► Basic Otology

The otology section performs all the basic procedures of the subspecialty: treatment of conductive hearing loss (stapes surgery and tympanoplasties), treatment of the chronic ear (myringoplasties, tympanoplasties, mastoidectomies) and treatment of tubal dysfunction (Tuboplasty). It has an Otology Committee where the most complex cases are presented.

► Implantable Devices Programme

The activities of this programme focus on the diagnosis of severe-to-profound hearing loss, its treatment with implantable devices such as bone conduction implants, middle ear implants and cochlear implants, and their programming and follow-up. The unit has a dedicated bimonthly clinic for cochlear and middle ear implants, and two audiology sessions for the programming of bone conduction implants.

► Otoneurology Unit

This unit is responsible for the diagnosis of vestibular pathology using vestibular tests such as Video-ENG, V-HIT, cervical VEMPs, ocular VEMPs and, more recently, Dynamic Visual Acuity testing. The unit holds a dedicated vestibular system assessment clinic three times a month and a multidisciplinary clinical committee.

► Neonatal Screening Programme

The Paediatric Otolaryngology Section, with the support of the audiology team, is responsible for the neonatal screening of congenital hearing loss in all babies born at Hospital Germans Trias i Pujol using automated evoked potentials, steady-state potentials and brainstem auditory evoked potentials.

► Lateral Skull Base Surgery Unit

A unit responsible for the diagnosis and treatment of otological pathology affecting the lateral skull base, primarily the treatment of vestibular schwannoma, but also any tumour pathology affecting this anatomical area (squamous carcinomas, jugulotympanic paragangliomas or endolymphatic sac tumours, among others). This unit has a weekly morning and afternoon operating theatre for the surgical treatment of the aforementioned pathology.

► Multidisciplinary Unit for CSUR-Phacomatosis

Hospital Germans Trias, together with the Catalan Institute of Oncology (ICO) and the Germans Trias i Pujol Research Institute (IGTP), has been accredited since 2015 as a National Reference Centre for Neurocutaneous Syndromes – Neurofibromatosis (CSUR) and is integrated into the European Reference Networks Genturis.

The CSUR Unit aims to provide comprehensive, multidisciplinary management for patients with phacomatosis, a group of diseases that includes neurofibromatosis type 1, schwannomatosis associated with the NF2 gene, other schwannomatoses, tuberous sclerosis and Von Hippel-Lindau disease. The Service of Otorhinolaryngology is integrated into this multidisciplinary unit and is an expert in the treatment of schwannomatosis associated with the NF2 gene.

The unit can see patients from across the state if they are referred by their home autonomous community. It also responds to consultations from specialists at other centres. The members of the CSUR-Facomatosis Unit meet twice a month and hold a dedicated clinic every fortnight.

► Multidisciplinary Unit for Facial Nerve Pathology

A multidisciplinary unit responsible for the diagnosis, management and treatment of complex peripheral facial paralysis. The unit offers patients with peripheral facial paralysis highly complex treatments such as neuromuscular re-education, botulinum toxin injections, oculoplastic surgery, facial nerve reinnervation, and microvascular muscle flaps to restore facial mobility. Currently, it meets once a month to discuss the most complex cases and to coordinate the different services involved.

► Audiology Unit

A unit that is responsible for the audiological diagnosis of hearing loss and the programming of implantable devices. It has 5 specialist clinics per month for complex cases and carries out audiometric studies daily. The unit performs pure-tone audiometry, speech audiometry, supraliminal audiometry, noise-level audiometry and localisation studies.

► Unit for Genetic Aetiology of Hearing Loss

A multidisciplinary unit which, together with the Clinical Genetics Unit, is responsible for the genetic diagnosis, genetic counselling and treatment of hereditary hearing loss. Its work is centred on a Clinical Committee that meets monthly. The unit has participated in the working group on genetic sensorineural hearing loss in Catalonia.

► Treatment of Eustachian Tube Dysfunction

Study and treatment of Eustachian tube dysfunction. Tubal dilation with a Tubavent catheter in selected patients.

► Head and Neck Functional Unit (UFOCC)

This is a multidisciplinary committee for the comprehensive treatment of oncological pathology of the head and neck. It is made up of the following departments: Otolaryngology, Oral and Maxillofacial Surgery, Plastic Surgery, Medical Oncology, Radiotherapy Oncology, Radiology, Endocrinology and Nutrition, Pathology, Rehabilitation, Social Work and specialist nursing.  It meets weekly to assess and manage patients from the entire hospital's catchment area.

The service performs all types of complex oncological surgery of the head and neck, including transoral robotic surgery and radical surgery requiring reconstruction with pedicled or free microvascular flaps, sometimes in collaboration with the Plastic Surgery Service.

► Robotic Transoral Surgery Programme

For the treatment of tumours located in the oropharynx, supraglottis or the para pharyngeal space that are amenable to excision through the oral cavity, or for surgeries for sleep apnoea. At our centre, we have developed extensive experience since 2017, the year the transoral robotic surgery programme with DaVinci was launched, making us one of the first centres in Spain to establish and develop this approach, and the first in a public hospital in Catalonia.  We are currently the referral centre for the Northern Metropolitan Area for this type of approach.

► Dysphagia Unit

This unit provides comprehensive, multidisciplinary diagnosis and treatment for oropharyngeal dysphagia (difficulty in swallowing), as well as nursing training for hospital dysphagia screening. The unit includes the Departments of Otorhinolaryngology, Rehabilitation, and Endocrinology and Nutrition. It is a pioneer in implementing the MEC hospital screening test and in standardising the Fibroendoscopic Swallow Study (FEES) as a diagnostic tool for dysphagia.

Specialised care for paediatric dysphagia, jointly with Paediatrics, Rehabilitation and Nutrition, with a dedicated clinic including observational examinations and FEES with breast milk.

► Voice rehabilitation in laryngectomised patients

Voice prosthesis. Primary and secondary placement in laryngectomised patients. Follow-up of patients in consultations to carry out necessary replacements.  Support in voice rehabilitation for patients not suitable for a voice prosthesis.

► Treatment with botulinum toxin in the Area of Otorhinolaryngology

Within our area, there are numerous conditions that may require treatment with botulinum toxin, such as patients with oropharyngeal dysphagia and sialorrhoea, facial nerve pathology, and some vocal disorders such as spasmodic dysphonia.

► Treatment of apnoea

Treatment of childhood and adult sleep apnoea and hypopnoea syndrome (OSAHS). The Department participates in the Multidisciplinary Sleep Unit alongside the Departments of Pulmonology, Oral and Maxillofacial Surgery, Endocrinology, Neurology, Paediatrics and Psychiatry. A comprehensive approach to the patient is undertaken, and as ENT specialists we lead the fibre-optic examinations under sedation (DISE), as well as any surgical treatments that may follow, including transoral robotic surgery.

► Surgical treatment of cervical and pharyngolaryngeal pathology

We carry out the full diagnostic and therapeutic assessment of vocal pathology and have a specialist clinic for voice disorders. From here, we coordinate speech therapy, either jointly with the Rehabilitation Service or by deciding on the phonosurgical procedures the patient requires.

We also have experience in airway surgeries, such as for subglottic stenosis or vocal cord fixations, which may require surgical procedures for their treatment.

Furthermore, we have extensive experience in the treatment of benign cervical conditions such as congenital cysts, pharyngolaryngeal or upper oesophageal diverticula, and adenopathies that may require surgical investigation and treatment, as well as tumour pathology of the salivary glands or thyroid.

► Clinical Assistance in Rhinology

The Rhinology Section is responsible for the diagnosis and treatment of allergic, non-allergic and vasomotor rhinitis. Acute and chronic rhinosinusitis, with or without nasal polyps. The follow-up of patients with nasosinusal inflammatory pathology. The treatment of nasal obstruction and recurrent epistaxis. Management of malformations and anatomical abnormalities of the nose. Treatment of infectious, oncological and structural pathologies of the paranasal sinuses.

► Rhinologic Surgery

The Rhinology section is responsible for the surgical treatment of rhinologic pathology; functional and advanced endoscopic surgery of the paranasal sinuses (FESS). Complex and revision nasal polypectomy. Endoscopic dacryocystorhinostomy. Treatment of mucoceles and benign lesions. Septoplasty (correction of nasal septal deviation). Functional rhinoseptoplasty. Turbinectomy and nasal turbinoplasty. Endoscopic surgery for nasal obstruction.

