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The main aim of this operation is to close perforation of ear drum. Perforation is considered as a hole in the ear drum which may lead to severe ear infection and impair it. Usually it gets rid of itself automatically but not so in many cases. There are number of ways to clear hole, all it depends on size of and hole and the anatomy of the ear. Tympanoplasty is a surgical technique which deals with the tympanic membrane of the ear. This method is adopted not only to close the perforation in the region but also in some cases to lift the tympanic membrane from its position in the ear canal to improve the hearing capacity and improve the functioning of the middle ear. This surgery is carried out in inner ear alone and no manipulation to middle ear bone is done. Lateral and medical grafting techniques are also adopted in this process Mastoidectomy is done to remove the infected mastoide air cells that gets accumulated in the hollow space of the skull behind the ear. This may cause a great damage to the ear. The diseased cell proliferates into the skull, also into the temporal bones which may lead to removal of the bones.

The types of mastoidectomy performed are simple mastoidectomy, radical mastoidectomy and modified radical mastoidectomy.

Radical Mastoidectomy is less severe when compared to other two methods. Not all the middle ear bones are removed in this process and the ear drum is rebuilt.Stapedectomy is a microsurgical process in which the innermost bone of the middle ear is completely removed and replaced by a small plastic tube to improve the movement hearing into this region

Stapedectomy is not done through incision. The surgeon directly does it through the ear canal by folding the ear drum forward. This entire process is done through operating microscope to have clear insights of the infection. Myringotomy is a surgical procedure in which a small incision is made in the tympanic membrane of the middle ear in the anteroinferior quadrant and posteroinferior quadrant to drain out fluid from the middle ear. Ear tubes made of plastic or metals are inserted through ear drums which may fall automatically or can be removed by doctor in later stage For discharging ears, we perform mastoidectomy where in we remove all accessible mastoid air cells clear active infection, the procedure is usually combined with MYRINGOPLASTY A pre-auricular sinus is a blind track of sinus formed in the front of the ear. In most cases it is congenital whose origin may be traced due to imperfect fusion of some of the elements that form the ear pinna. This is usually symptomless but in some cases formation of abscess becomes the symptoms for pre-aricular sinus. It also predisposes to ulser formation in front of the ear. A split or torn ear lobe is one of the most common problems of the ear. This may happen due to prolonged usage of heavy ear rings. It causes distress to patients who love wearing era ring. Hence ear lobe repair is an optimum rectification for this by which the original ear lobe can be restored.

Post Aural Fistula Closure

Post aural fistula closure is a procedure that follows chronic ear disease or an ear surgery. The traditional skin to skin closure is unsafe because of necrotic skin edges which may result to a larger fistula. Hence this method is adopted to avoid future post closure problems. Intra tympanic injection is usually injecting steroids into the inner ear as a remedy to sudden loss in hearing. At first topical phenol anesthesia is applied to the ear drum and the white area is anesthetized. The needle passes through the ear drum to inject the steroid inside. The patient is advised to keep the ear turned up for at least 30 minutes so that steroid remains inside as long as it can.

  1. FESS: Functional endoscopic sinus surgery is performed for patients with chronic sinusitis

  2. ENDOSCOPIC POLYPECTOMY: Done in combination with endoscopic sinus surgery

  3. in case of (a) Antrochoanal polyp (b) Ethmoidal polyp

  4. Endoscopic removal of sino nasal tumors

  5. Endoscopic skull base surgeries

  6. Septoplasty: Removal of deviated part of septum & straightening the same

  7. SMR: Remove of most part of septum

  8. TURBINOPLASTY / TURBINECTOMY: Partial / Total removal of inferior turbinate to reduce allergy symptoms and nasal block in snoring



  1. ADENOTONSILLECTOMY / TONSILLECTOMY: Repeated infections & enlargement of tonsils and adenoids we do this procedure.

  2. STYLOIDECTOMY: Removal of elongated styloid process following tonsillectomy in case of Eagle s syndrome.

  3. VALLECULAR CYST EXCISION




  1. MICRO LARYNGEAL SURGERY: For

  2. Vocal cord nodule

  3. Vocal cord polyp

  4. ? Laryngeal papilloma

  5. Vocal cord paralysis


(D/L SCOPY) Direct Laryngoscopy: For diagnosis and biopsy of malignant tumors.
Tracheostomy: Emergency / Elective surgery done to relative breathing difficulty due to obstruction above trachea.

