Een gezwel van de oorspeekselklier (parotis) laten verwijderen: verloop van de operatie en mogelijke gevolgen. Van Haesendonck NKO in Lier. Information on removal of the parotid sinus / parotidectomy Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams. The parotid gland (parotid gland) is located in front of and below the ear. There are 2 parotid glands, 2 under the jaw and 2 under the tongue. Together with numerous smaller salivary glands, they ensure saliva production. The parotid gland has a superficial and a deep lobe, between which runs the facial nerve (facial nerve). This ensures the mimicry of the face, the closing of lips and eyelids. When a tumor is found, it is best removed surgically. Most growths are benign. Purpose of the procedure When a tumor of the parotid gland needs to be removed, it is safe to do so after carefully locating the facial nerve to try to avoid facial paralysis. The technical aspects of the operation The operation is done under general anaesthetic. Through an incision, which runs in front of the ear and further into the neck, the parotid gland, the facial nerve and the tumor are searched for and the tumor is removed. Depending on the location and extent of the injury, the operation can take up to 4 hours. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By incising the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the area of operation. The numb area gradually becomes smaller and smaller. The immediate consequences Swelling usually occurs in the wound area for several weeks. There may be bleeding from the wound. This usually happens shortly after the operation. Sometimes it is necessary to find the source of bleeding again under anesthesia and to burn the bleeding vessel shut. A crooked face may occur after surgery due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The belated consequences There may be a collection of saliva previously visible at the bottom of the wound, which may need to be punctured. Frey's syndrome can develop after a few months. Then there is redness and perspiration of the skin of the operating area during eating. Serious and/or late complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Permanent facial nerve failure can occur but is extremely rare. Phlegmon or abscess formation in the neck area is rare. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated. Purpose of the procedure When a parotid gland tumor has to be removed, this can only be done safely after carefully locating the facial nerve, in an attempt to avoid facial paralysis. The technical aspects of the operation The operation is performed under general anesthesia. Through an incision that runs along the ear and further into the neck, the parotid gland, the facial nerve and the tumor are located and the tumor is removed. The operation takes an average of 2 hours, but can take up to 4 hours depending on the location and extent of the injury. During the procedure, the facial nerve is electrically monitored, which helps to locate the nerve safely and reduces the chance of complications. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By cutting the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the surgical area. The numb area gradually becomes smaller. The immediate consequences The wound area usually experiences swelling for a few weeks. There may be post-operative bleeding from the wound. This usually occurs shortly after the operation. Sometimes it is necessary to find the bleeding site again under anesthesia and to cauterize the bleeding vessel. After the operation, a crooked face may occur due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months). The late consequences There may be a collection of saliva visible at the bottom of the wound, which may need to be punctured. After a few months, Frey's syndrome may develop. Redness and perspiration of the skin of the surgical area will occur during eating. Serious and/or late complications Every surgical procedure, even in ideal circumstances and performed in the best possible way, can have complications. Permanent failure of the facial nerve can occur but is extremely rare. Phlegm or abscess formation in the neck area is rare. All these risks must be weighed against complications that can occur if surgical treatment is not resorted to. The purpose of this information is to provide you with generally applicable information about this type of surgery. It is of course possible that in your individual case certain aspects of this document may not apply or may need to be discussed more or additionally with your surgeon. Please remember to tell your surgeon all information about your general state of health and all medications you are taking regularly - especially aspirin and related products, or other medications that can affect clotting . Please mention any allergic reactions you have had in the past, especially reactions to medications. Bring any recent medical reports in your possession, such as blood tests, radiological and other preoperative examinations.

