Wednesday 18 May 2011

About Navigation machine


Fusion ENT Navigation System

About the Fusion ENT Navigation System for
 Image-Guided Surgery

Our Fusion™ ENT Navigation System is an innovative electromagnetic image-guided surgery system. It allows you to operate with the maximum amount of information about the unique anatomy of each patient and “see” the relative location of the instrument tip in the patient’s sinus anatomy during surgery.
Image-guided surgery with the Fusion system can help you make more informed decisions in the operating room for safer, more thorough procedures. The Fusion system provides:
  • Reliable accuracy – is the first and only electromagnetic ENT system with reproducible accuracy comparable to our optical navigation systems
  • Ease of use – is the first and only electromagnetic system that includes automated instrument verification, reusable instruments, multiple registration modalities, multi-instrument tracking, and customizable surgeon- and procedure-specific settings
  • Expandability – allows you to customize your image-guided surgery system with additional procedure modules and associated instruments
  • Standard Instrument Set – is a set of 6 reusable standard ENT instruments and custom tray included with your Fusion system
  • Optional Supplemental Instrument Set – features innovative, reusable instruments with unique designs that enable better visbility and ease of use

Integrating Technology for the O.R.

For simple or complex image-guided surgery, you can use the Fusion system with other ENT surgery products. Our integrated technology offers a complete procedural solution and helps streamline your O.R. For example, our Straightshot® M4 Automated Tracking Blades are factory-calibrated for Fusion navigation, right out of the box. During transnasal endoscopic skull base surgery, the Fusion system, Anterior Skull Base Burs, and MicroFrance® Wormald Instruments are designed to maximize visualization and access for anterior skull base procedures.

Comprehensive Service and Support

To help protect your investment, we include one year of our comprehensive Software and Support Program with every purchase of the Fusion system for image-guided surgery.

Additional Image-Guided Surgery Products

See our ENT Product Catalog for the full line of ENT image-guided surgery systems and products.

Why Image-Guided Surgery Is Needed

Disease, previous surgery, and normal anatomical variations can make it a challenge to perform the safest and most effective endoscopic sinus surgery, even with a detailed knowledge of anatomy and surgical skill. Avoiding orbital injuries, entry into the brain, and the carotid artery are paramount.
Similar to a global positioning system, our Fusion image-guided surgery system provides real-time images that can help you navigate in the sinuses for precise removal of diseased tissue while avoiding critical areas.
Image-guided surgery has become an industry standard for many endoscopic sinus surgeries. The American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) endorses the use of image-guided surgery for procedures including:1
  • Revision sinus surgery
  • Distorted sinus anatomy of development, postoperative, or traumatic origin
  • Extensive sino-nasal polyposis
  • Pathology involving the frontal, posterior ethmoid and sphenoid sinuses
  • Disease abutting the skull base, orbit, optic nerve, or carotid artery
  • CSF rhinorrhea or conditions where there is a skull base defect
  • Benign and malignant sino-nasal neoplasms
Whether you're performing functional endoscopic sinus surgery (FESS) or complex skull base procedures, our Fusion image-guided surgery system provides valuable information that can help enable a safer, more thorough procedure.

THROAT TIPS


Tonsil and Adenoid Infections:
Realities & Myths
Most of the children get frequent ear, nose, and throat infections from the time they start going to play school till the age of 6-7 years.

This leads to lot of anxiety in the parents, thinking their “ward” is particularly “weak”. But we should try to understand that this is a normal process by which the immune system of the body acquires the basic information about the “germs” of the child’s environment.

With each sub-clinical and clinical infection by virus and bacteria, the immune system develops antibodies to fight out that specific germs.

But as the body is unprepared during the first attack, it may become ill sometimes.

Each attack of infection also prepares the immune system to retain that information and produce antibodies in greater quantity during second attack. So most of the second attack by same virus and bacteria are aborted earlier.

But, as there are thousands of varieties of virus and bacteria capable of producing infections, most of the children are bound to get few ENT infections in a year-till the body’s immune system gets information about mot of the germs (which happens around 6-7 years of age).

As nose and throat are the main portals of entry for air, food and water into our body-a major component of immune system called “Waldeyer’s ring” is situated at these sites.

Waldeyer’s ring is actually a “ring” of lymphoid tissue at the back of mouth and behind the nose. “Tonsils” and adenoids are lymphoid tissues, which form a part of Waldeyer’s ring.


Frequently Asked Questions

Does every individual have tonsils and adenoids?

Yes, every person has tonsils-which are collection of lymphoid tissue on either side of throat a little behind the tongue. Likewise, adenoids are lymphoid tissue situated at the back of the nose.


What are the features of Tonsil infections?

Most of the tonsil infections are part of generalized cough and cold. But if the child complaints of throat pain, associated with some difficulty in swallowing and fever, Nasal decongestant it suggests a greater degree of tonsil infection.

                              In medical term it is called “Acute Tonsillitis”. If a child or person developes more than more than 3 attacks of sore throat with fever, the condition may be called as “Chronic Tonsillitis” but a better term is “recurrent Tonsillitis”.


Can Tonsillitis lead to any major illness or complications?

Sometimes, with some virulent bacterial germs, infection can spread beyond the covering of the tonsil and results in “peritonsillar abscess” which needs urgent treatment and it can be life threatening.

                   Sometimes particular strain of streptococcal bacterial infection of tonsil can lead to inflammation of heart and joint called as “rheumatic fever”.

Rheumatic fever is still a major cause of heart disease in our country with life long sequelae.


Why do doctors some times recommend removal of tonsils?

In some individuals, tonsil can act as a reservoir of infection leading to frequent sore throats.

If that individual suffers from severe sore throat with fever 5-6times a year that result in missing school/work, then doctors should advise him/her to undergo tonsillectomy.

Also, sometimes, the size of tonsils becomes so big that it causes problems during swallowing or obstruction to airflow then also it needs to be removed.

Some times if a tumor is suspected in the tonsil area it is removed for biopsy.

These are the usual indications for tonsil removal.

Does Tonsil removal result in reduction of body resistance?

Not at all. As there are 6 pairs of lymphoid tissue aggregation in Waldeyer’s ring, removal of one pair (tonsils) does not matter much.
Its functions are taken over by other lymphoid tissue.


What are the complications of tonsillectomy operation?

Tonsil removal is not a minor operation. Main problem during and after the operation is bleeding especially in small children. A little more than usual blood loss can be dangerous. Other problem is pain in the post operation period. Both of these problems has been overcome to a large extent recently by “COBLATION” Technique.

NOSE TIPS


Nose is a chamber divided into two by a midline septum (in about 90% it is off midline but doesn’t cause trouble) and its side walls contain mounds & troughs (called turbinates & meati). These turbinates & meati produce turbulence in airflow through nose. This, along with hair in the front part of nose, will stop good number of dust particles from entering the lungs. The most important function of the nose is to humidify the air, which enters lungs for oxygenation of our body. Also, it adjusts the temperature of air so that it is not harmful to lungs. The nose takes the brunt of this process and projects the more delicate and sensitive lungs.
Common Cold
Most of the times, it is due to virus infection. In 99% of cases it subsides in a week’s time without treatment, but little care will reduce the chances of complications.

Steam inhalation-vapours of plane hot water (no need to add Medicines, turmeric, mint etc). The temperature of steam need not be high and it should be comfortable to face. Ideally this should be started in the very early phase of viral infection.

Put two drops of nasal decongestant in each nostril twice a day in the given position (keep a pillow behind the shoulders; extend the neck, lift up the chin in such a way that chin and ear are same vertical line). In this position the drops will open the blocked sinus openings and prevent sinusitis. A word of caution: These drops are good for short courses of 5 to 10 days and prolonged use can lead a very dreaded condition called Rhinitis medicamentosa.

Complications of common cold
The viral infection turns into bacterial & needs antibiotics. Infections spreads to throat (sore throat); to ear (acute Suppurative otitis media, severe pain in the ear with block sensation. This needs urgent treatment from ENT specialist); very rarely to eye.
Sinusitis: Due to oedema/ swelling of sinus drainage path, the sinuses airflow is curtailed and results in negative pressure; collection of fluid – retention and stagnation of fluids will provide good environment for bacteria and fungi to multiply and “fix” the “Sinusitis”.

Deviated nasal septum: Gross deviations of the nasal septum to one side may block not only that side of the nose but also the opposite side. In such situation a Septoplasty operation is the only answer. However, all the deviated nasal septums need not be corrected, especially if they are not causing any trouble. This can be in the anterior (front half of the nose which is visible easily) or posterior (back half of the nose which is visible in Endoscopy only).
Allergy of the Nose/ Polyps in the Nose
Allergy of the nose, called allergic rhinitis, can be seasonal or perennial. In Seasonal allergic rhinitis, the symptoms are limited to particular seasons which are linked to the release of pollen from certain plants. These patients should identify these plants and be away from them. If this is not possible practically then they can use antihistamine tablets which are very safe in the long term use also. However they should consult the doctor for changing the type of drug once in 6 months. Perennial rhinitis can be due to allergy or pollution or both.
This is a little stubborn to manage, but again long-term antihistamine medicines are quite safe to use and should be used to avoid other complications and late stages of the allergic rhinitis like polyps in the nose.
Nose bleed (Epistaxis)
“Nose bleed” is a problem which almost everyone of us encounters in our life. Although most frequently it happens in elderly adults.

In children it is usually minor in amount but recurs frequently. Most of these children suffer from recurrent nose infections also. This infection leads to formation of crusts in the nose. Separation of the crust can lead to raw area, which bled.

Many children and adults have the habit of nose pricking, which also leads to raw surface (ulcer) in the nose that can bleed. To prevent this, nose pricking should be avoided. Parent of the child should consult an ENT physician to identify the cause of the bleeding and get appropriate treatment.

In adolescent age, a tumor called “angiofibroma” can lead to minor to severe bleeding. So, any teenage boy (this tumor dose not occur in girls) having repeated bleeding should consult an ENT specialist.

In adults and elderly, arthrosclerosis of the blood vessels lead to hardening of the blood vessels. This makes the blood vessel prone to injury and it leads recurrent bleeding. High blood pressure and people taking asprin also are prone to nose bleed. Some times elderly people can have tumor in the nose which can lead to bleeding. Chronic sinus problem, polyps are also cause of nose bleeds.

As a first aid in the home, the nose (soft part) of the bleeding person should be pinched hard for 3-4 minutes. Application of ice on nose and face is also helpful. If bleeding does not stop with these measures, that patient should be taken to a ENT specialist.

Changing Concepts in Management of “Sinus Problems”
“Sinusitis”- infection of sinuses – is one of the most common conditions affecting humans. With increasing amount of pollution and allergens in the environment, more and more people are getting affected with this problem.

Sinus infection of short duration – which is called “Acute Sinusitis” in medical term, is managed with medicine.
Usually doctors prescribe antibiotics, painkillers and steam. It is important to complete the course of antibiotics and other medicines religiously to prevent the condition becoming “chronic”.

Once a patient suffers from chronic sinusitis that is usually more than 3 months, he/ she is usually told by the physician or consulting surgeon that surgery might be needed.

Still at this stage it is worth while to try a long course of antibiotic (up to 2-3 weeks duration) along with anti allergic medicine.

Sinus surgery as such has a bad reputation in the general public opinion that it “Does not work”. This notion has some truth as operation done in the past had a success rate of 30-40%. In the “past”, surgeons used to open the sinuses with a scar on the face and tried to remove all the diseased lining of the sinus.

This used to be a futile exercise in most of the cases.

Sinus symptoms: Nose block; nasal discharge; facial or malar pain; headache; post nasal drip (feeling of phlegm/thick secretions coming into throat from back of the nose).

Now a days with the help of sinus endoscopes and CT scan, we identify the reason of sinus drainage obstruction. Subsequently this obstruction is corrected with the help of minute sophisticated instruments.

The whole process is called Functional Endoscopic Sinus Surgery (FESS). This procedure is done from inside the nose under endoscopic vision, so there will be no scar on the face.

EAR TIPS


“EAR” is one of the important specialized sensory organ of our body. We all very well know that it makes us aware of environmental sounds including other person’s voice. More than this, it helps in maintaining the body balance while performing various bodily activities. This is done along with the help of eyes, and joint sense etc. However, ear balances the body faster than the other two and is very essential in keeping the body balance in running and other rapid action events.
Structure of the Ear
The ear consists of three parts
Outer Ear
The funnel shaped projecting part of ear called “pinna” along with the narrow canal ending at “ear drum” or Tympanic membrane constitutes outer ear. This part of the ear helps in collecting sound from the environment and its transmission up to the ear drum.
Middle Ear
This is an air-filled space between ear drum and inner ear. This space contains three small, interconnected bones. This part of the ear acts as a bridge for transmission of sound from outer ear to inner ear.
Inner Ear
Inner Ear consists of very delicate nerve organs for hearing and balance situated inside a tough bony shell. Mechanical sound waves are converted into electrical nerve signals here. The nerve signals are later on transmitted along the hearing nerves to the brain. In the same way mechanical movements of the head are signaled in to electrical impulses and sent to the brain to perform the function of the balance.
Common Ear Problems 
Ear pain : This is a very common problem especially in children below 6-7 years of age. Most of the time “children” start screaming at odd hours in the night with ear pain. Contrary to popular belief, it is not due to “wax”. Wax never causes sudden pain. So putting dewaxing ear drops does not serve any purpose. This problem of earache in child is mostly due to infection of the middle ear due to virus or bacteria which travel To middle ear during an attack of “cold” or throat infection. (There is a small narrow tube for regulation of air-pressure in middle ear which opens behind the nose. This is called Eustachean tube). For some relief during odd hours of night, it is better to give child a pain killer like “Paracetamol” or “Combiflam” which is usually available at home. This will reduce pain for the time being at night. If the child had cold in the near past, then nasal decongestant drops like naseveon/ Diconal can be put in the nose in the suggested position and ask the child to breath the stream of pain hot water through the nose. This will open the blocked Eustachean tube which supplies air to the middle ear and hence further progression of the infection is arrested. Next day, parents should consult a doctor for appropriate medication. If this care is not taken, the ear drum may give way to the pressure due to accumulated secretions and a hole in the ear drum results (Acute Suppurative Otits media). If this is not treated with proper medication, the hole becomes a permanent one and ear discharge becomes perpetual (Chronic Suppurative otits media). In such situation, to avoid ear discharge, one should not allow water into the ears by keeping petroleum jelly (Vaseline) smeared cotton plug in the ear during bath and early treatment of attacks of the common cold/ sinusitis. This needs a surgical correction as early as possible to prevent further complications like paralysis of the muscles of face; brain abscess etc. This long standing discharging ear is the only one condition which needs antibiotic ear drops. In other conditions of ear ache, ear drops are better avoided.

If an adult gets an earache it is usually because of skin infection of the outer ear. A localized “boil” in the ear is very painful. Likewise a larger part of skin can get infection with bacteria. This happens usually due to scratching of the ear or contaminated water getting into the ear. This needs specific antibiotics under the guidance of the ENT surgeon. Self medication like putting hot mustard oil/ hydrogen peroxide should be avoided as they don’t help and at times may damage the delicate skin of ear and ear drum.

In humid rainy season, fungal infection of the ear is very common. This leads to ear itching and pain which can be mild very severe. (Remember: Pain with itching in the ear due to fungus and putting antibiotic ear drops or oil will further aggravate the damage to the tender structures of the ear). Occasionally, hard wax can lead to pain.

For prevention of ear pain, one should not scratch his/her ear either by nails or bud or matchsticks. It is better to use hearing plug during swimming. Once a person gets pain, self-medication with ear drops should be avoided as its of no benefit.

