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Ear, Nose & Throat

The Parkside Suite offers the private patient the experience and expertise of our ear, nose and throat consultants and their extensive range of interests. Many of our consultants have pioneered cutting-edge techniques in the treatment of various ear, nose and throat conditions and all are renowned for their standards of care.

As a private ENT patient, you will be seen by a dedicated consultant who will personally manage your treatment, giving you the benefit of their wealth of knowledge and experience. For more information about any of our ENT consultants, please click on the links below:

Services

Our team of consultants specialise in a wide spectrum of diseases and disorders that affect the Ear, Nose & Throat (ENT) including snoring and sleep disorders, cosmetic and skin surgery. For information about a specific condition or treatment, please follow the links below:

Ear | Nose | Head & Neck | Children's ENT

 

For further information, please contact the Parkside Suite on 01276 604895 or fill out our online enquiry form.

 

 Mr Jonathan Hern

Parkside Mr Jonathan Hern

Jonathan Hern qualified from the University of Birmingham in 1990 and undertook his surgical training in London and Surrey. Having undertaken a fellowship in Rhinology (Anatomy and diseases of the nose and sinuses) in Germany and Austria with Professors Draf and Stammberger, he was then appointed as a consultant at Frimley Park Hospital in 2003.

 

Jonathan's interests include Rhinology and Rhinoplasty surgery and he is fully trained in Balloon Sinuplasty techniques. He also runs a voice clinic and snoring and sleep apnoea clinic. Jonathan has written 30 scientific articles and a book chapter on facial plastic surgery and is a member of the Skin Cancer Multidisciplinary Team.

 

For more information, please contact Mr Hern's Private Secretary on 01252 852552

 

Mr David Jonathan

Parkside Mr David Jonathan

David Jonathan was appointed Consultant ENT Surgeon at Frimley Park Hospital in April 1991. He trained at Guy's Hospital, the Royal National Throat, Nose and Ear Hospital, St. George's Hospital and Great Ormond Street Hospital for Children, and went on to hold fellowships at the University of San Francisco, California and Melbourne, Australia.

While his practice encompasses all aspects of ENT, he has special interests in otology (diseases of the ear), balance disorders and childhood ENT problems. During his twenty years as a consultant he has developed expertise in the surgical management of middle ear disease (ear drum perforations, cholesteatoma and stapedectomy surgery), and since 1999 has been responsible for running a regional Bone Anchored Hearing Aid service. He is enthusiastically engaged with the training of junior surgeons at regional and national levels, serving as chairman of the South Thames Training Committee and sitting on the National Specialist Advisory Committee. Mr Jonathan has a keen interest in the aviation-related aspects of ENT; he is the Honorary Senior Lecturer in Aviation Otolaryngology at King's College, London and ENT Advisor to the Civil Aviation Authority.

He has published many articles on a variety of ENT topics, and has presented papers at both national and international levels. He is a contributing author to a textbook on aviation ENT.

For more information, please contact Mr Jonathan's Private Secretary on 01252 852552

 

Ear

 

Ear Infections

Ear infections affect either the external ear (ear canal) or middle ear. Sometimes an external ear infection develops very quickly and so we will try to see you as quickly as possible to start treatment.  This often involves 'microsuction' to clean the ear and then treatment of the infection itself.  Middle ear infections (otitis media) are common in children but less so in adults.  Usually an ear infection occurs with a cold but sometimes a perforation can cause recurring ear infections and in rare circumstances collapse of the eardrum may be a cause.  It is therefore important that the ear is examined carefully under the microscope to make a correct diagnosis and then appropriate treatment can be given.  Middle ear infections in children occasionally require Grommets.

 

Eardrum Perforation

Perforations can occur suddenly as a result of infection or an injury to the ear; usually they heal in time but sometimes they become 'chronic' which can lead to further ear infections and hearing loss. Eardrum perforation can be repaired with a Myringoplasty. 

 

Tinnitus

Tinnitus means a noise in the ear. Often this is harmless and only reassurance is required. An audiogram is useful to assess the hearing level as sometimes tinnitus is associated with hearing loss.  If the tinnitus occurs in just one ear, a MRI scan of the ears and brain may be required. More severe cases of tinnitus are referred to our Tinnitus therapist for Tinnitus retraining therapy.  

 

Prominent Ears

Prominent ears may cause low self-esteem and can be corrected with a Pinnaplasty.  This may be appropriate in children at the age of 5 years onwards or sometimes in adults. 

 

Cholesteatoma

Cholesteatoma is a condition in which skin debris accumulates in the middle ear. It can result in ear infections, hearing loss and other more serious complications. Treatment is usually by surgery to remove the skin pocket and repair the ear drum.  Sometimes the small bones which carry sound through the middle ear can be damaged and may also need repairing. 

 

Dizziness and Vertigo

Dizziness may relate to many differing causes but vertigo indicates an inner ear problem. A common cause is Benign Paroxymal Positional Vertigo (BPPV) which can be easily diagnosed and treated with the Epley or Particle Repositioning manoeuvre. Other causes include Menieres disease which can usually be controlled with medication but occasionally an injection of Gentamicin into the middle ear may be necessary to control the symptoms.  Labyrinthitis often occurs as a sudden attack which usually gets better on its own but sometimes recovery is slow and treatment is needed.  We work alongside our Physiotherapy colleagues who can help in the rehabilitation process with vestibular rehabilitation exercises.

 

Hearing Loss

Hearing Loss may result from a conductive cause (outer or middle ear problem) or sensorineural cause (inner ear problem). Conductive hearing loss in children is often due to 'glue ear' which occasionally can be treated with an operation such as grommet insertion.  A perforation in the ear drum may cause a hearing loss and so surgical repair by myringoplasty may improve the hearing.  The small bones within the middle ear are a very delicate structure and damage to these will cause hearing loss – they can sometimes be repaired by surgery, ossiculoplasty.  Sometimes these bones become fixed and so stapedectomy may be necessary to replace part of the chain of bones. 

 

Hearing aids are the usual treatment for a sensorineural hearing loss and we can access the very latest in digital hearing aid technology including the recent 'open fit' hearing aids through our audiology colleagues.   Sometimes conventional hearing aids cannot be worn so a bone anchored hearing aid may be an alternative option. If the hearing is worse in one ear, a MRI scan of the ears and brain may be required.

 

Nose

 

Nose Bleeds

Nosebleeds are a common problem in children and the elderly in particular. Treatments include antibacterial cream, cautery with a chemical silver nitrate or electric cautery and clipping a small artery within the nose using endoscopic techniques.

 

Nasal Aesthetics

Some patients do not like the shape of their nose. As ENT surgeons, we are uniquely placed to surgically improve the shape and function of the nose with Rhinoplasty. Open and closed approaches can be used depending on the complexity of the patient's requirements.

 

Chronic Sinusitis

Some patients have chronic sinus inflammation, sometimes associated with nasal allergies, infection or nasal polyps. Treatments may include Balloon sinuplasty or Endoscopic sinus surgery.

 

Nasal Allergy

The nose may be subject to allergic reactions to allergens in our environment. Allergy tests are required for allergies such as dust, pollens, moulds, cats, dogs, feathers, milk and eggs.

 

Nasal Blockage

A blocked nose may be due to a deviated nasal septum, large nasal turbinates or nasal polyps. The nasal septum can be straightened with Septoplasty and polyps treated with Endoscopic sinus surgery.

 

Recurrent Acute Sinusitis

Some patients have frequent sinus infections. These may be treated with Endoscopic sinus surgery or sometimes with new minimally invasive techniques such as Balloon sinuplasty. Balloon sinuplasty is particularly effective if the frontal sinuses are involved.

 

Head & Neck

 

Our consultants specialise in the managament of benign and cancerous conditions arising in the head and neck. Although most head and neck cancers occur in the elderly, often with a history of smoking, serious conditions can occur in young and otherwise healthy patients. As with all cancers, prevention is better than cure, but early diagnosis of cancer generally leads to a better outcome. If you have worrying symptoms we would much rather see you at an early stage to reassure you it is innocent, than delay the diagnosis of a potentially serious condition.

 

Any of the below conditions could be a symptom of Head and Neck cancer:

 

Neck Lumps

Most neck lumps are benign and include lumps in the parotid and submandibular salivary glands, thyroid gland and also lymph nodes in the neck.  Occasionally a lump in the neck may be cancerous.  All patients require a thorough history and examination and usually an endoscopic examination of the lining of the throat.  In additiona a needle samploe of the neck lump may be required.

 

Our head and neck cancer surgeons work in a Head and Neck Multidisciplinary Team with oncologists, radiotherapists and other allied health professionals such as Macmillan Cancer Support.

 

Lump in Throat

The feeling of  a lump in the throat is a common complaint in adults. It is usually harmless.  The symptom is more worrying when associated with the following;   earache, difficulty in swallowing, weight loss, painful swallowing, particularly on one side of the throat, and of course, in patients who smoke.

