The ENT (Otorhinolaryngology) Department at Hygeia Hospital Tirana consists of a team of experienced Greek and Albanian ENT surgeons specializing in diagnosis and surgery for all ENT-related pathologies.
The ENT medical staff at Hygeia Hospital Tirana, highly trained and experienced, offers a wide range of services covering all types of ear, nose, and head-neck conditions—from simple diagnostic examinations to complex treatments and surgical interventions. For the most complex cases, the ENT team collaborates closely with other renowned specialists such as maxillofacial surgeons, plastic surgeons, neurosurgeons, etc., to provide optimal and effective care for our patients. It is also worth noting that anesthesia during surgical procedures is performed by anesthesiologists with extensive experience in head and neck surgery support.
For more information about this Department, we invite you to watch the video below:
The ENT surgical team covers the full range of otorhinolaryngology procedures, including ear surgeries such as:
- All types of tympanoplasties
- Treatment of cholesteatomas and all related complications
- Various congenital malformations (e.g., atresia of the external auditory canal, congenital cholesteatoma)
- Surgical correction of otosclerosis
Another specialized area within this Department is skull base surgery (e.g., acoustic neuromas, paragangliomas, apex neuromas, petrous bone cholesteatomas).
Otoneurosurgical Interventions
Our team performs the full range of functional nasal and sinus surgeries professionally. The operating rooms are equipped with all necessary tools for performing all types of FESS (Functional Endoscopic Sinus Surgery), treating anatomical issues, post-traumatic conditions, polyps, and both acute and chronic inflammations. Endoscopic treatment of tumors (benign or malignant of the nose and sinuses) is also successfully performed. Additionally, endoscopic treatment is applied for epistaxis, cerebrospinal fluid leaks (post-traumatic, postoperative, or idiopathic), and tear duct problems. In collaboration with relevant specialists, surgeries of the orbit, optic nerve decompression, and endoscopic treatment of pituitary adenomas or skull base masses are also performed under the field of Rhino-Neurosurgery.
In cases where endoscopic approaches are not viable, open nasal surgery is performed, such as in masses of the frontal, ethmoid, sphenoid, or maxillary sinuses, osteoplasties of the frontal sinuses, and maxillectomies. Midfacial degloving and other open nasal surgeries are reserved for specific cases.
The CO2 laser technique is widely used in the head and neck area, particularly for benign and malignant tumors of the larynx and hypopharynx. Today, laser technology allows us to remove tumors that once required total laryngectomy, now limiting total procedures to only very rare cases.
Our Department is also equipped with optical fiber lasers (YAG Laser and LISA Laser), used for partial or posterior cordectomy, partial laryngectomy, or surgeries involving the nose, tear ducts, tonsils, tongue, etc.
Our team has had outstanding results in managing head and neck tumors. These cases are handled alone or in collaboration with maxillofacial plastic surgeons for cosmetic and functional restoration in advanced-stage diseases. There is also close collaboration with oncologists, radiotherapists, and chemotherapy specialists for a higher success rate in managing tumors in the head and neck region.
Unilateral paralysis with hoarseness and aspiration is treated with thyroplasty, while bilateral paralysis is managed with posterior cordectomy using CO2 Laser. Patients undergoing this procedure are typically discharged the next day, with improved breathing and satisfactory voice quality.
Salivary gland surgery is also noteworthy. In cases of parotid masses, the facial nerve is carefully preserved using intraoperative nerve monitoring equipment.
Superficial Parotidectomy
With the aid of ultra-modern and fine endoscopes, we can examine the parotid glands for both diagnostic and therapeutic purposes (e.g., removal of salivary stones).
Dr. Holta Sulaj, ENT specialist at Hygeia Hospital Tirana, provides information about obstructive sleep apnea syndrome (OSA), its symptoms, and the procedures offered by Hygeia Hospital for effective diagnosis and treatment, as well as the consequences of untreated OSA.
What is obstructive sleep apnea syndrome (OSA)?
Sleep apnea is a sleep disorder characterized by brief interruptions of breathing during sleep, affecting both men and women of all ages. The term “apnea” comes from Greek, meaning “cessation of breath.” There are two types: the more common obstructive sleep apnea syndrome and the less common central sleep apnea syndrome.
