About ENT

Sentra provides the expertise of highly specialized ear, nose, and throat (ENT) physicians, audiologists, speech-language pathologists, and auxiliary healthcare professionals to provide clinical care for patients with problems affecting the ear, nose, throat, head, and neck areas.

As one of the largest otolaryngology–head and neck surgery departments, with the latest coblation technology for ENT procedures.

Ear Surgery 

Endoscopic Sinus Surgery 

Tonsil/ Adenoid Surgery 

Sleep Apnea Treatment 

Sleep Study 

Hearing Aids/ Audiometry

Pediatric ENT 

Vertigo Treatment 

Thyroid & Parathyroid Surgery 

Oral Cancer Screening & Treatment 

Speech & Swallowing Therapy 

Voice Surgery

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Ear Surgery

Ear Surgery (Otoplasty)

Ear surgery, also known as otoplasty, improves the shape, position and proportion of the ear. It can correct a birth defect of the ear structure.

Ear surgery, also known as otoplasty, can improve the shape, position or proportion of the ear. A defect in the ear structure that is present at birth or that becomes apparent with development can be corrected by otoplasty. This procedure can also treat misshapen ears caused by injury.

Otoplasty creates a more natural shape while bringing balance and proportion to the ears and face. Co9999rrection of even minor deformities can have profound benefits to appearance and self-esteem. If protruding or disfigured ears bother you or your child, you may consider plastic surgery.

What can ear surgery treat?

  • Overly large ears – a condition called macrotia
  • Protruding ears occurring on one or both sides in varying degrees – not associated
  • Hearing loss
  • Adult dissatisfaction with previous ear surgery
  •  

Who is a good candidate for ear surgery?

Children who are good candidates for ear surgery are:

  • Healthy, without a life-threatening illness or untreated chronic ear infections
  • Generally 5 years old, or when a child’s ear cartilage is stable enough for correction
  • Cooperative and follow instructions well
  • Able to communicate their feelings and do not voice objections when surgery is discussed

Endoscopic Sinus Surgery

Endoscopic sinus surgery is a surgical procedure used to remove blockages in the sinuses. These blockages can cause sinusitis, in which the sinus mucous membranes swell and become blocked, causing pain, drainage and impaired breathing.

Endoscopic sinus surgery is designed to improve the drainage of the sinuses and to improve airflow through the nose. Endoscopic sinus surgery goals include:

  • Reduction of the number and severity of sinus infections
  • Improvement in symptoms associated with sinusitis
  • Improvement of airflow through the nose
  • Improvement in a patient’s sense of smell

Endoscopic Sinus Surgery: What to Expect

Usually under general anesthesia, the surgeon will use an endoscope, a thin camera rod with a light at the end, to provide visualization and magnification of the sinus tissues. Specialized instruments can be used to safely and effectively remove causes of sinus blockage like natural blockages, nasal polyps and scar tissue.

Specialized instruments are also used to straighten the septum and reduce the size of the turbinates if required. Endoscopic sinus surgery does not involve cutting through the skin, as it is performed entirely through the nostrils. Therefore, most people can go home the same day.

Tonsil/ Adenoid Surgery 

An adenoidectomy is the removal of the adenoid, the lymphatic tissue that sits behind the nose. The tonsils and adenoids are sometime also removed as a treatment for sleep apnea.

A technique pediatric otolaryngologists (ENTs) may use for an adenoidectomy is coblation. Coblation uses gentle radiofrequency energy with a natural salt solution to quickly and safely remove tonsils and adenoids. We also use microdebriders, cautery devices, and traditional sharp instruments when appropriate to remove adenoids effectively with improved recovery and lessened operative risk.

Monitoring your child post-surgery

Most adenoidectomies are performed on an outpatient basis. For those children who are younger or very sick, the procedure will be performed and the child will be admitted to the hospital for observation. Parents can be assured that their children are getting the very best standard of care after these procedures.

Sleep Apnea Treatment

What is sleep apnea?

