Mr Jonathan Joseph, ENT Specialist

Consultant ENT and Facial Plastic Surgeon

ENTUK
British Rhinological Society
Facial Plastic Surgery UK
British Society of Rhinoplasty Surgeons

Mr Jonathan Joseph is an experienced Consultant ENT Surgeon working at the Royal National Throat, Nose and Ear Hospital and the Hospital of St John and St Elizabeth. His responsibilities include the treatment of all forms of ENT disease both in adults and children. He has a specialist interest in rhinological disease and he is the lead surgeon for sinonasal cancer treatment in his hospital. His training and experiences allow him to treat complex sinus disease, both medically and surgically. He also performs nasal reconstruction to treat inherited and acquired nasal deformity. Another aspect of his practice is to run specialist paediatric ENT clinics and surgical theatre lists. In children he treats sleep apnoea, glue ear, recurrent tonsillitis, allergy, voice problems and other ENT problems.

Mr Joseph is conducting research in a number of areas. He is part of the team developing a device for providing accurate, reproducible measurement of nasal blockage. This will help with the decision on when to operate on patients and also to measure the success of surgery. Another area of research is in the management of psychological disease, in particular body dysmorphic disorder, in patients seeking nasal surgery. He has shown that collaboration with a psychologist is essential for such patients the value of screening questionnaires.

What are the common symptoms your patients tend to present with?

They tend to present with:
• Nasal blockage.
• Nasal discharge.
• Facial pain, presumably due to sinusitis
• Balance disorder
• Hearing loss
• Discharging ears with infections and other sensations in the ear such as ear crackling, popping ears.
• Sore throats
• Difficulty swallowing
• Changes in the voice

What are the treatments that you're able to offer your patients?

In terms of initial medical treatments, for the nasal symptoms, it's usually a combination of various nasal sprays and nasal washes. If those fail, then we tend to proceed to surgical treatments – operations to improve nasal airflow.

With the ears, I would often clean out any wax or discharge in the ear in the clinic and then administer topical treatments into the ears to help improve the condition of the ear.

In terms of treatment for any throat infections, commonly patients have acid reflux which contributes to throat discomfort and I administer medical treatments for that.

Other surgical treatments would be:
• Recurrent tonsillitis – tonsillectomy.
• Closure of eardrum perforations causing the cone infection – myringoplasty.

What are your areas of subspecialist interest?

My main interests are primarily diseases relating to the nose, like chronic sinus problems, structural problems with the nose itself, whether it's causing functional problems or cosmetic problems. Sometimes it's to do with birth defects. I'm looking at particular ways to solve those, whether it be medical or surgical.

My other area of expertise is paediatric ENT, looking at all the various conditions that are more specific to children, such as glue ear, tonsillitis, snoring problems and sleep-disordered breathing.

Tonsillectomy
Adenoidectomy
Grommet insertion
Septoplasty
Septorhinoplasty
FESS (functional endoscopic sinus surgery)
Neck lump excision
Microlaryngoscopy
Skin lesion excision and reconstruction