Otolaryngology - Head and Neck Surgery, Facial Plastic Surgery - What To Expect

Patients arriving at the Otolaryngology Head and Neck Clinic will be registered and may be asked to fill out a questionnaire. A nurse will then review the questionnaire with the patient and the patient is seen by a surgeon.

St. Joseph’s is an academic hospital, as such patients may also be seen by medical students, residents and/or clinical fellows.

The Otolaryngology Head and Neck Clinic provides:
•    Highly specialized clinical care
•    Education and support
•    Coordination of care, from diagnosis through surgery
•    Information about and referrals to community resources
•    Follow up

Consultation

Your consultation visit will be the first time you meet your surgeon. This visit will have you complete a questionnaire and provide you with the opportunity to discuss your medical history and issues with your surgeon. The initial plan for treating your issue will be discussed. A physical examination will be performed and will often involve inspection with a small telescope in your nose to view the inside of your nose and voicebox.

You are welcome to have one family member attend the consultation with you if you would like. In order to best attend to your health care needs, we ask that you do not bring young children with you.

Please bring with you your valid Health Card and a complete and up-to-date list of your medications and allergies (if applicable). 

If you have had medical imaging performed outside of London, please bring a copy of the images on CT. To do so, you will have to ask for a copy on CD at the hospital where the test was performed.

What to expect from an in-clinic procedure

For all in-clinic procedures:

•    Eat and drink lightly.  Do not eat or drink for one hour before the procedure.
•    Bring your valid health card
•    bring a driver with you

What should you expect?

Ear procedures - You may experience some mild discomfort after the procedure. Rest and take it easy for the remainder of the day. Plan for one to two days off after the procedure.

Functional Endoscopic Sinus/Polypectomy/Biopsy - You may experience nasal congestion and bleeding after the procedure. Rest and take it easy for a few days. Plan for three to four days off after the procedure. Remember to rinse the nose as instructed.

Palatoplasty - You may experience a dry, scratchy, sore throat after the procedure. Drink plenty of fluids and rest and take it easy for a few days. You may be quite sore after this procedure, and the pain may get worse before it gets better. Plan for one week off after the procedure.

Septal Button Placement – You may experience some mild discomfort after the procedure. Rest and take it easy for the remainder of the day. Plan for one to two days off after the procedure. Remember to rinse the nose as instructed.

Septoplasty - You may experience nasal congestion and bleeding after the procedure. Rest and take it easy for a few days. Plan for three to four days off after the procedure. Remember to spray the nose with saline as instructed.

Septorhinoplasty - You may experience nasal congestion and bleeding after the procedure. Rest and take it easy for a few days. Plan for three to four days off after the procedure. Remember to spray the nose with saline as instructed.

Skin cancer removal – You may experience some burning, discomfort and bleeding after the procedure. Rest and take it easy for the remainder of the day and use Tylenol/acetaminophen as needed. If you have some oozing from the incision, you may put gentle but firm pressure on the incision. Keep it covered with ointment as instructed. If the bleeding continues, or you have significant bruising, contact your surgeon’s office.

Turbinoplasty - You may experience some blood dripping and oozing from your nose after the procedure. Your nose will likely get more stuffy and congested before it gets better. Rest and take it easy for the remainder of the day. Plan for one to two days off after the procedure. Remember to spray the nose with saline as instructed.

Surgery

If the clinic team, with the patient, decides on a treatment plan that includes surgery, the patient will be booked for surgery. Patients will receive information about the surgery, attend a pre-admission appointment, undergo further testing and medical appointments if necessary, and receive support as needed.

Endoscopic sinus surgery tutorial for patients

Patients will find information about endoscopic sinus surgery in our interactive online education including options for treatment, how the procedure is completed and risks and benefits of the procedure.

Sleep Apnea and Test Fees

How are snoring and obstructive sleep apnea connected? 

Snoring is a loud annoying sound produced during both light and deep sleep. This is caused by soft tissues vibrating inside the throat.  Snoring can have important health and relationship concerns, but can also be a sign of a more serious problem called obstructive sleep apnea (OSA), where the airway actually closes during sleep. This can be a serious health disorder that requires investigation and treatment. Different parts of the airway can collapse in different people, so it is important to be assessed by an experienced physician when investigating OSA. Typically, OSA happens in those who are overweight, or having a small jaw or blocked nose. It also affects males more than females. Not everyone who snores will have OSA, but almost everyone with OSA will be a snorer too. 
 

Is there a test for obstructive sleep apnea (OSA)?

People with very loud or bothersome snoring, or those who have partners that witness them choking or gasping at night, should have a sleep study. A sleep study can both establish the diagnosis and also check how severe the problem is and in some cases guide therapy too. At St. Joseph’s there are two ways a sleep study can organized for you – hospital-based or in your own home. 

Hospital-based sleep lab: This is performed at either London Health Sciences Centre’s Victoria Hospital Sleep Lab, or in a local lab closer to your home if one is available.  In the hospital you would sleep overnight in the sleep lab where technicians would monitor numerous components of your sleep including, but not limited to brainwaves, body position, snoring sounds, blood pressure and heart rate.  

At-home sleep study: This is not as detailed, but usually gives enough information to make treatment decisions and does have the advantage of being in the comfort of your own home.  At-home sleep studies are not covered by OHIP and do have a fee associated with them. Please see fees below.
 

What happens if I want to have a home sleep study?

If you and your family physician agree that a home sleep study is the best option for you, then you would be referred to the Otolaryngology - Head and Neck Surgery clinic at St. Joseph's Hospital, where Dr. Brian Rotenberg would consult with you on your sleep concerns, including a history and physical exam. You will learn about the at home sleep study and you will receive the sleep testing machine to take home for overnight use. You return the machine the next day where the data would be reviewed and a report sent to your family doctor, after which further treatment would be prescribed as clinically indicated.

 

Fees for at-home sleep apnea test:

Disposable probe:

$50.00

Equipment rental fee:

$36.50

Physician assessment of study:

$98.50

Total Cost:

$185.00

Fees are subject to change.