Patient questions, answered

Tonsillectomy is advised for repeated tonsillitis that causes missed school or work and needs several courses of antibiotics, enlarged tonsils that block breathing during sleep (sleep apnoea), a quinsy (peritonsillar abscess) that keeps coming back, persistent foul-smelling tonsil stones, or a tonsil that looks abnormal and needs to be examined.

No. The tonsils are a small part of a large immune system. Children usually have fewer throat infections after surgery, not more.

Throat pain, and sometimes ear pain, is normal for about one to two weeks. Regular pain medicine, plenty of cool fluids and a soft diet make a big difference. Most children are back at school in 10 to 14 days. Modern techniques such as coblation have made recovery easier than it used to be.

On the day of surgery: cold liquids such as cold milk, water, ice cream, custard, coconut water or apple juice.

Days 1 to 3: a cold, soft diet such as curd, custard, milkshakes, soft sandwiches, mashed vegetables, banana and mango.

Days 4 to 10: soft foods such as khichdi, dalia, porridge, dal rice, oats, scrambled eggs, mashed potato, pudding and biscuits soaked in milk.

After day 10: soft chapati, pasta, soups, bread and dhokla.

Avoid anything spicy, citrus, fizzy, very hot, crunchy or hard-edged (chips, nachos, nuts, popcorn, pizza, samosa, kachori, raw carrots or apples) for at least 18 days. The healing scabs come off in the second week, and a scratch from hard food at that stage can cause bleeding.

Bleeding is uncommon but can happen, most often in the first 24 hours or between days 5 and 12. Spitting a little blood-streaked saliva can be normal. Bright red blood, repeated swallowing, or vomiting blood needs urgent attention: go to the nearest emergency department or call Artemis Emergency on +91 124 4588 888.

The voice can sound different for a few weeks while the throat heals. In children with very large tonsils, speech often becomes clearer after surgery.

Adenoids are a pad of lymphoid tissue at the back of the nose, above the roof of the mouth. They are largest between about three and seven years of age and usually shrink by the teenage years.

A constantly blocked or runny nose, mouth breathing, snoring, restless sleep, pauses in breathing at night, a nasal voice, repeated ear infections or fluid behind the eardrum, and frequent sinus infections.

Long-standing blockage can disturb sleep, slow growth, affect concentration and behaviour, worsen allergies and sinus problems, cause hearing loss from fluid in the ears, and, with years of mouth breathing, change the shape of the face and teeth.

Coblation uses radiofrequency energy at a relatively low temperature to remove adenoid tissue through the mouth and nose, without cuts on the face. It preserves the surrounding healthy tissue, so children usually have less pain and recover faster than with older methods.

Most children are comfortable within a few days and back at school within a week. A soft diet, plenty of fluids, saline nasal spray and a week without strenuous play are usually all that is needed. Bad breath and a stuffy nose for a week or so are normal.

Simple snoring is mainly a nuisance. Snoring with pauses in breathing, choking or gasping at night, and daytime sleepiness may be obstructive sleep apnoea (OSA). Untreated OSA raises the risk of high blood pressure, heart disease, diabetes, accidents and poor concentration.

Loud snoring, mouth breathing, restless sleep, sweating at night, bedwetting, morning headaches, daytime tiredness, poor attention, hyperactivity and falling behind at school. Enlarged tonsils and adenoids are the commonest cause, and surgery usually helps a great deal.

An ENT examination with a thin flexible scope checks the nose and throat. A sleep study (polysomnography, done in hospital or at home) measures breathing, oxygen levels and sleep. In selected adults, drug-induced sleep endoscopy (DISE) shows exactly where the airway collapses during sleep.

Weight loss, sleeping on your side and avoiding alcohol at night help everyone. A CPAP machine is very effective for moderate and severe OSA. Surgery is tailored to the level of blockage: nose, palate, tonsils or tongue base. For children it is usually removal of the tonsils and adenoids.

The septum is the wall of cartilage and bone that divides the nose into two sides. When it is bent, one or both sides can be blocked, leading to mouth breathing, poor sleep, sinus infections, headaches and nosebleeds.

Septoplasty straightens the septum through the nostrils using an endoscope (a thin camera). There are no cuts on the outside of the nose and the shape of the nose does not change.

No. Septoplasty improves breathing; rhinoplasty changes the outside shape of the nose. They can be done together if needed.

Turbinates are ridges on the side walls of the nose that warm and humidify the air. Allergy and irritation can make them swell permanently. If sprays and medicines do not help, turbinoplasty reduces their size using radiofrequency, coblation or a microdebrider, while keeping their lining and function.

Yes, when a badly bent septum is affecting breathing. A careful, conservative technique does not usually affect facial growth.

Expect a stuffy nose and some crusting for one to two weeks. Use saline spray, sleep with your head raised, do not blow your nose for a week, and avoid heavy lifting and strenuous exercise for two weeks. Most people return to desk work in about a week.

Inflammation of the sinuses lasting more than 12 weeks, causing a blocked nose, thick discharge or post-nasal drip, facial pressure or headache, and a reduced sense of smell.

When sinusitis continues despite good medical treatment, for nasal polyps, for cysts (mucoceles), for complications of a sinus infection spreading to the eye or brain, and rarely for tumours. A CT scan helps plan the operation.

Functional endoscopic sinus surgery is done entirely through the nostrils with an endoscope. A microdebrider precisely removes blocked tissue and polyps while preserving healthy lining, so the sinuses can drain and breathe again.

No. Surgery fixes the blockage, but allergy needs ongoing treatment with sprays or immunotherapy. Combining the two gives the best long-term result.

They can, especially with asthma or allergy. Regular steroid sprays or rinses after surgery reduce the chance. For severe, recurring polyps there are newer biologic injections.

Usually one to two weeks. Saline rinses, no nose blowing for a week and follow-up visits to clean the nose help healing. Serious complications involving the eye or skull base are uncommon.

An over-reaction of the nose to things like dust mites, pollen, mould or pet dander, causing sneezing, a runny or blocked nose, and itchy eyes and throat. It often runs alongside asthma.

No medicine cures allergy. Sprays and tablets control symptoms. Avoiding triggers and allergy immunotherapy are the only treatments that change the course of the disease.

It works like a vaccine. After testing shows what you are allergic to, tiny but gradually increasing doses of that allergen are given, so the body learns to tolerate it. It can be given as drops under the tongue (sublingual, SLIT) or as injections (subcutaneous, SCIT).

Sublingual drops are taken daily at first, then on alternate days, then two or three times a week. Most people notice improvement after four to five months, and their need for sprays and anti-allergy tablets falls over time. Treatment is usually continued for about three years for a lasting effect.

Sublingual drops are taken at home, are safer than injections and are widely used in children. Treating allergy early may also reduce the chance of developing new allergies or asthma.

Small holes from a recent infection or injury often heal within a few weeks. Long-standing holes, especially with repeated discharge, usually need surgical repair.

Tympanoplasty repairs a perforated eardrum, usually with a graft of the patient's own tissue. Dr Shashidhar performs it endoscopically through the ear canal, which avoids a large cut behind the ear and allows a faster recovery.

Closing the hole stops discharge and protects the middle ear, and hearing often improves. How much depends on the condition of the small hearing bones and the inner ear, which your hearing test shows before surgery.

Keep the ear dry and avoid swimming or putting your head under water until your surgeon says it has healed. Avoid flying and loud noise, and do not use earphones until you are cleared. Sneeze with your mouth open.

Infection, failure of the graft to take, ringing in the ear and, rarely, worse hearing or facial nerve weakness. With modern techniques in experienced hands these are uncommon.

Sticky fluid collects behind the eardrum, usually after colds or with large adenoids. It muffles hearing and can delay speech and affect learning in young children.

