An otolaryngological examination makes it possible to diagnose diseases of the ears, nose and/or throat, which are anatomically distinct but functionally interconnected organs. Thanks to this examination, the most suitable therapy can also be determined.

SERVICE DESCRIPTION

Direct steam jet inhalations are individual cures using devices designed to mix cold flowing sulphurous mineral water (in quantities of about 2 litres per therapy session) and saturated water vapour delivered at a pressure of about 2 atmospheres. The flow inhaled by the patient originates from a fragmentation and pulverisation in a nebulisation chamber of the thermal water sucked in by the Venturi effect from the flow of saturated steam directed by the device's circuit towards a porcelain mouthpiece that leads to an adjustable terminal that allows a slight variation in the direction towards which the emitted steam flow is directed. So even if the machine is at a fixed height, thanks to the swivelling terminal the flow can adequately serve users of substantially different heights without forcing them into unnatural postures for the ten or so minutes required to complete the therapy session. For children of a more modest age (and of course height), however, it is always advisable to use higher seats to facilitate proper alignment with the device. The ward operator will always take care to explain this detail to the parents, so as to avoid unpleasant accidents for the young users. The operator will also supervise all patients to ensure that they are seated at the optimal distance (usually 25-35 cm from the terminal) from the inhalation flow.

SERVICE DESCRIPTION

Direct steam jet inhalations are individual cures using devices designed to mix cold flowing sulphurous mineral water (in quantities of about 2 litres per therapy session) and saturated water vapour delivered at a pressure of about 2 atmospheres. The flow inhaled by the patient originates from a fragmentation and pulverisation in a nebulisation chamber of the thermal water sucked in by the Venturi effect from the flow of saturated steam directed by the device's circuit towards a porcelain mouthpiece that leads to an adjustable terminal that allows a slight variation in the direction towards which the emitted steam flow is directed. So even if the machine is at a fixed height, thanks to the swivelling terminal the flow can adequately serve users of substantially different heights without forcing them into unnatural postures for the ten or so minutes required to complete the therapy session. For children of a more modest age (and of course height), however, it is always advisable to use higher seats to facilitate proper alignment with the device. The ward operator will always take care to explain this detail to the parents, so as to avoid unpleasant accidents for the young users. The operator will also supervise all patients to ensure that they are seated at the optimal distance (usually 25-35 cm from the terminal) from the inhalation flow.

SERVICE DESCRIPTION

Humage is a special inhalation treatment that consists of having the patient inhale a mixture of sterile sanitary air enriched by gases released by movement from flowing sulphur water circulating in a bubbler vessel. The content of sulphurous gases (H2S) inhaled with this treatment can also be extremely high. Therefore, each establishment characterises this cure in the way it is carried out in relation to the type of water available. The main variables between establishment and establishment in the execution of the cure consist of the modalities of gas release (in the room or in a single station), the administration times (generally with progressive commitment), and the modalities of flow adduction to the patient (with adduction through a tube in the room close to the device or with direct adduction to the patient through a tube and contact device). In Cotilia, the Humage is an individual inhalation treatment. The particular characteristics of the sulphurous water recommend direct adduction with a rubber tube and polyethylene nasobuccal mask (class IIA medical device), and administration times varying between two minutes in the first sessions and four in the last. The gaseous state of the inhaled mineral component allows its complete diffusion throughout the respiratory tree and thus also into the finest alveolar branches and paranasal cavities.

SERVICE DESCRIPTION

This is a collective inhalation technique performed in rooms dedicated exclusively to this type of therapy (nebulisation chambers). In the nebulisation chambers, special devices (nebulisation arms or 'mushrooms') generate a mist of thermal water that is distributed throughout the room, saturating it. The thermal mist is produced inside the 'mushroom' by pulverising the mineral water pushed against jet bars after being drawn in by a flow of compressed sterile sanitary air. Further enrichment with a salt component (purified sodium chloride) facilitates the suspension of the micelles produced in the pulverisation of the sulphur water stream. The particle size of the nebuliser is extremely concentrated and fine (about 3 microns) and therefore able to preferentially stimulate that portion of the respiratory tree characterised by the presence of smaller airways. At Cotilia, there are 1 nebulisation chambers, which are available two by two for therapy, since the therapy session must be carried out in saturated chambers and at the end of the period of use (20 minutes) the chambers automatically undergo a sanitisation process through a total air exchange and subsequent reactivation of the nebulisation mushroom with resaturation of the environment (exchange-restoration in 20 minutes). Generally, nebulisations are progressive inhalation treatments, with one or two sessions per day of an initial duration of 8 - 10 minutes, to be gradually increased to 20 minutes in the last days of therapy. the presence of the earwax plug obstructing vision.

