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ENT Doctor (Otolaryngologist)

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ENT Doctor (Otolaryngologist)

Evangelos K. MRCS MSc

Professional experience in England
• Ear, Nose and Throat Consultant Surgeon at Royal Cornwall Teaching Hospital (2016 – 2019)
• Ear, Nose and Throat Consultant Surgeon at Royal Stoke University Hospital (2014 – 2016)
• ENT Specialist (Ear, Nose and Throat Specialist) at Queen Elizabeth Hospital King’s Lynn (2013 – 2014)

Professional experience in Greece
• ENT surgeon in the private practice / endoscopic and audiological laboratory (2002 – 2013)
• ENT Surgeon for adults and children at MITERA Private Hospital in Maroussi (2002 – 2013)
• ENT Surgeon at the General Clinic of Dodecanese Euromedica (2006 – 2013)

Postgraduate studies
• Degree in membership of the Royal College of Surgeons of England (final exams 1998)
(Member of the Royal College of Surgeons of England) (MRCS)
• Master of Hearing & Balance Medicine from the University of Manchester (final exams 2001)
(MSc in Audiological Medicine for Hearing and Balance Disorders)

Specialisation
Specialty in Otolaryngology from 1995 to 2001 in the following hospitals in England:
• Colchester General Teaching Hospital
• Queen Elizabeth University Hospital (Birmingham)
• Birmingham Heartlands Teaching Hospital
• New Cross Teaching Hospital (Wolverhampton)
• Royal Devon and Exeter University Hospital

Retraining
• Advanced ENT Emergencies Masterclass 2018 – Doncaster Royal Infirmary
• ENT Radiology Masterclass 2018 – Doncaster Royal Infirmary
• Thyroid and salivary gland Masterclass 2018 – Doncaster Royal Infirmary
• ENT Consultant Masterclass 2018 – Charing Cross University Hospital London
• Clinical Update for Doctors 2017 – University Hospital of Coventry & Warwickshire
• The National Health System: structure, decision making and your service – Open University (England)
• Developing yourself for clinical leadership – Open University (England)
• Thyroid and salivary gland Masterclass 2017 – Doncaster Royal Infirmary
• ENT Radiology Masterclass 2017 – Doncaster Royal Infirmary
• Keele Foundation Leadership Program for Clinicians – Keele University
• Midlands Laryngeal Surgery Course – Royal Derby University Hospital
• Functional Endoscopic Sinus Surgery Course – Royal National Throat Nose and Ear University Hospital, London
• Endoscopic Sinus Anatomy Course – The Royal College of Surgeons of England, London
• Surgical Anatomy of the Head and Neck Course – The Royal College of Surgeons of England, London
• Glasgow Temporal Bone Course – Stirling Royal Infirmary
• Revision Course for the MRCS exams – University Hospital of Liverpool
• Care of the Critically Ill Surgical Patient Course (CCRISP) – The Royal College of Surgeons of England, London
• Basic Surgical Skills Course – Norfolk and Norwich University Hospital
• MRCS Learning Course – The Royal College of Surgeons of England, London
• Advanced Trauma Life Support (ATLS) – Lister Hospital Peterborough
• Ionizing Radiation Core of Knowledge Course – Colchester General Hospital
• Advanced Cardiac Life Support (ACLS) – Colchester General Hospital
• Diving and Hyperbaric Medicine – Athens Naval Hospital – Underwater Disaster Unit

Research
• Dyslexia and disturbance of the central processing of hearing
(MSc thesis – MSc in Audiological Medicine, University of Manchester)

Teaching students and trainees
• School of Medicine, University of East Anglia (Norwich)
Keele University School of Medicine
• Medical School of the University of Exeter
• University of Plymouth Medical School (Penninsula Medical School)

Secondary education
Excellent graduate of the 2nd Lyceum of Rhodes with a grade of 19.9
National exams
First in Medicine of Thessaloniki in 1985 with 1970 points in the Panhellenic exams
University studies
Graduate of Medical Thessaloniki in 1991 with a grade of 8.4
Military service
Navy 1992 – 1994 (Naval Hospital of Crete)
Rural doctor’s office
Apollo of Rhodes, 1991 – 1992

