Epworth Hawthorn has become the first private hospital in Victoria to offer a local anaesthetic clinic for laryngeal procedures helping patients with voice, airway and swallowing issues.
The revolutionary treatment involves the simple targeted application of a couple of forms of local anaesthetic, in an awake setting, so clinicians can perform a large variety of procedures on the patient's vocal cords, throat and upper airway.
This is the first time a private clinic like this has been set up in Victoria. Until now, if patients wanted to expedite their treatment privately, they would have to choose to undergo the procedure under a general anaesthetic. It is also the first private or public clinic in Australia where a Speech Pathologist assists with the procedure, bringing their own set of skills and expertise to the process.
Epworth Ear, Nose and Throat, Head and Neck Surgeon, Laryngologist, Associate Professor Paul Paddle said the multi-disciplinary collaboration with Speech Pathologists and nursing staff creates a multi-disciplinary model that can be emulated in other services around Australia.
"We are treating various voice, airway, breathing and swallowing issues in adult patients, who would otherwise need to have a general anaesthetic and admission to hospital to undergo the same treatment,'' said Assoc Prof Paddle, who is one of the founders and directors of Melbourne ENT Group Pty. Ltd.
"The patient is completely awake, un-sedated, sitting upright in a comfortable chair, in the clothes they arrived in, and 30 mins later they can return to productive life, having had a quality of life improving procedure, without all the possible risks/side effects of a general hospital surgical admission.''
"We are also able to treat these conditions in patients too sick to safely undergo a general anaesthetic, who might not be offered a definitive treatment due to the possible risks of an anaesthetic. And because it's such a simple minimally invasive experience for the patient, issues that require planned repeat treatments, can be easily performed, walk-in / walk-out, and the patient can be back at work, or with family that afternoon, and avoid repeated exposures to general anaesthetics.''
Botox is one of the many therapeutic substances used, and is specifically for tremor and dystonic disorders of the voice, and for chronic cough disorders. It reversibly weakens the vocal cords and reduces sensory overload in the voice box.
Disorders being treated include non-cancerous voice disorders, such as vocal folds weakness, nodules, polyps, and benign narrowing of the airway such as subglottic stenosis.
In addition to Botox, other therapeutic treatments include steroid injections directed into the vocal cords or airway, which can melt away scar tissue and increase the calibre and movement of the airway - avoiding sometimes risky and repeated general anaesthetics.
Assoc Prof Paddle also injects fillers into vocal cords to augment and help strengthen voices and improve cough and swallow in patients with vocal cord palsies, thin vocal cords due to ageing, or neurological disorders such as Parkinson's.
He also uses flexible lasers through the nose to treat benign vascular lesions and benign tumours of the voice box and airway.
"With the growing scope of practice for Speech Pathologists worldwide, which now includes performing basic nasendoscopic procedures, we are the first hospital in Australia (public or private) to create a clinic where Speech Pathologist and ENT work side by side for awake procedures which further enhances the patient experience as it's the same team that sees them for their initial assessment, the procedure and the post-operative consultation and therapy,'' Assoc Prof Paddle said.
"This also helps Speech Pathologists increase their valuable scoping skills which can then be translated into enhancing other aspects of private hospital inpatient care such as independent speech pathologist bedside nasendoscopic assessments for voice and swallow issues which affect approximately 1/3 of multi-day hospital inpatients at any point in time.''
