Treatment of chronic sinusitis with ethmoidectomy in Hospital Schwabing Munich

About the department

The Department of Adult and Pediatric Otolaryngology, Head and Neck Surgery at the Hospital Schwabing Munich offers the full range of diagnostic and therapeutic services for the patients with ENT diseases. Of particular interest is the treatment of benign and malignant head and neck tumors – the department is a certified member of the Cancer Center Munich. In addition, the department's main clinical focuses include functional and aesthetic nasal surgery, cochlear implantation, minimally invasive sinus surgery and auricular microsurgery. The medical facility also provides competent medical care for traumatic injuries of the ENT organs. The department admits both adults and young patients for treatment. The high professionalism of the department's doctors and rich clinical experience make it possible to successfully treat both simple ENT diseases and especially complex pathologies. The department has a reputation of one of the largest medical facilities of this kind in Munich and offers its patients the very latest treatments available only in the most progressive medical centers in Europe. The department is headed by Prof. Dr. med. Wolfgang Wagner.

The department's specialists have vast experience in cochlear implantation, which is the only effective treatment method for severe hearing loss and deafness. A cochlear implant is a prosthesis, which captures sounds and converts them into electrical impulses. The electrical impulses are directed to the inner ear, which allows the patient to hear. Before deciding on the advisability of cochlear implantation, the attending physician carries out diagnostic examinations: audiogram, otoacoustic emission testing, audiometry using brainstem auditory evoked potentials, brainstem evoked response audiometry, CT and MRI scanning of the temporal bone. If the diagnostic results are satisfactory, and the patient has no contraindications for cochlear implantation (for example, irreversible damage to the auditory nerve, hearing loss due to meningitis, some types of injuries, tumors, etc.), he will undergo surgery. As a rule, the surgical intervention to implant a hearing prosthesis is performed on an inpatient basis. The operation takes about 2 hours and is performed under anesthesia. The first step in implantation is to place the electrode in the inner ear. The placement of the electrode is followed by a diagnostic examination to check its correct placement, after which the surgical intervention is completed. In some cases, 7-10 days after cochlear implantation the patient may need follow-up imaging tests. Like any other surgical intervention, cochlear implantation is associated with a number of postoperative risks – infections, bleeding, facial paralysis. Nevertheless, the department's otolaryngologists have vast experience in cochlear implantation, due to which the risk of complications is practically reduced to zero. About 3-4 weeks after the operation, the stage of adaptation, auditory and speech training begins, since after the placement of a cochlear implant the patient begins to hear sounds, but they seem new and unusual to him. Thus, rehabilitation after surgery is aimed at ensuring that the patient learns to hear, distinguish and understand sounds, as well as spoken language. Cochlear implantation is performed both for children (only up to the period when the child has not yet fully mastered the language) and for adults.

Another priority focus of the department's clinical practice is plastic surgery for nose reshaping – functional and aesthetic one. The department's surgeons specialize in rhinoplasty, septorhinoplasty and septoplasty. The Chief Physician of the department, Prof. Dr. med. Wolfgang Wagner, personally performs all the above mentioned operations for nose reshaping. He has already performed more than 4,000 such operations, so he can deservedly be proud of special successes in this field. The vast experience in the field of nasal plastic surgery allows the specialist to effectively eliminate functional defects, taking into account the aesthetic aspect. Nasal plastic surgery is performed under general anesthesia. The duration of the surgical intervention is 1-3 hours.

An integral part of the work of the department's otolaryngologists is the treatment of head and neck malignancies. The most common types of oncology in clinical practice are oral cancer, tongue cancer, pharyngeal cancer and laryngeal cancer. They account for about 4% of all cancers. In addition, the department provides treatment for malignant facial tumors (it is mostly skin cancer). To make an accurate diagnosis, the patient needs to undergo a set of diagnostic examinations, including ultrasound, CT and MRI scanning of the head and neck, chest and abdominal organs. These tests allow the doctors not only to determine the exact localization of the tumor, but also to find out if the cancer has spread to other organs. The treatment regimen is developed for each patient individually, during the interdisciplinary tumor boards with the participation of otolaryngologists, oncologists, radiologists, chemotherapists and other specialists. In most cases, the basis of treatment is surgical resection of the tumor. The operation is complemented by chemotherapy and radiation therapy. The choice of the optimal treatment method depends on the type of tumor, its location, size, presence or absence of metastases, and other factors.

The specially trained doctors take care of the health of young patients with ENT diseases. Key attention in the field of pediatric otolaryngology is paid to operations on the oropharynx, removal of tonsils, surgery for otitis media and cochlear implantation to treat severe hearing loss. The department's specialists care not only about the high quality of medical care, but also about the comfort of children. They devote enough time to communication with young patients in order to establish trust and help them overcome their fear of the upcoming treatment.

The department's range of medical services includes:

• Diagnostics
  • Microscopic and endoscopic examinations of the upper respiratory tract and digestive tract, including ear microscopy
  • Head and neck ultrasound scanning 
  • Audiology, including in children, tonal and speech audiogram, tympanogram, otoacoustic emission testing (TEOAE, DPOAE), brainstem audiometry (with sedation and general anesthesia in children)
  • Rhinomanometry
  • Smell and taste testing
  • Allergy diagnostics (skin tests, nasal provocative tests, etc.)
  • Dizziness diagnostics (electronystagmography, craniocorpography)
  • Video endoscopy and laryngeal stroboscopy (examination of the vocal cords)
  • Voice analytical analysis: assessment of voice field when speaking and singing, voice stress test and spectral analysis
  • Endoscopic diagnostics of swallowing disorders
  • Diagnostics of snoring and obstructive sleep apnea
  • Modern imaging diagnostics of the head and neck: ultrasound, CT, MRI, PET-CT, MR angiography, angiography, radiography
  • Electrodiagnostics of the facial nerve in the case of paralysis (electromyography, electroneurography)
• Conservative treatment
  • Drug therapy of acute infections and acute allergic edema of the ENT organs
  • Drug therapy for acute diseases of the inner ear (treatment-resistant sudden hearing loss, acute tinnitus, acute dizziness, imbalance)
  • Drug therapy for acute facial nerve palsy
• Surgical treatment 
  • Surgical removal of head and neck tumors, including modern reconstructive interventions
  • Functional and aesthetic nose surgery
    • Rhinoplasty
    • Septorhinoplasty
    • Septoplasty
  • Cochlear implantation for severe hearing loss and deafness (in adults and children)
  • Endoscopic and microscopic minimally invasive surgery on the paranasal sinuses and tear ducts
  • Treatment of traumatic injuries (for example, midface fractures, soft tissue injuries, skull injuries)
  • Microsurgical interventions to improve hearing, including hearing loss and balloon dilatation of the eustachian tube
  • Surgery to remove tonsils, including partial removal using coblation or laser techniques, especially in children
  • Full range of head and neck surgical procedures for children
  • Surgical removal of facial and neck skin tumors, including removal of sentinel lymph nodes
  • Skull base surgery using neuronavigation systems (in cooperation with the Department of Neurosurgery)
  • Plastic aesthetic facial surgery (for example, nose reshaping, eyelid surgery, scar revision, ear reshaping, repair of defects after accidents or congenital malformations)
  • Surgery on the salivary glands, including the use of neuromonitoring to prevent facial nerve lesions
  • Surgical treatment of snoring and obstructive sleep apnea
• Other diagnostic and therapeutic options