Dr.Himanshu Thakkar

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Ear

You should never try to clean your ears. Your ear canal makes earwax to protect the ear.
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Nose

Nose is a 7 cm long narrow vertical tube containing three swellings on either side called turbinates.
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Throat

Early diagnosis of cancer is very important for the pre cancerous conditions in the oral cavity.
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Why ulcers in the throat should always be shown to ENT specialist?
Early diagnosis of cancer is very important for the pre cancerous conditions in the oral cavity. Many times ulcers in the throat are not seen easily and ENT specialists are well trained to do indirect Laryngoscopy to diagnose these lesions. Most of the times the ulcers are situated on the margins of the tongue and cheek mucosa  and are due to the sharp edges of broken carious tooth. In such a case rather than treating the ulcer, get the tooth extracted first. Otherwise the ulcer can turn into cancer with serious consequences. If you are in a habit of eating gutkha, pan or tobacco or if you are a smoker you should take care of oral hygiene. Any ulcer must be shown to an ENT specialist because chances of development of cancer are more in you.

What should I do if fishbone, chicken bone or coin etc. gets stuck in my throat or food pipe?
Take out the remaining food from your mouth immediately and try to avoid swallowing movements. If you do this within minutes the stuck object passes down the food passage. If the foreign body remains stuck do not attempt eating banana or dry roti. Do not drink water which you will not be able to do if anything is stuck in the food passage. Rush to ENT surgeon or Endoscopist, who will remove the foreign body under local or general anesthesia. If the procedure requires general anesthesia you should be on empty stomach for at least 5-6 hrs. If you take anything orally then surgery will be delayed. Risk of food pipe getting ruptured during the procedure is more if you delay the procedure. 

How to get rid of repeated throat problem?
Oral hygiene is very important. Brush your teeth twice daily so that bacterial count is low in your mouth. Take steam inhalations using plain water twice daily. While taking steam open your mouth and allow the steam to enter your mouth breathing through your nose at the same time. If you have carious teeth which harbor infection get them treated by your dentist. After eating ice cream take 2 sips of water immediately so that the hypothermia of the throat mucosa is reduced. This prevents throat infection after taking cold drink or ice cream. Ask your ENT specialist to look for bad tonsils and if necessary get them removed. If you have chronic irritation in the throat and you need to clear your throat every now and then you may be having a deviated nasal septum. Surgical correction of the deviated nasal septum may be the answer. Recurrent sinus infection can also cause postnasal drip and chronic Pharyngitis. If in such a situation tonsils are removed then Pharyngitis may worsen.

ADENOID SURGERY

What are the adenoids?
Adenoids are small glands in the throat, at the back of the nose. They are there to fight germs in younger children. We believe that after the age of about three years, the adenoids are no longer needed. Your body can still fight germs without your adenoids.

Why take them out?
We only take them out if they are doing more harm than good. Sometimes children have adenoids so big that they have a blocked nose, so that they have to breathe through their mouths. They snore at night. Some children even stop breathing for a few seconds while they are asleep. The adenoids can also cause ear problems by stopping the tube which joins your nose to your ear, from working properly. For children over three years of age, removing the adenoids at the same time as putting grommets in the ears seems to help stop the glue ear coming back. Removing the adenoids may also make colds that block the nose less of a problem for your child

What are the alternatives to having the adenoids removed?
Your adenoids get smaller as you grow older, so you may find that nose and ear problems get better with time. Surgery will make these problems get better more quickly, but it has a small risk. You should discuss with your surgeon whether to wait and see, or have surgery now. For some children, using a steroid nasal spray will help reduce congestion in the nose and adenoids, and may be helpful to try before deciding on surgery. Antibiotics are not helpful and only produce temporary relief from infected nasal discharge. They have side effects and may promote ‘super-bugs’ that are resistant to antibiotics

Other operations
If we are taking adenoids out because of ear problems, we may put in grommets at the same time. If your child has sore throats or stops breathing at night, we may also take their tonsils out at the same time.

