharyngeale reflux (LPR) is een aandoening die kan leiden tot ongemakkelijke symptomen zoals heesheid, keelpijn, en chronische hoest. Hoewel de diagnose vaak lastig is, zijn er effectieve behandelingsopties beschikbaar. Door veranderingen in je dieet, levensstijl en het gebruik van medicijnen kun je de symptomen onder controle krijgen en je algehele welzijn verbeteren. Neem contact op voor een gepersonaliseerd behandelplan.

Information on thyroid removal / thyroidectomy Introduction The thyroid gland is located low in the front of the neck (just above the sternum) and has two halves, located to the left and right of the trachea, which are interconnected by a narrower “intermediate piece” located in front of the trachea. At the back of each thyroid half, two other small glands are attached to the thyroid gland: the parathyroid glands, these are usually only half a cm. great, but no less important. The thyroid gland produces a hormone that regulates the metabolism of our entire body, the parathyroid glands regulate the calcium content of our body: the absorption in the intestines and distribution to the blood and to our bones. The purpose of this information is to provide you with generally applicable information about this type of operation. Of course it is possible that in your individual case certain aspects of this document do not apply or that they should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). The general anesthetic is best discussed in advance with the physician-anaesthetist Purpose of the procedure The thyroid gland is operated on for several possible reasons. Its functioning can be disrupted and can not or insufficiently be adjusted with medication. Even when it is still functioning normally according to blood tests, it can increase strongly in volume and start to exert pressure on surrounding structures, or become aesthetically disturbing. Nodules can grow in the thyroid gland, usually these are benign, sometimes malignant, the distinction between the two is not easy to make “from the outside” so that surgery may be necessary for that reason. The decision to operate is almost always made in consultation with the endocrinologist (or “thyroid specialist”), who also plays an important role in the follow-up after surgery. During thyroid surgery, either one half or both halves of the thyroid gland is removed, sometimes it is also decided to leave a small healthy part of the thyroid gland in place. In other words, what does not happen is that one or a few isolated nodules from the thyroid are surgically removed, for various technical and medical reasons. The parathyroid gland(s) are always removed when they work too strongly, several different diseases can cause this, these are never malignant diseases Technical aspect of the procedure The surgeon makes a horizontal incision in the neck, about 2 cm above the upper edge of the sternum, the incision coincides with the natural skin lines so that the later scar is hardly visible. Some superficial structures are incised or moved to the side to access the thyroid gland. This is then loosened all around and removed. There are a few special points to pay attention to: the parathyroid glands are left in place (with thyroid surgery – in the case of parathyroid surgery it is vice versa) and must therefore first be peeled off the thyroid gland; the nerves of the larynx are also close to the thyroid gland and so should also be carefully avoided. The operation ends with the placement of a “drain” in the wound, which prevents the accumulation of exudate and blood in the neck wound, and with the re-closing of the neck wound in several layers. Immediate consequences of the procedure Mild neck and/or neck pain and mild temporary hoarseness may occur. Eating, drinking, swallowing and talking can be done almost immediately (but food and drink should be limited for the first few hours after surgery to prevent nausea and vomiting as is the case after any anaesthetic), sitting up and walking around as well. An intravenous line remains in the arm for the first 24 hours, the drain usually remains in place for 48 hours. Even when the parathyroid glands were perfectly respected during thyroid surgery, their functioning can be temporarily disrupted. That is why every patient is given preventive calcium intake after surgery and the calcium level in the blood is checked several times. Discharge typically follows the third day after the procedure. The thyroid hormone in our body has a fairly long "half-life", so that deficiency of it (eg when the thyroid gland has been completely removed) is not quickly noticeable. If necessary, however, thyroid replacement medication is also started after the operation. It is best taken in the morning sober. The belated consequences Wound healing is usually fast. Sutures are removed within a week, support plasters (Steri-Strips) are best left on the wound for an extra week. The neck wound must be healed. Stay strictly dry for 2 weeks. Scars heal best if they are not exposed to bright sunlight in the first months, a scarf or "sun block" is sufficient if you have holiday plans. Long-term follow-up of the thyroid gland function and the regulation of “thyroid substitution” are done in consultation with the general practitioner and endocrinologist. With a correct substitution there are no further consequences of the operation Serious and/or exceptional complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can