Acupuncture is a treatment method that has been used in China for millennia. Its effectiveness has been confirmed and recognized by researchers worldwide. As a form of therapy, acupuncture clearly has the longest track record in the history of medicine. Therefore, it is officially recommended by the World Health Organization (WHO).
The method is successfully employed by about 400,000 doctors in the western world. Compared to many other forms of treatment, acupuncture shows almost no side effects. In its application, sterile specially sharpened disposable needles are used, ensuring a gentle and particularly low-pain treatment. Due to the painless treatment, acupuncture is also suitable for therapy in childhood.
Acupuncture is suitable for the therapy of many disease patterns, especially also in ENT (Ear, Nose, and Throat) medicine. For example, for chronic headaches, acute ear noises, back pain, joint complaints, hay fever, dizziness, sleep disorders, spinal complaints, and allergies.
Also, good success is achieved with acupuncture in addiction treatment, for example in smoking cessation and weight reduction.
The costs for an acupuncture treatment are usually not covered by health insurance companies. For individual advice regarding therapeutic options and costs, we are always at your disposal.

The following operations are performed by us:

Ear

• Paracentesis (opening of the eardrum)
• Tympanic drainage (insertion of tympanic tubes)
• Tympanoplasty (reconstruction of the eardrum after injuries or inflammations)
• Hearing improvement surgeries for chronic middle ear infections
• Surgeries for chronic bone suppuration
• Surgeries for bony adhesions on the stapes (otosclerosis)
• Expansion of the ear canals for bone protrusions (exostoses)
• Antelixplasty (ear pinning)
• Removal of skin changes on the earlobe (basal cell carcinoma, etc.)

Nose

• Conchotomy (reduction of the nasal conchas)
• Septoplasty (straightening of the nasal septum)
• Realignment of the nasal bone in case of fractures
• Separation of adhesions in the nose
• Removal of nasal polyps
• Removal of cartilage spurs
• Endoscopic maxillary sinus surgeries
• Endoscopic and microscopic surgeries in the entire paranasal sinus area

Mouth

• Tonsillectomy (removal of the palatine tonsils)
• Tonsillotomy (laser)
• Palatal veil tightening and shortening of the uvula (UVPP)
• Improvement of snoring (LAUP)
• Removal of mucosal changes

Throat

• Adenoidectomy (removal of the adenoids)

Larynx

• Microscopic removal of vocal cord polyps
• Microscopic examination and biopsy in chronic laryngitis

Neck

• Removal of persistently enlarged lymph nodes
• Removal of submandibular salivary glands in chronic inflammations or stone formation
• Removal of congenital malformations in neck cysts
• Plastic correction of scars

Laser Surgeries

• Leukoplakia of the mucosa
• Enlargement of the nasal conchas
• Adhesions in the nose
• Nasal polyps
• Cartilage spurs
• Nasal breathing impairment: Nasal breathing is often impeded by enlarged nasal conchas, nasal polyps, or spur-like bends of the cartilaginous nasal septum. The CO2 laser is used to reduce the enlarged nasal conchas, “evaporate” nasal polyps, and remove cartilage spurs.
• Snoring: In many cases, snoring is caused by an excessively long uvula and too slack palatal muscles. Laser-Assisted Uvulopalatoplasty (LAUP), using the CO2 laser with a special handpiece, offers the possibility to shorten the uvula and tighten the palatal arch.
• Tonsil hyperplasia (tonsil capping)

Soft tissue surgery includes operations on the major salivary glands, particularly the parotid gland, and associated surgery of the facial nerve. We also perform various plastic and cosmetic surgeries.
Outpatient surgeries are performed in the rooms of Meliva MVZ Westpfalz in Landstuhl. Inpatient surgeries in St. Johannis Hospital Landstuhl, and in MVZ Landstuhl.

Why Wrinkle Treatment?

In today’s world, youthful and good looks increasingly determine success and reputation. However, environmental influences, sun, and nicotine, as well as the natural aging process, leave their marks. The skin loses tension and elasticity. Wrinkles form, especially in facial areas that are heavily used for expression. Examples include the so-called crow’s feet, nasolabial folds, and also frown lines. To avoid crow’s feet, we shouldn’t stop laughing, but when certain wrinkles are too pronounced or appear in the wrong places, they can give our face a tired, aged, angry, and even pessimistic expression. To assist good looks a bit, the scalpel isn’t immediately necessary – wrinkle injections can work wonders. “Normal” wrinkles can be smoothed out again by injecting hyaluronic acid. “Expression” wrinkles are best treated with Botox (Botulinum toxin A).
Wrinkle Treatment with Botox Many wrinkles are so-called expression wrinkles. They are formed by repeatedly making facial expressions, which, over time, become “deeply imprinted”. For instance, frowning creates the vertical, so-called frown line. Smile lines or the horizontal wrinkles on a thinker’s forehead are formed through muscle overactivity. This overactivity must be deactivated. Horizontal wrinkles on the forehead can also be caused by drooping eyelids and in this case, are due to the overactivity of the forehead muscle trying to lift the sagging eyebrows (also refer to eyelid correction topics).
Nowadays, Botulinum toxin A, shortly Botox, is used to treat expression wrinkles. Botox is a substance that reduces muscle activity. It smoothens expression wrinkles without surgical procedures or foreign material and is almost pain-free in its application. A treatment takes about 10 – 20 minutes. However, Botox only unfolds its effect after a few days; the skin becomes smoother, and one looks more relaxed. Facial expression remains natural since the rest of the mimicry is preserved. The effect lasts about 4 – 5 months until the substance is broken down by the body.

When is Wrinkle Treatment with Botox helpful?
Botox therapy is primarily useful for expression wrinkles, which means:

• Horizontal wrinkles on the forehead (worry lines)
• Vertical wrinkles on the forehead (frown lines)
• Lateral wrinkles around the eyes (crow’s feet)

What happens during Wrinkle Treatment with Botox?

About 1/10-drop of a solution (approximately the size of a pinhead) is introduced into the respective region with a very fine syringe. This is practically painless, as the solution consists of a naturally occurring bacterial protein.

How does Wrinkle Treatment with Botox work?

The solution blocks the cause of expression wrinkles: for example, precisely the nerve impulses used when frowning. As a result, these muscles cannot be tensed anymore. Other muscles, as well as the sensitivity of the skin, are not affected. The expressiveness of the face is preserved. Blocking the muscles has two effects:

1. The wrinkles do not continue to imprint.
2. The wrinkles decrease. The skin relaxes and the connective tissue can regenerate. In addition, the natural pull of the antagonist muscles increasingly smoothens the skin. Over time, even deep furrows can be balanced out. The first effect is visible after 2 – 5 days. The full effect shows after 1 – 2 weeks and lasts up to 6 months.

