Who is Dr Martin Vanlierde?

Dr Martin Vanlierde is an ENT Surgeon that has a keen interest in functional and cosmetic rhinoplasty. Besides having training and experience in cosmetic nose surgery and botox therapy, Dr Vanlierde is a trained specialist in nasal surgery, snoring surgery and general ear, nose and throat conditions.

An ENT surgeon, also called an otolaryngologist or head-and-neck surgeon, is a doctor in medicine that specialises in treating disorders or conditions of the head and neck, particularly disorders relating to the ear, nose and throat. Dr Martin Vanlierde spent 18 months in the UK working and studying. He graduated with a Fellowship in Otolaryngology from the College of Medicine of South Africa and relocated to Edinburgh, where he obtained the Fellowship of the Royal College of Surgeons of Edinburgh.

Dr Vanlierde spent nine years in private practice in British Columbia, Canada, before returning to South Africa. In 2001, he commenced private practice in Cape Town and was a part-time lecturer in the Department of Otolaryngology at the University of Cape Town, where he taught rhinoplasty and headed the Voice Clinic of the department.

His practice focuses more on rhinoplasty and nasal and sinus surgery. Outside of the operating room, Dr Vanlierde enjoys rowing and cycling and also has a passion for music, travel, good food and wine shared with family and friends.

Tonsillectomy aftercare

Tonsillectomy is a procedure performed to remove tonsils. In some cases, adenoids will also be removed during the same surgery. Tonsillectomy is done through the mouth. For more information about tonsillectomy, visit our website.

Most people after surgery may experience a lot of pain for about 1-2 weeks or longer. The pain can get worse before it becomes better, and the pain in your throat can also affect the ears. You may be able to go back to your normal routine in a week or 2. You can expect snoring or breathing through the mouth at night after surgery.

Tonsillectomy aftercare includes:

  • Physical activity
    Children must rest but may play inside for a while as they recover. Strenuous physical activities should be avoided.
  • Diet
    Drink lots of water to prevent dehydration. If it is painful to swallow, start out by eating popsicles, ice cream, or cold or room temperature drinks. Avoid hot beverages, soda, orange or tomato juice, and other acidic foods that may sting the throat. These can make the throat more painful and possibly cause bleeding. Avoid eating hard or scratching foods such as chips or raw vegetables.
  • Medicines
    Pain killers will be prescribed to help ease the pain. If you were taking medications before the surgery, the ENT specialist will give you instructions on when you can resume with that regimen. Antibiotics may also be prescribed to prevent an infection.

Follow up appointments will be scheduled to check your recovery progress.

Tonsils and adenoids – why remove them?

We are all familiar with the words tonsils and adenoids, but did you know that they are part of the immune system and they responsible for protecting the body from diseases?

Tonsils are two round lumps situated at the back of your throat, while adenoids are high at the back of the nose and the roof of the mouth. They are only visible through the mouth and nose with the use of special instruments. When bacteria and viruses enter through the mouth and nose, tonsils and adenoids sample and trap them.

Tonsils and adenoids can be enlarged or inflamed when they are fighting bacteria and viruses. However, some children have naturally enlarged tonsils and adenoids without an underlying cause. The reason why this occurs is not known, but a genetic link is suspected.

Why should you remove tonsils and adenoids?

While tonsils and adenoids are the body’s first line of defence against pathogens, they should be removed if:

  • You have recurring tonsillitis
  • You have blockages that cause snoring or sleep apnea
  • You have tonsil cancer
  • Frequent infections of the adenoids

Frequent infections of the adenoids can affect other areas such as the ear’s passage at the back of the nose and the inside of the ear, called the eustachian tube. This may result in frequent ear infections and collection of fluid in the middle ear, which can then cause temporary hearing loss.

What is an Endoscopic DCR?

An endoscopic dacryocystorhinostomy (DCR) is a surgical procedure done to treat a watery, sticky eye that’s caused by the narrowing or blockage of the tear drainage tubes. Tear drainage tubes run from the inner corner of the eye into the tear sac and then down into the nose.

An endoscopic DCR involves the surgeon creating a new passage between the tear sac and the nose, which will then bypass any blockage below the tear sac. This allows tears to drain normally again. This surgical procedure is also done to relieve blockages that occur higher in the tear drainage system. It may also be recommended for people who:

  • Are suffering from a watery eye
  • Have repeated eye infections
  • Have sticky eye discharge
  • A painful infection of the tear sac forms a lump between the eye and nose.

