Procedures

Common ENT operations.

General information on a selection of procedures Dr. Page regularly performs. This material is intended as an overview only and is not a substitute for a personal consultation, where your individual diagnosis, options, and risks will be discussed in detail.

01 / Paediatric ENT

Tonsillectomy & Adenoidectomy

Removal of the tonsils and/or adenoids to treat obstruction and snoring and recurrent throat infections. A partial (coblation) approach may be suitable for selected cases.

Procedure

Tonsillectomy removes the palatine tonsils; adenoidectomy removes the adenoid tissue from the nasopharynx. The two procedures are commonly performed together in children for obstructive sleep-disordered breathing or recurrent tonsillitis. In most cases, day-stay procedures are suitable. For children with obstructive sleep apnoea due to large tonsils, a partial (coblation) tonsillectomy may be offered. This technique removes the obstructive portion of the tonsil while preserving the underlying capsule, which can reduce post-operative pain and bleeding risk. Suitability depends on the indication, tonsil size, and individual patient factors.

Major risks

Primary bleeding occurs in approximately 3–4% of cases, most commonly around days 4-8. Oral injury is rare. Bad breath and comgetsion can be expected for 2 weeks.

Recovery

7–10 days of throat discomfort with careful pain management, soft diet, and hydration. Most children return to school at 10–14 days. Recovery from partial (coblation) tonsillectomy is often shorter, with less pain and earlier return to normal eating.

02 / Paediatric ENT

Grommets (Ventilation Tubes)

Tiny tubes inserted into the eardrum to drain persistent middle ear fluid and restore hearing or reduce infection in children with glue ear or recurrent otitis media.

Procedure

Grommets equalise pressure across the eardrum by providing a temporary ventilation channel into the middle ear. They are inserted under a brief general anaesthetic through the ear canal, ocassionally with removal of adenoids in selected cases. The procedure takes approximately 15 minutes and is performed as day surgery.

Major risks

Ear infection or discharge while tubes are in place are possible but usually minor and easily treatable. Persistent tympanic membrane perforation after tube extrusion occurs in a very small minority (<1%)

Recovery

Same-day discharge with minimal discomfort. Activities, including swimming, may be resumed after 24hrs. No water precautions (ear plugs for bathing and swimming) are necessary while the grommets are in place. Tubes typically extrude spontaneously at 8–12 months.

03 / Rhinology

Septoplasty & Turbinate Reduction

Surgical correction of nasal obstruction caused by a deviated septum and enlarged inferior turbinates.

Procedure

A septoplasty straightens the cartilage and bone of the nasal septum, while turbinate reduction (typically endoscopic shaver partial reduction) decreases the bulk of the inferior turbinates. The combined procedure improves airflow and may aid sleep quality and exercise tolerance for patients with chronic nasal blockage unresponsive to medical therapy.

Major risks

Septal perforation, infection, cosmetic change and persistent nasal obstruction are uncommon. Bleeding requiring packing or return to theatre is rare (<1%).

Recovery

Day procedure in most cases. Congestion and crusting for 2 weeks with mild congestion for 2-3 months. Most patients return to office work and activities within 1-2 weeks. Post operative nasal rinses and regular analgesia are advised.

04 / Rhinology

Endoscopic Sinus Surgery (FESS)

Minimally invasive surgery to open the sinus drainage pathways in patients with chronic rhinosinusitis including nasal polyps and recurrent acute sinusitis.

Procedure

Functional endoscopic sinus surgery uses high-definition endoscopes and image-guided navigation to remove diseased tissue, polyps, and obstructions from the ethmoid, maxillary, frontal, and sphenoid sinuses. The procedure preserves normal anatomy while restoring ventilation and access for topical therapies.

Major risks

Significant bleeding is rare (1%). Altered sense of smell is common temporarily. Orbital injury and cerebrospinal fluid leak into teh nose is extremely rare. Ongoing sinusitis symptoms incpuding recurrence of polyps is possible despite successful surgery and usually requires ongoing medical management.

Recovery

Saline rinses begin the day after surgery. Mild bleeding and congestion for 1–2 weeks. Return to work and activities 2 weeks

05 / Otology

Myringoplasty

Repair of a perforated tympanic membrane to restore hearing and prevent recurrent ear infections.

Procedure

A graft (typically temporalis fascia or tragal perichondrium) is used to close the eardrum perforation, performed either through the ear canal or via a small post-auricular incision. Indications include chronic perforation with recurrent or persistent discharge, or conductive hearing loss.

