ENT Clinical Services & Diagnostics
Complete adult and paediatric ENT care, advanced outpatient surgical interventions, and on-site diagnostic testing suites at 109 Harley Street.
Ear, Hearing, Tinnitus & Balance Care
Led by clinic co-founder Mr Gerald Brookes and otologist Mr Azhar Shaida, our ear department provides rapid investigation and treatment for acute and chronic conditions of the outer, middle, and inner ear.
Key Symptoms & Conditions Treated
- • Hearing Loss: Triage of conductive loss (cerumen impaction, glue ear, otosclerosis) and sensorineural loss (presbyacusis, acoustic trauma, and sudden hearing loss emergencies).
- • Ear Pain (Otalgia) & Discharge: Diagnosis of acute otitis externa, middle ear infections, cholesteatoma, or referred otalgia from the temporomandibular joint (TMJ).
- • Tinnitus & Hyperacusis: Investigation of pulsatile tinnitus (vascular anomalies) and continuous subjective ringing, coordinated with tinnitus masking sound therapy.
- • Vertigo, Dizziness & Imbalance: Diagnosis of Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuronitis, labyrinthitis, Ménière’s disease, vestibular migraine, and Mal de Débarquement Syndrome (MdDS).
Specialist Ear Procedures
Safe water-free removal under high-magnification binocular operating microscopes.
Outpatient ventilation tube insertion under local anaesthetic for persistent glue ear.
Dexamethasone steroid rescue for sudden hearing loss or gentamicin for disabling Ménière’s.
Instantaneous physical canalith repositioning for benign positional vertigo (BPPV).
Harley Hearing Centre On-Site
Our affiliated hearing centre provides pure digital hearing aid fittings (receiver-in-canal, completely-in-canal, Bluetooth-enabled) with trial return privileges and custom hearing protection for musicians and swimmers.
Nose, Sinus, Rhinoplasty & Sleep Surgery
Supervised by co-founder Mrs Natalie Brookes, our rhinology service integrates high-definition flexible nasendoscopy, allergy diagnostics, and advanced endoscopic sinus surgery.
Pathologies & Structural Airway Conditions
- • Chronic Rhinosinusitis & Facial Pain: Comprehensive medical regimes and Functional Endoscopic Sinus Surgery (FESS) for recalcitrant sinus inflammation.
- • Nasal Polyps & Congestion: Medical management with intranasal corticosteroids and microdebrider polypectomy to restore nasal airflow.
- • Deviated Nasal Septum: Surgical septoplasty to straighten obstructed cartilage and bone without external alteration.
- • Loss of Smell (Anosmia / Hyposmia): Quantitative olfactory assessment differentiating sinonasal blockage from post-viral nerve injury.
- • Nosebleeds (Epistaxis): Immediate silver nitrate chemical cautery or bipolar electrocautery under local anaesthetic.
- • Snoring & Sleep Apnoea: Upper airway evaluation, turbinoplasty, and referral for sleep studies (polysomnography) or CPAP titration.
Rhinoplasty Excellence (Functional & Cosmetic)
Mrs Natalie Brookes performs open and closed rhinoplasty, preservation rhinoplasty, and complex tertiary revision rhinoplasty. Every aesthetic modification is planned with functional airway preservation to guarantee uncompromised nasal breathing.
Rhinoplasty FAQ Snapshot
Setting: Day-case or overnight private hospital stay under general anaesthesia.
Recovery: External splint removed at 7–10 days; bruising resolves in 14 days; subtle tip refinement continues over 12 months.
Airway Impact: Procedures are designed to expand the internal nasal valve and prevent secondary airway collapse.
Throat, Vocal Cord & Swallowing Disorders
Our laryngology team, featuring Mr Nick Hamilton and speech therapist Gary Wood, delivers multidisciplinary care for voice loss, chronic cough, acid reflux, and swallowing impairment.
Clinical Focus Areas
- • Hoarseness (Dysphonia): Mandatory video laryngostroboscopy for hoarseness persisting >3 weeks to evaluate vocal nodules, polyps, cysts, and rule out malignancy.
- • Silent Acid Reflux (LPR): Laryngopharyngeal reflux where gastric pepsin irritates the arytenoid cartilages, causing throat clearing, globus sensation, and cough.
- • Chronic Refractory Cough: Detailed investigation for neurogenic cough, post-nasal drip, and cough-variant asthma.
- • Swallowing Difficulty (Dysphagia): Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to identify cricopharyngeal spasm, pharyngeal pouches, and neurological transit delays.
- • Spasmodic Dysphonia: Intralaryngeal botulinum toxin injection directly into laryngeal muscles under electromyographic (EMG) guidance.
Specialist Voice Therapy with Gary Wood
Dedicated vocal coaching, singer rehabilitation, resonance enhancement, and dysphagia retraining available in partnership with speech therapist Gary Wood.
Head & Neck Surgery, Neck Masses & Thyroid
Led by Consultant Head & Neck Surgeon Mr Alasdair Mace, our department provides rapid evaluation, ultrasound imaging, fine-needle biopsies, and definitive surgical care for adult neck lumps.
