Mr. Jay Goswamy F.R.C.S.
Patient Information
Having trained in all aspects of ENT I am qualified to manage all adult and paediatric ENT conditions. Both Spire Manchester and The Alexandra Hospital have dedicated paediatric nurses and a dedicated paediatric ward. I regularly work with the same anaesthetists to provide consistently excellent care. Please click the links below to find out more about the conditions I treat in sites across Manchester and Cheshire. Click the buttons to read or learn more.
Videos
I have produced some educational videos to try to help patients and trainees understand some of the aspects of diseases of the ears, nose and throat. Keep an eye on this space for more in the future.
Adenoidectomy. If you have a blocked nose or problems breathing at night you may have enlarged adenoids blocking the back of your nose. By looking through your nose I will be able to tell if you would benefit from having your adenoids removed.
Grommets. Grommets are tiny tubes that sit in your eardrum and usually stay in position for around 9 months. If you get ear infections or your hearing drops you may have glue ear. Glue ear is when fluid accumulates behind your eardrum. If your child has difficulty concentrating, if they have speech delay, painful ears or lots of infections they may benefit from grommets.
Joint voice clinic. If you are a professional voice user, you've had surgery to your voice box or had treatment or an event that has affected your voice you may benefit from a Joint Voice Clinic assessment. I perform these assessments in the company of highly skilled senior speech and language therapists using stroboscope to make a very detailed dive into the underlying cause of your voice challenge.
Neck lumps. Neck lumps that come and go are usually completely normal. If you have a neck lump that won’t go away, is getting bigger or is painful then it needs to be investigated. We can organise investigations to find out what is causing the neck lump very quickly. All cancers are curable if caught early enough.
Septoplasty. Your septum runs down the middle of your nose separating your nasal cavities. No one has a completely straight septum. If it is very bent it can affect your breathing and make your feel that you have a blocked nose. Straightening the septum is done as a day case operation with no bruising and no visible scarring.
Sinus surgery. Sinusitis can present with facial pain, a blocked nose, a runny nose, catarrh, reduced sense of smell and a dry cough, a chesty cough or a mucous cough. Getting started one the right medication is all that is required in most cases. Some people will go on to require sinus surgery also known as FESS. Sinus surgery is done using keyhole surgery through your nostrils so that there is no scarring and no bruising.
Snoring. Snoring can affect the harmony in the home. When it’s very severe it can be associated with obstructive sleep apnoea, or OSA. Sleep apnoea in children can affect growth and development and needs treatment. In adults, it is associated with heart problems and premature death. The solution in children is adenotonsillectomy. In adults once weight loss has been tried, surgery can help get oxygen into the body by opening the airways. In severe cases in adults air delivered via a mask at night may be required. Snoring without sleep apnoea can be treated with a number of surgical and non-surgical technques depending on whether the noise originates from the palate, the back of the tongue or the tonsils.
Swallowing difficulty. If you are having difficulty swallowing or have developed a painful swallow it can be there sign of an infection or a sign of throat cancer or oesophageal cancer. Early detection results in a much greater ability to cure the cancer. Often, it’s difficult to locate the problem yourself but utilising a flexible camera system in clinic will give us a very good idea about where the swallowing problem is coming from.
Tinnitus. Tinnitus is a sense or ringing in the ears or the sound of your heartbeat in your ear. It can be associated with hearing loss or dizziness. If you let us know about any hearing problem we can arrange to have your hearing tested at the same time as your clinic appointment.
Tongue tie. Tongue tie can be associated with difficulty feeding with choking or painful nipples and sometimes mastitis. Later in life it can be associated with speech problems. Immediately following a full medical assessment, tongue tie division can be performed in clinic at Spire Manchester with on-site paediatric nurses and a comfortable breast-feeding room to ensure that the problem is solved before you leave. You will be given a 24-hour number to call if you have any questions or concerns after the procedure. It’s not painful and your child will be able to feed straight away.
Myringoplasty. Eardrum repair is necessary if you have a perforated eardrum that won’t heal by itself. Often it can be performed without any visible scars. You won’t be able to fly or swim for 6 weeks after the procedure. Any ear infection must be treated before planning the repair.
Salivary gland surgery. Salivary gland lumps can be due to stones in the gland, gland infections or tumours. Parotid lumps in front of your ear are most commonly benign but if you have facial weakness or pain that can be a sign of cancer. Submandibular gland lumps are usually due to stones but if there is a gland tumour there’s a 50% chance of the tumour being malignant, that is, containing cancer. Urgent investigation is very important. Salivary gland surgery usually requires a 1 night stay in hospital.