For fluid that persists for about three months with hearing loss, frequent ear infections despite treatment, or Eustachian tube problems causing pain and pressure. Adults can need them too.

A tiny opening is made in the eardrum (myringotomy), the fluid is drained and a small ventilation tube (grommet) is placed. It takes a few minutes under a short anaesthetic, and adenoids are often removed at the same time.

Short-term grommets usually fall out by themselves in 6 to 12 months as the eardrum heals. Long-term T-tubes stay for two to four years when repeated grommets would otherwise be needed.

Keep the ears dry for the first 7 to 10 days. After that, surface swimming is usually fine. Ask about ear plugs for diving or for bathwater with soap.

An abnormal growth of skin inside the middle ear that slowly erodes nearby bone. Typical signs are a smelly discharge that keeps returning and worsening hearing. It does not go away with medicine and needs surgery.

Surgery to clear infected air cells or cholesteatoma from the mastoid bone behind the ear. The eardrum and hearing bones can be repaired in the same operation (tympanoplasty and ossiculoplasty).

Untreated chronic ear disease can damage hearing and balance and, rarely, cause facial weakness, meningitis or brain abscess. Early surgery prevents these complications.

Mild pain, a dressing for a few days and temporary dizziness or ringing are common. Keep the ear dry, avoid flying and loud noise until cleared, and attend follow-up so the ear can be checked for recurrence.

Long exposure to loud noise (earphones, music, factories, traffic, construction), ear infections, ear wax, a hole in the eardrum, ageing, and some medicines, including certain painkillers, antibiotics and cancer drugs.

Asking people to repeat themselves, difficulty following conversation in noisy places, turning up the TV, trouble hearing high-pitched sounds, ringing in the ears, or dizziness.

Keep music and TV volume low, and keep earphones below about 60% of full volume. Noise-cancelling headphones let you listen at lower volume. Wear ear plugs in loud places, stop smoking, keep diabetes, blood pressure and thyroid under control, and get ear infections treated promptly.

A balanced diet supports ear health. Leafy greens, carrots, capsicum, beetroot, oranges, soya, nuts such as almonds and walnuts, and omega-3 rich fish are good choices.

Depending on the cause: medicines, wax removal, surgery to repair the eardrum or hearing bones, or hearing aids. A hearing test (audiometry) is the first step.

Yes. Losing hearing in one ear over hours to a few days, often with ringing or a blocked feeling, should be seen by an ENT specialist the same day if possible. Treatment works best when started early, ideally within the first few days.

Sometimes, but it is not safe to assume so. An examination and hearing test tell the difference between a blocked ear and nerve (sensorineural) hearing loss.

Usually with steroids, given as tablets, as injections through the eardrum (intratympanic) or both. Tests, sometimes including an MRI, look for an underlying cause.

Short courses are generally safe. Side effects such as raised blood sugar and blood pressure, acidity, mood changes and sleep problems are more likely with longer courses. People with diabetes should check their sugar daily. Never stop a long course suddenly without advice. Intratympanic injections avoid most whole-body side effects.

Many people recover some or all of their hearing, especially with early treatment. If hearing does not fully recover, hearing aids and other options can help.

A false sense that you or the room is spinning. It usually comes from the inner ear, which controls balance, and less often from the brain.

That is typical of BPPV, the commonest cause of vertigo. Tiny crystals move into the wrong part of the inner ear. A simple repositioning manoeuvre (such as the Epley manoeuvre) done in clinic often cures it in one or two sessions.

Yes. Vestibular migraine causes episodes of dizziness, sometimes without a headache. Common triggers include lack of sleep, stress, skipped meals, caffeine, alcohol, chocolate, aged cheese and hormonal changes. A diary helps find yours.

Lie still on a flat surface and fix your eyes on one point that does not move until it settles. Do not drive.

Go to an emergency department straight away if dizziness comes with weakness or numbness, slurred speech, double vision, a severe new headache, difficulty walking or fainting, as these can be signs of a stroke.