Sleep apnea is a serious, potentially life-threatening condition. It is far more common than previously thought. Sleep apnea happens in all age groups and both genders, although it is more common in men. It is estimated that as many as 18 million Americans have sleep apnea.

Sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep. There are two types of sleep apnea:

  • Central sleep apnea happens when the brain fails to send the appropriate signals to the muscles to start breathing. Central sleep apnea is less common than obstructive sleep apnea.
  • Obstructive sleep apnea happens when air can’t flow into or out of the nose or mouth although efforts to breathe continue.

Sleep apnea is characterized by a number of involuntary breathing pauses or “apneic events” during a single night’s sleep. There may be as many as 20 to 30 or more events per hour. These events are usually accompanied by snoring between apnea episodes. But, not everyone who snores has sleep apnea. Sleep apnea may also be characterized by choking sensations. The frequent interruptions of deep, restorative sleep often lead to early morning headaches and excessive daytime sleepiness.

During the apneic event, you can’t breathe in oxygen or exhale carbon dioxide. This results in low levels of oxygen and increased levels of carbon dioxide in the blood. This alerts the brain to resume breathing and cause an arousal. With each arousal, a signal is sent from the brain to the upper airway muscles to open the airway. Breathing is resumed, often with a loud snort or gasp. Frequent arousals, although necessary for breathing to restart, prevent restorative, deep sleep.

Early recognition and treatment of sleep apnea is important, as it may be associated with:

  • Irregular heartbeat
  • High blood pressure
  • Heart attack
  • Stroke
  • Daytime sleepiness
  • Increased risk of motor vehicle accidents

What are the causes of sleep apnea?

Certain mechanical and structural problems in the airway cause the interruptions in breathing during sleep. Apnea happens:

  • When the throat muscles and tongue relax during sleep and partially block the opening of the airway.
  • When the muscles of the soft palate at the base of the tongue and the uvula relax and sag, the airway becomes blocked, making breathing labored and noisy and even stopping it altogether.
  • In obese people when an excess amount of tissue in the airway causes it to be narrowed.
  • With a narrowed airway, the person continues his or her efforts to breathe, but air can’t easily flow into or out of the nose or mouth.

Who is at risk for sleep apnea?

Sleep apnea seems to run in some families, suggesting a possible genetic basis. People most likely to have or develop sleep apnea include those who:

  • Snore loudly
  • Are overweight
  • Have high blood pressure
  • Have some physical abnormality in the nose, throat, or other parts of the upper airway

Use of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea.

What are the symptoms of sleep apnea?

In either form of sleep apnea, your breathing pauses a number of times during sleep. These are called apneic events. There may be as many as 20 to 30 or more events per hour. Between events, you may snore. But, not everyone who snores has sleep apnea. Sleep apnea may also cause a choking sensation. When breathing starts, you may make a loud snort or gasp. These frequent breaks in deep, restorative sleep often lead to headaches and excessive daytime sleepiness.

Other symptoms include dry mouth or sore throat and problems paying attention.

How is sleep apnea diagnosed?

Diagnosis of sleep apnea is not simple because there can be many different causes. Primary healthcare providers, pulmonologists, neurologists, or other healthcare providers with specialty training in sleep disorders may be involved in making a diagnosis and starting treatment. Several tests are available for evaluating sleep apnea, including:

  • Polysomnography. This test records a variety of body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels.
  • Multiple Sleep Latency Test (MSLT). This test measures the speed of falling asleep. People without sleep problems usually take an average of 10 to 20 minutes to fall asleep. People who fall asleep in less than 5 minutes are likely to need some type of treatment for sleep disorders.

Diagnostic tests usually are done in a sleep center, but new technology may allow some sleep studies to be done in your home.

How is sleep apnea treated?

