Other Nose Operations
Endoscopic Dacryocystorhinostomy (DCR) Surgery (watery eye surgery)
If surgery is deemed necessary, and after appropriate workup from the ophthalmologists (eye doctors) we carry out this surgery jointly. As a specialist ENT surgeon, Mr Unadkat will carry this surgery out endoscopically (via the nose using telescopes) to ensure that there are no external scars.
Rather than perform a large revision septorhinoplasty operation, one option that may be appropriate is an intranasal z-plasty. This is a minimally invasive surgical technique to open up the internal nasal valve by repositioning healthy nasal mucosa in order to improve nasal airflow.
CSF Leak Repair
Most such cases can be undertaken by skilled rhinologists through the nose endoscopically but occasionally, for larger defects, an open approach with a neurosurgeon is necessitated. Tissue from the leg (fascia lata) is often required to help close larger defects. Mr Unadkat has had extensive fellowship training in this type of surgery, especially in reconstructing large skull base defects.
Endoscopic Modified Lothrop Surgery
Fractured Nose Manipulation
Under a short general anaesthetic, the nose can be repositioned into a better position, provided that the bones haven’t fully set – typically within the first three weeks. After this time, potentially a larger procedure such as a rhinoplasty or septorhinoplasty may be required.
Surgery For Nosebleeds
For straightforward simple nosebleeds, the majority occur from the front of the nose and can be treated with simple measures such as nasal creams and ointments and cautery under local anaesthesia. For more severe nosebleeds, a detailed history and examination with full blood work up is needed; on occasion CT and MRI scans of the sinuses may be needed.
Surgery can take many forms but the most common surgery for intractable nosebleeds is a procedure under general anaesthesia called an endoscopic sphenopalatine artery (SPA) ligation. This is a relatively straightforward operation that identifies one of the major vessels which causes nosebleeds – the sphenopalatine artery. Under general anaesthesia and using an endoscope, it is clipped or cauterised and is a very successful long-term solution for some patients.