Joseph Boutros Sleiman, M.D.
We provide care for adults and children with ear, nose and throat disorders. From correcting painful sinus conditions, to treating hearing loss, we make a difference in people's lives everyday. We want to do the same for you. Using state-of-the-art lasers, electrosurgery or endoscopic surgery, we can treat most of your ailments, specifically tonsilitis and ear infections in children, snoring, breathing or hearing problems in adults.
| > | ENT surgeon (ear, nose and throat), D.I.S – France. |
The highest quality of Ear Nose and Throat services are provided by a state-of-the-art clinic in the following areas:
- General Otolaryngology (Laserturbinectomy, Tonsillectomy, Adenoidectomy, Myringotomy, Polypectomy)
- Nasal & Endoscopic Sinus Surgery
- Septoplasty
- Otoplasty
- Allergy
- Laser Snoring Surgery
- Voice, Laryngeal Microsurgery
- Dysphagia/Swallowing Disorders
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The development of snoring
Snoring is caused by the vibration of the soft tissue in the languishable part of the upper respiratory tract. This vibration is created by currents of air in the respiratory tract of the sleeper breathing through nose or mouth. This causes a fluttering effect that can be compared to the rattling of wind at a window not shut properly or to the sound of a flag flapping in a strong breeze.
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How can I distinguish harmless from dangerous snoring?
pathological snoring harmless snoring Frequency snores every night snores occasionally Volume very loud, audible in the next room medium to loud, harmonic Sound explosive, hard, high frequencies, rasping sound low frequency Breathing frequent breaks awakening regular, without breaks sleeping behaviour troubled sleep, frequent undisturbed sleep
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What can I do to reduce my snoring?
Weight reduction in case of obesity, a light dinner, reasonable consumption of alcohol, sleeping on ones side, higher sleeping position (of upper body), cutting down on cigarettes and caffeine all contribute enormously to reducing the snoring.
For severe obesity gastric banding with keyhole surgery may be a good solution.
Obstructed nasal respiration caused by septal deviation, allergy, polyps can contribute considerably to triggering snoring. In these cases, treatment by a ENT specialist will help.
Soporifics and sleep deprivation due to shift work favour the development of snoring still further.
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What possibilities for surgery are there today?
Depending on the individual indication, three proven surgical procedures are used in modern snoring therapy:
UPPP Uvulo-Pharyngo-Palatoplasty is the conventional method of surgery (stationary)
LAUP Laser-assisted Uvolo-Palatoplasty – the laser-assistance considerably reduces the risk of secondary haemorrhage, can therefore be carried out ambulatory under propohol-anaesthesia. Until 1998, this was the most frequent way of treatment.
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What method of surgery is best for me?
Every patient has individual, anatomical pre-conditions and will benefit from a different, special technique.
The most effective therapy is one developed specifically for the individual patient that the specialist can also recommend as a combination of several approaches.
- The modern surgery procedure is tissue-conserving (small wounds, quick recovery); it can be carried out ambulatory.
- The most modern computer technology controls the intensity of the treatment – pre-requisite for a tissue-conserving, efficient therapy.
- Duration of the surgery: 9 – 12 minutes
- Carried out by a specialist innovative technique is a precise and elegant surgical procedure, outstanding due to its high record of success.
- The laser is no instrument for a beginner!!!
- The difficulties in swallowing (dysphagia) are bearable and abate after a couple of days.
- The modern surgery procedure is tissue-conserving (small wounds, quick recovery); it can be carried out ambulatory.
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How high is the record of success?
If indicated correctly and carried out by an experienced specialist, the snoring surgery has a high record of success.
Statistically, the percentage in success lies between 75-80%.
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For how long will I be unfit to work?
Due to the precise and gentle treatment, most patients start to feel better after 2 days. Depending on the amount of physical strain, a recovery period of 3 to 7 days is recommendable.
The patient isn’t bedfast, no bed rest is needed. Brain-work is possible after 24 hours.
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Is the surgery painful?
The surgery itself isn’t painful at all, the patient is anaesthized. From day 4 to day 7 after the surgery, difficulties in swallowing (dysphagia) become more frequent, the pain is comparable to the pain caused by tonsillitis. However, this pain can be controlled using mild medication.
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Is the surgery carried out under general anaesthesia?
The surgery is carried out using the very agreeable propofol-anaesthesia. Within 10 minutes after the end of the surgery the patient is wide awake, nausea or vomiting, typical after a conventional anaesthesia, don’t occur. After 30 minutes the patient is able to consume a cup of coffee. After a 2-hour surveillance the patient can leave the hospital if in company.
3 experienced anaesthetists ensure a highly qualified, excellent performance before, during and after the surgery.
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Is the surgery ambulatory or stationary?
Due to the gentle laser assistance a local anaesthesia or a mild propohol-anaesthesia, the surgery can be carried out ambulatory under most optimal, surgical surveillance. There is no prolonged hospital stay and the patient can return to work soon. Therefore, this surgery procedure is time-saving and economical.
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Is the surgery carried out in the practice or in hospital?
The operation is carried out in a state-approved hospital with high medical standards.
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Is a preliminary examination necessary?
The preliminary examination is an absolute pre-requisite. Based on the patient’s medical history, the details and, if necessary, the clinical results of the sleeping laboratory, are discussed with Dr. Marc Muller Nieberg – at the patient’s request this can be done in the presence of a partner.
Only then it is determined if the patient is a suitable candidate for the snoring surgery.
All questions are discussed thoroughly.
A preliminary examination is also necessary for the anaesthesia; it can be carried out on the same day.
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Is it necessary to undergo an examination in a sleeping laboratory before the preliminary examination?
Patients with suspected OSA-Syndrome or distinct exhaustion have to undergo an examination in a sleeping laboratory. This can be done in a sleeping laboratory.
On request, the patients can arrange an appointment in a neighbouring specialized sleeping laboratory.
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Where do I stay after the surgery?
After the surgery, the patients can leave the hospital – if in company – after a surveillance period of two hours. Living less than 2 hours away from the hospital can be taken home.
Non-local patients can be accommodated in our guest house.
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How many follow-up examinations are necessary?
As a rule, 2-3 follow-up examinations are necessary. The after-treatment serves to speed up the healing process. Of course, those patients who live nearby can take up more appointments for after-treatments.
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What side-effects are to be expected?
Following side-effects are to be expected:
Difficulties in swallowing (dysphagia) between day 4 to 8 after the surgery.
A feeling of dryness and as if there was a foreign object in one’s throat for 3 to 4 weeks.
Because of the modern surgery procedure, serious side-effects are highly unlikely.
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Will my snoring be gone immediately after the surgery?
No. It is possible that, during the first 3 weeks, the snoring is even worse than before.
This occurs during the post-surgical healing process. After 3-4 weeks the snoring starts to cease, the nasal respiration is unobstructed, depending on the individual disposition, minimal breathing sounds may continue for a while.
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Does Health Insurance cover the costs for the surgery?
Normally, private Health Insurance does not cover the cost.