Specific treatment will be determined by your healthcare provider based on:

  • Your age, overall health, and medical history
  • Severity of the disease
  • Your tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Medicines are generally not effective in the treatment of sleep apnea. Therapy may include the following:

  • Giving oxygen may safely help some people, but does not end sleep apnea or prevent daytime sleepiness. Its role in the treatment of sleep apnea is controversial.
  • Behavioral changes are an important part of a treatment program, and in mild cases of sleep apnea, behavioral therapy may be all that is needed. You may be advised to:
    • Avoid the use of alcohol.
    • Avoid the use of tobacco.
    • Avoid the use of sleeping pills.
    • Lose weight if overweight (even a 10% weight loss can reduce the number of apneic events for most people).
    • Use pillows and other devices to help sleep in a side position.
  • Physical or mechanical therapy options are also available. Nasal continuous positive airway pressure (CPAP) is a device that is used nightly in which you wear a mask over the nose during sleep, and pressure from an air blower forces air through the nasal passages. Dental appliances that reposition the lower jaw and the tongue have been helpful to some people with mild sleep apnea, or who snore but do not have apnea.
  • Some people with sleep apnea may need surgery. Examples of these procedures include:
    • Surgical procedures to remove adenoids and tonsils, nasal polyps, or other growths or tissue in the airway, or to correct structural deformities may be done.
    • Uvulopalatopharyngoplasty (UPPP) is a procedure used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate).
    • Surgical reconstruction for deformities of the lower jaw may benefit some people.
    • Surgical procedures to treat obesity are sometimes recommended for a person with sleep apnea who is obese.

Key points about sleep apnea

Sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep. Sleep apnea is a serious, potentially life-threatening condition that is far more common than generally understood.

  • There are two types of sleep apnea:
    • Central sleep apnea
    • Obstructive sleep apnea
  • Sleep apnea seems to run in some families, suggesting a possible genetic basis.
  • Diagnosis of sleep apnea is not simple because there can be many different causes.
  • Medications are generally not effective in the treatment of sleep apnea.
  • Treatment may involve behavioral changes, weight loss, CPAP therapy and sometimes surgery.

Hearing Aids/ Audiometry

It’s simple: we want you to hear better. Keeping your hearing healthy allows you to stay engaged in your daily life. It’s an essential part of life, one that not only has an impact on you, but can also affect those around you. When there is a change in your hearing or the hearing of a loved one, it is our job to partner with you to find the right solution.

We use state-of-the-art tools and offer the full range of hearing devices. From our experience, we have selected the top brands of consumer hearing products (hearables), non-surgical medical devices (hearing aids), and surgical medical devices (bone anchored and cochlear/brainstem implants)—and will help you determine which will work best for you.

Pediatric ENT

In the Pediatric Airway, Voice, and Swallowing Center, we provide care for pediatric patients with congenital and/or acquired disorders of the aero-digestive tract that may affect their ability to eat, breathe, or speak. Our center is a multidisciplinary collaboration between Mass. Eye and Ear and the Mass General Hospital for Children, offering enhanced care to children by allowing them to see several specialists during one visit.

Under the direction of Christopher J. Hartnick, MD, MS, our center includes specially trained physicians, technicians, nurses, and speech-language pathologists. Our focal point is on the diagnosis and treatment of disorders affecting voice and breathing in infants and young children. These disorders can include, but are not limited to:

  • Chronic cough
  • Recurrent croup
  • Feeding difficulties
  • Sleep disorders
  • Breathing and swallowing difficulties

The causes of these disorders may be straightforward, but often require expertise from several specialties, including pediatric otolaryngology, gastroenterology, and pulmonology. Our team will work with you and your child to find the treatment plan that best suits your needs.

Vertigo Treatment

As one of the largest centers of its kind, we specialize in treating disorders that affect your thyroid and/or parathyroid glands. Thyroid disorders are common and can dramatically affect a person’s quality of life. We work closely with a team of fellowship-trained specialists to provide each patient with a plan of care that best fits their needs.

As one of the highest volume centers for thyroid and parathyroid surgery, our team led by 

Dr Rahul Modi, has extensive experience treating a variety of thyroid and parathyroid conditions. Your thyroid is a butterfly-shaped gland that sits at the base of the neck, while your parathyroid glands are four tiny neck glands that control calcium levels.

