ENT

Overview

The Otolaryngology (ENT) Department at Sir H. N. Reliance Foundation Hospital is recognised as one of India’s leading centres, with specialised teams in rhinology, audiology, laryngology, head-and-neck surgery, paediatric ENT, and speech, language & swallowing therapy.

Our multispecialty healthcare team of physicians, surgeons, therapists, rehabilitators, and support staff provides personalised care.

We are at the forefront of cochlear implant technology and offer advanced surgical and non-surgical interventions, including endoscopic cerebrospinal fluid (CSF) leak repair, ear and nasal reconstruction, transoral laser microsurgery, professional voice-modulation surgery, and safe removal of foreign bodies from the ear, nose, airway, and oesophagus.

Our department also offers comprehensive speech, language, and swallowing therapy and the Lee Silverman Voice Therapy Programme for patients with Parkinson's disease.

Location: Level 1, Heritage Building

Timings: 08:00 am to 08:00 pm

Our Services

Our department is equipped with experienced professionals with extensive expertise in the following specialities:

Our otology team focuses on diagnosing and treating of ear-related conditions. With a dedicated team of professionals committed to delivering personalised care, our hospital is at the forefront of cochlear implant technology. We prioritise thorough assessments, comprehensive pre-implant counselling, and ongoing support to ensure the best possible outcomes for our patients.

Tests/Examinations:

Physical ear examination using an otoscope, microscope, or endoscope
Tuning fork test
Hearing test (pure-tone audiometry; PTA)
Tympanogram (impedance audiogram)
Staining, culture, and sensitivity testing of ear discharge
Temporal bone HRCT (High-resolution computed tomography)
Temporal bone MRI (Magnetic resonance imaging)
Biopsy
Blood tests

Procedures: Our hospital has a team of highly qualified and dedicated ENT specialists who perform a variety of surgical procedures using state-of-the-art medical technologies:

Cochlear implants: Electronic devices that help improve hearing.
Myringotomy with or without insertion of grommet: Puncturing of the eardrum to insert a ventilation tube to relieve ear pressure or for fluid drainage.
Tympanoplasty: Surgery to repair the ear drum.
Mastoidectomy: Surgery to remove diseased air cells from the mastoid bone, which is located behind the ear.
Ossiculoplasty: Repair/reconstruction of ear bones to improve hearing.
Stapedotomy/Stapedectomy: Replacing fixed stapes (smallest bone in the ear) with a prosthesis.
Excision of pre-auricular sinus: Surgery to remove a preauricular sinus, a small pit located in front of the ear.
Reconstruction of ear pinna: Surgery to repair the external ear.
Intratympanic injection: Administration of medicines directly into the middle ear.
Endoscopic ear surgery
Biopsy: For suspected tumours or unusual infections of the ear canal or mastoid

Our rhinology team focuses on the diagnosis and treatment of conditions related to the nose.

Tests/Examinations:

Blood tests
Complete blood count (СВС)
Computed tomography (CT) paranasal sinus (PNS)
Magnetic resonance imaging (MRI)
Laboratory analysis of nasal culture/swabs
Allergy testing: Comprehensive allergy panel and skin prick testing.

Non-surgical procedures:

Nasal packing/nasal bleeding management
Endoscope-guided nasal cleaning/suctioning

Surgical procedures:

Nasal biopsy: Sample taken from the nasal tissue for investigation.
Nasal foreign body removal: Extracting objects lodged in the nasal cavity.
Nasal bone fracture reduction: Correction of nasal bone fracture.
Septoplasty (endoscopic): Correcting a deviated septum to improve airflow.
Endoscopic sinus surgery: Removing nasal polyps and improving sinus drainage.
Balloon sinuplasty: Using a balloon catheter to open blocked sinus passages.
Turbinoplasty/turbinectomy: Reducing the size of the nasal turbinates, i.e., structures within the nose that humidify and warm the air we breathe, to enhance breathing.
Rhinoplasty: Cosmetic surgery to improve the shape of the nose.
Endoscopic cerebrospinal fluid (CSF) leak repair: Closure of CSF leaks in the nasal passages.
Optic nerve decompression: Releasing swelling or traumainduced pressure over the optic nerve.

Our laryngology team addresses a broad range of conditions related to the larynx (voice box), in addition to disorders that affect a person’s ability to speak or perform normal daily activities, such as eating and drinking. Our team adopts a multi-disciplinary approach to ensure patient-centric care.

Tests/Examinations:

Physical examination and history collection
Thorough evaluation by a speech-language/swallow therapist
Laryngoscopy (rigid or flexible): Examination of the voice box.
Videostroboscopy: Use of strobe lights to view vocal cord vibrations in slow motion to assess vocal cord function.
Flexible endoscopic evaluation of swallowing (FEES): Assessment of swallowing function as food and beverages pass through the throat.
Narrow band imaging: Endoscopic visualisation of vascular and mucosal patterns using specific blue and green light to ascertain the presence of any abnormalities.
Electromyography: Measurement of the electrical activity of muscles and nerves in the throat and oesophagus.
Transnasal esophagoscopy: Insertion of an endoscope via the nasal cavity to examine the oesophagus.
Neck ultrasonography (USG)
CT and MRI
Barium swallow: Examination of the upper digestive tract using X-rays after the patient is asked to consume a barium solution (which coats the inner lining of the organs and makes them visible under X-rays).
Blood tests

Procedures:

Microlaryngoscopy (conventional or laser-assisted): Minimally invasive procedure to examine the larynx and vocal cords.
Injection laryngoplasty: Injection of Botulinum, collagen, or other gel fillers to temporarily manage vocal cord paralysis or muscle weakness.
Laryngoplasty: Surgical modification of the laryngeal cartilage to improve muscle attachment to the vocal cords and improve their function.
Laryngectomy and laryngeal reconstruction surgery
Biopsy: For examining any suspected mass or lesion and to help diagnose granulomatous or autoimmune disorders.
CO2 and potassium titanyl phosphate (KTP) laser treatment: Use of CO2 and KTP lasers for ear surgeries.
Vocal cord medialisation and lateralisation: Surgeries to reposition the vocal cords and restore their function.
Phonosurgery: Surgery to enhance voice quality.
Mass excision with co-ablation: Removal of tissues (excision), along with the elimination of surrounding tissues (ablation).
Endoscopic surgery
Transoral laser microsurgery: Minimally invasive surgeries for removing tumours in the head and neck.
Subglotic and tracheal stenosis surgery: Widening the airway between the vocal cords or in the trachea (wind pipe).
Professional voice-modulation surgery
Post-radiation therapy

Common head- and neck-related complaints, including pain, headaches, neck swelling, oral cavity ulcers, loss of smell or vision, and personality changes, require detailed history taking by the ENT specialist followed by a meticulous ear, nose, and throat examination.

Tests/Examinations:

Physical examination of the ears, nose, and throat
Nasal endoscopy
Flexible laryngoscopy
Neck examination and USG
CT and MRI
Fine needle aspiration cytology (FNAC): Collection of cells using a thin needle and further examination under a microscope.
Biopsy
Histopathological analysis

Surgical procedures:

Thyroidectomy: Removal of the thyroid gland completely or partially.
Parotidectomy: Removal of the parotid gland, a salivary gland located in front of the ear (completely or partially).
Submandibular gland excision: Removal of the submandibular gland, a salivary gland located under the jaw.
Sialendoscopy: Minimally invasive surgery to detect and treat salivary gland disorders.
Sistrunk operation: Surgery to remove thyroglossal cysts, which is the most commonly occurring congenital neck masses.
Maxillectomy: Removal of the maxilla (upper jaw) completely or partially.
Excision of oral swellings
Tracheostomy: Surgery to create an opening in the trachea (windpipe) through the neck and insertion of a tube to facilitate breathing.
Tracheoplasty: Surgery to reconstruct the trachea.
Laryngectomy: Removal of the larynx (voice box) completely or partially.
Drainage of retropharyngeal and parapharyngeal abscesses: Performed for deep neck space infections
Tonsillectomy and adenoidectomy: Performed for recurrent tonsillitis and adenoid hypertrophy
Obstructive sleep apnoea surgeries: Uvulopalatoplasty, which is the reshaping of the uvula and palate to reduce snoring, along with tongue base reduction and epiglottis trimming.
Transsphenoidal pituitary tumour excision: Surgery to remove tumours from the pituitary gland via the nasal passages.
Orbital decompression for thyroid eye disease

The Paediatric ENT Department at Sir H.N. Reliance Foundation Hospital provides expert care for children with a wide range of ear, nose, and throat conditions. With a team of skilled paediatric ENT specialists, surgeons, audiologists, and nurses, we deliver personalised treatment plans that prioritise the well-being of each child. Our approach ensures the highest standard of care in a supportive, child-friendly environment, where every child’s unique needs are met with compassion and expertise.

Know more

The programmes for speech, language, and swallowing therapy at the Sir H. N. Reliance Foundation Hospital are as follows:
Speech and Language Development Programme: This programme is recommended for children with speech and language disorders, delays, and disabilities. The children are offered high-quality evaluations, coordinated multi-disciplinary healthcare, and interventions with state-of-the-art medical technology to support their physical, emotional, social, and academic development.
Articulation and Phonological Intervention Clinic: This programme is for children and adults with difficulties in producing speech sounds or groups of speech sounds that persist beyond the typical period of speech development and/or result in difficulty understanding speech. This programme includes screening, assessment, diagnosis, and treatment of patients with speech sound disorders. Latest evidence-based methods, such as oral placement therapy, are used as interventions.
Voice Clinic: This programme is for singers, actors, TV news broadcasters, telemarketing agents, teachers, and other professionals who use their voice to perform their jobs. Additionally, it is also useful for patients with neurological conditions or those experiencing the side effect of treatments such as radiation therapy for cancer. We focus on the diagnosis and management of patients with voice disorders.
Neurocommunication Disorder Clinic: This programme is for patients experiencing speech and language difficulties post brain injury or as complications of progressive neurodegenerative disorders. The speech, language, and swallowing therapists will assess and recommend exercises to help the patient regain/improve lost functions. We also offer the Lee Silverman Voice Therapy Programme for patients with Parkinson's disease.
Augmentative and Alternative Communication Intervention: These are a set of strategies, methods, and devices to assist people who are unable to meet their communication needs through speech or writing.
Stuttering Intervention: This programme includes a multi-modal approach to bring about the behavioural changes needed to achieve improvements that will be integrated into daily life.
Onco-rehabilitation: For patients with head and neck tumours, assessment and treatment are offered at various stages of therapy, i.e. pre-surgery, post-surgery, during radiation, and post-radiation.
Swallowing Clinic: We provide detailed assessments for patients with trouble swallowing, including bedside clinical assessments, flexible endoscopic evaluation of swallowing, and modified barium swallow.
Other programmes, such as our muscle strengthening programme, VitalStim, which represents the electrical stimulation of the neck muscles to aid swallowing, and diet modification, are used with appropriate patient education to achieve safe and efficient swallowing.
Audiology: Our audiology team provides comprehensive audiological services and specialises in identifying, diagnosing, treating, and monitoring the disorders of the auditory and vestibular systems. We provide hearing aids, manage and rehabilitate individuals with hearing loss, and assess candidacy for hearing implants, such as cochlear implants and bone conduction implants.

The services offered by the hearing aid clinic include:

Hearing assessments: Our clinic provides thorough hearing assessments conducted by skilled audiologists. These evaluations help determine the extent of hearing loss, enabling us to create personalised treatment plans.
Consultations: Our team attempts to understand each patient's unique needs, lifestyle, and communication preferences. Through detailed consultations, we guide individuals in selecting the most suitable hearing aid options.
Hearing aid fittings: Our audiologists ensure that the chosen hearing aids are custom-programmed and adjusted to meet the individual requirements of each patient. Moreover, we offer trial periods for selected hearing aids, allowing patients to experience the benefits of the device in real-life situations before making a final decision. This ensures satisfaction and confidence in their chosen devices.
Follow-up care: Our commitment extends beyond the initial fitting. We provide ongoing support, adjustments, and follow-up appointments to address any concerns, ensuring that patients continue to optimally enjoy their hearing aids.

Technology & Infrastructure
Conditions We Treat

The ENT Department provides the best infrastructure and cutting-edge technology to ensure optimal benefits for our patients. We collaborate with other departments at the hospital to provide head and neck, oncology, neurosurgery, plastic surgery, and dental surgery support and multi-disciplinary patient-centric care. Our technology and infrastructure cater to patients from all age groups and follow international guidelines and standards.

Our department boasts the following technologies, equipment, and facilities:

Pure Tone Audiometry (PTA): The primary test to assess hearing and identify the cause of hearing disorders.
Impedance audiometry: This test evaluates the functioning of the eardrum and the middle ear space behind the eardrum, in addition to investigating the muscle reflex of the ear.
Speech audiometry: Helps audiologists determine a patient's ability to discriminate speech sounds and recognise speech.
Newborn hearing screening: A quick and safe way to determine if your baby can hear sounds needed for speech and language development.
Oto-acoustic emissions: An appropriate hearing screening tool for children from birth to three years of age. It is also used along with other tests to diagnose various hearing problems.
Automated auditory brainstem response (AABR) screening: Performed as a part of newborn hearing screening protocol to ascertain the hearing status of the baby.
Visual reinforcement audiometry (VRA): Allows audiologists to assess hearing in toddlers too young for conventional; audiometric testing. It involves training the child to associate sounds with visual reward, making it engaging and effective way to assess hearing.
Behavioural observation audiometry (BOA): Used to estimate the hearing of infants and young children. It involves observing the behavioural response of the child to various sounds.
Conditioned play audiometry: Allows audiologists to test the hearing of young children and pre-schoolers in a playful manner.
Brainstem evoked response audiometry (BERA): Air conduction and bone conduction BERA is used to estimate a person’s hearing. The test involves recording the response that travels from the ear towards the brain when a sound is heard.
High-frequency audiometry: This is helpful when testing hearing impairments caused as side effects from medication, noise exposure, and loud sound exposure.
Tinnitus evaluation and retraining therapy: This modality evaluates buzzing and ringing sounds in the ear (tinnitus). Tinnitus retraining therapy is a promising strategy for tinnitus treatment, involving counselling and sound therapy to get people habituated to the tinnitus/ringing sound in the ear.
Vestibular evoked myogenic potential (VEMP): A read-out of muscle responses to loud acoustic stimulation. It is used to test patients suffering from dizziness.
Hearing aid trial, fitting, and dispensing: Appropriate hearing aids are selected, adjusted and customised to meet the needs of the person with hearing loss. It involves several steps, such as assessment, selection, customisation, and follow-up care.
Aided audiogram: Audiometry performed with the hearing aid or cochlear implant to ascertain the benefits of the hearing aid or cochlear implant.
Bone anchored hearing aid (BAHA): A surgically implantable system for certain types of hearing loss. It is the only implantable device that can be tried before surgery.
Cochlear implant candidacy and evaluation: Cochlear implants are suitable for individuals for whom conventional hearing aids may offer limited improvement. Extensive investigations are performed to determine whether a person can be a candidate for cochlear implant.
Cochlear implant switch-on and mapping: Around two weeks after implant surgery, the cochlear implant sound processor(s) will be fitted and activated (the 'switch-on'). Mapping refers to the process of programming your cochlear implant sound processor.
Auditory verbal therapy (AVT): A specialised approach to teach children with hearing loss to use hearing along with hearing aids or cochlear implants to develop spoken language.