The Advantages of Botox

1. Botox therapy reduces wrinkles without surgery. Botox therapy can be used selectively and has no impact on other facial muscles. Expressiveness and skin sensitivity are not impaired.
2. The effect of Botox therapy is temporary. That means: If you unexpectedly feel uncomfortable with the result, you just need a little patience until the substance has broken down.
3. Even if the muscle effect decreases after three to six months, wrinkles usually reappear significantly later. A follow-up treatment is therefore only necessary after four to eight months. Typically, these intervals get longer each time.
4. Injections with Botox can be repeated any number of times and are easily combinable with other wrinkle treatment methods.
   Wrinkle Treatment with Hyaluronic Acid For the wrinkle treatment of all “non-expression” wrinkles, hyaluronic acid is injected into and under the skin using a fine needle. Hyaluronic acid is a main component of natural connective tissue and is biologically synthesized. NASHA (Non-Animal Stabilized Hyaluronic Acid) refers to hyaluronic acid that is not derived from animals.

Hyaluron comes in four variants:

• For fine wrinkles
• For medium wrinkles
• For deep wrinkles
• For lip injection The difference between the individual materials lies in their different viscosity (slight, strong, viscous). Thus, hyaluron can be used very individually. The treating doctor can take into account the different depths of wrinkles and choose the suitable hyaluron, considering your personal initial situation. Previous allergy tests are unnecessary. Moreover, the material is completely broken down by the body, which reduces additional health risks. Currently, due to its good compatibility and moldability, hyaluron is one of the best filler materials on the market. Hyaluron is also excellent for cosmetic lip correction. Lips can be gently and naturally filled with hyaluron without looking “injected”.

The Risks of Wrinkle Treatment?
If used properly, no undesirable side effect is to be expected. However, you should ensure that the doctor has sufficient experience in the application.
Wrinkle Treatment – What Needs to Be Considered? Do not take anticoagulant medications (aspirin or acetylsalicylic acid-containing agents) immediately before wrinkle treatment.

Balance Disturbances
Everyone encounters feelings of dizziness differently. Some may experience a loss of spatial orientation, a sensation of weakness, or a “blacking out” before their eyes, while others report nausea or a propensity to fall. Roughly 38% of German citizens suffer from episodes of dizziness – with women being more commonly affected than men. For 8% of those afflicted, the dizziness is linked to a specific medical condition. When dizziness presents itself with an unpleasant distortion of space and motion perception, it is not a disease per se, but a symptom.
Various factors can cause this. Dizziness is a warning signal from the body, necessitating a search for its cause. The equilibrium system itself might be the trigger. However, other factors like high or low blood pressure, spinal issues, heart arrhythmias, metabolic issues, or psychological factors could also be responsible. Therefore, precise medical diagnosis, especially when dizziness is a new occurrence, is crucial and forms the foundation for all subsequent treatments.
Equilibrium depends on the finely-tuned cooperation of various organs, including the eyes, the balance center in the inner ear, the cervical spine, and the central processing in the brain. If one link in this chain fails, the entire system may falter. For instance, in “motion sickness,” the brain receives contradictory information about the body’s position and movement, causing a kind of physiological induced dizziness.
Taking numerous medications can also induce episodes of dizziness. When the balance organ in the ear is diseased or fails completely, it is referred to as vestibular dizziness. Possible causes are inflammations, tumors, circulatory disorders, epilepsy, multiple sclerosis, or diseases like Menière’s disease. This condition, typically manifesting between the ages of 40 and 60, presents through episodes of dizziness lasting from minutes to hours, coupled with a tendency to fall, perspiration, nausea, and vomiting. The disease usually follows a favorable course. Dizziness is most common in the elderly…
Positional and positioning vertigo is the most common form of dizziness in adults, predominantly occurring when the head is tilted to the side. This dizziness can happen after falls or very forceful head movements. Often appearing as an age-related ailment between the ages of 60 and 80, this form of dizziness is typically prevalent.
Older individuals, especially at night when turning in bed or when getting up, often suffer from brief dizzy spells, potentially accompanied by nausea, vomiting, and anxiety.
Alongside treating the underlying causes of balance disorders, physiotherapeutic measures have proven particularly beneficial. This involves provoking postural instabilities, which demand corrective movements from the patient. Ultimately, the therapy aims to enhance balance responses. For medicinal treatment of dizziness and motion sickness, one can utilize tablets or homeopathic preparations.

Dizziness Therapy
The possible therapy is as varied as the causes and manifestations of a dizzy sensation. The root cause resides in our senses: during dizziness, the perceptions of the balance organ located in the inner ear, the eyes, and the brain are misaligned. One may feel as if they are spinning or swaying. However, general malaise and blacking out before the eyes are also colloquially often described as “dizziness.”
To date, more than 300 different causes are known for dizziness. They range from spinal misalignments, high or low blood pressure, heart arrhythmias, alcohol or medications, psychological diseases, glaucoma, or migraines, to tumors, to mention just a few possibilities.
Dizziness is widespread. Approximately 20% of patients who consult a general practitioner are suffering from frequent or persistent dizziness. Especially stubborn forms of vertiginous diseases can even lead to disability because those affected become “unbalanced” in their daily lives and can literally “no longer walk straight.”
However, it does not have to reach this point. Early diagnosis and treatment play a crucial role in managing dizzy conditions, as is the case with many other diseases.
Depending on the cause, therapy options may include medication, surgeries, or even simple repositioning maneuvers. For instance, against “benign paroxysmal positional vertigo,” which is caused by tiny particles in the inner ear moving to the wrong place, a physical maneuver helps. Here, the ENT specialist securely holds the patient’s head and moves the entire patient in a carefully calculated manner within a few seconds. The tiny particles, also known as otoliths, are thus propelled back to their original place.
Travel sickness or sea sickness is also harmless but can be annoying. The first symptoms are yawning, weariness, and fatigue. Here, medication, which one can take as a tablet or apply to the skin as a patch well in advance of traveling, can help.
Prolonged but often successful for many dizzy diseases is a kind of acclimatization training involving the deliberate practice of coordinated movements. For instance, some ENT textbooks suggest: “For further strengthening, dancing is highly recommended.”

How is the Neck Lifting surgery done?
Sometimes, skin sagging is limited to specific areas, such as noticeably prominent wrinkles in the neck area. In such cases, a neck lift, rather than a facelift, is performed. Depending on the diagnosis, there are two different treatment options:

1. Liposuction: 
Up to a certain degree of skin sagging, it may be sufficient to suction the underlying fat tissue. The superficial suction leads to retraction (tightening of the skin). If the skin sags significantly (turkey neck), skin removal is mandatory.
2. Neck Lift: In a neck lift, slackened skin in the neck area is removed. In this context, there are two different incision techniques:
   

• Beneath the chin: Potential fat cells are removed, and the skin and musculature are tightened with small, very fine stitches. Scars are typically barely visible following healing.
• Behind the ear: Similar to a facelift, the neck muscles are fixed upwards, and the neck is tightened. However, it’s vital to note that we provide thorough consultations regarding all these procedures. We do not merely “prescribe” a neck lift but explain how you can achieve the best result for yourself. This consultation is free of charge.