Before the operation
Arrange for a week off school.

How is the operation done?
Your child will be asleep for the operation. We will take out the adenoids through his or her mouth, and then stop the bleeding before he or she is woken up.

How long will my child be in hospital?
In some hospitals, adenoid surgery is done as a day care, so that the child can go home on the same day as the operation. Some surgeons may prefer to keep children in hospital for one night. Either way, we will only let him or she goes home when he or she is eating and drinking and feels well enough. Most children need about a week off nursery or school.

Possible complications              
Adenoid surgery is very safe, but every operation has small risks.
The most serious problem is bleeding, which may need a second operation to stop it. However, bleeding after adenoidectomy is very uncommon. During the operation, there is a very small chance that we may chip or knock out a tooth, especially if it is loose, capped or crowned. Please let us know if your child has any teeth like this. Some children feel sick after the operation. This settles quickly. A small number of children find that their voice sounds different after the surgery. It may sound like they are talking through their nose a little. This usually settles by itself within a few weeks. The child’s nose may seem blocked up after the surgery, but it will clear by itself in a week or so.

Sore throat and ears
Your child’s throat may be a little sore after the operation. Prepare normal food. Eating food will help your child’s throat to heal. Chewing gum may also help the pain. Your child may have sore ears. This is normal. It happens because your throat and ears have the same nerves. It does not mean that your child has an ear infection.

Bleeding can be serious
If you see any bleeding from your child’s throat or nose, you must see a doctor. 

TONSILS:
                                                                                                          
What are tonsils?
Tonsils are small glands in the throat, one on each side. They are there to fight germs when you are a young child. After the age of about three years, the tonsils become less important in fighting germs and usually shrink. Your body can still fight germs without them. 

Why take them out?

We only take tonsils out if they are doing more harm than good. We will only take your child’s tonsils out if he or she is getting lots of sore throats, which are making him or her lose time from school. Sometimes small children have tonsils so big that they block their breathing at night. Tonsils are also taken out in case the child is suffering from repeated ear infection following cold.

Are there alternatives to having the tonsils removed?
Your child will not always need to have his or her tonsils out. You may want to just wait and see if the tonsil problem gets better by itself. Children often grow out of the problem over a year or so. The doctor should explain to you why he or she feels that surgery is the best treatment. Antibiotics may help for a while, but frequent doses of antibiotics can cause other problems. A low-dose antibiotic for a number of months may help to keep the infections away during an important period such as during examinations. The removal of enlarged tonsils like this can relieve the airway. 
Before your child’s operation arrange for your child to have a couple of weeks off school. Let us know if he or she has a sore throat or cold in the week before the operation - it will be safer to put it off for a few weeks. It is very important to tell us if your child has any unusual bleeding or bruising problems, or if this type of problem might run in the family
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How long will my child be in hospital?
In some hospitals, tonsil surgery is done as a day case, so that he or she can go home on the same day as the operation. Other hospitals may keep children in hospital for one night. It may depend on whether your child has their operation in the morning or the afternoon. 

Possible complications
Tonsil surgery is very safe, but every operation has a small risk. The most serious problem is bleeding. This may need a second operation to stop it.

Your child’s throat will be sore.  Your child’s throat will get better day-by-day. Give him or her painkillers regularly, half an hour after meals for the first few days. Do not give more than it says on the label.

Your child may have sore ears. This is normal. It happens because the throat and ears have the same nerves. It does not usually mean that your child has an ear infection. Your child’s throat will look white. This is normal while the throat heals. You may also see small threads in your child’s throat - sometimes these are used to help stop the bleeding during the operation, and they will fall out by themselves. Some children get a throat infection after surgery, usually if they have not been eating properly. If this happens you may notice a fever and a bad smell from your child’s throat. If this happens call your hospital for advice. Keep your child off school for 10 to 14 days. Make sure he or she rests at home away from crowds and smoky places. Keep him or her away from people with coughs and colds. 

Bleeding can be serious If you notice any bleeding from your child’s throat, you must see a doctor.