An inner ear condition caused by excess fluid in the inner ear. It brings attacks of spinning vertigo with ringing, a feeling of fullness and reduced hearing, usually in one ear at first.

From about 20 minutes to several hours, often with nausea and vomiting. Between attacks people may feel normal, though hearing can gradually worsen over the years.

From the pattern of symptoms, an ear examination, hearing tests and balance tests. An MRI is sometimes done to rule out other causes.

It cannot be cured, but it can be well controlled. Treatment includes diet changes, medicines to reduce vertigo and fluid build-up, injections through the eardrum, and rarely surgery.

Eat regular meals at the same times each day and do not skip meals. Keep salt low, avoid caffeine, MSG and smoking, limit alcohol, drink enough water and find ways to manage stress.

Most often noise damage or age-related hearing loss. Other causes include wax, ear infections, Meniere's disease, some medicines, stress and jaw or neck problems.

See a specialist if the tinnitus is in one ear only, came on suddenly with hearing loss, comes with vertigo, or beats in time with your pulse (pulsatile tinnitus). Pulsatile tinnitus can come from blood vessels near the ear, and some causes can be cured with surgery.

The cause is treated where possible. For persistent tinnitus, hearing aids, sound therapy, relaxation techniques and counselling (including CBT) reduce how much it bothers you, and for most people it becomes much less noticeable over time.

Loud noise, silence at bedtime, stress, poor sleep, excess caffeine and alcohol. Soft background sound at night often helps.

Usually not. Wax protects the ear and moves out by itself. Cotton buds push wax deeper and can injure the canal or eardrum.

A blocked feeling, muffled hearing, itching or ringing, often after a bath or swim. Only an examination confirms it, because infections and other conditions feel similar.

Softening drops for a few days often clear it. Stubborn wax is removed in clinic under direct vision with fine instruments or suction. Avoid ear candling and pointed objects.

If it lasts more than three weeks, and sooner if you smoke, have pain, difficulty swallowing or breathing, or cough up blood. A quick camera examination of the voice box (laryngoscopy) in clinic shows the cause.

Voice overuse, colds, acid reflux, vocal cord nodules or polyps, vocal cord paralysis, and in smokers, growths that need early diagnosis.

Drink plenty of water and sip through the day. Avoid habitual throat clearing (swallow instead). Do not shout over noise or try to out-talk background sound; use a microphone for lectures. Speak at a comfortable pitch with relaxed shoulders, jaw and neck, and pause to breathe. Do not whisper, because it strains the voice more than soft speech. Rest your voice when you are ill or tired, warm up before long speaking or singing, and avoid smoking and too much caffeine or alcohol.

Teachers, singers, call-centre staff, lawyers, preachers and anyone who talks a lot for a living. Early voice therapy prevents many problems from needing surgery.

Yes. Depending on the cause and how long it has been present, options include voice therapy, injection to bulk up the cord, and surgery. In children and adults with breathing difficulty from paralysed cords, airway surgery can help them breathe without a tracheostomy.

Yes. Acid and stomach contents can reach the throat (laryngopharyngeal reflux), causing hoarseness, throat clearing, a lump-in-the-throat feeling, chronic cough and post-nasal drip, often without obvious heartburn.

Common triggers are tea and coffee, alcohol, fizzy and energy drinks, chocolate, mint, onion and garlic, spicy and acidic foods (chilli, vinegar, citrus, tomato-based dishes), fried and fatty foods, and high-fat dairy.

Eat smaller, more frequent meals and avoid large drinks with meals. Do not eat for two to three hours before bed, and do not lie down or exercise straight after eating. Raise the head end of your bed by about 15 cm (6 inches), wear loose clothing at the waist, lose weight if needed, stop smoking and manage stress.

Many people improve with diet and habit changes alone. Antacid medicines help when symptoms persist. Take painkillers such as aspirin or ibuprofen only if your doctor advises, as they can worsen acidity.

For thyroid cancer, nodules that are suspicious on ultrasound or needle test (FNAC), a goitre that presses on the windpipe or food pipe or is visibly large, and an overactive thyroid not controlled by medicines.