Foreign Languages
• English (Cambridge University Certificate of Proficiency, grade A)
• French (Certificat de Langue Francaise)
• Spanish

Clinic Equipment

• OPMI surgical microscope video from ZEISS Germany (leading optical company)
• Flexible nasopharyngeal endoscope of STORZ Germany (the world’s leading company for endoscopic equipment)
• Rigid rhinoscope and otoscope 0 degrees STORZ Germany
Rigid rhinoscope and otoscope 30 degrees STORZ Germany
• Cold light sources 150 and 250W STORZ Germany
• Suction Unimat 12 STORZ Germany
• Endovision XL STORZ endoscopic camera from Germany
• Bipolar and monopolar diathermy Autocon 50 STORZ Germany
• Nose and palate radiofrequency device (for the treatment of snoring) Celon OLYMPUS Japan
• Laboratory of provocative dynamics, audiovisual emissions and videography of INTERACOUSTICS Denmark (one of the leading companies in ultrasound and balance system testing machines)
• Unit for measuring audiovisual emissions for newborns, infants and children Alpha OAE + MADSEN Denmark
• INTERACOUSTICS Danish audiometer
• German MAICO drum meter
• Hot and cold air device for HOMOTH videogynogram Germany
• Oven TAU 2000 Italy
• Surgical instruments STORZ & EXPLORENT Germany

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Service Pricelist
NamePrice
Initial consultation70 €
Follow up consultation40 €
Aural toilet 50 €
Endoscopy (nose, pharynx, larynx)50 €
Audiometry50 €
Tympanometry 30 €
Otoacoustic emissions 80 €
Epley manoeuvre50 €
Myringotomy and grommet insertion 300 €
Biopsy of skin lesions 300 €
Biopsy of mucosal lesions (mouth, throat, nose)300 €
Salivary stone removal 300 €
Nasal cautery for nasal bleeding 200 €
Nasal bipolar diathermy for nasal bleeding 200 €
Excision biopsy of skin lesions600 €
Myringotomy and grommet insertion 600 €
Excision of auricular lesions800 €
Tympanoplasty 1500 €
Tonsillectomy 1000 €
Microlaryngoscopy and excision of a laryngeal (vocal cord) lesion1200 €
Septoplasty1000 €
Septoplasty and turbinate reduction (radiofrequency)1400 €
Turbinate reduction800 €
Excision of thyroglossal cyst1800 €
Excision of small superficial neck lump (except parotid)1000 €
Excision of preauricular sinus1500 €
Service Terms

The following paragraphs refer to the ENT surgeries performed by the doctor in two hospitals.

 

-> Correction (straightening) of the nasal septum

It is performed under general anesthesia and aims to straighten the partition (the diaphragm) between the left and right airways of the nose. This improves airflow and the ability to breathe through the nose. The whole operation is performed endoscopically without incisions and does not cause any bruising or swelling externally.

-> Tonsillectomy

Tonsillectomy is performed in a very delicate and careful way to minimize postoperative pain. Using low-power bipolar diathermy or coblation device, the operation is essentially bloodless. The operation is always performed under general anesthesia.

-> Adenoidectomy (meatballs)

The removal is almost bloodless with the method of suction diathermy adenoidectomy. There is no significant postoperative pain. General anesthesia is needed.

-> Installation of ventilation tubes in the drums (tubes)

With a brief general anesthesia in children or under local anesthesia (in adults) a tiny tube is applied to each eardrum. This treats severe cases of hearing loss due to fluid in the ears as well as cases of frequent severe acute otitis.

-> Rhinoplasty

Its purpose is to improve the external shape (appearance) of the nose while maintaining or improving the ability to breathe. It is performed under general anesthesia and in collaboration with an experienced, trained and competent plastic surgeon.

-> Reduction of the lower nasal passages with radio frequencies

Aims at the internal widening of the nasal airways resulting in improved respiration. It is done under general or local anesthesia.