  1. UVULOPALATO PHARYNGOPLASTY.

  2. ? ZETAPALATO PHARYNGOPLASTY.

  3. TURBINOPLASTY / TURBINECTOMY.

  4. TONGUE BASE CHANNELLING / TONGUE BASE REDUCTION.


Is an advanced technology that uses gentle radio frequency energy with a salt solution to ablate tissues.

  • ? ADENOIDECTOMY & TONSILLECTOMY

  • ? ALL SNORING SURGERIES

  • ? TURBINATE & TONGUE CHANNELLING


Ear symptom

1.? EAR ACHE Ear Pain

2.? EAR DISCHARGE Fluid / Water from ear

3.? HARD OF HEARING Decreased hearing sensation

4.? TINNITUS Ringing sensation in ear

5.? VERTIGO Giddiness, feeling of rotation of ones self / surrounding

6.? SUDDEN HEARING LOSS

Nasal symptoms

1.? HEAD ACHE Due to sinusitis, migraine

2.? NASAL BLOCK

3.? EPISTAXIS Bleeding from nose

4.? SNEEZING

5.? MOUTH BREATHING: It can be perceived by Dryness of throat. Here the patient opens mouth to breathe while bleeding.

6.? THROAT DRYNESS

7.? POST NASAL DRIP: Phlegm coming behind the nose to the throat.

8.? HYPOSMIA / ANOSMIA: Decreased / Complete absence of sense of smell.

Throat symptoms

1.? THROAT PAIN

2.? DYSPHANGIA: Difficulty while swallowing

3.? ODYNO PHAGIA: Pain while swallowing

4.? DRY COUGH

5.? VOICE CHANGES

Sleep related symptoms

1.? SNORING

2.? SLEEPLESSNESS

3.? GENERALISED FATIGUE / MYALGIA

4.? NIGHT TERRORS

5.? BED NETTING: Secondary Enuresis

6.? INSOMNIA

7.? GASTRIC DISCOMFORT

OPD/diagnostic procedure

1.? OTO ENDOSCOPY

2.? DIAGNOSTIC NASAL ENDOSCOPY (DNE)

3.? VIDEO LARYNGOSOPY (VLE)

Interventional Pulmonology Procedures

Bronchoscopy

Bronchoscopy can be defined as a diagnostic and therapeutic procedure that permits direct visualization of the tracheo bronchial lumen with the help of the bronchoscope, a specialized device.

Bronchoscopy is the most commonly used invasive procedure in pulmonology.

Bronchoscopy permits collection of respiratory secretion from the tracheo bronchial tree as well as tissue samples from the airway mucusa, lung parenchyma and lympnedes and other masses located immediately adjacent to but out side the tracheo bronchial lumen.

Bronchoscopy is also used as a therapeutic tool to treat the airway luminal obstruction caused by various diseases, bleeding from respiratory structures and several pulmonary disorders.

Diagonostic Indications

  • Unexplained Cough
  • Hemoptysis
  • Localised Wheeze (with suggestion of obstruction)
  • Stridor
  • Unexplained Chest Radiography Opacity.
  • Pulmonary infection (when not improving)
  • Immuno Compromised
  • Diffuse lung diseases Non-infectious
  • Intra thoracic Lympthadenopathy
  • Pulmonary Neoplasm
  • Foreign body
  • Burns
  • Vocal cord & Diaphragm Palsy

Therapeutic Indications

  • Removal of airway secretions, mucus plugs, clots and necrotic debris
  • Atelectasis
  • Foreign body
  • Neoplasms
  • Laser
  • Electro cautery
  • Endobronchial ultrasound
  • Argon Plasma Cogulation ( APC)
  • Cryotheraphy
  • Stenting
  • Lavage

Medical Thoracoscopy
PulmonaryTuberculosis(TB)
Bronchial Asthma
10 Jun

Chest Medicine

  • 9 AM - 3 PM
  • Dr. Lakshmipathy
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