With a strong emphasis and commitment to surgical safety, we utilize intraoperative nerve monitoring in every surgery we perform. We have used intraoperative monitoring in more than 3,500 thyroid and parathyroid surgical cases to date, making us one of the most experienced in the world.

Seeing thyroid and parathyroid patients at five locations throughout New England, our team has the expertise and state-of-the-art technology to successfully treat the entire breadth of conditions related to these areas.

Oral Cancer Screening & Treatment 

Speech & Swallowing Therapy 

Voice Surgery 

Comprehensive Otolaryngology

Comprehensive otolaryngology is both a starting point and a destination for ear, nose, and throat patients. Many patients have their initial assessment and investigation with our general ear, nose, and throat specialists before potential referral to other specialists as needed to address specific problems and conditions.

Under the direction of Dr Rahul Modi, comprehensive otolaryngology concentrates on both surgical and non-surgical treatment of a wide variety of ear, nose, throat, head, and neck disorders, including:

  • Infections and lesions of the tonsils and adenoids
  • Problems in the mouth (oral lesions, taste/tongue/palate function, evaluation of disease related to tobacco use)
  • Throat and swallowing disorders
  • Voice box problems (vocal cord/larynx infections, voice disorders, breathing, coughing)
  • Neck lesions, nodules, cysts
  • Nose and sinus disorders (nasal congestion, facial/sinus pain, nasal discharge, bleeding, smell disorders)
  • Salivary gland disease (infections, stones, enlargement, pain, nodules, lesions, inflammatory disorders)
  • Thyroid and parathyroid disorders (masses, nodules, enlarged thyroid)
  • Snoring and obstructive sleep apnea

Facial Plastic and Reconstructive Surgery

Facial plastic and reconstructive surgery is performed to reshape structures in the head and neck including the nose, ears, chin, cheekbones, lips, hair and neckline. Success in this field depends on the skill, training, qualifications and experience of the medical team. Our team is comprised of some of the world’s finest facial plastic and dermatologic surgeons.

  • Aesthetic facial surgery, injectables, and other interventions specially designed to achieve your cosmetic goals.
  • Specialists in the surgical treatment of skin cancer.
  • Advanced nasal reshaping techniques that enable us to meet a full range of cosmetic and functional goals.
  • A unique multidisciplinary center dedicated to the treatment of facial movement disorders.
  • The treatment of congenital ear deformities, ranging in severity from a minimally deformed ear to the complete absence of an ear structure.
  • State-of-the-art lasers that are used to treat vascular birthmarks, cutaneous lesions, scars, and more.

Ear, Hearing, and Balance Disorders

If you or your child suffer from problems of the ear, hearing loss, or often feel dizzy and unsteady, we are here to help. With dedicated services in both hearing and balance, we offer the latest treatments and surgical techniques for such diagnoses.

Voice 

Experts in treating the voice box and upper airway, we are one of the few laryngology centers in the world. Laryngology focuses on the larynx (voice box), which is responsible for three central functions: voice, swallowing, and breathing. When troubles occur here, our team offers the most advanced therapies that not only treat the problem, but also preserve your voice.

Speech

The voice box (larynx) enables us to create sounds using air pressure from the lungs. When something goes wrong in the larynx or the nerves that control it, the voice can be adversely affected. Some of the warning signs of a serious voice disorder include:

  • Hoarseness (dysphonia) or voice loss
  • Breathing difficulties (stridor)
  • Easy voice fatigue 

Most voice problems stem from injury, nerve damage, cancer, or other growths in the body. With a team of specially trained physicians and speech-language pathologists, we are equipped to diagnose and treat the many causes of voice disorders.

If you or a loved one has experienced voice difficulties or sudden changes in voice, it is important to see a specialist to evaluate the problem. Depending on your symptoms and diagnosis, you may be seen by specialists in each of those areas throughout your visit.

Led by Dr Rahul Modi, the Voice and Speech Laboratory is here to help bring your voice back to proper function.