SERVICE DESCRIPTION

The micronised nasal douche is a therapeutic method that straddles the line between inhalation and irrigation treatment. The technique consists of pressurising the nasal passages with nebulised mineral water. The nebuliser is produced by a polypropylene Rino-Jet ampoule
(medical device class IIA) by mixing sanitary compressed air and sulphur water in the device. The nebuliser consists of water particles of a certain diameter (approx. 20-30 microns). It is performed by adhering a special ampoule connected to the Rhino-Jet to the nostrils, which is able to keep the incoming water separate from the residual wash water, which is discharged into the sink by a special tube. The micronised nasal douche results in a nasal douche that is certainly as effective as the one

SERVICE DESCRIPTION

The micronised nasal douche is a therapeutic method that straddles the line between inhalation and irrigation treatment. The technique consists of pressurising the nasal passages with nebulised mineral water. The nebuliser is produced by a polypropylene Rino-Jet ampoule (class IIA medical device) by mixing sanitary compressed air and sulphur water in the device. The nebuliser consists of aqueous particles of a certain diameter (approx. 20-30 microns). It is performed by adhering a special ampoule connected to the Rhino-Jet to the nostrils, which is able to keep the incoming water separate from the residual wash water, which is discharged into the sink by a special tube. The micronised nasal douche produces a nasal douche that is certainly just as effective as that produced by simple irrigation, but more delicate and with greater penetration capacity into the paranasal cavities. The patient has 15 minutes to complete the irrigation session.

SERVICE DESCRIPTION

The impedance measurement examination is generally performed by an ENT specialist, through which information is obtained about the state of health and functionality of the ear. This examination makes it possible to assess the elasticity of the eardrum and the chain of ossicles responsible for hearing function; it is therefore useful for diagnosing possible middle ear disorders. It can also be used to monitor the progress of a prescribed therapy. There are no special preparation requirements for this diagnostic examination. This examination can be performed without any difficulty by both adults and children. However, subjects with a perforation of the tympanic membrane or acute otitis of the middle ear cannot undergo it. The examination is non-invasive, non-dangerous and the patient feels no pain while it is being performed. The examination is performed by inserting a cone inside the ear from which a sound pressure of varying magnitude is emitted that can move the eardrum and the chain of ossicles attached to it. Based on the results of the examination, the specialist will be able to detect any disturbances in auditory perception and understand the nature of the hearing problem.

SERVICE DESCRIPTION

is an examination that can provide information about hearing ability. It is generally performed by the audiometric technician. This examination makes it possible to detect any loss of hearing perception. No preparation is required to undergo this diagnostic examination, which is not invasive. The examination has no contraindications and can be performed by adults and children. The examination is non-invasive, not painful and not dangerous. How does the audiometric examination work? The tonal audiometric examination is performed inside a special soundproof booth and involves the use of a pair of headphones to be placed over the ears. The operator will send sounds to the headphones - starting from low to high tones - and will ask the patient to give a nod of consent or press a button as often as he or she perceives the sound: in this way the doctor can determine the subject's threshold of minimum audibility. The examination may also involve the use of a device that is placed on the bone behind the ear and that transmits vibrations directly through the bone to the inner ear. Through the subject's ability to pick up sounds, the specialist is able to assess the functionality of the outer ear and middle ear. Through the use of vibrations, on the other hand, the functionality of the inner ear is assessed.

SERVICE DESCRIPTION

Rhinofibrolaryngoscopy is an investigation using an optical instrument that, by viewing the nasal cavities (nasopharynx and pharyngolarynx), allows the specialist to have a complete view of the pathologies of the otolaryngological district.