Under general anaesthesia, through an incision placed in a natural neck crease. Part of the gland (hemithyroidectomy) or all of it (total thyroidectomy) is removed, along with nearby lymph nodes if cancer is present.

The nerves to the voice box run close to the thyroid and are carefully protected. Temporary hoarseness can happen; permanent voice change is rare with an experienced surgeon. Rest your voice for the first few days.

After total thyroidectomy you will need a daily thyroid hormone tablet for life. Calcium and vitamin D may be needed for a while if the parathyroid glands are slow to recover.

Most people go home in one to two days and return to light work in one to two weeks. Avoid heavy lifting for two weeks, and keep the wound clean and dry as advised.

A narrowing of the voice box (larynx) or windpipe (trachea). In babies it can be present from birth. In children and adults it most often follows a period on a breathing tube (intubation) in intensive care, injury or infection. Symptoms include noisy breathing, breathlessness on exertion, a weak voice, or being unable to come off a tracheostomy.

In many children, yes. After a detailed airway assessment under anaesthesia, the narrowing can be treated with balloon dilatation, endoscopic surgery or open reconstruction, so the tube can be removed (decannulation). Dr Shashidhar has performed more than 150 airway reconstructions.

Depending on the type and length of narrowing: balloon laryngoplasty (first done in India by Dr Shashidhar in 2007), laryngotracheal reconstruction with cartilage grafts, partial cricotracheal resection, and slide tracheoplasty for long narrowings.

With a microlaryngoscopy and bronchoscopy under general anaesthesia, sometimes with a CT scan, swallowing assessment and tests for reflux. The findings decide the best operation and timing.

Send the medical summary, scans and any airway endoscopy videos on WhatsApp or by email, or book an online video consultation. Families travel to Artemis from the Middle East, Africa and neighbouring countries, and the international patient team helps with visas, cost estimates and accommodation.

There are three steps: discuss the operation and expected result with Dr Shashidhar; complete the tests and get anaesthesia fitness; then the ENT coordinator books the date and processes insurance approval. You can reach the ENT coordinator on +91 97111 39570 between 9 am and 5 pm.

For most adults: blood count with ESR, liver and kidney function, urine test, blood sugar, viral markers, chest X-ray and ECG. Some patients need clearance from a cardiologist, neurologist, gastroenterologist or chest physician. Children need fewer tests, usually a blood count, viral markers and a clotting profile. You then meet the anaesthetist in the pre-anaesthesia (PAC) clinic.

Nothing to eat or drink (including water, milk, tea and biscuits) after midnight before surgery, unless you are told otherwise. Take blood pressure tablets early in the morning with a sip of water, but do not take diabetes medicines that morning because you will be fasting.

Blood thinners such as aspirin, clopidogrel and warfarin usually need to be stopped before surgery, but only after checking with your doctor. Tell us if your blood pressure or sugar is high or you have had a recent chest infection.

The hospital helps you obtain cashless approval, but payment is between you and your insurer. For pre-approval you will need: your insurance card, the patient's and the policy holder's Aadhaar, the policy holder's PAN card and photo, the doctor's prescriptions, all scan and test reports, the hospital's estimate, and your company ID card for a corporate policy.

Bring all reports, prescriptions, CT films and hearing tests. You will sign consent forms, which is a good time to ask any last questions. Preparation takes about 30 minutes before surgery and waking up takes about 30 minutes afterwards, so you will be away from your family longer than the operation itself. Theatre timings can occasionally be delayed by emergencies.

Patients usually stay nil by mouth for about four hours after surgery and are kept comfortable with a drip, and it can take two to four hours before moving back to the room. A sore throat, nasal packs or temporary difficulty passing urine are common and are managed by the team. Insurance (TPA) clearance takes about four to five hours after the discharge summary is sent. Before leaving, collect your discharge summary and go through your medicines, dos and don'ts, and follow-up date.