Obstructive Sleep Apnea
This occurs when the upper airways become blocked during sleep. Typically, soft tissues at the back of the throat collapse, narrowing airflow (hypopnea) or completely blocking it (apnea). The body senses the lack of oxygen, causing the person to wake up to resume breathing. This cycle repeats frequently throughout the night (sometimes 50–100 times per hour), disrupting sleep and leaving the person tired and sleepy during the day.
Snoring
During snoring, the muscles of the tongue and soft palate relax, narrowing the airway and making breathing difficult.
Normal Sleep
In normal sleep, upper airways remain open, and the tongue and soft palate muscles maintain their tone.
Apnea
If the muscles relax fully, the airway becomes blocked, stopping breathing.
Central Apnea
This rarer form occurs when the brain fails to send signals to the respiratory muscles. Unlike obstructive apnea, there is no airway blockage; the cause is neurological, often linked to strokes or heart failure.
Who is at risk?
People at risk include:
- Overweight individuals
- Frequent snorers
- Those with high blood pressure
- Those with arrhythmias
- People with a family history of snoring or sleep apnea
- Those with narrowed airways (e.g., large tongue, recessed chin, underdeveloped jaw, enlarged tonsils, or soft palate)
Also at risk are people with diabetes, hypothyroidism, or acromegaly.
Factors that worsen snoring or apnea:
- Sleeping on the back
- Alcohol consumption in the evening
- Use of sedatives, narcotics, or painkillers before bed
How common is sleep apnea?
OSA affects 5–10% of the population. Most people at risk go undiagnosed. Many are unaware they snore or experience apnea and simply assume their daytime fatigue is normal. Fortunately, OSA is identifiable and treatable.
Signs and Symptoms:
Upon waking:
- Dry mouth
- Fatigue
- Morning headache
During the day:
- Lack of energy
- Irritability and mood changes
- Drowsiness
- Reduced sexual desire
- Difficulty concentrating and memory loss
At night:
- Frequent urination
- Choking sensation
- Loud snoring and noisy breathing (noticed by others)
- Restless sleep
- Night sweats
Physical signs:
- Neck circumference >43 cm in men and >38 cm in women
- High blood pressure, often higher in the morning
- Leg edema
Diagnosis:
If you suspect OSA, consult your ENT specialist for a sleep study. Diagnosis is made through a simple hospital test.
Severity:
Measured by the Apnea-Hypopnea Index (AHI)—the number of apnea or hypopnea episodes per hour:
- AHI 5–15: Mild OSA
- AHI 15–30: Moderate OSA
- AHI >30: Severe OSA
For example, an AHI >50 means you stop breathing over 50 times an hour, preventing restful sleep and stressing your cardiovascular system.
Treatment:
The most common treatment is CPAP (Continuous Positive Airway Pressure). Other options include oral appliances, surgery, positional therapy, reduced alcohol and sedative use, and weight management.
Surgical treatments include nasal, oropharyngeal, and laryngeal procedures, maxillary and mandibular advancement, bariatric surgery, or hypoglossal nerve stimulation (under research).
Benefits of treatment:
- Reduced daytime sleepiness
- Improved quality of life
- Better work performance
- Improved cognitive function
- Reduced anxiety and depression
- Fewer car accidents
- Better blood pressure control
- Lower blood sugar levels in type 2 diabetics
- Reduced cardiac stress
- Lower stroke risk
- Reduced risk of sudden death
Untreated OSA risks:
- Daytime sleepiness
- High blood pressure
- Heart disease
- Stroke
- Sudden death
- Tenfold increased risk of car accidents
- Workplace accidents
- Poor quality of life
- Cognitive impairment
- Type 2 diabetes
- Sexual dysfunction
- Pregnancy complications
- Children: developmental delay, behavior issues, and poor academic performance
In conclusion, OSA is a serious but treatable condition. Early diagnosis and effective treatment improve quality of life, reduce health risks, and benefit society by lowering accident and healthcare costs.
More about Apnea: