Duration of surgery: 45-60 minutes Anesthesia: local anesthesia The chronic nasolacrimal duct obstruction leads to inflammation or infection of the lacrimal sac: the endoscopic surgery of the tear ducts is a new and advanced technique to solve the problems connected with epiphora, that is a continue and persistent lacrimation. Through the use of an innovative technology which takes advantages of fiber optics and microsurgical instrumentation, the surgeon can clearly and precisely visualize any obstructive problems in the tear ducts, recanalizing them. This method offers multiple advantages over traditional open surgery in terms of surgical precision, surgical duration, safe results and absence of external scars. The operation can be performed in adults with a full anesthesia and in children with the use of light total sedation.

For all people suffering from epiphora (excessive lacrimation) and congenital obstruction of the nasolacrimal duct: tears, unpleasant ocular secretions, redness, inflammation and dangerous blurred vision, especially when driving.

Duration of surgery: 40/50 minutes Anesthesia: general anesthesia in day hospital, without the use of nasal tampons. The nasal septum is the dividing wall that runs down the middle of the nose, separating the two nasal cavities, each of which ends in a nostril. Septoplasty is a surgical procedure that corrects the nasal septum position and eliminates its deviations which can have a congenital or traumatic origin. These deviations can cause an obstruction which results in difficulty in breathing. Septal deviations may not be seen externally, that is the nasal septum can be deviated despite a correct nasal pyramid alignment. Similarly, there can be patients with a noticeable deviation of the nose and a straight nasal septum, although this is less common. Therefore, the nasal dorsum does not reveal whether the nasal septum is deviated or not. The procedure involves making a septal mucosal incision, raising the membranes that cover the cartilage and bone of the septum. The nasal septum contains bone in the inferior part and hyaline cartilage in the superior part. The deviated portions of cartilage and bone are removed and the membranes are sewn down onto the cartilage in order to close the incision. If the septum is severely deviated, parts of your nasal septum could be completely removed before reinserting them in the proper position. In case of turbinate hypertrophy, turbinate reduction could be necessary during the operation. Moreover, this operation may involve a combination of rhinoplasty and septoplasty (septorhinoplasty) to improve the appearance of the nose.

Subjects with breathing difficulties, obstructive sleep apnea syndrome, snoring and other problems related to the deviated nasal septum.

Septoplasty is a surgery used to correct a deviated septum, restoring proper nasal breathing.

Anesthesia: general anesthesia in day hospital, without the use of nasal tampons. Only nasal surgery can correct nasal septal perforations. The operation requires general anesthesia. There are several surgical techniques depending on each case. In cases of small perforations (less than 1 cm in diameter), local flaps may be sutured in order to repair the perforation. In cases of perforations up to 2 cm in diameter, we use a mucosal pedicled endonasal flap to repair the defect. In cases of larger septal perforations, a composite graft of the auricular cartilage and the temporalis muscle fascia is used endonasally and/or through or an open procedure with microsurgical suturing. Fiberoptic video endoscopy is always used in surgery. Surgical closure of nasal septal perforation is not 100% effective for several reasons. For example, there could be retraction or graft failure or the persistence of the original pathology which caused perforation (mucosal atrophy, cocaine use, autoimmunity, etc.). In these cases, the intervention might not be effective and a new posterior perforation could occur.

Subjects with a nasal septal perforation for different reasons.

The operation corrects nasal septal perforation, restoring proper nasal breathing.

Duration of surgery: 30 minutes Anesthesia: anesthetic spray Turbinoplasty is indicated when other conservative approaches do not achieve satisfactory results and do not provide good ventilation. For turbinate decongestion, our team uses the innovative method of radiofrequency, an outpatient minimally invasive approach performed with an anesthetic spray. In order to perform this procedure, the physician administers a local anesthetic and decongests the turbinates using a micromaniple: the high-frequency electromagnetic waves emitted by the machine cause a resonance between the cells of the mucous membrane tissue vaporizing them and thus reducing the volume of hypertrophic turbinates. Inferior turbinate reduction is painless, there is no bleeding and there is no need to use bothersome post-operative tampons; the patient can therefore resume his daily life the next day after surgery. In the following days, some localized scabs may appear, which will be easily treated thanks to the program of washings and dressings prescribed by our team. The results can be seen after twenty/thirty days and are long-lasting. Radiofrequency is considered a “cold” method because it operates at a temperature between 40° and 70°: a “biosurgery” technique that preserves the function of the tissues involved without damaging them. An innovative technique that leads to very satisfactory results: breathing has never been so easy!

For all people suffering from turbinate hypertrophy, a constant inflammatory state that causes a persistent increase in the volume of turbinates and a reduction of the amount of free space in the nose for airflow, causing breathing problems.

This intervention corrects a persistent increase in the volume of the turbinates. If turbinate hypertrophy is left untreated, symptoms may worsen. Breathing through the nose can become difficult and can result in a decreasing sleep quality with consequent snoring and obstructive sleep apnea syndrome (osas). Moreover, it increases the likelihood of frequent sinus infections, which can create discomfort in daily life. The most common complications include chronic sinusitis, recurrent or chronic pharyngitis, nasal polyps, otitis media or recurrent serum mucous.

Duration of surgery: 45-60 minutes Anesthesia: general anesthesia Uvulopalatopharyngoplasty (UPPP) is a procedure that removes excess tissue in the soft palate and, if necessary, in the nasopharynx areas, in order to make the airway wider. This can allow air to move through the throat more easily and thus reduce severity of obstructive sleep apnea syndrome (OSAS). The tissues that are removed may include: The uvula, that is the soft flap of tissue that hangs down at the back of the mouth; Part of the palate (soft palate); Excess tissue from throat, tonsils and adenoids; An enlarged tongue is an important factor in sleep apnea; the surgeon may remove a small part of the tongue. A continuous positive airway pressure therapy (CPAP) could be necessary after the surgical procedure. CPAP therapy utilizes machines specifically designed to deliver a flow of constant pressure which can help a person who has obstructive sleep apnea syndrome (OSAS) breathe more easily during sleep. Some analgesics (painkillers) can relax throat muscles. It may be necessary to avoid these medications after the surgical intervention in order to reduce the chances of airway narrowing and causing apnea episodes.

For patients with excess tissue (both soft palate and nasopharynx) blocking the airway. This procedure is also indicated for all people who do not want to or cannot use CPAP or who do not find benefit from using this device for sleep apnea.

The intervention corrects and reduces obstructive sleep apnea, eliminating snoring.