Major risks

Graft failure with persistent perforation occurs in approximately 10–20% of cases. Worsening hearing, infection, or tinnitus are uncommon. Rare risks include facial nerve weakness or dizziness.

Recovery

Day procedure. Keep the ear dry for 4–6 weeks. Ear drops will be used for several weeks. Hearing improves gradually as the graft heals over 6–12 weeks and biodegradable packing dissolves.

06 / Otology

Exostosis Surgery (Surfer's Ear)

Removal of bony growths in the ear canal caused by repeated cold-water exposure.

Procedure

Exostoses are benign bone overgrowths that progressively narrow the external auditory canal, trapping water and debris and causing recurrent infections and hearing loss. Surgery is performed using a drill through a post-auricular approach to widen the canal and restore normal anatomy. 

Major risks

Hearing loss from injury to the ossicles or tympanic membrane is uncommon. Infection, delayed healing, and canal stenosis from re-growth are possible. Temporary taste disturbance from chorda tympani irritation may occur.

Recovery

Day procedure. Ear must remain dry for 6-8 weeks. Return to swimming and surfing typically at 8–12 weeks with custom-fitted plugs strongly recommended.

07 / Head & Neck Cancer

Parotidectomy

Removal of part or all of the parotid (cheek) salivary gland for benign or malignant tumours.

Procedure

The parotid gland wraps around the facial nerve, which controls movement of the face. A superficial or total parotidectomy is performed with meticulous identification and preservation of the facial nerve, using intra-operative nerve monitoring. In some cases a more limited, extrcapsualr dissection technique, may be used safely. The vast majority of parotid tumours are benign (most commonly pleomorphic adenoma), but surgery is required to obtain a histological diagnosis and prevent transformation or recurrence.

Major risks

Temporary facial nerve weakness may occur in 10–20% and permanent weakness in <1%. Frey's syndrome (gustatory sweating), salivary fistula, and haematoma are possible. Recurrence of benign tumours or need for further treatment if malignant.

Recovery

1–2 nights in hospital with a drain in most cases. Patients having a limited extracapsular dissection may be able to go home the same day. Most patients return to office-based work within 2 weeks. Numbness over the ear lobe is common long term. The facial scar heals well with minimal visibility in 12 months.

08 / Head & Neck Cancer

Submandibular Gland Excision

Removal of the submandibular salivary gland under the jaw for stones, chronic inflammation, or tumours.

Procedure

Performed through a small skin crease incision in the upper neck, the gland is removed with careful preservation of the marginal mandibular branch of the facial nerve, the lingual nerve, and the hypoglossal nerve. Indications include recurrent sialolithiasis, chronic sialadenitis, and benign or malignant neoplasms.

Major risks

Weakness of the lower lip (marginal mandibular nerve) and altered tongue sensation (lingual nerve) are uncommon but may be permanent. Haematoma, infection, and salivary fistula are possible. Rarely, tongue movement may be affected.

Recovery

Usually home the same day. Return to most activity within 1–2 weeks; scar barely visible by 12 months.

09 / Head & Neck Cancer

Neck Lump & Neck Dissection

Assessment and surgical management of neck lumps, ranging from excision of a single lump for diagnosis through to formal neck dissection for head and neck cancer.

Procedure

Neck lumps are first evaluated with examination, imaging, and often fine needle aspiration to determine the cause. Surgery may involve excision of an isolated lump (such as a branchial cyst, lymph node, or benign tumour) for diagnosis and treatment. When malignancy is confirmed or strongly suspected, a neck dissection may be performed to systematically remove the lymph node groups at risk. Modern selective and modified radical techniques preserve key structures including the spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle wherever oncologically safe. Cancer cases are coordinated with multidisciplinary input from oncology, radiation oncology, and reconstructive teams.

Major risks

Spinal accessory nerve injury causing shoulder weakness and pain (shoulder syndrome) may occur with more extensive surgery. Lymphocele, chyle leak, and haematoma are uncommon. Wound infection and delayed healing are possible. Cosmetic contour changes from tissue removal.

Recovery

Simple lump excision is often a day case or overnight stay. Formal neck dissection usually requires 2–4 nights in hospital with drains. Physiotherapy may support shoulder and neck mobility. Return to normal activity typically at 2–6 weeks, depending on extent of surgery and adjuvant treatment.

Considering one of these procedures?

Dr. Page consults across Melbourne and Bendigo. A valid GP or specialist referral is required for new appointments.

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