Treatment of chronic sinusitis with ethmoidectomy in University Hospital Erlangen

About the department

The Department of Adult and Pediatric Otolaryngology, Head and Neck Surgery at the University Hospital Erlangen offers all the possibilities of modern medicine for the prevention, diagnostics and treatment of ENT diseases. The department also performs surgical treatment of head and neck tumors, the quality of which is confirmed by the certification of the German Cancer Society. The range of medical services is complemented by the diagnostics and treatment of hearing, voice, speech and swallowing disorders. Special attention is paid to the placement of hearing aids, cochlear implantation, middle ear surgery, skull base surgery, paranasal sinus surgery, salivary gland surgery and interventions with the use of computer navigation. The department admits adults, elderly patients, as well as children of all age groups. The department has 80 planned beds for inpatients, as well as 6 beds in the intensive care unit. Surgical interventions are performed in six state-of-the-art operating rooms equipped with the most advanced surgical instruments and computer technology. The highly professional team of doctors with colossal clinical experience takes care of the patients' health. The department's doctors successfully apply their progressive knowledge and all available technical resources to effectively restore the health of patients. The department is headed by Prof. Dr. med. Dr.h.c. Heinrich Iro.

The department includes specific sections specializing in ultrasound diagnostics, audiology, vestibular diagnostics, neurophysiology, allergology and sleep medicine. All these structural units have their competence and perform an examination if a particular pathology is suspected.

Ear microsurgery is an important area of ​​the department's work. The department annually performs about 700 operations on the middle ear. Prior to a surgical intervention, the patient undergoes a comprehensive diagnostic examination. The specialists use sparing microsurgical techniques in their clinical practice, namely operations using a microscope or a binocular loupe. Most of these interventions are performed through the external auditory canal and leave no cosmetic defects. The department also demonstrates excellent results in the field of hearing aids and cochlear implantation in adults and children. The doctors have a perfect command of the techniques of computer-assisted surgery, which are widely used in the department.

The department also specializes in skull base surgery. It performs over 800 skull base surgical interventions every year. The department's doctors most often perform endoscopic interventions for chronic inflammatory processes, remove benign and malignant tumors of the paranasal sinuses and orbit, and also carry out endoscopic repair of defects in the brain meninges, removal of angiofibromas, acoustic neuromas localized in the cerebellopontine angle, etc. The department uses advanced computer neuronavigation, which provides accurate visualization of the surgical field and monitoring of the patient's health condition during the operation. The department currently has four advanced electromagnetic navigation systems: three Fiagon systems and one Storz device. These high-tech devices are complemented by the Zeiss OPMI Pentero surgical microscope. The innovative technologies make it possible to perform highly effective and safe surgical interventions in the skull base, eliminating damage to vital anatomical structures.

The department's doctors are proud of their outstanding achievements in the treatment of acoustic neuroma, which is one of the most common benign brain tumors. When admitted to the department, the patient undergoes an examination, including hearing tests, MRI and CT scans. In most cases, the most informative and reliable diagnostic method is MRI. This diagnostic test allows the doctors to accurately determine the size and location of the neoplasm. If the diagnosis is confirmed, the attending physician develops the optimal treatment regimen. In the case of localization of an acoustic neuroma in the area of ​​the internal auditory canal, the department's specialists often give preference to monitoring in dynamics. Doctors periodically carry out MRI scans to assess the growth rate of a neoplasm. If there are no significant changes in the size of the tumor, doctors do not recommend surgery. If there are signs of tumor growth, specialists consider various options for surgical resection of the acoustic neuroma. The surgical procedures are performed using computer navigation. In some cases, radiation therapy is the first-line treatment. It is usually used in patients with contraindications for surgery and in elderly patients with high health risks. It is worth noting that the department's specialists have vast experience in this medical field, as evidenced by over 1,300 successfully performed operations to remove neuromas.

Another important focus of the department's clinical activities is on the diagnostics and treatment of malignant head and neck tumors. The department's ​​specialization includes the treatment of cancer of the lip, nasopharynx, larynx, salivary glands, paranasal sinuses, scalp and neck, as well as carcinomas of the oral cavity, larynx and tumors of unknown primary. To confirm the diagnosis and determine the stage of cancer, the department's doctors use such diagnostic methods as ultrasound examination, CT, MRI, PET and PET-CT, scintigraphy and biopsy with histological examination. After confirming the diagnosis, an individual treatment regimen is developed at an interdisciplinary tumor board. As a rule, the treatment involves the use of surgical tumor resection, radiation therapy, chemotherapy, and antibody therapy. The patients also receive the help of highly qualified psychologists, since a diagnosis of cancer can cause a severe psycho-emotional state. After completing the course of treatment, the patient receives the necessary medical care and regularly undergoes follow-up examinations to exclude or early detect a recurrence.

The department's medical team includes highly qualified pediatric otolaryngologists who get along well with young patients and provide them with the best possible treatment. The specialists in the field of pedaudiology carry out a thorough examination of the hearing organs in children and, with any pathologies detected, they prescribe the optimal therapy. Surgical interventions range from removing tonsils to correcting complex ENT malformations, namely, ear reshaping, removal of cysts/fistulas in the neck and ears. The department has unique experience in performing operations for the treatment of choanal atresia and other laryngeal and tracheal pathologies in children.

The department's key clinical focuses include:

• Ear and temporal bone microsurgery
• Placement of implantable hearing aids
• Cochlear implantation in adults and children
• Treatment of salivary gland stones and inflammation
  • Endoscopy
  • Extracorporeal shock wave lithotripsy
• Treatment of acoustic neuromas
  • Surgical treatment using computer neuronavigation
  • Radiation therapy
• Paranasal sinus surgery, including microscopic, endoscopic and laser techniques, computer-assisted surgery
• Skull base surgery
• Computer-assisted ENT surgery
• Tracheal surgery
  • Treatment of tracheal stenosis in childhood and adulthood
  • Treatment of benign and malignant tracheal tumors
  • Voice restoration after laryngectomy
  • Closure of tracheal defects (for example, after surgery or irradiation)
• Head and neck tumor surgery
  • Pharyngeal tumors
  • Laryngeal tumors 
  • Salivary gland tumors
  • Nasal and paranasal sinus tumors
  • Scalp and facial tumors 
  • Neck soft tissue tumors
• Surgical treatment of otolaryngological diseases in children
  • Removal of tonsils
  • Correction of simple and complex malformations (for example, ear reshaping, surgery to treat choanal atresia)
  • Cochlear implantation for hearing loss
• Thyroid and parathyroid surgery (minimally invasive interventions)
• Plastic and aesthetic surgery
  • Nose reshaping
  • Ear reshaping
  • Reconstruction of eyelid defects
  • Facelift (classical and endoscopic)
  • Treatment of wrinkles (botox, injectable fillers)
• Other medical services