SERVICE DESCRIPTION

Flushing of the external auditory canal using a special syringe or by suction. It is used to remove earwax and exudates from the ear canal that contain bacterial toxins and debris that may contribute to possible inflammation. Through otoscopic examination, the presence of the earwax plug obstructing the vision of the tympanic membrane is detected and its size and consistency is estimated. This service can be performed by an ENT specialist.

SERVICE DESCRIPTION

The micronised nasal douche is a therapeutic method that straddles the line between inhalation and irrigation treatment. The technique consists of pressurising the nasal passages with nebulised mineral water. The nebuliser is produced by a polypropylene Rino-Jet ampoule
(medical device class IIA) by mixing sanitary compressed air and sulphur water in the device. The nebuliser consists of water particles of a certain diameter (approx. 20-30 microns). It is performed by adhering a special ampoule connected to the Rhino-Jet to the nostrils, which is able to keep the incoming water separate from the residual wash water, which is discharged into the sink by a special tube. The micronised nasal douche results in a nasal douche that is certainly as effective as the one

SERVICE DESCRIPTION

At Terme di Cotilia, nasal irrigation consists of the injection of 3-5 litres of sulphurous water (flowing and preheated to 37-38°C) into the nasal cavities through a sanitary silicone probe terminating in a rigidly disposable contact device (polypropylene olivette - class IIA medical device). The water is delivered with very little pressure, just enough to ascend the nasal cavities. The patient has 15 minutes to complete the irrigation session.

SERVICE DESCRIPTION

Insufflations allow a gas mixture (for a limited time 1-3 minutes in the middle ear a sulphur gas mixture at a temperature of about 32° - 35° C - thus in all respects similar to that used for Humage - at a modest pressure of 0.2 - 0.5 Bar) produced by a bubbler in which sulphur water flows. There are two methods of carrying out the cure:
- with an endotympanic catheter to insufflate gas into the middle ear through tight contact with the tubal ostium. The catheter is brought into position after being introduced into the nasal fossa, slid gently along the floor and, once it reaches the nasopharynx, rotated until it comes into contact with the tubal ostium. The catheter used is made of disposable plastic. The catheters are sufficiently malleable to allow the physician a substantial customisation of the therapy. Customisation is also indispensable, given the frequency with which even significant abnormalities of septal axiality and turbinate size appear in patients undergoing this therapy. By connecting the catheter to the insufflator device via a sanitary silicone tube, it is possible to cause a modest dilation of the tube and consequent aeration of the tympanic cavity. The catheter is sent through the Eustachian tube. The insufflator monitors the entry of the mixture into the eardrum case by means of a phonendoscope equipped with a polypropylene terminal olivette (class IIA medical device), which is inserted in a non-hermetic manner into the external ear canal of the treated ear;
- by means of crenotherapeutic politzer: the method in practice involves less invasiveness, although it perhaps requires greater involvement and participation on the part of the patient. In practice, the therapy is performed by feeding an intermittent flow of sulphurous mixture produced in the insufflator device to the nasal vestibule, through the interposition of a rigidly personal and disposable contact device (polypropylene olivette - medical device class IIA), which is hermetically inserted into one nostril, while the contralateral one is occluded with a modest digital pressure by the insufflator doctor. The entry of the sulphurous gas mixture into the middle ear (at a temperature of about 32° -35° C) is due to the transient increase of pressure in the upper portion of the pharynx linked to the concomitant release of the flow by the insufflator doctor and closure of the glottis caused by the patient with the emission of particular phonemes or with the act of swallowing (ghi, akka, etc.). For this reason, the patient must be trained in the emission of the phoneme and must also cooperate throughout the session to rhythmically achieve a valid sequence of raising levels
pressures in the high pharynx, which is at least sufficient to transiently overcome tubal resistance to opening. Although the method is less invasive and extremely simple in its implementation, it is, however, less monitorable than endotimpanic insufflations and, moreover, involves the two tubes at the same time, which in some patients may also have significant differences in their dynamics (release mode, stenosis, inflammation, etc.). Therefore, at Cotilia, the Politzer is only used in those cases where insufflations are really impractical (extremely small and restless children, adults with severe abnormalities in the anatomy of the first airways, adults with hypersensitivity in the mucous membranes of the first airways, etc.).