An endoscopic DCR is done under general anaesthesia and is a day-care case. An endoscope will be used and passed through the affected area, which will guide the surgeon throughout the procedure. A new pathway is made between the tear sac and the inside of the nose. A rubber tube will be inserted in the tear ducts in order to allow healing to take place within 6-12 weeks, and then it will be removed. A dressing inside the nose will be used to avoid a nosebleed.

How to take care of your ears, nose and throat…

Healthy ears, nose and throat is a healthier you. This is important, especially for people with problems like chronic sinusitis, hearing loss, sleep disorders, and year-round allergies. The following are tips on how to take care of your ears, nose and throat.

Health tips for the ear:

  • Wear hearing protection
    Hearing protection aids are normally recommended for use to help to protect your ears in loud environments such as a concert, the shooting range, or even a sporting event. Hearing protection is also necessary for industrial settings involving large machinery.
  • Clean out the earwax
    It is important that you visit your physician regularly to clean out earwax. Getting your ears cleaned by a physician will help prevent ear infections and temporary tinnitus.

Health tips for the nose:

  • Flush out the nose and sinuses
    Every now and then, it’s good to flush out the sinuses of any dust or pollen to prevent an allergic reaction or sinus infection. The recommended tool for this is an irrigation bottle and a water dispenser.
  • Get a proper diagnosis
    Note, not everything is allergy-related or even sinus infection-related. In order to ensure that you get a proper diagnosis for symptoms that affect your nose, visit your doctor or ENT specialist.
  • Avoidance
    When it comes to allergies, it is important that you avoid allergens such as pollen, dust, and mould.

Health tips for the throat:

  • Drink plenty of water
    Drinking water is good for our entire system. For the throat especially, drinking lots of water ensures that you remain well hydrated.
  • Check your reflux
    Acid reflux and GERD can cause oesophagal cancer and can damage the lining of the oesophagus. A regular checkup for acid reflux can help treat symptoms and prevent further damage.

Ear, Nose and Throat – All you need to know

We all know what the ears, nose and throat look like on the outside, but do we know them from the inside out? A basic overview of their anatomy can help you better understand your body and how it works.

The ear:

The ear helps us hear the world around us and consists of the following:

  • The pinna or auricle
    the outside part of the ear.
  • External auditory canal/tube
    the tube that connects the outer ear to the middle/inside ear.
  • The eardrum, called the tympanic membrane
    divides the external ear from the middle ear.
  • Ossicles
    3 small bones that are connected and are responsible for transmitting sound waves to the inner ear.
  • Eustachian tube
    a tube/canal that connects the middle ear with the back of the nose and is responsible for equalising the pressure in the middle ear for proper sound waves transfer.
  • Cochlea
    contains nerves for hearing
  • Vestibule and semi-circular canals
    contain receptors for balance.

The nose:

The nose is responsible for smell and is a part of the peripheral nervous system. It consists of the following:

  • External nose
    this is a triangular-shaped projection situated at the centre of the face.
  • Nostrils
    these are two chambers that are divided by a septum, the cartilage in the nose.
  • Nasal passages
    these are passages that are lined with mucous membranes as well as cilia (tiny hairs) which help filter the air.
  • Sinuses
    these are air-filled cavities that are also lined with mucous membranes.

The throat:

The throat is a ring-like muscular tube that is a passageway for air, food and liquid. It helps in forming speech. The throat consists of the following:

  • The larynx
    also called the vocal box, the larynx houses the vocal cords and is responsible for speech and breathing. It also acts as a passageway to the trachea (the windpipe to the lung).
  • Tonsils and adenoids
    these are lymph tissues located at the back and sides of the mouth. They are responsible for protecting the body from pathogens such as bacteria’s and viruses.
  • Epiglottis
    these are located above the larynx and are responsible for pushing food into the oesophagus, therefore preventing food from entering the windpipe.

Five possible reasons for snoring

Did you know that factors such as alcohol consumption, the anatomy of your mouth and sinuses and allergies can contribute to snoring?

When you doze off and progress from a light to deep sleep, the tongue, throat and the muscles in the roof of the mouth (called the soft palate) relax. If these muscles relax too much, they begin to partially block the airway, causing them to vibrate. The more narrowed the airway, the more forceful the airflow becomes, which increases tissue vibration and results in louder snoring.