Duration of Surgery
Depending on the objective and technique, the procedure takes between one and two hours. Additional measures can accordingly extend the treatment duration.

Anesthesia
The procedure can be performed under local anesthesia. In this case, the neck and chin are numbed by injecting a pain-relieving medication. Often, a calming substance is administered to alleviate anxiety and nervousness about the operation. Sometimes, general anesthesia, inducing artificial sleep, is used, which requires an anesthetist.

The risks of Neck Lift
Every surgical procedure carries risks. The extent of these risks depends on personal health, the type and scope of the procedure, and various other factors, about which we will thoroughly inform you prior to the procedure. We might even advise against a procedure. In such a case, we will not perform a neck lift but will discuss alternative options with you. General surgery risks include the occurrence of wound healing disorders or infection. Additionally, post-operative bleeding might occur, which in rare cases mandates surgical intervention. In isolated cases, hematomas (accumulations of blood under the skin) may appear, necessitating removal. Injuries to critical anatomical structures, such as the facial nerve (Nervus facialis) with generally temporary paralysis of the mimic muscles and circulation disorders of the skin (more common in smokers), are possible but rare.

What to consider beforehand?

• Please avoid taking anticoagulant medications (such as aspirin or acetylsalicylic acid-containing agents) two weeks prior to surgery.
• Also, please refrain from sunbathing and using tanning beds (especially on the face and décolleté area) for at least two weeks before the operation.
• If you plan to diet, postpone the procedure until after the weight reduction, as you will likely lose weight in your face, chin, and neck.

What to consider afterwards?

• Be prepared for a longer healing phase following a neck lift. While the most noticeable swelling usually subsides within 12–24 hours and bruises disappear within a maximum of 2 weeks, the actual result won’t be visible until all swelling has subsided after several weeks.
• A neck lift is a significant procedure. Therefore, you should remain under medical observation for 1–2 days.
• Avoid sunbathing for six months.

How long does the effect last?
This strongly depends on individual cases, considering genetic predispositions, age, personal lifestyle, applied technique, and much more. Typically, the effect lasts between 5–10 years.

Nasal Conditions – Hay Fever (Pollinosis)
Hay fever, while exhibiting the same symptoms as “ordinary” rhinitis, is characterized by a seasonally induced swelling of the nasal mucous membranes and a runny nose due to an allergic reaction. Between 10 to 20% of the population are troubled by sneezing attacks, a runny or blocked nose, as well as itchy and watery eyes. Allergic diseases are fast becoming one of the major widespread ailments.

What Causes Hay Fever?
Pollen from various plants enters the body through inhaled air, adhering to the mucous membranes of the respiratory tract. The body mistakenly identifies these particles as “dangerous pathogens” and vigorously combats them. This hypersensitivity to otherwise harmless substances (allergens) is termed an allergy. However, allergies can also be triggered by mites, household dust, mold, animal hair, and countless other substances. Upon first contact with an allergen, the body produces antibodies. These attach themselves to so-called mast cells. Newly arriving allergens are then captured by the antibodies, and the mast cells release a specific substance, histamine.

Desensitization
An allergy represents a misreaction of the immune system. In the case of hay fever, the immune system reacts to utterly harmless substances as if they were extremely harmful. The body responds – the nose swells, and the mucous membranes produce large amounts of secretion. All this occurs to prevent further “harmful” substances from being inhaled. The nose runs to expel the already inhaled substances. Allergy medications aim to suppress these symptoms. While they provide temporary relief to allergy sufferers, once the medication is discontinued, the cycle begins anew. The only way to permanently resolve an allergy is through desensitization. In this method, the allergen is injected under the skin in increasing dosages. The immune system must continually deal with small amounts of the supposedly dangerous substance and typically undergoes a learning process. The innocuousness of the allergen is recognized by the immune system, which then ceases the unwarranted reaction to supposedly dangerous substances. The allergy disappears. The success rate of desensitization in combating allergies is very high. However, it must be performed consistently and systematically.

In age-related hearing loss, high-pitched sounds and consonants, such as L, T, or M, are often less distinctly heard. If one ear hears significantly worse than the other, affected individuals might struggle to determine the spatial location of sound sources.
This limitation can pose a substantial safety risk in traffic. Especially dangerous scenarios arise when crossing a street if a car is not heard or noticed until the last moment.

In elderly people, hearing issues often stem from so-called sensorineural hearing loss. Here, the hair cells and auditory nerves in the inner ear are damaged due to years of noise exposure or diminished blood flow to the inner ear that comes with aging. Conversely, if conductive hearing loss is present, the outer or middle ear is affected. This can also frequently occur in younger people and can often be treated with medication or surgery.

There are numerous potential causes of hearing problems: In the most benign cases, a blockage from earwax may obstruct the ear canal. However, an ear infection could also be the culprit. Less common is congenital malformation of the ossicles being to blame.
While wearing visual aids, like glasses, is widely accepted today, many people find adopting the use of a hearing aid to be a significant hurdle. However, the use of a hearing aid should not be excessively delayed. If the auditory nerve is not regularly stimulated, it can lose its efficiency, and a hearing aid fitted too late may not recover this loss.

If an Ear, Nose, and Throat doctor determines that hearing is impaired, they may prescribe a hearing aid. The appropriate hearing aid depends on the severity of the hearing impairment and the individual’s dexterity in operating the device. It is also possible to take a hearing aid on a trial basis.
The digital age has not spared our ears. Today’s hearing aids bear no resemblance to the beeping and hissing devices of earlier generations.

Here’s an overview of the various models:

• In-Ear Devices: Relatively small, virtually “disappearing” into the ear canal, suitable for mild to moderate hearing loss.
• Behind-the-Ear Devices: Worn behind the ear, connecting to the ear via a transparent earpiece, suitable even for severe hearing issues.
• Hearing Glasses: Suitable for hard-of-hearing individuals who wear glasses, integrated into the glasses frame.
• Directional Microphones: Assist those with profound hearing loss in isolating individual voices amid background noise, useful at large events or concerts.

Technical differences among the devices:

• Single-Channel Devices: Only allow uniform amplification of all frequencies.
• Multi-Channel Devices: Can amplify various frequencies individually depending on the hearing issue, optimizing speech intelligibility amid unfavorable ambient noise.
• Analog Hearing Aids: Amplify sounds and noises without filtering out specific interference frequencies.
• Digitally Programmable Hearing Aids: Possess a microscopically small computer chip, programmed to amplify precisely the frequencies that are poorly heard.
• Fully Digital Hearing Aids: Also controlled by a computer chip, they autonomously and flexibly adjust to the respective environmental situation, for instance, filtering out disruptive noises and highlighting speech.