Wax in the Ear : Wax in the ear is normal. This normal wax comes out on its own due a physiological process of epithelial migration towards the outer end of the ear canal. Accumulation of wax in the ear canal is seen 5% of the population and commonest cause for this is self cleansing with ear buds. Bulky ends of these buds tend to push the wax deep into the ear. One need not clean his ears, rather this attempt leads to accumulation. At times while cleaning the ear canal one may injure the canal skin or even the ear drum.
Glue Ear
This is also called secretory Otitis media or serous otits media or Otitis media with effusion (OME). This is a very common condition in school children and is due to adenoid tissue blocking the ET tube opening. This is commonest cause of hearing loss in children and precursor for the bone eroding disease of the ear (Cholesteatoma) also called as unsafe CSOM. Due to negative pressure in the middle ear, fluid accumulates and leads to thinning of the ear drum and ear drum with the skin gets sucked in over a long period and turns into Cholesteatoma. This has to be identified by the school teacher/parent by screening all children who are inattentive/ frequent complainers of ear ache. Impedance audiometry helps in early and correct diagnosis of this condition. There should not be any hesitation to correct this by removing the adenoids and putting a grommet/ ventilating tube in the ear.
Hearing Loss 
Hearing loss is a serious concern especially in children as it can lead to impaired development of speech. If a parent suspects that his/her child’s hearing is probably not right, he/she should have no hesitation in consulting an ENT specialist. Now because of availability of sophisticated instruments it is possible to determine the extent of loss of hearing even in a newborn child. If a child is suspected to have a hearing loss, he/she should be fitted with a hearing aid as early as possible. This measure can prevent the problem of deafness in a child to a large extent. For profound to severe hearing loss in a child, “Cochlear-Implant” is being done at the age of 1-2 years, with very good result. So, never wait for a deaf child to grow up to address the hearing loss problem. After the age of 4-5years, “almost nothing” can be done for most of the deaf and mute children. A lot of school going children have problem of mild hearing loss which may be due to secretary Otitis media. (A silent form of ear infection leading to collection of fluid in the middle ear). If a parent suspects that his/her child is probably not listening properly or is becoming inattentive or raising the volume of TV, they should consult a doctor. Teachers of primary school should be made aware of this.
Hearing losses in adults are either due to problems in the middle ear or in the inner ear/ Depending upon the cause, most of the hearing loss can be corrected either by surgery or hearing aids.

Facilities and services




FACILITIESS

MAA ENT addresses ENT problems of patients by offering the best of technology & services.
"We are the only speciality unit in South India to have an exclusive R&D wing. Our equipment range is on par with international hospitals."
Technology clubbed with well-experienced practitioners is integral to our innovative services.
A brief glimpse of our facilities, equipment and services:

  • R&D Wing on Genetics and Molecular biology to find causes and cures for various ENT related diseases.

  • Arthrocare Coblation II unit for Coblation based surgeries (Cold – Precise surgery)

  • Specially equipped Sinus Surgeries Operation Theatre (OT)

  • Exclusive Micro Ear Surgeries OT

  • Full equipped State of Art Audiology (Hearing Test) lab

  • Complete Bio chemical and heamatology lab with Elisa Reader (Thermo Fisher Scientific), latest PCR (Bio-Rad) and Karyotyping.

  • Fully equipped sleep lab with 24 channel Polysomnography

  • Ultra modern E.N.T. Outpatient unit Equipped with latest endoscopes Four Consultant chambers Air-conditioned patient waiting hall with hospitable environment & pleasant ambience.
  • Deluxe & Super Deluxe Rooms, General Wards and Cubicles equipped with
    Centralized Air conditioning for the comfort of patients waiting to be admitted.
                  
EQUIPMENTS
  •         Medtronic XPS 3000 with M4 hand piece & Robotic Laser
  • The most powerful and precise debrider in the world

ent surgeon,snoring diseasesStorz Endoscopes
 Over 40 Telescopes
Tympanoplasty, Stapedectomy, Phono Surgery, Voice surgery, Hoarse voice.ear,Zeiss OPMI 111 microscope
 The only microscope with 55mm objective lens and high depth lens systems to give a perfect    magnified vision to the surgeon.
ent surgeon,snoring diseasesLatest HD (High Definition) cameras and monitors


SERVICES

MAA ENT has successfully implanted hearing aids in 140 children till date with absolutely no complications, complaints or concerns.
We are amongst the few centers in India who perform ESRT based fittings.
We offer a choice of available Fully Digital Hearing Aids for age groups ranging from 3-month-old baby to 60-year-old Adult.

We Specialized in
First Co2 “Robotic” Laser in the South India

Coblator-II from Arthocare USA First unit in India

Most Advanced Hearing Implants in the world

Digital Hearing aids “Music for your Ear” Best HEARING AIDS in the world brought to Hyderabad.

Two Zeiss Operating Microscopes-- OPM1-111 from Germany for Perfect micro surgery

Excellent Sinus Surgery results with Debrider--Robotic Laser--Coblator