Five possible reasons you could be snoring include:

  • The anatomy of the mouth
    Having a low, thick, soft palate can often narrow your airway. People who are overweight and obese normally have extra tissues at the back of their throats, which may narrow their airways. Also, if the uvula is elongated, the airflow may be obstructed, and the vibration may also increase. The uvula is the triangular piece of tissue that is hanging from the roof of the mouth (soft palate).
  • Alcohol consumption
    Consuming too much alcohol before bedtime can lead to you snoring because alcohol relaxes the throat muscles and decreases the natural defences against airway obstruction.
  • Nasal problems
    Crooked partition between the nostrils or chronic nasal congestion may be contributing to your snoring.
  • Sleep position
    Snoring is normally frequent and loudest when you are sleeping on your back, leading to the gravity’s effect on the throat to narrow the airway.
  • Sleep deprivation
    Not getting enough sleep may contribute to the relaxation of the throat muscles, resulting in snoring.

Snoring? We can help

Snoring is that irritating, hoarse or harsh sound that occurs when air flows past relaxed tissues in your throat, causing those tissues to vibrate when you breathe. Studies show that 45% of men and 30% of women snore on a regular basis. Snoring doesn’t only affect the snorer’s sleep but also the spouse, partner or family members too.

Snoring can be a sign of a more serious health condition called obstructive sleep apnea (OSA). Obstructive sleep apnea is a health condition where breathing stops involuntarily for a short period of time when you are sleeping.

While snoring can be frustrating for all involved, remember – where there is a problem, there is a solution. Dr Martin Vanlierde is an ENT Surgeon and offers the following treatments to help with snoring:

  • Nasal sprays and lifestyle changes may be recommended as first-line treatment.
  • Palatal surgery
    This is a group of palate procedures that are done to treat obstructive sleep apnea. Palatal surgery involves tissue removal and repositioning, which aims to increase the size of the airway without affecting normal functions like speaking, breathing and swallowing.
  • Nasal surgery
    Nasal congestion can cause or contribute to snoring. Nasal surgery is aimed at opening the pathways of sinuses and clear blockages.
  • Oral prostheses
    may also be recommended to help keep the tongue forward when sleeping.

Grommets, what are they?

What are grommets really?

Grommets are very, very small plastic or metal tubes that are inserted into a child’s eardrum to allow air to get in and out of the ear by draining fluid in the middle ear. The build-up of the thick, sticky fluid is called glue ear. Glue ear can be caused by the reoccurrence of middle ear infections, which is common in childhood, but may also affect adults too.

When are grommets used?

Grommets are normally recommended for glue ear that won’t clear up or for frequent ear infections. They may also be recommended if the child has had:

  • Glue ear for more than three months
  • Acute ear infections in a pace of a year, especially if the infection has occurred in both ears.
  • Previous complications due to an ear infection.

The insertion of grommets is done under general anaesthesia, and the surgeon makes a small incision on the eardrum. He will then insert the grommet into the incision. After the operation, the child may be unsettled for a while. Ear protection is required when using water, especially when swimming, shampooing, showering and bathing. Some children may have ear discharge after the operation, which is not usually painful and can be treated with ear drops. The insertion of grommets helps improve the child’s hearing. If the discharge continues for prolonged periods, seek medical attention.

The most common post-nasal surgery complications

Just like all other surgical procedures, nasal surgery has complications. Even though the chances of a complication occurring are slim, it is essential that one is aware of and understands the potential complications. These complications may include:

  • Bleeding
    Nasal surgery involves some degree of blood loss. This can be managed with the use of a nasal pack or tissue spacer after the procedure, which will be removed after one week.
  • Recurrence of the disease
    Nasal surgery is normally performed using minimally invasive procedures; you may expect to continue to use sinus medication even after the procedure. This is because the surgery provides significant symptomatic benefits in most cases. Therefore, should you feel like you are not getting any better, contact your surgeon for further testing and possible revision of the surgery.
  • Infection
    after surgery, infection may occur, but this can be effectively managed with a course of antibiotics. The length of treatment varies and may range from 2-4 weeks.
  • Pain
    Nasal and sinus pressure or pain may be experienced for the first several day’s post-nasal surgery. The surgeon may prescribe pain medication to help ease discomfort.
  • Nasal congestion and discharge
    Nasal congestion and discharge may be experienced few weeks after surgery.

Post-operative care instructions may include nasal saline spray and sinus irrigations. Nasal saline mist spray may be prescribed for use every 2-3 hours to help make your nose more comfortable. Sinus irrigations include sinus rinse kits to clean out debris that might be left behind in the sinuses after surgery.