Impacted cerumen: Accumulation and hardening of earwax in the ear canal, the passage leading to the ear drum.
Otitis externa: often called swimmer’s ears is the inflammation or infection of the ear canal.
Necrotising (malignant) otitis externa: Severe otitis externa that may spread to the skull base, cranial nerves, and surrounding tissues.
Acute otitis media: A common infection that causes inflammation and fluid buildup in the middle ear.
Otitis media with effusion: Fluid buildup in the middle ear in the absence of an active infection.
Chronic suppurative otitis media: Long-term inflammation of the middle ear characterised by a persistent ear discharge and a tear in the eardrum.
Cholesteatoma: Growth of a benign cyst behind the eardrum.
Otosclerosis: Abnormal bone growth in the middle ear.
Barotrauma: Physical damage to the ear tissues occurring because of pressure differences between the external environment and body’s internal space.
Pre-auricular sinus and abscess: When a malformation, usually appearing as a small hole in front of the ear, is infected and becomes filled with pus.
Perichondritis: Infection/inflammation of the outer ear cartilage.
Keratotsis obturans: A rare condition characterised by the accumulation of keratin, a structural protein that forms hair, nails, and skin, in the ear canal.
Vertigo: A sensation that the outside environment is spinning when it is actually not.
Emergency ear problems:
- Ear trauma and bleed
- Presence of foreign bodies
- Sudden sensorineural hearing loss: Rapid loss of hearing (over a few days).
- Angioedema: Swelling of the deeper layers of the skin or tissues.
- Anaphylaxis: An allergic reaction that may be fatal.
Deviated nasal septum: The shifting of the septum (the thin layer of cartilage that divides the nose into two parts).
Acute and chronic rhinosinusitis: Inflammation of the sinuses and nasal passages lasting up to 4 weeks (acute) or 12 or more weeks (chronic).
Nasal polyposis: Presence of noncancerous growths (polyps) in the nasal passages.
Allergic rhinitis: Overreaction of the immune system to allergens in the air, causing sneezing, running of the nose, nasal congestion, and itching in the eyes.
Epistaxis: Nasal bleeding.
Nasal bone fracture
Malignancies of the nasal cavity
CSF rhinorrhoea: Leakage of CSF through the nose often after trauma.
Laryngitis (acute and chronic): Inflammation of the larynx lasting up to 3 weeks (acute) or 4 or more weeks (chronic).
Granuloma (Contact ulcers): Benign lesions appearing on the vocal cords.
Reinke’s oedema: Swelling of the vocal folds due to fluid accumulation within the Reinke’s space, which is a layer beneath the surface of the vocal folds.
- Vascular lesions:
- Vocal cord bleeding
Vocal fold varix, an abnormally dilated blood vessel in the vocal folds, increasing the risk of haemorrhage.
Laryngeal papillomatosis: Formation of benign wart-like growths (papillomas) in the larynx.
Vocal cord paralysis, cancer, and scarring
Sulcus vocalis: An abnormality in the vocal folds arising due to The presence of a groove on the edge of the vocal fold, ultimately causing voice problems.
Neurogenic disorders: Conditions affecting the nervous system (in this context, those affecting the functions of the ear, nose, and throat).
Voice disorders: These may include spasmodic dysphonia, which represents voice changes related to the brain and nervous system or muscle dysfunction, puberphonia, which represents the presence of a high-pitched voice despite the occurrence of puberty-related physical changes, and presbyphonia, which represents the age-related occurrence of a weak, breathy voice.
Polyps, nodules, or cysts on the vocal cords
Precancerous and cancerous growths
Leucoplakia: Formation of thick, white patches in the mouth.
Achalasia: Improper contraction of the oesophageal muscles and failure of the lower oesophageal sphincter to relax, ultimately leading to regurgitation.
Oesophageal spasm: Abnormal contraction of the oesophageal muscles.
Oesophageal tumours
Oesophageal ring: Narrowing of the oesophagus caused by a ‘ring’ of mucosal tissues, causing chest pain, difficulty swallowing, and food regurgitation.
Gastroesophageal Reflux Disease: Regurgitation of stomach acid into the oesophagus, resulting in damage to oesophageal tissues.
Dysphagia: Difficulty in swallowing.
Pharyngoesophageal diverticulum (Zenker diverticulum): Formation of a pouch in the throat (at the top of the oesophagus).
Aspiration pneumonia: Infection caused due to the entry of bacteria into the lungs through the airway along with food or liquid during swallowing.
Obstructive sleep apnoea: A common sleeping disorder characterised by the interruption of breathing during sleep due to the upper airway collapsing and blocking the windpipe.
Choanal atresia: A congenital condition associated with the blockage of the nasal passage by bone or tissue, preventing airflow from the nose into the throat.