Ear, nose and throat surgery abroad

Ear, nose and throat surgery abroad is mostly nose and throat: straightening a deviated septum so that you can breathe, reducing swollen turbinates, opening blocked sinuses, taking out tonsils that keep getting infected, repairing a hole in the septum, and the two voice operations that change pitch. People travel because the operation has been on a waiting list for a long time, because it has been classed as not urgent enough to fund, or because they are combining it with a rhinoplasty and want one surgeon and one anaesthetic for both. The prices are lower than at home almost everywhere, and the operations are short.

What the short operation hides is that ENT surgery has two of the most inconvenient recoveries in medical travel. Bleeding after a tonsillectomy peaks about a week after the operation, which is exactly when a patient on a package would be flying home, and a repaired septum or sinus needs cleaning and checking in the weeks that follow by someone who can see inside the nose. This page explains which ENT operations travel well and which do not, where people go, how the trip works, the risks that belong to the trip and what a quote needs to contain.

Turkey dominates the nose operations, because its rhinoplasty volume has built large ENT and facial plastic practices that do septoplasty, turbinate and sinus surgery every day, at low prices and a short flight from Europe. Germany, Spain and Poland offer European Union hospitals for people who want reimbursement or proximity, at higher prices. Romania, Hungary and Cyprus are smaller markets closer to home for some. Mexico, Thailand and Colombia serve the Americas and Asia. For the voice operations and septal perforation repair, the surgeon matters more than the country, and the shortlist is short everywhere.

• Turkey. ENT in Turkey: high-volume nasal surgery in Istanbul, often combined with rhinoplasty, private hospitals used to international patients, low prices, follow-up by message after the first check.
• Spain. ENT in Spain: private hospitals with ENT and voice surgery, prices between Germany and Turkey, inside the European Union.
• Poland. ENT in Poland: European Union hospitals a short flight from the United Kingdom and Ireland, with private ENT units used to foreign patients.
• Hungary. ENT in Hungary: a Central European option inside the European Union, known more for dentistry, with ENT available in private hospitals.
• Mexico. ENT in Mexico: private hospitals serving the United States, where distance allows a return visit for the nasal check.
• Thailand. ENT in Thailand: accredited hospitals in Bangkok with ENT and voice surgery, a long flight from Europe.
• Colombia. ENT in Colombia: a growing destination for patients from the Americas, with a large facial plastic and nasal surgery sector.

• Secondary bleeding after tonsillectomy. Peaks around the end of the first week, can be heavy, and needs an emergency department; the reason the stay or the plan for home has to cover that window.
• Nasal care nobody does. Crusting, adhesions and infection after septoplasty and sinus surgery are prevented by cleaning and inspection in the weeks afterwards, which needs someone who can look inside.
• Surgery for the wrong reason. A blocked nose from allergy, or snoring without a sleep study, is not fixed by an operation; a looser threshold abroad makes this more likely.
• Bleeding and infection after nasal surgery. Less dangerous than after tonsillectomy but still a reason not to fly the day after.
• Empty nose and over-resection. Turbinate surgery that removes too much leaves a nose that feels blocked forever; ask what technique is used and how much is removed.
• Combined operations. Septorhinoplasty means a cosmetic result and a breathing result judged separately, and a revision that is harder than either alone.
• Home services and insurance. Public systems treat emergencies such as bleeding; routine follow-up of surgery done abroad may be refused or charged; travel insurance excludes planned treatment.

• An ENT surgeon, examined with an endoscope. For nasal surgery, a specialist who looks inside the nose and reads the CT; for combined operations, a surgeon trained in both functional and cosmetic nasal surgery.
• Volume for your operation. Septoplasty and sinus surgery weekly; for voice surgery and septal perforation, a surgeon who does them at all.
• A threshold for surgery. Ask what is tried before an operation is offered; a surgeon who never says no is a warning sign.
• The stay and the checks. A minimum stay set by the surgeon, splint removal and the first clean before you fly, and a plan for the bleeding window after tonsillectomy.
• Complication cover. Bleeding, infection and revision; what is included, for how long, and who pays for the return trip, in writing.
• Records in both directions. Endoscopy findings and CT in; operation note and care instructions out, for the ENT clinic at home.

• ENT UK, patient information on septoplasty, sinus surgery, tonsillectomy and bleeding after tonsillectomy.
• National Institute for Health and Care Excellence, guidance on tonsillectomy for recurrent tonsillitis and on obstructive sleep apnoea management.
• American Academy of Otolaryngology, Head and Neck Surgery, clinical practice guidelines on tonsillectomy, sinusitis and nasal obstruction.
• European Rhinologic Society, position paper on rhinosinusitis and nasal polyps.
• NHS England, guidance on going abroad for planned medical treatment and the treatment of complications.