Vergrote neusschelpen laten verkleinen met een conchaplastie om de neusademhaling te verbeteren. Van Haesendonck NKO in Lier. Information on septoplasty and conchaplasty Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Don't forget to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). What function does the nose have? The nose is certainly not only there for the smell, although this is of course an important part of the function. The nose is primarily a part of the respiratory organs. In the nose, the inhaled air is heated, moistened and cleaned. For example, more than 95% of the particles that pollute our air are filtered out through the nose and made harmless. The nose ensures the best possible breathing. In addition, the nose has an important function in voice formation and the drainage of tear fluid also runs through the nose. Finally, the external shape of the nose is also an important aspect; this determines a person's appearance to a large extent. Nasal function can be affected in many ways. For example, due to a cold as it sometimes occurs in everyone, or due to an allergy (hypersensitivity). Disorders in the function of the nose can often be made worse by an abnormal shape of the interior of the nose. The most common is a misalignment of the nasal septum (the septum), which separates the nasal halves. This abnormal shape of the nasal septum is very common and can lead to a wide range of complaints, such as a feeling of constipation, disturbed breathing or headache. This is an explanation for the fact that straightening the nasal septum (the so-called septal correction) is an operation that is common. The aim of this procedure is to improve nasal function. Septoplasty (septum correction) The purpose of the operation The aim of the operation is to correct deviations/crookedness of the nasal septum, so that it is straightened and there is therefore sufficient breathing space in the nose on both sides. The technical aspects of the operation Surgery is performed exclusively in the interior of the nose, so no visible scars are to be expected. During the operation, the cartilage and bone of the nasal septum is exposed through a small incision inside the nose, usually on the right side, a few millimeters past the entrance to the nose. After this, the partition is then straightened, ie protruding parts are removed, curved parts are straightened, etc. Immediate Effects The thus repaired nasal septum is then temporarily held in place by so-called splints inserted into the nose (silicone plates that are placed in the nose on both sides and that allow some breathing through the nose). In this way the septum is supported in the correct position on both sides, so that the mucous membrane, cartilage and bone can grow back together. The splints are removed after about 1 week. The sutures at the incision are removed after 1-2 weeks, if applicable. Late Effects The healing of the nasal mucosa takes several weeks. During this period, treatment with nasal rinses and/or vapors and/or nasal ointments may be applied. In rare cases, problems during healing can cause a misalignment of the septum or cause deformities that could negatively affect nasal breathing. Serious and/or exceptional complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Bleeding is always more or less to be expected, there are of course cases where the doctor will have to intervene extra. Cerebrospinal fluid leakage can occur after both nasal and sinus surgery (although it is extremely rare with septoplasty). If a leak does occur, it is not very noticeable and only becomes apparent late. Confusing in this regard, of course, is that any patient undergoing surgery on the nose or sinuses will always have some watery nasal discharge. If the nasal discharge is profuse or noticeably one-sided, it is best to inform the doctor. Nasal turbinate surgeries (conchaplasty or conchacoagulation) The purpose of the operation Especially the inferior concha (the lower turbinate) is mentioned in this context as it plays the most important role in nasal breathing. The concha media can also be surgically corrected, usually in conjunction with sinus or septal surgery, so that we only focus on the inferior concha here. Most procedures on the inferior concha are intended to reduce this structure and thus improve nasal breathing. The technical aspects of the operation In order of invasiveness we distinguish the RF conchaplasty, the conchacoagulation and the conchaplasty. In the RF conchaplasty, a needle is inserted into the concha (usually under local anaesthetic), which causes a controlled heating of the concha, after which the concha scars and shrinks. In the concha coagulation, this effect is achieved by burning the concha from the surface using electric current. This can be done under local or general anaesthetic. In conchaplasty, part of the conchamucosa is cut away, almost always under general anaesthetic. Many turbinate surgeries are done in conjunction with a septal correction or sinus surgery. Immediate Effects Bleeding is to be expected to a greater or lesser extent if a conchaplasty is performed. this is why a nasal tamponade is sometimes temporarily applied, which can then be removed after 1 or a few days. Late Effects Crust formation at the inferior concha occurs in the first weeks, as long as the mucosa is still in the healing phase. Nasal rinses and/or nasal ointment are usually used for this or nasal drops. Serious and/or exceptional complications There are, apart from the already mentioned bleeding with conchaplasty, no serious or exceptional complications from these operations.

