Throat Conditions & Surgery

Tonsillectomy remains the commonest operation Dr Altmann performs for both Children and Adults. Tonsillectomy when indicated is one of the best operations for improving a patient’s quality of life. This can be one of the simplest operations but can also occasionally be a complex and dangerous procedure requiring specialist expertise and experience. Preoperative blood tests are usually not indicated unless there is a history or family history of easy bruising or bleeding. 

Tonsillectomy causes varying degrees of pain in all patients, however children from 3-5 years of age seem to complain the least and usually require less than one week away from Kindergarten or School. Teenagers at around 17-19 years of age seem to complain the most of pain postoperatively though females at this age seem to complain of much less pain than males of a comparable age!

Patients living more than 90 minutes' drive outside Townsville are advised to stay in Townsville or nearby for 10-14 days post Tonsillectomy due to the rare (less than 1% in Dr Altmann’s hands) incidence of major postoperative bleeding requiring return to a major hospital and sometimes a second operation if bleeding doesn’t cease with conservative measures.

Dr Altmann trained as an ENT Surgeon in Qld and much of his training was in surgery of head and neck malignancies such as tongue and oral cancer, laryngeal cancer, and neck lymph node cancer and lymphoma.

Thankfully over the last 25 years there have been significant advances in the understanding and nonsurgical treatment of Head and Neck Cancers with Radiotherapy. As such, procedures such as laryngectomy (removal of voice box) have become much less common due to the increased success of radiotherapy, often with mild chemotherapy for one week at the initiation of Radiotherapy. Radiotherapy usually involves 1 hour per day, Mon – Fri for 6 weeks, with the patient often able to continue work for the first few weeks until tiredness and throat pain become a problem at about week 3-4.

Dr Altmann will biopsy upper aerodigestive cancers under local or general anaesthetic depending on location and patient preference, and then arrange appropriate investigations such as PET CT ( radio labelled Glucose whole body CT) which takes most of a working day ( please bring some music or something to read), and MRI scan as indicated and in most cases the investigated patient is referred to The Townsville University Hospital “ Head and Neck Clinic” which occurs on a Tuesday morning , where Radiotherapy Doctors, ENT Surgeons, Dentists, Speech Pathologists and Dietitians review the patient and their results and discuss the best options of management with the patient.

The patient is usually reviewed on the Friday or Monday before the Tuesday Head and Neck Clinic by a Radiation Oncologist.

Dr Altmann is happy to perform tongue and oral cancer surgery , as well as neck dissection for enlarged neck lymph nodes at Mater Townsville , however for more major and now more uncommon surgery such as laryngectomy Dr Altmann recommends the patient have their surgery as a Public patient at Townsville University Hospital with one of the experienced surgeons there.

The Parotid Glands are paired salivary glands beneath the skin of the cheeks just in front of and below the ear and they produce 80% of saliva. Parotidectomy is an uncommon operation and is usually performed because of a tumour within the Parotid Gland. The main risk of Parotidectomy relates to the facial nerve which controls movement of facial muscles and which runs from the brain, exiting the skull base and then runs through the Parotid Gland as very fine, hair-like branches which are very sensitive to any trauma, even simply being touched.

Dr Altmann trained extensively in Parotid Gland surgery  at Royal Brisbane Hospital and uses continuous facial nerve monitoring in all cases.

Dr Altmann prides himself in taking whatever length of time is required to safely perform the procedure, with some difficult revision cases taking more than 7 hours.

One of the first cases Dr Altmann performed in Townsville was for a difficult deep lobe Parotid tumour in a professional 18yo international Opera singer who thankfully had a happy outcome.

Dr Altmann is happy to be consulted by GP’s or skin cancer specialist doctors about complex facial flap and graft repairs for facial skin cancers.

Conditions

Condition TreatedCommon Names And SymptomsOperation
Recurrent Tonsillitis
COMMON NAMES
  • Tonsillitis
  • Sore Throat
  • Tonsil Stones
  • Halitosis Or Bad Breath
OPERATION
Tonsillectomy, Adenotonsillectomy
Nasal Obstruction, Rhinorrhoea
COMMON NAMES
  • Blocked Nose
  • Runny Nose
  • Nasal Speech
  • Poor Pronunciation
OPERATION
Adenoidectomy
Snoring
COMMON NAMES
Snoring
OPERATION
Adenotonsillectomy, UPPP (Uvulopalatopharyngoplasty)
Obstructive Sleep Apnoea (OSA)
COMMON NAMES
  • Snoring With Gasping
  • Stopping Breathing
  • Restless Sleep
  • Morning Tiredness
  • Crankiness
  • Morning Headache
  • Unrefreshing Sleep
  • Nocturnal Enuresis (Bed Wetting)
  • Bruxism (Tooth Grinding)
  • Malocclusion
  • Orthodontic Problems
  • Behavioural Problems
  • Poor Attention
  • Slow Learning
  • Poor Growth
  • Fussy Eater
  • Sleep Walking
  • Sleep Talking
  • Nightmares
  • Night Terrors
OPERATION
Adenotonsillectomy, UPPP
Vocal Cord Nodules
COMMON NAMES
  • Teacher’s Nodes
  • Screamer’s Nodes
  • Hoarse Voice
OPERATION
Microlaryngoscopy
Head and Neck Malignancies
COMMON NAMES
  • Throat Cancer
  • Hoarse Voice
  • Dysphagia Or Difficulty Swallowing
  • Neck Lumps
OPERATION
Biopsy, Microlaryngoscopy, Neck Dissection, Lymph Node Of Neck Biopsy
Skin Malignancies of Head And Neck
COMMON NAMES
  • Basal Cell Carcinoma(Bcc)
  • Squamous Cell Carcinoma(Scc)
  • Melanoma
OPERATION
Wide Local Excision of Skin Cancers, Complex Skin Repairs Including Flaps And Skin Grafts (Local Anaesthetic Or General Anaesthetic)
Salivary Gland Calculi
COMMON NAMES
Salivary Stones
OPERATION
Removal of Salivary Stones
Salivary Gland Tumours
COMMON NAMES
Parotid And Submandibular Gland Lumps
OPERATION
Parotidectomy, Removal Of Submandibular Gland
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