Skin cancer. If you have a discoloured mark on your skin that is changing in size, texture, is bleeding or itchy it may be a skin cancer. Once a biopsy has confirmed a cancer removal surgically which can be performed with you awake or asleep is usually the most effective treatment. Care is taken to disguise and scars within natural creases in the skin.
Thyroidectomy. Thyroid surgery is performed if you have an overactive thyroid where medical treatment hasn’t worked. It is also performed if you have a thyroid lump where there is a suspicion of cancer or if your thyroid lump is pressing on your windpipe or oesophagus. With thyroid surgery, there is a risk to the nerve that supplies your vocal cords and so a nerve monitor is used in all cases to minimise this risk. If your thyroid hormone drops after surgery it is easily supplemented with a tablet with no risk of unexpected weight gain if the dose is correct.
Vocal lesions. If you have noticed a voice change that won’t get better it’s important that your vocal cords are inspected. This can be done in clinic at your first appointment. Having a hoarse voice or a croaky voice can also be related to how your nerves function, this can all be assessed at the same time. Early cancer of the vocal cords has an almost 100% chance of cure with treatment.
Airway surgery. If you have asthma that is not responding to inhalers, a cough not responding to treatment or breathlessness on exertion there may be a narrowing of your airway. I have close links with chest doctors and thoracic surgeons in the region so whichever point of your airway is causing the problem we’ll find the best solution for you.
Laser surgery. Laser is the most effective treatment for some throat cancers and some vocal cord cancers. Before cancer surgery is embarked upon I will discuss your case with my head and neck cancer team at The Christie and between us we will go through all the options available.
Pinnaplasty. Ears can sometimes be prominent or asymmetrical. I perform this procedure in those aged over 7 and under 18. The reason for waiting until at least the age of 7 is that up to that point the ear cartilage is very soft and getting an excellent result is less predictable. The main reason however is that it is a life-changing operation and whilst the child or young person is too young to consent for themselves, I like them to be the driver behind wanting the operation; that way they take the post-operative care regime seriously and ultimately they alongside their parents and I go on the journey together. After the initial appointment I always offer a free follow up appointment so that the young person and their parent(s)/guardian have had a chance to process everything that we discuss in the first appointment.
Throat cancer. If you have a painful swallow, voice change, difficulty swallowing or ear pain you could have throat cancer. In the past throat cancer was usually caused by smoking. It has become much more common in non-smokers and is thought to be due to the HPV, or human papillomavirus infection. The chance of cure in HPV related cancers is higher but nonetheless the sooner it is caught the better the chance of cure. Caught early sometimes a laser or robotic resection is all that is required.
Tonsillectomy. If you suffer with tonsillitis, tonsil stones, snoring or are worried about an enlarged tonsil you may be a candidate for a tonsillectomy. The procedure is usually performed as day case surgery but you will need 2 weeks off school or away from work.
Clarifix. Clarifix is the tradename for cryotherapy (freezing therapy) to the posterior nasal nerve. If you have a reactive nose that can become blocked and runny then you may benefit from this treatment. It is delivered by a device through the nostril under direct vision and the 'pad' applied to a specific place at the back of your nose. Most people feel significant benefit for several years following a single treatment. It can be done at the same time as other nasal procedures like sinus surgery or by itself either under a general or local anaesthetic. NICE guideline are awaited and we think insurance companies will provide it once these guidelines are in place. Up to that time it is mainly funded via self pay. Take the quiz to see whether you would benefit. You can also read more on the
R-CPD. Retrograde cricopharyngeus dysfunction is now recognised as a debilitating condition and often presents as an inability to burp, upper abdominal discomfort, gurgling sounds in the chest and excessive flatulence. If there is diagnostic uncertainty a barium swallow will be requested. Botox to the muscle under direct vision is the treatment of choice and usually works within 2 weeks. There can be a lump in the throat sensation for the first week in some people.
Coblation intracapsular tonsillectomy. Unlike traditional tonsillectomy and adenoidectomy Coblation (controlled ablation) aims to remove 95% of the tissue rather than 100%. This means that there is a slightly increased risk of tonsil or adenoid regrowth. However it is less painful with a reduced risk of bleeding and so is the preferred choice for children and those with tonsil stones. Coblation can be used outside the capsule but may have an increased risk of bleeding and pain which is why I always perform this type of surgery within the capsule.