Otorinolaringologi (ORL)

The Department of Otorhinolaryngology and Head & Neck Surgery in the Hospital Selayang is at Secondary level of service i.e. to provide general Specialist Care for patients with disorders of the ear, nose, throat and related areas of the head and neck region. Since 2010, several subspecialized services such as management of Obstructive Sleep Apnoea (OSA) and sleep study; management of Vertigo; Laryngology and voice rehabilitation has been established.

Mission

We are committed to:

Deliver high quality, efficient, cost effective and evidence based health care

Promote wellness in the community

Work as a disciplined, competent and professional workforce

Vision

To provide a comprehensive clinical patient- centered medical and surgical services in all aspects of Otorhinolaryngology with emphasis on active participation of the patient, family members and the healthcare providers.

Objective

1. As a center that provide Secondary level as well as Subspecialised   Otorhinolaryngology service

• To provide all the services related to Otorhinolaryngology as in any General Hospital that provides such services to the community. To provide adequate investigative procedure/s and preliminary care for the patient prior to referral to another unit for specialized care as and when deem necessary.
• To provide the necessary supportive allied health services related to the Otorhinolaryngology and Head & Neck Surgery i.e. Audiology and Speech Therapy.
• To perform elective surgical procedures as scheduled in the operation list/s and this shall apply to inpatients as well as for day surgery
• To attend to emergency cases irrespective of working hours and according to scheduled rotation.

2. Other functions of the ORL Department

This shall imply public health educating as related to the care of the ear, nose and throat, and to increase the awareness of the public on pollution, occupational health hazards such as noise-induced deafness and the importance of its prevention, traumatic injuries, effects of smoking and drug abuse, and factors contributing to cancers of the head & neck.

Annual awareness campaign is conducted in the Hospital Lobby for 2 weeks to

educate the staff and public on the care of the ear, hearing and speech. Activities include lectures, posters display, games and puzzles. The public and staff participation has been very encouraging

As The Training Centre

The ORL Department in Selayang Hospital shall be actively and fully participates, not only in training of the specialty but also be involved in training of the basic principles of Medicine and Nursing.

The Department shall play an important role in stimulating interest and in promoting the science of Otolaryngology and Head & Neck Surgery.

The Department shall fully participate in the training of the following groups:

• Candidates undergoing Sub-specialized training in Laryngology and Head & Neck Surgeries
• Post- graduate Master In Otolaryngology Programme candidates and Fellowship candidates
• Nurses and Assistant Medical Officers
• Trainee Audiologists and Audiology Technicians
• Speech Therapists and Trainees

3. Promoting Research and Innovations in Otorhinolaryngology & Head and Neck Surgery

Research and innovations are highly encouraged in the Department as in accordance

with G.O.P No. 4.5 with specific reference to the field. This shall be carried out by the

Department initiative or along with the training programs.

Currently, the Department is conducting 2 research studies i.e.

• Nasopharyngeal Carcinoma (NPC) Molecular studies, collaboration with Institute of Medical Research (IMR) and
• The reliability and accuracy of Multiple Auditory Steady State Response (MSSR) and Auditory Brainstem Response (ABR) in Children

Services

General Clinic sessions cater for patient with scheduled appointment Specialized clinic sessions cater for patient from the General clinic with specific illness which requires further investigations e.g. Fine needle aspiration cytology, allergy tests or specific management such as voice rehabilitation, hearing aid fitting, vertigo evaluation and rehabilitation; or continuous care.

FEES & Swallowing Clinic scheduled on Thursday afternoons provides a comprehensive approach in managing dysphagic patients by the ORL surgeon, Speech Therapist and dietitian.

Vestibular Clinic conducted by the ORL surgeon and assisted by a Nursing Sister trained in the diagnosis, management and rehabilitation of patients with vertigo and balance disorders. The clinics are on Thursday and Friday afternoons.

OSA Clinic provides an avenue for the ORL surgeon to review the sleep study montage and results and jointly managed these patients with the sleep technicians, CPAP suppliers and the dietitian in order to get the optimum advantage of the collaborations.

Audiology Clinics are of 2 types; Walk-in which runs concurrently with the General ORL Clinic sessions and Scheduled Clinic for specific audiological tests and rehabilitation.

Speech Therapy provides services to adult and children including swallowing rehabilitation; hearing impaired; speech & language and voice.

Patients are admitted for elective operations according to schedule session; for continuing care for emergencies in the Head & Neck regions including infection, trauma and foreign bodies insertion; for palliative care and for investigations such as

Audiological tests requiring general anesthesia.

Sleep study is done twice a week i.e. Friday and Saturday nights because of limitation in technical availability. Follow up appointment is scheduled in the

Specialized Clinic session for OSA on Thursday afternoons.

Hearing screening for high risks neonate is performed in the Neonatal Intensive Care Unit. Currently, the coverage rate is 85% for the 1^st screening and the refer rate is 9%. Both these quality indicators comply with the Joint Committee of Infant Hearing (JCIH) Position Statement, 2007.

Urgent cases are seen immediately. Referral are accepted from the hospital services or from external medical sources such as other public health facilities and private practices. The On-call team is made of a specialist, medical officer and a paramedical assistant, is available by contacting the Emergency Department or Ward 6A.

The FPP scheme provides an avenue for the patient to select his own clinician who shall provide continuous care. All the services are provided as along as it is on elective basis.

All operations perform are according to the stipulated Fee Act currently practicedin the MoH. Besides, the commonly performed operations such as tonsillectomy,septoplasty etc, major Head & Neck operations are also performed as indicated. The department is not designated to perform Cochlear Implantation. However, other otology surgeries are carried out.

Emergency procedures are carried out as indicated, after the case reviewed by the specialist.

There was an increment of 20% in the number of operations performed last year despite the reduction of operation sessions by the Anaesthetic Department.

The graft below shows the workload of the service provided by the ORL department since being operational in September 1999. It indicates, as in any ORL discipline, that most of the work is conducted in the clinics. The inpatients, both emergency and elective, along with operations performed are in tandum with each other.

Structurally, the department has:

• a designated Specialist clinic area with facilities for audiological and vestibular as well as speech therapy located on level 3 of the outpatient Specialist Service area
• a mixed ward with 28 beds of second class and third class with complete inpatient facilities as well as to conduct Sleep Study.
• Operating sessions in the Daycare Center and General Operating suites of level 5 fully equip including LASER machine. And Daycare based  surgeries are done in the DayCare Complex, Level 2. Currently, the Operation sessions are:

 Clinic Operation Hours: