KGH pioneers ENT procedures under local anaesthetic

Kettering General Hospital is pioneering new ways of doing some ear, nose, and throat (ENT) procedures under local anaesthetic enabling more patients to benefit from them.

The new procedures will support patients with underlying conditions that make general anaesthetics more dangerous as well as enabling more procedures to be done in a quicker and easier way reducing waiting lists and saving money on inpatient stays.

The four procedures now being done under local anaesthetic by experienced ENT Consultant Mr Rohan Bidaye are:

· Injections to the voice box – For people whose vocal cords are partially paralysed meaning they have a permanent croaking ‘lost voice’. The injection material ‘plumps up’ or makes fuller the vocal cords and improves closure of the glottis (the opening between the vocal cords), giving a stronger voice. There are variety of injection materials available, such as steroids and botox, which are also used for other conditions.

· Biopsies – The removal of tissue from the back of the nose or tongue to check for potential cancers.

• Laser papilloma removal – Where wart-like tumours grow on a person’s larynx or vocal cords affecting their voice. Lasers are used to remove them with precision reducing damage to the surrounding tissue. In severe cases the surgeon injects bevacizumab which is latest treatment available only in a handful of centres across UK.
• Balloon dilation of the oesophagus - For stricturesof the throat which mean people really struggle to eat and drink and swallow. An endoscope is used to guide a balloon which is inflated in the area opening it up. Sometimes several procedures are needed to improve the condition.

The hospital has now completed its first 100 procedures and patients who have had them under local anaesthetic have been positive about both the procedure and outcome.

Mr Bidaye said: “We are the first hospital in Northamptonshire, and one of only a few in the UK, to offer these procedures under local anaesthetic.

“Patients undergoing these procedures no longer require hospital admission or extended inpatient stays, significantly mitigating the risks associated with general anaesthesia.

“With streamlined procedures often completed in as little as half an hour, patients can return home within an hour post-procedure, experiencing shorter recovery times and enhanced overall well-being.

“The reduction in bed days saves the hospital a lot of money and because the procedure takes less time we can do more of them in a day – which will help us to address waiting times and waiting lists for these kind of procedures.

"I am immensely proud of our team's dedication and expertise. By offering this wide array of procedures under local anaesthetic, we are setting a new standard of care, prioritizing patient safety and comfort.”

Because KGH and NGH work as an NHS Group across Northamptonshire – and because our ENT departments are integrated and work together - it means that patients from across the county are able to have the procedures this way if they are suitable for it.

The use of local anaesthetic also fits the direction of travel the NHS is heading in under the programme called ‘Getting it Right First Time’.

Patients say care was quick and supportive

Patients say having their procedures under local anaesthetic is quick and enables them to go home right away.

Dianne McKendrick, 60, from Kettering, also has vocal cord paralysis and has now had the injection filler procedure. She said: “The procedure did not take long and was much less involved than having a general anaesthetic. My voice started to improve and about three to five weeks after the operation it was back to normal. It is amazing.”

Kalvin Lodder, 49, from Orlingbury, had a laser papilloma removal from his larynx. He said: “I have actually had six procedures to remove the papilloma but it keeps coming back. The first three were under general anaesthetic and the last three have been under local anaesthetic.

“It is much quicker and less fuss to have it done under local anaesthetic. I am teacher at a school in Bedford so I really need my voice and it is improving now after the procedure. I just had a little discomfort for the first two weeks but that has now gone. The next step will be to have some monthly injections to prevent them from forming again.”