still involve complications. A bruise in the neck may require urgent reoperation, this complication is rare and never occurs after discharge. Permanent hoarseness or even breathlessness due to limited mobility of the vocal cords is very rare and has its specific treatment options. Technical aspect of the procedure During a direct laryngoscopy, an instrument called a laryngoscope is used. This instrument is gently guided to the back of your throat, giving the doctor a good view of your larynx and vocal cords. Using a microscope or camera, the doctor can magnify the images of your larynx and view them on a monitor. If surgery is needed, the doctor can perform it using small instruments through the laryngoscope, often using a CO2 laser. Anesthesia: A direct laryngoscopy is always performed under general anesthesia. Duration: The examination usually takes 30 to 60 minutes Consequences of the procedure Mild pain in the throat and/or neck and slight temporary hoarseness may occur. Eating, drinking, swallowing and talking can be done almost immediately (but food and drink should be limited for the first few hours after surgery to prevent nausea and vomiting as is the case after any anesthesia). Serious and/or exceptional complications Every surgical procedure, even in ideal conditions and performed in the best possible way, can still lead to complications. Damage to the teeth, lips or throat tissue during insertion of the laryngoscope. Temporary voice change or hoarseness as a result of manipulation of the vocal cords. Possible reactions to anesthesia, such as allergic reactions or breathing problems are also possible, as with every procedure. The purpose of this information is to provide you with generally applicable information about this type of surgery. It is of course possible that in your individual case certain aspects of this document do not apply or need to be discussed more or additionally with your surgeon. Do not forget to tell your surgeon all information about your general state of health, as well as all medications that you regularly take - especially aspirin and related products, or other medications that can affect clotting. General anesthesia (narcosis) should be discussed in advance with the physician-anesthetist

Home Make an appointment Nieuwe pagina About us Useful Documents FAQ Zoekresultaten More Information on ear operations Introduction The purpose of this information is to inform you about the course of this procedure, we ask you to do so read the document carefully. Your surgeon is at your disposal to answer any further questions you may have. Of course, it may be the case that certain aspects of this document are not applicable in your individual case or that they need to be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams. Questions regarding the general anaesthetic – if applicable – are best discussed in advance with the physician-anaesthetist. Before going into the technical aspects and purpose of the procedure, it is useful to explain how the ear works. Sound consists of air vibrations. These vibrations come through the ear canal to the eardrum. The eardrum and the ossicles amplify and conduct the vibrations to the cochlea. The cochlea contains the sensory (nerve) cells, which convert the vibrations into nerve impulses. These nerve impulses are carried via the auditory nerve to the brain, where they are translated into “hearing”. Under normal circumstances, the middle ear is filled with air, which has the same pressure and composition as outside air. The Eustachian tube allows for exchange so that the air pressure in front of and behind the eardrum is the same. The ear can be roughly divided into: the external auditory canal; the eardrum with the middle ear behind it. It contains three ossicles, which together form the ossicle chain: the malleus (malleus), the anvil (incus) and the stirrup (stapes). The middle ear is connected to the nasopharynx via the Eustachian tube. the actual organ of hearing, also called the cochlea or inner ear. Schematic ear with: ear canal eardrum hammer anvil stirrup middle ear vestibular system Eustachian tube snail shell vestibular nerve facial nerve auditory nerve Hearing loss can be due to an inner ear loss (sensorineural hearing loss) or a conductive hearing loss (transmission loss). Sensorineural hearing loss involves damage to the nerve part. With a conduction loss, there is insufficient transmission of sound from the ear canal to the cochlea. The cause of the hearing loss is usually in the middle ear. For example, due to permanent damage to the eardrum or the ossicles after an ear infection. In this section only those operations where conduction loss is present are discussed. Purpose of the procedure If there is hearing loss due to a defect in the middle ear, surgery can usually improve hearing. This is the case with a hole (perforation) in the eardrum, or with an interruption or fixation of the ossicles. Sometimes, in addition to the hearing loss, there is a chronic inflammation in the middle ear (cholesteatoma) and the aim of the surgery is initially to heal the ear of the inflammation . The surgeon will also try to restore hearing as well as possible in that situation, but depending on the seriousness of the situation, this is not always possible. Your doctor will discuss this with you beforehand. The technical aspects of the operation Tympanoplasty (repair of the eardrum) This