Sudden hearing loss is an acute dysfunction of the inner ear, typically affecting only one ear. Those experiencing it often report a sudden deterioration in hearing, accompanied by a sensation of pressure in the ear. Concurrently, auditory disturbances, such as hissing or whistling (see also: tinnitus treatment), can occur. Additionally, sudden hearing loss can also induce vertigo.
The causes of sudden hearing loss are manifold, with circulatory disorders in the inner ear frequently implicated, which themselves can be triggered by various factors.
Emotional strain or a “stress situation” are common culprits. Additionally, consumption of nicotine and alcohol, lipid metabolism disorders, heart diseases, increased blood coagulation, blood pressure fluctuations, elevated blood lipids, cervical spine diseases, arteriosclerosis, diabetes mellitus, and obesity can all be potential causes for sudden hearing loss. It can also be triggered by a viral infection, extreme noise exposure, or a brain tumor.
An Ear, Nose, and Throat (ENT) specialist can quickly and definitively diagnose sudden hearing loss through a hearing test and a microscopic examination of the ear. If sudden hearing loss is confirmed, further examinations follow to ascertain the cause.
Subsequent therapy naturally depends on the cause of the hearing loss. However, primary treatment typically aims to promote circulation within the inner ear. Various treatment methods are available for this purpose:

• In-patient infusion therapy
• Out-patient infusion therapy
• Tablet medication
• In the case of tumors (a very rare cause of sudden hearing loss), surgery may be required.

Laryngitis, whether acute or chronic, represents inflammation of the laryngeal mucosa.

Causes
The larynx, positioned at the entrance of the trachea, plays a crucial role in voice production. Its upper end features the epiglottis, a cartilage essential for sealing the larynx during swallowing. Given that breathing air flows through the larynx, swelling of the mucous membranes can pose a life-threatening risk. Laryngitis can affect individuals of all ages, with certain forms particularly prevalent among children.

Acute Laryngitis
Acute laryngitis often emerges as part of an upper respiratory tract inflammation, but may also “ascend” from the lower airways, for instance, following existing bronchitis. Excessive voice use through singing or speaking, extended exposure to extremely dry, hot, or cold climates, and rare instances of bacterial infections or irritant gases can also trigger it. Notable forms include:

• Pseudo-Krupp (Subglottic Laryngitis): Induced by viruses, it involves acute swelling of the mucosa beneath the vocal cords, often impacting toddlers.
• Epiglottitis: This bacterial inflammation swells the epiglottis, causing severe swallowing pain and hoarseness, accompanied by fever, excessive saliva, and potentially rapid respiratory distress.

Chronic Laryngitis
Chronic laryngitis usually evolves from other chronic respiratory inflammations or an unresolved acute variant. Additional causes encompass:

• Vocal strain via speaking or singing
• Cigarette smoking, dust-heavy working conditions, exposure to extremes in temperature or dryness, and exposure to industrial or automotive emissions
  Excessive alcohol consumption
• Constant mouth breathing due to obstructed nasal airflow
• Allergic reactions
• Incorrect vocal technique

The Reinke’s Edema represents a specific chronic laryngitis form, manifesting as a benign disorder swelling the vocal cords, predominantly among smokers who also strain their voices. Therapy typically involves surgical removal of the mucosal enlargements.

Symptoms
Acute laryngitis characteristically presents as cough and hoarseness, voice loss, a tickling and burning sensation in the throat, pain during speaking and swallowing, and occasionally fever and general fatigue. Symptom intensity correlates with inflammation severity. Shortness of breath, especially among children, is relatively rare but mandates immediate medical intervention. Chronic laryngitis symptoms include hoarseness, reduced vocal resilience, compulsive clearing of the throat, and coughing.
Complications and Consequent Conditions
Damaged laryngeal mucosa is more susceptible to pathogens, elevating risks particularly for smokers and individuals exposed to pollutant-laden air. Substantial mucosal swelling impeding breathing poses the gravest threat. Moreover, laryngitis symptoms resemble those of laryngeal cancer, underscoring the necessity of investigating persistent symptom causes.

Diagnosis
Precise diagnosis necessitates laryngeal examination by an ENT (Ear, Nose, Throat) specialist, primarily employing direct laryngoscopy to exclude malignant tumors. An endoscope, either flexible and inserted through the nose or static and introduced through the mouth, facilitates a straightforward, painless in-office examination. Direct laryngoscopy under general anesthesia, typically conducted in a hospital, enables microscopic laryngeal examination and is indispensable for biopsies determining tumor nature and checking for potential laryngeal cancer.

Therapy
Acute laryngitis treatment necessitates complete vocal rest and avoidance of smoking and dry, overheated environments. Warm neck wraps and beverages may alleviate symptoms, as can inhalations, while gargling is generally ineffective. Antibiotics and anti-inflammatory medications may be prescribed in some cases. For epiglottitis, hospital treatment involving antibiotics, anti-inflammatory medications, and application of a cold compress is requisite, typically resulting in rapid epiglottis de-swelling. Managing chronic laryngitis primarily involves circumventing causative irritants, conserving the voice, and avoiding excessively dry, hot, or cold air. Inhalations assist in mucosal clearance and addressing underlying diseases is pivotal. For instance, if improper vocal technique has led to chronic laryngitis, speech therapy may be beneficial. Reinke’s Edema necessitates surgical removal of mucosal swellings, performed via endoscopy and microscopic magnification, with the excess tissue being excised or lasered away. Uncomplicated laryngitis generally resolves after several days.

In our clinic, we deploy various lasers to treat numerous conditions, offering a reliable, low-risk, and minimally invasive treatment method through laser therapy. Administered under local anesthesia and available as an outpatient procedure, it ensures patients experience convenience alongside effective care.

Treatment Applications:

• Leukoplakia of the Mucosa: Addressing white patches or spots on the mucous membranes.
• Enlarged Turbinates: Reducing the size of enlarged nasal conchas to improve breathing.
• Nasal Adhesions: Targeting unwanted nasal tissue growth and adherences.
• Nasal Polyps: Effectively ‘vaporizing’ non-cancerous growths in the nasal passage.
  Cartilage Spurs: Carefully removing spurs from nasal cartilage to enhance comfort and functionality.
  Nasal Breathing Obstruction: Nasal breathing can be hindered by enlarged turbinates, nasal polyps, or spurs and bends in the cartilaginous nasal septum. Using a CO2 laser, we reduce the size of the turbinates, ‘vaporize’ nasal polyps, and remove cartilage spurs to alleviate obstructions.
• Snoring: Often caused by an elongated uvula and lax palatal muscles, snoring can be mitigated via Laser-Assisted Uvulopalatoplasty (LAUP). Utilizing the CO2 laser, equipped with a specialized handpiece, we can shorten the uvula and tighten the palatal arch to mitigate snoring.
• Tonsillotomy (Partial Tonsillectomy): Efficiently reducing the size of the tonsils to alleviate associated issues while preserving their functionality.

Enhanced Treatment Approach:
Our laser therapy integrates innovative technology with clinical expertise to provide optimal patient outcomes. It ensures precision in targeting the affected area while minimizing damage to surrounding tissues, promoting faster recovery with reduced discomfort and risk of infection. Additionally, it grants an alternative to traditional surgical procedures, especially for patients seeking less invasive options.
Our commitment extends towards offering patient-centered care, where your comfort, safety, and well-being are our paramount concerns. Engaging laser therapy facilitates efficient, safe, and accurate treatment, contributing to a holistic approach in managing and alleviating various conditions. We welcome you to explore the benefits of laser therapy in enhancing your health and wellness journey.

Tonsillectomy, the removal of the palatine tonsils, has been one of the most common planned surgical procedures for over a century. In the 1960s, it was almost routinely performed to prevent secondary diseases. However, today, the role of tonsils in our body’s immune system is more highly valued. The palatine tonsils, part of the lymphatic pharyngeal ring, play a crucial role in defending against invading germs. Hence, surgery is now only recommended under specific health conditions:

• Recurrent acute tonsillitis (more than three times per year)
• Tonsillitis that doesn’t heal despite antibiotic treatment or when an abscess forms
• Chronic tonsillitis
• Enlarged palatine tonsils that hinder breathing

Clinical Presentations
Acute inflammation of the palatine tonsils (angina tonsillaris) arises due to the penetration of viruses or bacteria in the throat area, particularly affecting children between five and eleven years. This “angina” results in severe swallowing difficulties and high fever, with a significantly compromised general condition. Viral infections typically subside within one to three days without specific therapy, while bacterial infections—often due to streptococci—present inflamed, highly red tonsils with white to yellowish coatings and bad breath. Bacterial infections can become perilous when an abscess forms, necessitating prompt surgical intervention—typically accompanied by tonsil removal—and antibiotic treatment.

Chronic Tonsillitis

Many individuals experience no symptoms from the infection. Some may encounter mild swallowing difficulties or unpleasant taste and breath. Upon pressure, dead cells exude from the tonsil’s small dimples. Antibiotics cannot effectively permeate tonsil tissue now, and persistent bacterial colonization can act as a focal point for further infection, spreading bacteria and signaling molecules through the bloodstream to potentially affect other organs. Neglected chronic tonsillitis can threaten kidney function and heart valves and may lead to rheumatic fever.

The Importance of Tonsils in Children

Tonsils are particularly esteemed in children as “guardians” against viral and bacterial attacks, serving as biological filters, trapping germs that penetrate blood and lymph vessels. Studies indicate that early tonsil removal can impair a child’s immune system’s efficacy for years. Thus, typically, palatine tonsils are removed after the age of six. However, in cases of chronic inflammation, it is crucial to ascertain health risks and possibly proceed with a tonsillectomy.

Are There Complications?

The operation, usually performed under general anesthesia, is brief but necessitates in-patient care due to the risk of post-operative bleeding. Bleeding most often occurs on the day of the operation and the subsequent day, but risks persist on the 5th and 6th day as white wound coatings detach from the tonsil beds. Given that such bleeding can be substantial and life-threatening, immediate medical intervention is paramount, with patients typically remaining under observation in the hospital for 6-7 days.

Considerations Post-Procedure
Tonsil removal, prompted by persistent inflammations or chronic conditions, often leads to immediate improvements or complete resolution of the existing medical issue, especially reducing susceptibility to infections in children. Experience indicates that children, whose physical development was hindered by continuous infections, often make swift progress post-operation.

Are There Alternatives to Surgery?
For palatine tonsil enlargement and chronic tonsillitis, laser therapy is a potential alternative, albeit not suitable for every patient. Please feel free to contact us for detailed information in this regard. In the case of an abscess, an incision to drain the pus might be made instead of tonsil removal, but typically, tonsils should still be removed after several weeks.

Popular sayings poignantly note, “I can’t stand his nose!”, which usually expresses antipathy. However, when one is dissatisfied with their own nose, it often comes with significant psychological strain.
The ideal image of a nose has evolved considerably over time. While the “ancient Romans” valued a prominent, curved nose, today the aesthetic ideal leans toward a nose with a straight bridge and a precise 110-degree angle between the nose and the upper lip. Additionally, the nose tip and wings should be finely shaped, yet few noses naturally meet this standard. Frequent issues include congenital deformities, such as humps or a misaligned nose. Nose bone fractures from sports or falls can also lead to nose deformations. In many instances, the nose tip or bridge may not harmoniously integrate with the face. Here, a surgical correction, or rhinoplasty, can provide a solution.

Procedure Techniques and Execution:

• Techniques: The exact procedure for a nose correction largely depends on the initial situation and the objective. Addressing only the nose tip involves a different approach than reshaping the entire nose. Common issues like humps or elongated noses can often be corrected by trimming the bony, cartilaginous nasal bridge.
• Execution: The surgery is carried out through the nostrils, leaving no visible scars. Sometimes, an additional incision on the nasal bridge or at the base of the nostrils may be necessary, but typically heals inconspicuously.

Operative Details:

• Duration: Depending on complexity, the surgery takes between 60 and 90 minutes, possibly longer in complicated cases involving cartilage transplants. Usually, a 1 – 2-day hospital stay is needed.
• Anesthesia: The procedure is performed under general anesthesia, inducing a state of artificial sleep, overseen by an anesthetist.

Considerations:

• Choosing a Surgeon: Particularly for a nose correction, careful selection of a surgeon is vital. They should not only demonstrate exceptional medical and surgical skills but also have a keen aesthetic sense. Since the nose is a pivotal facial feature, it should be adjusted in a way that optimizes your appearance, ensuring that the new nose complements you.
• Consultation and Documentation: Comprehensive pre-surgery consultation is paramount. The entire treatment is documented through photographs, facilitating a thorough visual comparison of the surgical results and aiding pre-operative planning.

Risks:
Complications: While serious complications in nose correction are very rare, general surgical risks do exist and vary according to the extent and complexity of the procedure. These may include healing difficulties or infection. Anticipate different degrees of swelling and bruising, which usually subside within a few days. Post-operative bleeding may occur, though seldom necessitating surgical intervention. Injuries to vital anatomical structures (e.g., tear duct, olfactory, or sensory nerves) are theoretically possible but practically eliminated with a qualified surgeon.

Pre-Operative and Post-Operative Care:

• Before Surgery: Avoid anticoagulant medications (like Aspirin or acetylsalicylic acid) two weeks prior to the operation.
• After Surgery: Social activities can typically be resumed after about 3 weeks post-operation, though the final result of your “new nose” will only be fully realized after six months. Additional considerations include: 24-hour nasal packing post-operation, wearing a nasal splint for approximately 2 weeks if bony parts were removed, and avoiding sports activities, sunbathing, tanning beds, and saunas for 3 months. Eyeglass wearers should opt for contact lenses during this period.

Deviated Nasal Septum (Septum Deviation)
A deviated nasal septum involves an alteration in the nasal septum (Septum nasi). In most cases, the septum is laterally displaced from birth or has been moved from its normal position due to a nasal injury, such as a blow to the nose. If every individual were examined for the condition of their nasal septum, 80% would display a slight deviation. A minor shift in the nasal septum can thus be considered physiologically normal and typically does not adversely affect the individual.

Causes and Symptoms
A severe nasal septum deviation can be congenital, caused by an accident or a nasal injury, or arise from chronic inflammation of the nasal mucosa. Often, the nasal conchae are also enlarged on one side (Hyperplasia of the Conchae nasalis), severely restricting free nasal breathing through this nostril.

Complications
An existing septum deviation can perpetually worsen. This can create a “vicious cycle”: in the less ventilated, narrow, and warm nose, microbes accumulate. Typically, these are viruses and bacteria, which prompt the nasal mucosa to produce excess mucus, causing rhinitis. This moist environment further promotes bacterial proliferation and continuously drives mucus production. Prolonged rhinitis can also inflame adjacent mucous membranes in the throat and paranasal sinuses, leading to pharyngitis or sinusitis. Observation might reveal significant redness in the throat and occasionally whitish mucus sliding down the throat wall. Without treatment, breathing through the nose can become almost impossible for days and nights, leading to breathing through a slightly open mouth.

The Next Problem Arises
The air inhaled through the mouth is neither warmed nor filtered, reaching the tonsils, pharynx, and bronchi of the lungs directly. Combined with mucus in the throat and the presence of viruses and bacteria in the airways, the cold, dusty air can provoke new inflammations. Difficulty swallowing may indicate a tonsil inflammation (tonsillitis), and a mild cough can hint at irritation or inflammation of the bronchi (acute bronchitis).

Treatment
In cases of significant discomfort, the nasal septum is surgically straightened. With new, gentle surgical methods available today, this procedure can even be performed on an outpatient basis, without substantial pain.

Enlarged Nasal Concha (Concha Hyperplasia)
In the nose, three erectile bodies (nasal conchae) are situated on each lateral wall, serving to moisten and warm the breathed air. These mucous membrane-covered erectile bodies also regulate airflow and follow the so-called nasal cycle, alternately swelling and subsiding approximately every 4-6 hours. Typically, one nasal side is more ventilated than the other.
However, the nasal conchae can also be pathologically enlarged (concha hyperplasia), resulting in obstructed nasal breathing and inadequate air intake through the nose. An operation—commonly in conjunction with the straightening of the nasal septum—can be performed to reduce the size of the inferior nasal concha. Various techniques, all aiming to shrink the erectile bodies, are available.
However, identifying the cause is paramount: if an allergy or nasal spray abuse (“Privinismus”) is present, these should be addressed before opting for surgery. The surgical reduction of the nasal conchae can be performed painlessly as an outpatient procedure using laser therapy.

Who is it Suitable For?
Ears are fully grown and shaped from an early age, typically around the age of 6. However, not all earlobes maintain an optimal angle from the skull. Genetically, “prominent ears” (or “bat ears”) may occur, which can become a source of relentless teasing, especially during childhood—think of “Dumbo”, the little flying elephant. This small aesthetic flaw, which can be particularly noticeable with short hair, can be corrected with a relatively pain-free postoperative procedure known as anthelixplasty.

How Does the Technique Work?
During an anthelixplasty, prominent ears are repositioned to the correct angle relative to the head, and if necessary, the shape of the earlobe is corrected. The shape of the ear cartilage is permanently altered by removing individual pieces of cartilage.

Procedure Details
The incision is made behind the ear and usually heals within a week.
Operation Duration
The procedure takes about 60 minutes, depending on the effort involved. In most cases, no overnight hospital stay is needed.

Anesthesia
For children, general anesthesia is used, inducing a state of artificial sleep and requiring an anesthesiologist. Adults typically undergo the procedure under local anesthesia, where a pain-relieving medication is injected into the ear. Often, a calming substance is also administered to reduce anxiety and fear associated with the surgery.

What Should Be Considered?

• For children up to 12 years old, health insurance generally covers the cost of the procedure, although pre-approval for cost coverage is required.
  At the time of the procedure, no respiratory infection should be present.
• Be prepared for a longer healing phase following ear correction. Noticeable swelling usually subsides after a few days, and bruises vanish after a maximum of 2 weeks. However, the final result will only be visible after several weeks once everything has healed properly.
• Ear correction is a significant procedure. Therefore, plan to remain under medical observation for 1-2 days.

Are There Risks?
Severe complications from ear correction surgery are very rare. However, general surgical risks, varying in severity and likelihood, do exist. These may include issues with wound healing or infection. Swelling and bruises of varying severity are to be expected but usually subside completely within a few days. Postoperative bleeding may occur, but rarely necessitates further surgical intervention.

Pre-Surgery Considerations
Prior to surgery, you must have a small blood count and ECG performed. This can be done with us or by your family doctor. The findings must be available to us on the day of surgery and should not be older than 2 weeks. Please avoid taking anticoagulant medications (such as aspirin or acetylsalicylic acid) two weeks before the surgery.

Post-Surgery Care

• You will need to wear an ear bandage for 2 days post-surgery and a headband for an additional 2 weeks.
• It is advisable to avoid any sporting activity for at least 4 weeks.
• Please abstain from sunbathing, visiting tanning salons, or saunas for 3 months. If you wear glasses, consider using contact lenses for the first 3 months post-surgery.

Snoring is an often-overlooked destroyer of many a peaceful marital night. Amidst nudges, shakes, and disgruntled exits from the bed, the perpetrator remains largely unaware. While prods and nudges may be innocuous, approximately 5% of snorers face a genuine and potentially life-threatening medical condition when their breathing becomes disrupted. Enter the world of sleep apnea, colloquially known in German as ‘Atemstillstand.’

Identifiable Causes
While for some, occasional snoring-related partner stress is harmless and caused by vibrations of the palate while breathing through an open mouth, there are more serious potential causes:

• Enlarged pharyngeal or palatal tonsil
• Deviated nasal septum
• Intense congestion

Danger lurks when the tongue slides backward during sleep, completely blocking the relaxed throat tissues and airways.

Warning Signals
Obstructive sleep apnea, although not widespread, demands immediate specialist attention upon detection. Partners can play a vital role by observing potential signs, which include:

• Extremely loud and persistent snoring and constant fatigue
• Irregular, powerful snoring with more than ten respiratory pauses per hour, each exceeding ten seconds
• Abrupt episodes of breathlessness, coinciding with snoring pauses and ending in a loud snore
• Pronounced daytime sleepiness, especially during sedentary activities like reading

Aside from obstructive, there’s also central sleep apnea, which keeps the airways open but slackens the diaphragm and chest muscles to an extent that interrupts oxygen supply, leading to similar consequences. Middle-aged men and overweight individuals are often more affected. Both alcohol and sleeping pills can also slow down respiratory control, even in “healthy” snorers.

Diagnosis and Treatment
For preliminary diagnosis, physicians might lend patients a device to monitor heart rate and blood oxygen saturation at home. Should suspicions deepen, a sleep laboratory visit may be prescribed, ensuring detailed sleep observation. Upon diagnosis, potential treatments include surgical adjustments of the nasal septum, or encouraging a side-sleeping position using various aids, and in severe cases, Continuous Positive Airway Pressure (CPAP) therapy.

Sleep Apnea Therapy

In cases where nasal breathing is obstructed or the palatal veil is slackened, surgical enhancement may be sought:

• For Nasal Obstruction: Procedures using a CO2 laser to reduce enlarged nasal conchae, vaporize nasal polyps, and remove cartilaginous spurs.
• For Snoring: Procedures like Laser-Assisted Uvulopalatoplasty (LAUP) can be utilized to shorten the uvula and tighten the palatal arch using a specialized CO2 laser handpiece.

Snoring in Children
International studies show that between 21 to 37% of children experience sleep disturbances, and about 9% of infants and children snore. Shockingly, estimates suggest that one in five child snorers may suffer from sleep apnea, which in rare instances demands so much effort for breathing that it can delay development. A notable percentage of children between one and four years occasionally snore, with 8% doing so nightly. Boys tend to snore more than girls, and snoring is a warning: their sleep is disrupted!
Children who sleep poorly are tired in the morning and exhibit decreased concentration, negatively impacting their academic performance. Furthermore, day sleepiness, hyperactivity, pallor, and a heightened susceptibility to infections like chronic cough, colds, and ear infections are more prevalent among snoring children.

Causes and Therapy
The nightly “sawing” might be attributable to upper airway blockage from enlarged pharyngeal tonsils or an enlarged palatal tonsil. Factors like obesity and secondhand smoke can also exacerbate the issues. For instance, the risk of snoring rises by 60% in one-to-four-year-olds if even one parent smokes around them.
Snoring can often be alleviated by removing the pharyngeal tonsil and, in cases where the palatal tonsils are also significantly enlarged, a partial laser removal may be executed.

Conclusion
If your child snores, ensure to discuss it during your next pediatrician visit. Following a thorough examination, your child may be referred to an ENT specialist to determine and initiate further steps.

The Essence and Challenges of Language Development
Language is pivotal in human interaction, supporting perception, cognition, and problem-solving through the engagement of over 100 muscles and various organs during speech. During typical conversations, we articulate approximately 120 words per minute, each requiring distinct coordination of muscles and organs. This complex activity reaches a certain degree of maturity in children between ages four and five, progressing from initial baby talk to more perfected speech.

The Interplay of Language and Respiration
The larynx, a critical organ for speech composed of cartilages, tendons, and muscles, is positioned higher in the first two years of life, enabling children to swallow and breathe simultaneously. Its subsequent descent facilitates speech, while children learn new breathing techniques to support it. To generate sound, air is pushed from the lungs through the trachea to the vocal cords in the larynx, creating vibrations known as phonation. This sound gains its unique timbre from resonance spaces located above the larynx, within the pharynx, and oral and nasal cavities, finalized by articulation.

Language Development Delays in Children
Typically, a child’s language development concludes upon entering school, necessitating unimpaired hearing. Any suspicion of abnormal language development should prompt a visit to an ENT (Ear, Nose, Throat) specialist.

Prerequisites for Normal Language Development
Commencing in infancy and concluding around school age, regular language acquisition varies per individual. However, it is contingent upon factors such as undisturbed hearing, social interactions, intellectual abilities, and functional muscular coordination, influencing articulation capabilities through the synergy of numerous muscles.

Indicators of Normal Language Development
Despite variable individual progression, scientific milestones can determine children’s language development, distinguishing between the development of language comprehension and active speaking:

• Development of Language Comprehension
  • Birth to 15 months: Newborns respond to human speech, recognizing their mother’s voice and its emotional intonation within weeks.
  • 12 to 24 months: The child understands situational instructions and discerns diverse objects, even performing actions with them.
  • 24 to 30 months: Children begin to follow previously unknown or “absurd” instructions and, by around 30 months, can refuse nonsensical requests.
• Development of Active Speech
  • Newborn: Initial vocalizations occur through crying, followed by vowel formation within weeks.
  • Up to 9 months: Infants engage in babbling periods, attempting to mimic sounds and forming syllabic sounds like “Mama”.
  • 9 to 24 months: Conceptualization begins, assigning vocalizations to specific entities or categories and constructing “pseudo-language”.
  • 24 to 48 months: Two-word sentences emerge, progressing to inquiries and multi-word sentences, with grammatical and dialectal refinements continuing until around six years of age.

Normal language development should finalize between ages five and six, and post-six years, dialect or accent solidification takes place, typically persisting throughout life.

Identifying Language Development Delays
Approximately 10% of children experience at least transient language development irregularities, with enduring treatment necessity in roughly 0.5 to 1%. Language development delay is defined when the progression is retrogressed in one or both aforementioned domains, considering a delay of a quarter to a third of life months noteworthy, at which point, further examinations by a pediatrician or ENT specialist should be undertaken. Early manifestations of abnormalities in the speech apparatus can sometimes be detected through feeding difficulties in infancy.

When and Where to Seek Assessment
Should parents suspect a language development delay, an ENT specialist should be consulted, first examining the child’s hearing. If hearing is normal, subsequent neurological and developmental diagnostic assessments, potentially at a Social Pediatric Center or a similar specialist department, are advised, possibly including logopedic examination for detailed categorization of the language development delay. Further investigations, such as measuring brain waves using Electroencephalography (EEG), might also be necessary to elucidate causes for delayed language acquisition.

Potential Causes of Language Development Delays and How to Navigate Them Language development delays can arise from various causes, and addressing them appropriately can be pivotal for a child’s overall development.
Common Causes:

• Hearing Impairments: A common culprit behind language delays, hearing problems can be congenital or stem from frequent ear infections, meningitis, or malformations in the nasal and oral areas, like a cleft palate.
• Family History: Sometimes, if a parent struggled with language acquisition, their child might experience similar challenges.
• Cognitive Disabilities: General intellectual disabilities might also impact language development.