Pathologies Investigated
- • Adult Neck Masses: Rapid triage for unexplained, firm, or persistent lumps persisting >3 weeks to exclude malignancy.
- • Salivary Gland Pathology: Parotid and submandibular gland enlargement, pleomorphic adenomas, salivary stones (sialolithiasis), and dry mouth syndromes.
- • Thyroid Nodules & Goitres: Evaluation of solitary nodules and multinodular goitres with ultrasound-guided Fine Needle Aspiration (FNA).
- • Facial Nerve Weakness: Evaluation of Bell’s palsy, Ramsay Hunt syndrome, and botulinum toxin for facial synkinesis.
- • Cutaneous Head & Neck Lesions: Outpatient punch and excisional biopsies under local anaesthetic for facial moles and skin cancers.
The 3-Week Rule for Adult Neck Lumps
Clinical guidelines dictate that any solitary neck swelling persisting over 3 weeks in an adult should receive urgent ultrasound and fine-needle cytology rather than empirical antibiotic delays.
Specialist On-Site Diagnostic Testing Suite
Objective evaluations performed in-house at 109 Harley Street for immediate diagnostic answers.
| Diagnostic Modality | Purpose & Indications | Procedure Details | Duration & Preparation |
|---|---|---|---|
| Pure Tone Audiometry (PTA) | Measures hearing thresholds across 250 Hz to 8000 Hz. Identifies conductive vs sensorineural loss. | Patient seated in an acoustically isolated soundproof booth with air and bone conduction transducers. | 20 minutes. No special preparation. |
| Tympanometry & Acoustic Reflexes | Assesses middle ear pressure, eardrum compliance, Eustachian tube function, and ossicular chain mobility. | Soft pneumatic probe inserted into the ear canal modulating pressure from +200 to -400 daPa with 226 Hz tone. | 5 minutes. Safe and painless. |
| Videonystagmography (VNG) | Distinguishes peripheral inner ear vestibular disease from central brainstem/cerebellar pathology. | Infrared goggle-mounted high-speed cameras record eye movements during smooth pursuit, saccades, and optokinetics. | 20–30 minutes. Avoid balance suppressants for 48 hrs. |
| Bithermal Caloric Irrigation | Quantifies unilateral lateral semicircular canal weakness in Ménière's disease and vestibular neuritis. | Warm (44°C) and cool (30°C) water introduced into the external canal to generate convection currents and nystagmus. | 30–45 minutes. No heavy meals beforehand. |
| Vestibular Evoked Myogenic Potentials (VEMP) | Evaluates saccule (cVEMP) and utricle (oVEMP) otolith organs and superior canal dehiscence (SSCD). | Acoustic tone bursts trigger reflex electrophysiological responses measured via surface muscle electrodes. | 25 minutes. Comfortable clothing. |
| Fiberoptic Nasendoscopy & Laryngostroboscopy | Visualises nasal cavity, sinuses, adenoids, pharynx, vocal cord mucosal wave motion, and larynx. | Chip-on-the-tip flexible or rigid endoscope introduced following topical anaesthetic Cophenylcaine spray. | Under 5 minutes. Instant video review. |
| Nurse-Led Allergy Skin Prick Panel | Identifies aeroallergens (dust mites, tree/grass pollen, moulds, cat and dog dander). | Forearm gridded with allergen drops and pricked with sterile lancets. Wheal-and-flare read at 15 minutes. | 20 minutes. Stop antihistamines for ≥48 hrs. |
| Fine Needle Aspiration (FNA) & Biopsy | Cytological analysis of thyroid nodules, neck lumps, and salivary lesions to exclude malignancy. | Ultrasound guidance directs a narrow needle into the lesion for cellular sample aspiration under local anaesthetic. | 15 minutes. Rapid laboratory processing. |
Consultation & Diagnostic Fee Schedule
Clear, honest pricing with no hidden facility charges for self-paying patients.
| Consultation or Diagnostic Service | Clinical Details | Fee (Self-Pay) |
|---|---|---|
| Initial Consultant Consultation | Detailed 30–45 min review with accredited ENT Consultant Surgeon / Physician | £250 |
| Follow-up Consultant Consultation | Review of results, treatment response, postoperative monitoring | £175 |
| Standalone Ear Wax Removal (Microsuction) | Water-free binocular operating microscope procedure led by Audiologist | £95 |
| Fiberoptic Flexible Nasendoscopy | High-definition chip-on-the-tip inspection with topical anaesthetic spray | Billed as diagnostic add-on |
| Pure Tone Audiometry & Tympanometry | Acoustically isolated sound booth hearing evaluation | Covered by insurance / bundled |
| Allergy Skin Prick Test Panel | Standardised 10+ aeroallergen test with 15-minute turnaround | Quoted upon request |
Private health insurance patients: our clinic settles directly with Bupa, AXA Health, Aviva, Vitality, Allianz, Cigna, Simplyhealth, WPA, and Healix once pre-authorisation is confirmed.