Out Patient Procedures

Special examinations and treatments carried out in the ENT Clinic


Please note the following describes our usual clinical practice. There may be reasons why your procedure is carried out in a different way. Other specialists will use their own preferred methods. There are many valid ways to carry out these examinations and treatments.



Photo of surgeon carrying out microsuction of the ear as an outpatient procedure. Patient is lying on a couch and specialist uses a speculum and tiny suction tube to examine and treat conditions of the outer and middle earMicrosuction of the EarSurgeon's magfified view down the ear speculum of removal of ear wax by microsuction


Content last updated 26 Jan 2010

Microsuction is an examination and treatment of the ear using a high powered binocular operating microscope. We use very fine delicate instruments, including a miniature vacuum cleaner. This Hoovering of the ear is usually done as an out-patient procedure. Sometimes, and especially in younger children, it is done as a day case surgery under general anaesthetic. Microsuction of the ear is carried out

  • to diagnose the condition of the ear accurately using
    • binocular vision for 3-d stereoscopic view
    • high power magnification
    • very bright illumination
  • to remove material blocking the ear canal such as
    • wax
    • infected debris
    • dead skin layers
    • foreign bodies
  • to apply medication to the ear

Earol olive oil spray applied to ear canal to soften waxHaving microsuction treatment: what to expect and what to do

Before microsuction of the ear

You may be asked to use ear drops or Earol olive oil spray for several days beforehand. This will make the treatment easier for you.

During the procedure of microsuction of the ear

  • You do need to lie very still.
  • Despite all our efforts to be as gentle as possible, it will be noisy, and may be painful.
  • It usually causes some short lived vertigo (dizzines), lasting no more than a minute or so.

After the procedure of microsuction of the ear

  • Don't get up until the nurse says so - you may be dizzy.
  • You should be ok to drive afterwards but may need to wait until any dizziness has settled.

Cleaning the ear without microsuction using cotton wool on a Jobson-Horne probeWhat's the alternative?

An alternative to microsuction often used in children with runny, discharging ears is to gently mop out the ear with a cotton wool applicator. Illumination is from light shone over the child's shoulder and focussed onto the ear by a head mirror worn by the surgeon. The view is nothing like as good, and we can't normally reach right down to the eardrum, but it is less scary for the child. If we can't carry out an adequate examination with the child awake, a General Anaesthetic may be recommended.


Surgeon carrying out rigid nasal sinus endoscopy and suction treatment Nasal polyp seen through an endoscope in the right side of the nose. Key:mt = middle turbinate it = inferior turbinate s = nasal septum p = polyp Rigid Nasal Sinus Endoscopy


Updated 26 Jan 2010

This out-patient examination procedure is carried out

  • to diagnose conditions of the nose, sinuses and nasopharynx accurately, using
    • Storz Hopkins rod telescope for magnified view of narrow openings
    • angled lenses to see around corners
    • high power magnification
    • very bright illumination
  • to cary out minor treatments such as
    • removal of blood clots & crusts following nasal surgery
    • sucking out pus from infected sinuses
    • cautery for nosebleeds

Having rigid nasal sinus endoscopy: What to expect

Before the procedurelocal anaesthetic spray applied to nose before flexible fibreoptic nasolaryngoscopy

  • you will normally receive a local anaesthetic spray immediately beforehand
  • the local anaesthetic will taste bitter and you may imagine your throat is swelling up. Don't panic, that is just the local anaesthetic working

During the procedure

  • the instrument will be passed gently through your nose, you will be told exactly what to do during the procedure
  • lie still and breathe through the mouth
  • remember your nose is 4 to 5 inches long

After the procedure

  • don't get up until the nurse says so - you may be dizzy
  • we will normally tell you the result of the examination straight away
  • you should not eat or drink till the local anaesthetic has worn off - about an hour
  • you should be ok to drive after an hour

Flexible fibreoptic nasolaryngoscopy (FOL)


Updated 26 Jan 2010

This out-patient examination procedure is carried out to diagnose conditions of the nose and throat. A flexible laryngoscope

  • allows close up view of inaccesible areas of nose and throat
  • the flexible instrument allows us to see around corners
  • the vocal cords can be seen in motion
  • very bright illumination helps diagnose conditions of the nose, nasopharynx, larynx and hypopharynx accurately

Having flexible fibreoptic nasolaryngoscopy: What to expect

Before the procedure local anaesthetic spray applied to nose before flexible fibreoptic nasolaryngoscopy

  • you will normally receive a local anaesthetic spray immediately beforehand to reduce any tendency to gag
  • the local anaesthetic will taste bitter and you may imagine your throat is swelling up. Don't panic, that is just the local anaesthetic working

During the procedureFlexible fibreoptic nasolaryngoscopy: ENT Specialist passing flexible endoscopic camera through the seated patient's nose, while nurse supports the head from behind

  • the instrument will be passed gently through your nose & into your throat
  • sit still and breathe through the mouth, the nurse will support you
  • you may be asked to sing a high pitched note, maybe to cough, and to puff out your cheeks - don't worry, you will be told exactly what to do during the procedure

After the procedure

  • don't get up until the nurse says so - you may be dizzy
  • Surgeon's view of laryngitis as seen by flexible fibreoptic nasolaryngoscopywe will normally tell you the result of the examination straight away
  • you should not eat or drink till the local anaesthetic has worn off - about an hour
  • you should be ok to drive after an hour