operation is performed to close a hole in the eardrum. Your own tissue or an allograft (donor) eardrum can be used for this. Own tissue can be fascia, this is the thin membrane that surrounds a muscle behind the ear or cartilage tissue originating from the pinna. The procedure can be done through the external auditory canal or through an incision behind the ear. After the procedure, a bandage is placed in the ear consisting of synthetic sponges in ear ointment and a bandage behind the ear in case of incision and stitches. A large bandage is placed around the head during the first 24 hours after the procedure. The bandage in the ear remains in place for seven days. Ossiculoplasty (repair ossicles) When there is hearing loss due to reduced sound transmission via the ossicles, this may be due to an interruption of the ossicles (after inflammation) or by a fixation (otosclerosis or tympanosclerosis). Fixation by otosclerosis is discussed in a separate chapter. The procedure is usually performed through the external auditory canal, whereby the eardrum is detached and lifted. The repair can be done with your own tissue, plastic or donor material. Your doctor will discuss this with you in advance, depending on the situation. The goal is to improve hearing. This procedure can also be combined with the repair of the eardrum. A bandage is placed in the ear consisting of synthetic sponges in ear ointment. The bandage remains in place for several days. Otosclerosis Otosclerosis is a progressive disease that slowly makes a person hard of hearing. The hearing loss can occur in one or both ears in otosclerosis. The cause is an abnormal overgrowth of the bone, causing a progressive fixation of the stapes. By sticking the stirrup, there is a less good transfer of the sound vibrations and a conduction loss occurs. The process can also occur in the cochlea, causing sensorineural hearing loss. When there is mainly a conduction loss, surgery can improve hearing. The procedure is performed along the external auditory canal, lifting the eardrum. The stirrup is partially replaced by a plastic leg. After the procedure, a bandage is placed in the ear canal, consisting of sponges in ear ointment. The bandage remains in place for several days. cholesteatoma A cholesteatoma is a chronic inflammatory process in which skin grows through the eardrum into the middle ear and forms a cyst. This cyst has a destructive effect due to its growth character and can affect the ossicles, the vestibular system, the facial nerve and even grow into the inner ear. Hence the importance of a surgical procedure to remove the cyst. Sometimes multiple operations may even be required to remove the cholesteatoma permanently. During the procedure, an incision is always made behind the ear. The mastoid cavity (air-containing cells behind the ear) is drilled open in this way to allow complete removal of the cyst. The aim of the operation is initially to remediate the ear and to free it from the chronic inflammatory process. In the second instance, the surgeon will try to restore hearing, but depending on the situation, this will not always be possible. The surgeon will discuss this with you in advance as well as possible. After the procedure, a bandage is placed in the ear consisting of sponges in ear ointment. There are stitches behind the ear. A large bandage is placed around the head for the first 24 hours. The stitches and bandage in the ear are removed after one week. The immediate consequences You may experience mild pain after ear surgery. If there is a large bandage, this can cause pressure and tension. This feeling of pressure disappears when the bandage is will be removed. You may take painkillers if necessary. The sensitivity of the pinna may be reduced; there may be a temporary numbness that disappears after a few weeks or months. Temporary dizziness may occur after ear surgery, as the ear and balance organs are close together. Report this to your doctor. Temporary taste disturbances may occur. There may be a slight temperature increase in the first 24 hours after the procedure. There may be some bloody fluid from the ear canal for the first few days; this is normal. If one of the sponges falls out of the ear canal, don't worry; DO NOT try to put it back in. Your hearing will not improve for the first few days, given the presence of the bandage. A popping sound and ringing in the ears after the procedure is normal. The belated consequences If the aim of the surgery is to improve your hearing, such as with a tympanoplasty, a ossiculoplasty or otosclerosis, this will only be assessed a few weeks after the procedure. It healing process happens rather slowly and progressively. You will have to apply local care in the form of ear ointment or ear drops every day for the first weeks after the procedure. Serious and/or exceptional complications. Any surgical procedure, even performed under ideal conditions and in the best possible manner, can entail complications. All these risks must be weighed up against the benefits that can normally be expected from an intervention, and it must not be forgotten that “not intervene” can sometimes also have serious consequences. You should report any sudden onset or worsening dizziness or pain to your doctor. Heavy or bad smelling ear canal or fluid from the wound behind the ear is rare, but you should report it to your doctor. Likewise, the occurrence of facial paralysis.

Van Haesendonck NKO Father and son, both specialized in ear, nose and throat diseases and head and neck surgery. You can contact us for expert advice, diagnosis and treatment of nose, throat and ear diseases and head and neck surgery. dr. Jan Van Haesendonck dr. Gilles Van Haesendonck

Information on removal of the parotid sinus / parotidectomy Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams. The parotid gland (parotid gland) is located in front of and below the ear. There are 2 parotid glands, 2 under the jaw and 2 under the tongue. Together with numerous smaller salivary glands, they ensure saliva production. The parotid gland has a superficial and a deep lobe, between which runs the facial nerve (facial nerve). This ensures the mimicry of the face, the closing of lips and eyelids. When a tumor is found, it is best removed surgically. Most growths are benign. Purpose of the procedure When a tumor of the parotid gland needs to be removed, it is safe to do so after carefully locating the facial nerve to try to avoid facial paralysis. The technical aspects of the operation The operation is done under general anaesthetic. Through an incision, which runs in front of the ear and further into the neck, the parotid gland, the facial nerve and the tumor are searched for and the tumor is removed. Depending on the location and extent of the injury, the operation can take up to 4 hours. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By incising the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the area of operation. The numb area gradually becomes smaller and smaller. The immediate consequences Swelling usually occurs in the wound area for several weeks. There may be bleeding from the wound. This usually happens shortly after the operation. Sometimes it is necessary to find the source of bleeding again under anesthesia and to burn the bleeding vessel shut. A crooked face may occur after surgery due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The belated consequences There may be a collection of saliva previously visible at the bottom of the wound, which may need to be punctured. Frey's syndrome can develop after a few months. Then there is redness and perspiration of the skin of the operating area during eating. Serious and/or late complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Permanent facial nerve failure can occur but is extremely rare. Phlegmon or abscess formation in the neck area is rare. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated. Waarom een resectie? Een operatie om de cyste te verwijderen is nodig als: De cyste ontstoken raakt. De cyste groeit en klachten veroorzaakt, zoals slikproblemen of ademhalingsproblemen. De cyste cosmetisch storend is. Doel van de ingreep Het doel van de operatie is om de cyste volledig te verwijderen en te voorkomen dat deze terugkomt. De technische aspecten van de operatie Verdoving: De operatie vindt plaats onder algehele narcose. Procedure: De chirurg maakt een kleine incisie in de huid van de hals, meestal in een huidplooi om het litteken zo min mogelijk zichtbaar te maken. De cyste wordt voorzichtig losgemaakt van de omliggende weefsels. Om te voorkomen dat de cyste terugkomt, wordt ook een deel van het tongbeen verwijderd, evenals het weefsel tussen de cyste en de basis van de tong. Deze procedure wordt de Sistrunk-procedure genoemd. Duur: De operatie duurt gemiddeld 1 tot 2 uur. Mogelijke complicaties Zoals bij elke operatie zijn er ook bij een resectie van een thyreoglossus cyste risico's, zoals: Nabloeding Infectie Heesheid (tijdelijk of, in zeldzame gevallen, blijvend) door beschadiging van de stembandzenuw Terugkeer van de cyste: In zeldzame gevallen kan de cyste terugkomen, vooral als de Sistrunk-procedure niet volledig is uitgevoerd. The immediate consequences The wound area usually experiences swelling for a few weeks. There may be post-operative bleeding from the wound. This usually occurs shortly after the operation. Sometimes it is necessary to find the bleeding site again under anesthesia and to cauterize the bleeding vessel. After the operation, a crooked face may occur due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The late consequences There may be a collection of saliva visible at the bottom of the wound, which may need to be punctured. After a few months, Frey's syndrome may develop. Redness and perspiration of the skin of the surgical area will occur during eating. Serious and/or late complications Every surgical procedure, even in ideal circumstances and performed in the best possible way, can have complications. Permanent failure of the facial nerve can occur but is extremely rare. Phlegm or abscess formation in the neck area is rare. All these risks must be weighed against complications that can occur if surgical treatment is not resorted to.

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Information on removal of the parotid sinus / parotidectomy Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams. The parotid gland (parotid gland) is located in front of and below the ear. There are 2 parotid glands, 2 under the jaw and 2 under the tongue. Together with numerous smaller salivary glands, they ensure saliva production. The parotid gland has a superficial and a deep lobe, between which runs the facial nerve (facial nerve). This ensures the mimicry of the face, the closing of lips and eyelids. When a tumor is found, it is best removed surgically. Most growths are benign. Purpose of the procedure When a tumor of the parotid gland needs to be removed, it is safe to do so after carefully locating the facial nerve to try to avoid facial paralysis. The technical aspects of the operation The operation is done under general anaesthetic. Through an incision, which runs in front of the ear and further into the neck, the parotid gland, the facial nerve and the tumor are searched for and the tumor is removed. Depending on the location and extent of the injury, the operation can take up to 4 hours. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By incising the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the area of operation. The numb area gradually becomes smaller and smaller. The immediate consequences Swelling usually occurs in the wound area for several weeks. There may be bleeding from the wound. This usually happens shortly after the operation. Sometimes it is necessary to find the source of bleeding again under anesthesia and to burn the bleeding vessel shut. A crooked face may occur after surgery due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The belated consequences There may be a collection of saliva previously visible at the bottom of the wound, which may need to be punctured. Frey's syndrome can develop after a few months. Then there is redness and perspiration of the skin of the operating area during eating. Serious and/or late complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Permanent facial nerve failure can occur but is extremely rare. Phlegmon or abscess formation in the neck area is rare. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated. Purpose of the procedure When a parotid gland tumor has to be removed, this can only be done safely after carefully locating the facial nerve, in an attempt to avoid facial paralysis. The technical aspects of the operation The operation is performed under general anesthesia. Through an incision that runs along the ear and further into the neck, the parotid gland, the facial nerve and the tumor are located and the tumor is removed. The operation takes an average of 2 hours, but can take up to 4 hours depending on the location and extent of the injury. During the procedure, the facial nerve is electrically monitored, which helps to locate the nerve safely and reduces the chance of complications. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By cutting the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the surgical area. The numb area gradually becomes smaller. The immediate consequences The wound area usually experiences swelling for a few weeks. There may be post-operative bleeding from the wound. This usually occurs shortly after the operation. Sometimes it is necessary to find the bleeding site again under anesthesia and to cauterize the bleeding vessel. After the operation, a crooked face may occur due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The late consequences There may be a collection of saliva visible at the bottom of the wound, which may need to be punctured. After a few months, Frey's syndrome may develop. Redness and perspiration of the skin of the surgical area will occur during eating. Serious and/or late complications Every surgical procedure, even in ideal circumstances and performed in the best possible way, can have complications. Permanent failure of the facial nerve can occur but is extremely rare. Phlegm or abscess formation in the neck area is rare. All these risks must be weighed against complications that can occur if surgical treatment is not resorted to. The purpose of this information is to provide you with generally applicable information about this type of surgery. It is of course possible that in your individual case certain aspects of this document may not apply or may need to be discussed more or additionally with your surgeon. Please remember to tell your surgeon all information about your general state of health and all medications you are taking regularly - especially aspirin and related products, or other medications that can affect clotting . Please mention any allergic reactions you have had in the past, especially reactions to medications. Bring any recent medical reports in your possession, such as blood tests, radiological and other preoperative examinations.