Treatment Avenues:
Treatments are typically determined by the root cause of the delay. For example, persistent ear infections may initially be treated with decongestants and mucolytics. If there’s no marked and consistent improvement, surgical interventions such as adenoidectomy or insertion of grommets might be necessary.
In cases of congenital hearing disorders, initiating hearing aid prescriptions and early auditory support becomes imperative. For generalized developmental delays, therapeutic early interventions aimed at preparing the child for subsequent speech therapy are considered once a certain developmental level is reached.
When motor disturbances are present, early interventions like orofacial myofunctional therapy (such as the Castillo-Morales therapy) can be implemented by specially trained speech therapists.
Early detection and timely therapy are crucial. By ages three and a half to four, therapy becomes essential for children who have significant speech comprehensibility issues, letter pronunciation problems, or physical anomalies in the oral and pharyngeal areas.
Parental Involvement:
From birth, consistently engaging in dialogue with the child – using standard language, not baby talk – is vital. Avoid overwhelming their auditory senses with constant stimuli, like tapes or TV, and allow them to experience silence. Should any hearing or language development issues arise, consult a pediatrician or ENT specialist immediately.
Stuttering: Unveiling the Layers and Solutions
In Germany, approximately 1% of adults stutter, translating to around 800,000 individuals. This communication disorder, despite its prevalence, can often catapult the affected into a vortex of immense psychological stress and social isolation.
Faces of Stuttering:
Stuttering is not merely a psychological issue; it is a loss of control over the speech apparatus. This phenomenon manifests in various forms, such as:

• Clonic Stuttering: Characterized by repeated letters during speech.
• Tonic Stuttering: Involving halted or blocked speech flow.
• Mixed Form: A combination of clonic and tonic stuttering.

Emerging in Childhood:

Stuttering usually appears between the ages of two and five, a phase of rapid multifaceted development: linguistically, physically, intellectually, and emotionally. Though it often diminishes by puberty, boys are four times more likely to be affected than girls.
The root cause of why some children begin to stutter remains elusive, but genetic predispositions are recognized.
Navigating Through Stuttering:
For parents observing symptoms of stuttering in their children, immediate medical consultation is crucial—waiting for the issue to resolve independently is not advisable.
Adult Therapies:

Adults may need to manage their stuttering throughout life, and there are a couple of predominant therapeutic approaches available:

• Fluency Shaping: This involves learning specific techniques that alter and sometimes mechanize the speech pattern.
• Non-avoidance or Van-Riper Therapy: This involves directly addressing words that trigger stuttering, utilizing specific speaking techniques.

The efficacy of these methods varies, necessitating an individualized approach to therapy selection. Other methods like hypnosis or psychotherapy might render short-term improvements and are typically viewed as adjunctive to speech therapies. Medications that relax muscles are also only effective while being taken and may come with side effects.
Authentic stuttering therapies are structured for long-term engagement and also venture beyond the therapeutic setting, incorporating exercises in real-world situations. Follow-up and a relapse program are integral components, and while complete curing is not promised, many experience significant improvements, often navigating towards symptom-free communication.

Tinnitus, the medical term for ear noises or ringing, is a phenomenon that one in four individuals has experienced at some point. Fortunately, for most, it’s usually temporary. Often perceived as whistling, hissing, or buzzing, these sounds within the head or ears are typically audible only to the affected person.

Tinnitus is Not a Disease
Tinnitus is a symptom, akin to pain, and often serves as a warning signal indicating physical or emotional overload. Therefore, addressing not just the symptom of tinnitus, but also its root cause, is crucial!

Causes and Treatment
Various factors can cause tinnitus, including hearing impairments, noise-induced damage, Menière’s disease (vertigo), and other organic disorders. Sudden hearing loss is also often accompanied by tinnitus. Issues with the cervical spine or dental and jaw areas can also be triggering or exacerbating factors.
Half of all affected individuals suspect stress as a trigger, besides medical causes. Although the causes can often be rectified or effectively treated, frequently, no organic causes are identified. Whether due to stress or a medical reason, the ear noise may completely subside or persist.

Acute Tinnitus: Seek Immediate Medical Attention!
Within the first three months, the chances of recovery are particularly high. If no organic causes are identified, the doctor will develop an individual treatment concept with you.

Chronic Tinnitus
If the ear noises persist for more than 12 months, they are unlikely to disappear – a condition referred to as chronic tinnitus. However, this is no cause for despair! The term “chronic tinnitus” merely indicates the presence of ongoing ear noises. It does not imply that the affected individual must suffer or is ill. Nevertheless, tinnitus can assume the nature of a disease if it becomes a severe daily burden or gives rise to additional health issues.
Possible secondary effects include concentration difficulties, insomnia, hypersensitivity to loud noises, depressive phases, social interaction limitations, and loss of self-confidence. Tinnitus then becomes the soul’s noise!

Living with Tinnitus
Even if tinnitus persists, there are viable approaches to manage it. Tinnitus is a phenomenon that thrives on misinformation, resignation, and fear.
Consult your ENT specialist, as there are technical aids available today to mask tinnitus. Moreover, through education, therapeutic support, self-help, and self-help groups, one can learn to accept tinnitus. This facilitates a redirection of attention towards other significant noises and aspects of life, despite the presence of ear noises.

Tumor Prevention
The most common preventive measure against tumors in the ear, nose, and throat area pertains to smoking. The carcinogenic substances inhaled while smoking cigarettes can lead to new formations in the mouth, the swallowing tract, and the larynx. Initially, these changes occur on the surface of the mucous membranes and are relatively small and not necessarily malignant, undergoing intermediary stages. Ideally, it is best to avoid smoking to lower your risk. The second-best approach is regular preventive examinations to identify and treat potential changes in the mucous membranes and the larynx at an early stage.
Our practice’s preventive examination includes a gentle inspection of the mucous membranes and the larynx using a small optic device, facilitated further by a topical anesthetic for the mucous membranes. An ultrasound examination of the neck complements the check-up.

Tumor Follow-Up
If you or one of your relatives has undergone surgery for a tumor in the ear, nose, and throat area, and additional radiation (radiotherapy) with or without chemotherapy has been administered, regular follow-up examinations should be conducted. Following consultation with the clinic where the surgery was performed, these follow-up exams can also be conducted in our ENT practice. Due to our experience as senior physicians at clinics where we ourselves have performed such operations, we can offer competent and individual follow-up care.
Post-tumor-operation care, aside from the early detection of recurring tumor recurrences or the emergence of secondary tumors, primarily involves initiating further steps to re-integrate into social and professional environments. This can be achieved through close cooperation with speech therapists (e.g., voice and swallowing training) and physiotherapists (lymphatic drainage). Close cooperation with the clinic where the surgery was performed, the radiotherapist, and your general practitioner is also essential.
The follow-up examination includes an endoscopic or microscopic inspection of the operated region, complemented by an ultrasound examination of the neck to rule out spreading (metastasis). Regular X-ray examinations of the chest, including the lungs (thorax), should also be performed at specific intervals. Further specialized examinations, such as MRI or CT scans, may also be necessary and should be discussed individually.