When you arrive at the Manor Hospital you will be asked to check in at the reception desk. This will alert Professor Winter that you have arrived. You will then be directed to one of the waiting areas where complimentary hot drinks are available as well as water are available. If you arrive early then there is a café on the first floor of the hospital for drinks and sandwiches.

If you can fill in this form prior to your arrival it will be helpful so that we can ensure your details are correct.

Professor Winter understands that you may have concerns about your health, and his aim is to make you feel at ease.

During your initial appointment with Professor Winter he will take a thorough history and undertake a clinical examination. The examination will vary according to the nature of your consultation and certain specialised investigations may be performed. These may include ear microscopy, ear suction, rigid or flexible nasal or laryngopharyngeal endoscopy, Ultrasound assessment, hearing tests and fine needle aspiration of lumps.

Sometimes further tests are necessary, such as x-rays, blood tests, MRI scans, CT scans, Ultrasound scans or allergy testing. The majority of tests can be performed at the Manor Hospital often at the time of your appointment to minimise delays. 

For complex balance assessments (which may take up to three hours to perform) or complex audiology tests, further arrangements will be made.

Results of most tests are available within a few days and follow up appointments are arranged accordingly. 

Follow up appointments are tailored to clinical need. In the interests of the patient we aim to complete treatment as quickly as possible and in the fewest sessions possible.

A follow up is an appointment less than 12 months after your previous visit, unless a longer time gap was agreed. A follow up must be for the same problem as originally seen. Consultations with a gap of greater than 12 months (unless agreed at the consultation) or consultations for a new problem are deemed as a new patient consultation

If you have been advised to have surgery for your nose then you may be asked to fill in a questionnaire.

Outpatient Procedures

A number of tests may be performed during your appointment:


Pure Tone Audiometry is the standard assessment of hearing. Tympanometry is a measure of middle ear function and frequently helps diagnosis. This is a quick and painless investigation and may also be performed.


This involves the cleaning of the ear under the microscope, usually with a small sucker to remove wax and debris. This allows a clearer view of the eardrum and aids in diagnosis. It is also frequently therapeutic.


If you present with a neck lump then Professor Winter may advise taking a few cells from this to aid diagnosis. This can be done in clinic and uses a small needle. The results will be available after a few days.


Professor Winter is able to perform outpatient endoscopy. This is either endoscopy of the nose using rigid nasal endoscopes, or flexible nasopharyngolaryngoscopy. Rigid nasal endoscopy affords a good view of the nasal cavity and the back of the nose. It also allows a view of the sinus openings into the nasal cavity which aids in the diagnosis of sinusitis and other sinus problems. Flexible nasopharyngolaryngoscopy allows a view of the throat and voice box (larynx) as well as a view of the nasal cavity. Professor Winter will decide in discussion with you, the most appropriate way of examining your upper airways. Preparation of the airways may include the use of decongestant spray and a local anesthetic. As required stroboscopy of the voice box may also be needed.

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