Outpatient Procedures And Tests Within Appointment
This page has been created to provide information only relating to procedures and tests you may undergo during your outpatient visit at either One Ashford hospital, KIMS Hospital, Maidstone or Spencer Private Hospitals. The clinical codes are useful for insured patients as you may need to let your insurance company know the procedure code prior to your appointment.
Ear microsuction, aural toilet and removal of foreign bodies from the ear canal
Clinical code: D0702
This procedure involves a microscope and a small suction device to remove wax, pus (if you have an infection) or debris (after an infection has been treated) from the ear canal. Occasionally if we are not able to remove it with the suction device because it is too hard or impacted, we will need to use small instruments such as graspers or hooks to remove the material or object within the ear canal. It is not painful, but it can be uncomfortable due to the noise of the suction device or some gentle pressure on the ear canal. Very occasionally, the procedure can cause trauma to the ear canal which can lead to some bleeding – and this will feel a little uncomfortable. Usually this settles down quickly and has no lasting effects.
Clinical code: E0380
Nasal cautery is used to treat nose bleeds. The procedure treats the area within the nose where the bleeding originates from. Nose bleeds can come from a specific point or from prominent vessels which split and bleed. Using a headlight or a microscope and speculum to visualise the front part of the nose, we apply silver nitrate on the tip of a small stick to the area. It can sting at the time and make your eyes water, but it is not usually painful. Occasionally, you may suffer with small nose bleeds over a few weeks following nasal cautery but these are usually very mild and can be managed with simple pressure. The whole procedure takes between 30 seconds to a minute or two and is a very effective treatment for new nose bleeds. We commonly prescribe a cream to apply to the area to help it heal and keep it clean following nasal cautery. Please do let us know if you have a peanut allergy as the cream contains peanut oil.
Fibreoptic nasal endoscopy and laryngoscopy
Clinical Code: E2500 or E2501
Nasal endoscopy is used to inspect the nose, throat and voice box. It is an important diagnostic tool to assess the nose and throat and helps diagnose conditions such as sinusitis, nasal polyps, voice and swallowing problems and cancers. We use video scopes and can show you anything that we find on a screen in the clinic. The procedure takes between 30 seconds to one minute. It is a little uncomfortable and can make your eyes water but is very manageable as the camera is only around 3 millimetres in size. Should you really struggle with the camera or are anxious about it, we can apply local anaesthetic to the nose, however this is often more unpleasant than the actual procedure itself.
Intra-tympanic steroid injection
Clinical Code: D2070
Steroids can be given through the ear drum for specific conditions (such as sudden hearing loss and balance disturbance). We will apply numbing cream to the ear drum before removing it prior to the injection. The cream is left in place for around 30 minutes to allow it to work. We then inject around 1 millilitre of steroid behind the ear drum which is around 40 milligrams of steroid (our preferred steroid is methyl prednisolone). Very occasionally, you can taste the steroid at the back of your throat as it can escape through a tube in your ear which connects to the back of your nose (the eustachian tube). Very rarely, you can develop an infection after the injection. However this is a very safe procedure and an excellent treatment.
Pure Tone Audiogram
Clinical Code: 20210
A Pure Tone Audiogram (PTA) is performed by an Audiologist in a soundproof booth. They will place headphones over your ears and play sounds at various frequencies and volumes to assess your hearing. When you hear the sound in your ear you should press a button to register that you have heard it. These appointments are usually arranged in between your initial appointment and your follow up appointment. We will send a referral to the Audiologist who will arrange the appointment date with you. The Audiologist will go through the results with you at your appointment and depending on the outcome, they may suggest additional testing.
Clinical Code: AUD0016
This is used to assess the ear drum compliance (how much the ear drum moves). It helps assess if the ear drum is scarred and gives an idea of the pressures in the ear (helping diagnose fluid behind the ear drum or eustachian tube dysfunction). It will also assess whether there is a hole in the ear drum (a perforation) and how well the bones behind the ear drum are conducting the sound to the nerve of hearing. Tympanometry is performed by placing a small probe in the external ear canal (this looks like an ear plug) which creates an airtight seal. The probe then emits sounds and changes the pressure between the sensor and the ear drum to assess the ear compliance by testing how much sound is absorbed by the ear drum at different pressures. It is completely painless, takes only a few minutes and can be essential for helping to diagnose certain conditions.