 

A lump in the throat needs a thorough examination, including an endoscopic examination of the lining of the throat. The symptom is often due to benign conditions but always needs appropriate assessment by an ENT surgeon. In addition the throat and oesophagus may need examining with a barium swallow examination or transnasal oesophagoscopy under local anaesthetic or rigid endoscopy under general aesthetic.

 

Sore Throat

Sore throats may be due to conditions such as the common cold or tonsillitis and occasionally a tonsillectomy is required.  A persistent sore throat lasting more than four weeks needs further assessment by an ENT consultant.

 

Voice Problems

The causes of a hoarse voice are varied, and include benign conditions of the larynx such as vocal cord nodules, polyps, cysts. Sometimes surgical treatment is required with a microlaryngoscopy.  Any persistent hoarsness for more than four weeks requires further assessment by an ENT consultant.

 

Mouth Lesions

Any lump, red or white patch or ulcer that will not go away in four weeks requires further assessment.

 

Swallowing Problems
Causes of swallowing problems are diverse but may include acid reflux, a pharyngeal pouch or more serious problems including throat or oesophageal cancer. Difficulty in swallowing, particularly obstruction of swallowing and regurgitation of food needs further assessment.

 

Thyroid Disease

Enlargement of the thyroid gland is called a goitre. This may be a diffuse enlargement of the whole gland or due to one or more nodules in the gland. Most thyroid nodules are benign, but all need assessment because some are due to serious conditions.  A goitre may need monitoring and may cause obstruction to breathing or swallowing difficulties.

 

Parotid and Submandibular Salivary Gland Disease
Most lumps in the salivary gland are benign and include swelling resulting from the the formations of stones which block the drainage of saliva into the mouth. Benign tumours of the salivary gland require assessment usually with a needle biopsy and ultrasound scan or MRI scan.  Malignant tumours of the salivary gland are rare.

 

Facial Skin Cancer

Most skin cancers occur in the Head and Neck region of the body. Most cancers occur in the more elderly patients but there is a great increase in the occurrence of all skin cancers, especially in the younger patients and often due to excess exposure to sunlight (and sunbeds!)

 

Any non healing growth of the skin of the face or neck should be assessed by a doctor. A mole that changes in colour or size or which starts to bleed needs an urgent assessment and any skin lump associated with a lump in the neck.

 

Children's ENT

 

Ear Infections & Glue Ear

Most children will, at some point, have ear problems which include ear infection and hearing loss.  The situation may be more persistent and a specialist opinion necessary. Even when referred to a specialist we will often recommend a period of observation before advising surgery.  Grommets and sometimes removal of the adenoids may be recommended if the problem is felt to be significant and has not responded to non-surgical treatments.

 

Nose Bleeds

A lot of children will suffer with nose bleeds and whilst they are typically short-lived they always seem to happen at the most inconvenient times and the effects can sometimes be dramatic. Antiseptic ointments applied just inside the nose can be an effective treatment, although sometimes "nasal cautery" is recommended. This procedure, which can often be carried out in the out-patient clinic, is aimed to specifically target the bleeding vessel, and is usually very effective.

 

Sore Throats

Tonsillectomy (surgery to remove the tonsils) is the treatment of choice for a child who is suffering with frequent attacks of acute tonsillitis and where there is no sign that they may be growing out of the problem. It is still a commonly performed operation and is sometimes done in association with an adenoidectomy in those situations where there are significant nasal symptoms as well. It is important to remember that not all sore throats are caused by tonsillitis; sometimes the cause may be a more generalised viral throat infection, and therefore a tonsillectomy will not help.

 

Sleep Apnoea

Occasionally tonsil and adenoid surgery will be recommended if your child is suffering with obstructive sleep apnoea. This is a condition which occurs during sleep resulting in brief, regular pauses in breathing. If significant it can interfere with the quality of sleep with repercussions during the day. Very occasionally it can have more serious effects on the heart. In order to investigate this problem it may sometimes be necessary to arrange a sleep study. This is a simple, painless test to monitor the breathing overnight and can usually be carried out at home.

 

Prominent Ears

Some children are born with one or both ears that are noticeably more prominent than normal. Usually this is as a result of a specific abnormality where one of the folds of the outer ear has not fully developed. It may be a characteristic of the family. This can result in teasing and bullying at school causing psychological distress to the child.  If all agree that it is a significant problem then surgical correction is possible.

 

To learn more about bringing your child to the Parkside Suite, please visit out Children's Suite page