► Anterior skull base surgery

The Department performs minimally invasive endoscopic approaches to lesions of the anterior skull base, whether benign or malignant tumours (meningiomas, pituitary adenomas, esthesioneuroblastoma). It is also specialised in the treatment of cerebrospinal fluid (CSF) leaks, the repair of osteodural defects and advanced anterior skull base reconstruction. In complex cases, combined surgery is performed with Neurosurgery, and the transsphenoidal approach is routinely used for pituitary tumours. The most advanced techniques, such as navigation-guided endoscopic surgery, are used.

► Olfaction Unit

The Olfaction Unit at Hospital Germans Trias i Pujol was created in the wake of the COVID-19 pandemic, but has established itself as one of the few specialised and referral units in the country. It offers comprehensive, multidisciplinary care for post-viral, post-traumatic and neurological olfactory pathology, including the follow-up of patients with sinonasal inflammatory conditions, and ensures continuous assessment and monitoring of patients. It develops specific therapeutic protocols, including a structured olfactory training programme, and has one of the most comprehensive diagnostic tests, the Sniffin' Sticks, with over 4,000 tests performed, available in only a few centres. Today, it acts as a referral centre for several health areas. The Unit is integrated with the Persistent COVID Unit.

► Nasal function study

Study of nasal function using rhinomanometry, a test that allows the objective assessment of nasal airflow and the different areas of nasal stenosis with the aim of improving diagnosis, surgical indication, and the evaluation of surgical outcomes in patients with nasal obstruction. Olfaction is also assessed using Olfactometry (Sniffin' Sticks).

► Severe Asthma Committee (UAG)

This is a multidisciplinary committee that meets monthly, comprising professionals from the Allergy, Pulmonology, Paediatrics and Otorhinolaryngology, aimed at the global assessment and management of patients diagnosed with severe asthma, chronic rhinosinusitis and allergic rhinitis, as well as the discussion and approach to current issues in these pathologies. The SEAIC (Spanish Society of Clinical Allergy and Immunology) has accredited this unit as a centre of excellence and as a teaching unit for providing practical, in-person training in severe asthma.

► Facial Pain Committee

This is a multidisciplinary team comprising specialists from the Departments of Otorhinolaryngology, Neurology and Anaesthesiology, dedicated to the comprehensive assessment and management of patients with facial pain.

► Thyroid-Orbitopathy Committee

A unit comprising the Endocrinology, Ophthalmology, Plastic Surgery, Maxillofacial Surgery and Otorhinolaryngology services, which assesses patients with orbitopathy secondary to thyroid gland pathology.

► Neuroendocrine Tumour Committee

The Departments of Neurosurgery, Neurology, Endocrinology, Radiology and Otorhinolaryngology meet to assess these patients with complex tumours.

► Anterior skull base surgery

The Department performs minimally invasive endoscopic approaches to lesions of the anterior skull base, whether benign or malignant tumours. It also specialises in the treatment of cerebrospinal fluid (CSF) leaks, the repair of osteodural defects and advanced anterior skull base reconstruction. In complex cases, combined surgery is performed with Neurosurgery, and the transsphenoidal approach is routinely used for pituitary tumours.

► Basic Paediatric Otorhinolaryngology

A unit that treats basic paediatric pathology in collaboration with the Paediatrics department and the Paediatric Anaesthesia Unit. In particular, this includes inflammatory/infectious disorders of the Waldeyer's ring, adeno-amygdalar hypertrophy, recurrent infections, and recurrent otitis media due to tubal obstruction.

► Neonatal Screening Programme

The Paediatric Otorhinolaryngology section, with the support of the audiology team, is responsible for the neonatal screening for congenital hearing loss of all babies born at the Germans Trias i Pujol Hospital, using automated evoked potentials, steady-state potentials and brainstem auditory evoked potentials. The Service coordinates with the local CREDAs and CDIAPs, with whom it holds regular meetings to monitor infants in need. It provides indications for and manages PAOs for hearing aids. It participates in the working group on genetic sensorineural hearing loss in Catalonia.