-> Endoscopic polypectomy and functional endoscopic sinus surgery (FESS)

Endoscopically (without incisions) and under general anesthesia, the polyps are removed from the nose to restore the ability to breathe. At the same time, the openings of the sinuses are enlarged in order to treat sinusitis (sinusitis, ethmoiditis, frontal sinusitis and sphenoiditis) which is the cause of the formation of polyps. This significantly reduces the chances of polyps re-forming.

-> Treatment of nosebleeds with bipolar diathermy

By applying thermal energy under local or general anesthesia, fragile or swollen arteries or veins that cause nosebleeds (nosebleeds) are treated. It is the best method for the vast majority of cases.

-> Tympanoplasty

A hole is drilled (drilled) in the eardrum with an implant taken from the back of the ear with a small incision. The goal is to improve hearing and reduce the chance of infection (otitis). It is done under general or local anesthesia.

-> Microlaryngoscopy and removal / biopsy of laryngeal lesion

Using a powerful microscope and general anesthesia, the vocal cords are examined at high magnification to show any abnormalities in their shape and texture. Lesions such as polyps, cysts, etc., are carefully removed, using LASER or special micro-tools.

-> Endoscopic ligation of the wedge artery

A tiny metal clip is placed around one of the largest arteries in the back of the nose. It is done endoscopically (without incisions) under general anesthesia and aims to reduce blood flow inside the nose. This treats some rare severe cases of nosebleeds (nosebleeds).

-> Endoscopic biopsy of the nose and / or nasopharynx

With an endoscopic approach (without incisions), small samples (the size of a grain of rice) are taken from areas of the nose or upper part of the pharynx, under general or local anesthesia. These are sent to special laboratories to examine cells with special colors under a microscope. The method is recommended in rare cases where the diagnosis can not be made with the usual examination.

-> Reduction of a displaced fracture of the nasal bones

With special manipulations and under general or local anesthesia, the shape of the nose is restored when after a fracture (fracture) a deformity has been created. No incisions are made.

-> Nasal septal hematoma drainage

The blood that has accumulated under the membrane (mucosa) of the middle part of the nose is removed with a small internal incision under general or local anesthesia. This is necessary to do urgently in some cases of injuries, because otherwise the nose can collapse and become like a horse saddle (equestrian nose).

-> Posterior nasal cap

Under general anesthesia, special gauze is placed on the back of the nose to stop difficult (persistent, dangerous) cases of bleeding.

-> Wedge resection of the ear flap

A triangular area is removed from the rim of the fin and sewn in such a way as to maintain the shape of the ear. It is the best method to remove diseased areas from the fin without spoiling the normal convex shape of the fin. It is done under general or local anesthesia.

-> Rigid endoscopy of the larynx, pharynx or esophagus (direct scan)

Under general anesthesia, an examination is performed and lesions or foreign bodies are removed that cannot be treated with the usual method of flexible endoscopy.

-> Dilation of the esophagus

During rigid esophagoscopy (with general anesthesia) special methods are used to dilate narrow points of the esophagus to facilitate swallowing.

-> Drainage of parapharyngeal or periampical abscess

The operation is performed either under local anesthesia (painless) or under general anesthesia. Removing the infectious fluid prevents serious complications that could occur locally and in neighboring areas and facilitates a speedy recovery.

-> Excision of submandibular salivary gland

With general anesthesia and a small incision, the diseased gland is removed. The incision is made along the skin tension lines so that the postoperative scar is barely visible.

-> Cervical lymph node resection

Under general or local anesthesia, the enlarged gland is removed and sent to a pathology laboratory to determine the cause of the enlargement.

-> Thyrocystic resection (Sistrunk)

The cyst is removed with a small horizontal incision (under general anesthesia). At the same time, a small piece of bone is removed (a small bone that serves to connect the muscles of the neck), which minimizes the chances of recurrence.

-> Grape-palate-pharyngoplasty

Under general anesthesia, the tonsils, the grape and a small part of the palate are removed. In this way, severe snoring is treated in selected patients. There are many cases of snoring that are not suitable for surgical treatment and need different treatment (eg weight loss, use of CPAP mask, etc.).