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Home Make an appointment Nieuwe pagina About us Useful Documents FAQ Zoekresultaten More Information about placing ventilation tubes in the eardrum Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, it may be the case that certain aspects of this document are not applicable in your individual case or that they need to be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring recent medical records in your possession such as blood tests, radiologic and other preoperative examinations. Purpose of the procedure A malfunctioning Eustachian tube interferes with normal middle ear ventilation. Inadequate ventilation can have one or more consequences: recurring acute middle ear infection, hearing loss due to fluid in the middle ear and, at a later age, the collapse of the eardrum, which can cause a benign skin tumor (cholesteatoma) and/or permanent hearing loss. The technical aspects of the operation The placement of a transtympanic ventilation tube (also called a diabolo or tube for short) is done in children (and in some adults) under general anaesthetic. The eardrum is easily reached along the ear canal. A transtympanic ventilation tube is inserted through the eardrum under the view of a microscope after a small incision. The mucus that is usually in the middle ear can be immediately aspirated from the ear at the same time. Immediate Effects There is no pain upon awakening. There may be some (sometimes bloody) ear bleeding in the immediate aftermath. Only if this is very abundant can it cause premature shedding of the tube. Earring can also occur later on: this occurs in 1 or 2 children in 5 and often stops spontaneously after a few days. If the earring persists, this indicates an infection and it is best to consult a doctor; after all, these are ventilation pipes and not drainage pipes. Sometimes the tube can clog as a result of dried ear canal and the original problem can start again. If the hearing was impaired before, it will usually return to normal almost immediately after the procedure. However, this does not mean that “too much noise” should be avoided. The presence of the tube itself in the eardrum does not cause hearing loss. Late Effects It is normal and desirable for the tube to be expelled after a few months to over a year. How long this will last in each individual person is not predictable and can even be very different between left and right ear in the same person. Whether the problem will resume after expulsion depends on the functioning of the Eustachian tube (which in most cases in children gradually improves with age). Only very rarely does a tube fall inside; it does not necessarily have to be removed. In 1 to 2% of cases, the tube leaves a hole in the eardrum. This often happens in an eardrum that has already been damaged by inflammation. Incidentally, inflammation itself can of course also be the cause of a cavity. Serious and/or exceptional complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Any intervention on an ear can cause irreversible hearing loss, ear murmurs, facial paralysis or (usually temporary) balance problems, but this is extremely rare when a transtympanic ventilation tube is placed. The same applies to causing a cholesteatoma (a benign skin growth), by enclosing a piece of skin behind the eardrum when it is punctured. One must weigh the (extremely rare) occurrence of serious complications against the benefits that can normally be expected from this procedure, and certainly not forget that "not intervening" can sometimes also have serious consequences.

Info Parotis / oorspeekselklier Read more about parotid salivary gland procedures - parotidectomy Thyroid Read more about thyroid surgery - thyroidectomy Parathyroid gland Read more about parathyroid surgery - parathyroidectomy Directe laryngoscopie Read more about vocal cord or larynx procedures - direct laryngoscopy Submandibular salivary gland Read more about submandibular salivary gland procedures Thyroglossal cyst Read more about thyroglossal cyst surgery Pediatric interventions placing diabolos or tubes Adenotonsillectomy - removal of tonsils and polyps (in children) Additional information regarding Tonsillectomy - removal of the tonsils Post-operative guidelines after tonsillectomy / tonsil removal Sinus surgery Septoplasty - correction of the nasal septum Conchaplasty - surgery of the nasal conchae Ear surgeries Preoperative questionnaire General information about hospitalization