Dr. Gilles Van Haesendonck is KNO-arts en hoofd-halschirurg in Lier, gespecialiseerd in schildklier-, speekselklier- en tumorchirurgie. UZA en AZ Sint-Maarten. dr. Gilles Van Haesendonck Make an appointment Graduated as a doctor from the University of Antwerp in 2016. Afterwards specialization in ENT and head and neck surgery at Antwerp University Hospital (UZA) and ZNA Middelheim. Special interest and ability in head and neck surgery: Thyroid: Swelling, nodule, or cyst of the thyroid gland. Benign and malignant tumors of the thyroid gland. Salivary gland: Swelling, nodule, or cyst. Benign and malignant tumors (parotid and submandibular salivary gland). Vocal cord pathology: vocal cord nodules, cysts, and cancer. Benign and malignant tumors in the head and neck area (mouth, tongue, tonsil,...) Surgical treatment of facial skin cancer. Disorders of facial movemen / facial paralysis or palsy. Also diagnosis, advice and treatment of: Voice and swallowing disorders facial paralysis Nasal congestion, nosebleed, runny nose, loss of smell and taste Functional Rhinoplasty / Septoplasty Tonsils and polyps Placing ventilation tubes Snoring and sleep disorders Hearing loss Hearing aid advice Dizziness and balance disorders BAHA surgery Also working at the Antwerp University Hopital (UZA Edegem) and AZ Sint Maarten (Mechelen) . Member of: Belgian Association for ORL EORTC Head and Neck surgical group Flemish Working Group for Head and Neck Tumors (VWHHT) Editorial board B-ENT

Ventilatiebuisjes bij terugkerende oorontstekingen of gehoorverlies: doel van de ingreep, verloop en mogelijke gevolgen. Van Haesendonck NKO in Lier. Information about placing ventilation tubes in the eardrum Introduction The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, it may be the case that certain aspects of this document are not applicable in your individual case or that they need to be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring recent medical records in your possession such as blood tests, radiologic and other preoperative examinations. Purpose of the procedure A malfunctioning Eustachian tube interferes with normal middle ear ventilation. Inadequate ventilation can have one or more consequences: recurring acute middle ear infection, hearing loss due to fluid in the middle ear and, at a later age, the collapse of the eardrum, which can cause a benign skin tumor (cholesteatoma) and/or permanent hearing loss. The technical aspects of the operation The placement of a transtympanic ventilation tube (also called a diabolo or tube for short) is done in children (and in some adults) under general anaesthetic. The eardrum is easily reached along the ear canal. A transtympanic ventilation tube is inserted through the eardrum under the view of a microscope after a small incision. The mucus that is usually in the middle ear can be immediately aspirated from the ear at the same time. Immediate Effects There is no pain upon awakening. There may be some (sometimes bloody) ear bleeding in the immediate aftermath. Only if this is very abundant can it cause premature shedding of the tube. Earring can also occur later on: this occurs in 1 or 2 children in 5 and often stops spontaneously after a few days. If the earring persists, this indicates an infection and it is best to consult a doctor; after all, these are ventilation pipes and not drainage pipes. Sometimes the tube can clog as a result of dried ear canal and the original problem can start again. If the hearing was impaired before, it will usually return to normal almost immediately after the procedure. However, this does not mean that “too much noise” should be avoided. The presence of the tube itself in the eardrum does not cause hearing loss. Late Effects It is normal and desirable for the tube to be expelled after a few months to over a year. How long this will last in each individual person is not predictable and can even be very different between left and right ear in the same person. Whether the problem will resume after expulsion depends on the functioning of the Eustachian tube (which in most cases in children gradually improves with age). Only very rarely does a tube fall inside; it does not necessarily have to be removed. In 1 to 2% of cases, the tube leaves a hole in the eardrum. This often happens in an eardrum that has already been damaged by inflammation. Incidentally, inflammation itself can of course also be the cause of a cavity. Serious and/or exceptional complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Any intervention on an ear can cause irreversible hearing loss, ear murmurs, facial paralysis or (usually temporary) balance problems, but this is extremely rare when a transtympanic ventilation tube is placed. The same applies to causing a cholesteatoma (a benign skin growth), by enclosing a piece of skin behind the eardrum when it is punctured. One must weigh the (extremely rare) occurrence of serious complications against the benefits that can normally be expected from this procedure, and certainly not forget that "not intervening" can sometimes also have serious consequences.

Onderkaakspeekselklier laten verwijderen bij ontstekingen, speekselstenen of een gezwel: verloop en mogelijke gevolgen. Van Haesendonck NKO in Lier. Information on removing the submandibular salivary gland (glandula submandibularis) Introduction The purpose of this information is to inform you about the progress of this procedure. We ask that you read this document carefully. Your surgeon is at your disposal to answer any further questions you may have. Of course, it may be the case that certain aspects of this document are not applicable in your individual case or that more or more additions should be discussed with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams. There are 2 submaxillary glands, which together with the 2 parotid and sublingual glands form the six major salivary glands. Together with numerous smaller salivary glands, they ensure saliva production. Because of recurrent inflammation, whether or not due to salivary gland stones or a tumor in one of the submaxillary glands, it can be decided to remove the affected salivary gland. Purpose of the procedure Stones can be found in the gland or duct leading to the mouth that obstruct the flow of saliva. When these stones remain, chronic inflammation can develop. Also without salivary stones, the submaxillary gland can become chronically inflamed. If removal of the stone by mouth has no effect or is not possible or if the pain and inflammations take on serious forms, a decision can be made to treat the affected person. submandibular gland removal. A tumor of the lower jaw salivary gland is best removed, it can be seen as a malignant tumor. The technical aspects of the operation The submaxillary gland is removed under general anesthesia through a skin incision under the jawline. In this part runs a branch of the facial nerve, the tongue and the taste nerve. Every effort is made to conserve these structures. The operation ends with the placement of a wound drain and the suture of the wound. The duration of the procedure is one hour, the duration of admission is 2 to 3 days. The immediate consequences The pain after the operation is usually rather minor, swelling can occur which after a few weeks has disappeared. A significant swelling indicates inflammation or bruising. There may be bleeding from the wound. This usually happens shortly after the operation. Sometimes it is necessary to find the source of bleeding again under anesthesia and to burn the bleeding vessel shut. The wound drain usually has to be left in place for 24 hours and is then removed, which is sensitive. The incision under the jaw causes a numbness of the surgical site. This only decreases after a few months. Nerve damage can result from removal of the submaxillary gland. After the operation there may be a weakness in the mobility of the corner of the mouth. This usually improves after a few weeks. Rarely, this is permanent. The chance of damage to the nerves of the tongue is rather small. The belated consequences Nerve damage may be permanent with weakness in the movement of the corner of the mouth, or sensation, taste and movement of the tongue. Serious and/or exceptional complications Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. A permanent loss of the mandibular branch of the facial nerve can occur but is extremely rare. Phlegmon or abscess formation in the neck area is rare. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated. The technical aspects of the operation The submandibular salivary gland is removed under general anesthesia, via a skin incision under the edge of the jaw. A branch of the facial nerve, the tongue nerve and the taste nerve runs through this section. Every effort is made to preserve these structures. The operation ends with the placement of a wound drain and the suturing of the wound. The duration of the procedure is approximately one hour. After the operation Recovery: After the operation you will usually stay in the hospital for one night. Wound care: The wound is sutured and a drain is usually placed to drain wound fluid. Eating and drinking: You may eat and drink normally again after the operation. As with any surgery, there are risks associated with submandibular gland resection, such as: Post-operative bleeding Infection Nerve damage: In rare cases, damage may occur to the facial nerve (causing temporary weakness of the corner of the mouth), the lingual nerve (causing numbness in part of the tongue), or the taste nerve. Dry mouth: Sometimes the mouth may feel a little drier after surgery, but this is usually temporary. Swelling: Swelling may occur in the surgical area. The purpose of this information is to provide you with generally applicable information about this type of surgery. It is of course possible that in your individual case certain aspects of this document do not apply or need to be discussed more or additionally with your surgeon. Do not forget to tell your surgeon all information about your general state of health, as well as all medications that you regularly take - especially aspirin and related products, or other medications that can affect clotting. General anesthesia (narcosis) should be discussed in advance with the physician-anesthetist