-> Endoscopic pharyngeal diversion stapling

With general anesthesia, the partition between the diverticulum and the esophagus is cut so that food retention and difficulty in swallowing do not occur.

-> Tracheostomy

It is indicated when there is a progressive or abrupt blockage of breathing at the height of the pharynx or larynx so severe that it threatens the life itself. Local or general anesthesia creates an opening in the central airway of the body (trachea) in which a tube is placed that allows breathing and facilitates aspiration. Most often, when after days or weeks the disease that caused the initial difficulty in breathing is cured and the patient’s condition improves, an adhesive bandage is placed on the opening. Thus healing occurs and the anatomy and function of the breath returns to normal.

Service Reviews

“Thank you very much for fixing the nose. 7 doctors on 3 continents – only you”

“… massive change and improvement … now I can sleep … thank you again …”

“… the hospital is very fortunate to have you in its team …

“… to thank you for your patience and understanding and for explaining everything in detail …”

“… thank you so much for the training and support …

“… it was perfect to have you in the ENT … patients love you …”

“… you will explain everything very well with great clarity and knowledge and with care …”

… the doctor made my daughter feel very at ease and explained everything he was going to do with her … “

“…mr. Katsogridakis is a credit to the NHS, his care is outstanding…”

“Fantastic with my daughter. Absolutely brilliant.”

During the appointment

Record:

Proper medicine is based entirely on an accurate and complete history, the receipt of which is the first thing to do during the visit. The doctor will want to know all the details about the patient’s problem as well as some basic information about general health, medication, family history etc.

 

 

Clinical examination:

The organs of the ENT system are examined in detail.

The ears are examined under a microscope. If cleaning is needed, it is done with suction or special tools with high magnification and completely painless.

The nose, pharynx and larynx are examined with the endoscope with a special no touch technique. This endoscopy is the easiest endoscopy that exists since it is completely painless and does not cause a tendency to vomit.

The throat glands are examined visually and by palpation. The whole examination is done calmly, with a lot of attention and fine movements, without causing pain.

 

 

Special tests:

Whenever appropriate, measurements of hearing and function of the Eustachian tubes are performed, measurement of otoacoustic emissions, audiometry with provoked potentials of the brainstem, videostigmography, Dix – Hallpike test for benign postural vertigo, etc. neurological examination.

There are cases where several of these tests are needed as there are others in which none are needed.

 

 

Discussion – Explanation:

The doctor informs the patient about the findings and conclusions of the assessment and discusses with him the next step. This can be an additional examination (eg radiological examination), the application of a treatment (eg medication, surgery, therapeutic movements), the re-examination after a while or just reassurance, if no health problem has been found.

No difficult medical terms are used in the discussion. With understandable language and with the help of technological visual aids (images, videos, models) the patient seeks to understand his state of health. So he can be involved in making the right decisions, especially when there are more than one option to follow up. The doctor explains the advantages and disadvantages of each case and guides the patient in the right decisions.

 

 

Basic principles of surgery:

Treatment sometimes requires surgery. Modern ENT surgery does not cause significant pain or discomfort, nor any significant blood loss. Often you do not even need to stay in the hospital. The basic principles include:

• The choice of method with the sole and absolute criterion of improving the patient’s health.
• Informing the patient about the operation but also about other methods of treatment.
• The correct preparation, with control of general health and application of preoperative treatment where needed.
• The existence of detailed knowledge of each method from practical seminars and trainings.
• The many years of experience of applying each method.
• The availability of modern materials and machinery that maximize safety and efficiency.
• The collaboration with a selected and experienced anesthesiologist
• The cooperation with competent, responsible, willing and pleasant staff of the operating room and ward.
• Carrying out the operation with care and fine handling.
• Proper postoperative monitoring.
• Giving clean, written instructions for recovery.
• The general support of the patient by the doctor in every possible way and definitely in the psychological field. Encouragement, reassurance and guidance are of paramount importance in getting the patient well without unnecessary stress and without fear.