Surgery

1. Perforations of the eardrum can be repaired under a general anaesthetic in about 1 hour in a procedure known as a "Myringoplasty" or "Tympanoplasty".
2. A cut is made behind the ear or above the ear canal and material taken from under the skin to patch the eardrum. This "graft" is placed against the ear drum and dressings placed in the ear canal. There will be an internal dressing that will be removed after 1 week and an external head bandage that is removed before going home the same day.
3. The national average success rate is approximately 75%. Complications are uncommon. There may be a change in your sense of taste, which is only temporary. There is also a very small risk of dizziness, which will normally resolve in time. Very rarely patients hearing will worsen or experience facial weakness.

1. The operation will take about 15 minutes.
2. You may notice in the following week, fluid coming from the ears. This is rarely an infection as at the time of the operation Mr Murty puts antibiotic eardrops into the ears to prevent infections. The fluid is usually these drops and will settle itself.
3. Use cotton wool soaked in Vaseline to plug the ears when washing your hair. Do not go swimming until Mr Murty tells you.
4. This is not usually a sore operation but if you do think painkillers are needed Calpol for children and Paracetamol for adults is recommended.
5. It takes 48 hours for the full effects of the anaesthetic to wear off and Mr Murty recommends that children take the next day off school and adults take the next day off work. Having said that, this operation often takes more out of parents than the children!
6. Mr Murty likes to review you after a couple of weeks. Usually at that time he allows swimming but not diving. If a child is having swimming lessons you need to inform the swimming instructor of this restriction as children are often asked to pick rubber shapes from the bottom of the pool. Provided the above instructions are followed, swim plugs are not usually necessary.
7. Flying is safe after 2 weeks. Patients with grommets in place usually find flying easier than those without, and indeed Mr Murty has inserted grommets in half a dozen airline pilots to enable them to continue to work professionally!
8. The grommets stay in on average for about 6 – 9 months. They are usually extruded spontaneously and do not require an operation to remove them. 90% of patients are cured after the grommets come out and require no further treatment.
9. Grommet insertion is one of the commonest operations performed in Britain and is thankfully a very safe procedure. Occasionally complications can occur. If the grommets do become infected they are easily treated with a course of antibiotic eardrops. Occasionally when the grommet comes out the hole remains. This usually heals with time but rarely an operation is required to close the hole.

1. Fast from Midnight.
2. Take your normal evening dose of insulin.
3. Do not take your normal morning insulin.
4. If you take insulin and tablets to control your diabetes, take neither in the morning.
5. Do take all other medicines including inhalers as normal. Tablets can be taken with a sip of water.
6. On arrival at the hospital your blood sugar will be checked. Both Mr Murty and his consultant anaesthetist will see you before your surgery and will explain your operation to you.
7. Your blood sugar will be measured regularly during the operation and glucose and insulin will be given via a drip depending on these results.
8. As soon as you are eating normally, you will be restarted on your normal insulin regime.

1. The operation is performed under general anaesthetic and lasts about 30 minutes.
2. Your nose will be blocked after the operation. It will be several weeks before the bruising inside settles to get the full benefit of the surgery.
3. There may be old blood coming from the nose for a couple of days. This will settle.
4. If stitches were used in the nose, these are inside, will be absorbed and do not need to be removed.
5. You may blow your nose but gently.
6. Do not pick at or probe the nose with finger, tissue, cotton buds etc.
7. Mr Murty recommends keeping away from crowded places and people with colds for 1 week. You need not necessarily stay indoors.
8. You will be more tired than you think when you go home. Most people will laze about on the couch or even retire to bed!
9. Nasal operations are common and complications are rare. Bleeding may be difficult to control but further surgery is rarely required. The partition part of the nose (septum) can fail to heal properly and a hole persists. Further surgery is available to correct this.

1. If you take your diabetic medication more than once a day the day before surgery take only the morning dose. If you take your medication only once a day, take your medication as usual.
2. Fast from midnight before the operation day.
3. Do not take your medication on the day of operation.
4. Do take all other medicines including inhalers as normal. Tablets can be taken with a sip of water.
5. On arrival at the hospital your blood sugar will be checked. Both Mr Murty and his consultant anaesthetist will see you before your surgery and will explain your operation to you.
6. Your blood sugar will be measured regularly during and after the operation.
7. As soon as you are eating normally, you will be restarted on your normal regime.

1. The operation is performed under a general anaesthetic and lasts 40 - 60 minutes. It is all done inside your nose – there are no scars on your face.
2. You will need a dressing inside each side of your nose to prevent bleeding. These dressings are called "packs". Nowadays they are dissolvable and do not need to be taken out. Occasionally non-dissolvable packs may also be used but if required these are removed before you go home the same day.
3. Do not blow your nose until 5 days after the operation or it might start to bleed or swell. After 5 days you should blow your nose forcefully. If you sneeze, open your mouth to protect your nose.
4. Your nose will be blocked after the operation and it will take several weeks before the bruising inside settles and you get the full benefit of the surgery.
5. You may get some blood coloured watery discharge for the 1st week or so – this is common. You may also develop crusts from the nose at this time. The spray and drops prescribed are designed to loosen the crusts. Gradually the amount of crusting will settle. The antibiotic tablets you will be prescribed are designed to prevent infection.
6. Mr Murty recommends keeping away from crowded places eg Cinema, Pub and religious gatherings as well as avoiding people with colds for 1 week. You need not necessarily stay indoors.
7. You will be surprised at how tired you are when you go home. Most people will laze about on the couch or even retire to bed!
8. Expect to go home the day of your operation. You will need to rest at home for at least a week. If you do heavy lifting and carrying at work, you should take 2 weeks off. If you require a sick note ask Mr Murty.
9. There are some risks that you must be aware of before you give consent to this treatment. These potential complications are thankfully rare and vary depending on the site of the disease.

The sinuses are very close to the wall of the eye. Sometimes damage to the eye can be caused by bleeding around the eye and can cause a mild black eye. In very rare instances (less than 1 in 1000), a blood vessel in the eye can rupture and this can place the sight at risk, although no permanent damage is caused providing the surgeon treats it without delay. Very rarely another operation may be needed to stop the bleeding. The chances of this happening are very low. The muscles that turn the eye can sometimes be damaged, but, again, very rarely. If this happens, you may have double vision. Treatment from an eye doctor may then be needed.

The sinuses are very close to the thin bone at the base of the brain. All sinus operations carry a very small risk of leakage of fluid from the space around the brain or even more rarely damage to brain blood vessels. If this rare complication happens, you will have to stay in hospital until it stops. Sometimes another operation is needed to stop the leak.

90% of patients troubled with nasal blockage can expect significant improvement but sometimes your symptoms (especially catarrh) are not always completely relieved. A repeat operation may be necessary at a later date, especially if you have polyps.

Sometimes internal scarring after the operation may cause nasal blockage but is usually easily treated with a minor revision operation.

1. Tonsils are removed under general anaesthetic in a procedure lasting about 25 minutes.
2. The operation is performed through the mouth and the bleeding stopped. There are different techniques available – diathermy dissection, laser, radio frequency coblation – and which most appropriate for safe removal of tonsils is decided by Mr Murty when the patient is asleep.
3. You are encouraged to eat and drink as soon as you are awake. You can eat and drink whatever you want. The more the better as this will get the throat muscles working and help the healing process.
4. Earache is normal. This is due to referred pain from the ear to the throat. We have not made a mistake and operated on your ears!
5. Do not look at the back of your throat! If you do it will look awful. It is normal for a grey sludge to grow over where the tonsils were. It is not an infection. You do not need to see your GP. This should disappear in about 5 days.
6. The discomfort is usually equivalent to that of another episode of Tonsillitis. Mr Murty recommends Calpol for children and Paracetamol for adults. You should be prepared to take 2 weeks off school or work although most patients are sufficiently recovered to return after about 10 days. Tonsil surgery is one of the commonest operations performed in the UK and problems are uncommon. No operation is however without any risk. The most serious problem is bleeding and occasionally a second operation is needed to stop it.

1. Laser and endolaryngeal microsurgical techniques are used to remove lesions from the larynx and restore mobility to weakened vocal cords.
2. Botox can be used to relax and recalibrate throat muscles in spasm. Incomplete closure of vocal cords can be improved using the patient's own fat and is particularly effective in the ageing voice.
3. Surgery is performed as a day case and Mr Murty and his consultant anaesthetists use minimally invasive techniques for voice surgery.
4. A customised post operative care plan will be agreed with you before you go home on the day of surgery.