An ENT specialist or an otolaryngologist is a physician trained to treat patients with issues pertaining to the ear, nose, throat and structures of the neck and head. This is a specialist with the skills required for diagnosing and treating diseases of the larynx, upper pharynx, sinuses and oral cavity. The specialist treats both children and adults. The training for this profession includes surgical and medical skills for the following disorders.
• Balance disorders
• Cranial and facial nerve disorders
• Ear infections
• Nerve pain
• Hearing issues
• Congenital disorders of the inner and outer ear
Otolaryngologists treat more than 35 million cases of chronic sinusitis per year. One of their primary skills is managing the nasal area. This includes the sense of smell, breathing properly through the nose and allergies. Expertise in the management of diseases affecting the esophagus and larynx such as swallowing and voice disorders is mandatory.
The face, hearing, sense of smell and sight are controlled by nerves. In the neck and head, the specialist treats malignant and benign infectious diseases including facial deformities, facial trauma and cancerous tumors. An otolaryngologist performs both reconstructive and cosmetic plastic surgery within their areas of expertise. What is ENT can be answered simply. ENT is an abbreviation for ear, nose and throat.
What is an ENT Doctor Areas of Expertise
An ENT physician can choose a specific area of expertise. This requires additional training. These areas include:
Neurotology/Otology: This specialty includes disease of the ear impacting balance and hearing. This includes injury or trauma to the ear, nerve pathway disorders, cancer, swimmer’s ear, pain in the neck, face or ear, tinnitus, ear infections, hearing loss and dizziness.
Head and Neck: This includes noncancerous and cancerous tumors on the neck, head, parathyroid, thyroid, cancer in the voice box and lumps in the thyroid and neck.
Pediatric Otolaryngology: This involves specific ENT issues including delays in development, birth defects of the neck and head, adenoid and tonsil infections, Down’s syndrome, sinus disease, airway issues, allergies and asthma.
Allergy: This specialist uses immunotherapy or medications to treat sensitivities including dust, food, pollen and mold. Additional treatments include perennial and seasonal rhinitis, laryngitis, otitis media, hay fever, chronic sinusitis, dizziness and sore throat.
Facial Reconstructive and Plastic Surgery: This includes reconstructive, functional and cosmetic surgery for abnormalities of the neck and face such as a deviated septum, face-lift, drooping eyelids, rhinoplasty, cleft palate and hair loss.
Laryngology: This is the treatment of throat disorders including difficulty swallowing, voice issues, hoarseness, sore throat and (GERD) gastroesophageal reflux disease.
Rhinology: This is the treatment of sinus and nose disorders including loss of smell, stuffy nose and nose bleeds.
The Conditions Most Frequently Treated By an ENT Specialist
Chronic Sinusitis: This condition occurs due to swelling within the nasal passages. Mucus accumulates making it difficult to breathe properly through the nose. Chronic sinusitis results from polyps growing within the nose, infection or a deviated septum.
Airway Issues: This encompasses mild to severe breathing difficulties. When there is a severe obstruction in the airway, the condition can be life-threatening. These issues can be caused by numerous underlying conditions.
GERD: Gastroesophageal reflux disease causes the contents in the digestive tract and acid in the stomach to travel to the esophagus. Stomach acid is usually prevented from traveling in an upward direction by the sphincter. This ring of muscle is located at the base of the esophagus. When the sphincter is not performing correctly, the result is often difficulty swallowing, chest pains and heartburn.
Deviated Nasal Septum: The nasal cavity is divided by the nasal septum. When there is a significant shift of the septum from the midline, it becomes deviated. This usually results in chronic sinusitis and difficulty breathing. A baby can be born with a deviated septum or it can be the result of an injury to the nose.
Cancer: The approximation is over 55,000 individuals in the United States will develop cancer of the neck and head during the coming year. Almost 13,000 of these individuals will not survive the disease. Treatment from an ENT specialist is critical.
Swallowing Disorders: Anyone can have issues moving saliva, liquids and food to the stomach. This condition is known as dysphagia. The most common symptoms are impaired nutrition, discomfort, choking and coughing.
Cleft Palate and Cleft Lip: When the mouth is split, the palate, lip or both are unable to properly develop while the fetus is growing. There are different cleft sizes. Some result in minor issues while others cause significant problems breathing, talking and eating.
Drooping Eyelids: In some instances, the aging process can cause the upper eyelid to sag excessively. This can also be the result of an underlying condition including stroke, diabetes or tumors. These conditions can affect the reactions of the muscles or nerves. In some cases, vision can be impacted by drooping eyelids.
Dizziness and Vertigo: The term dizziness is a generalization including imbalances and light-headedness. One of the specific types of dizziness is called vertigo. This condition causes the individual to feel like they are falling even when they are still. Vertigo can also cause a spiraling sensation. The specialist is trained to treat vertigo and any condition impacting the inner ear or the central nervous system.
Loss of Hearing: Hearing loss can occur at any age. There are numerous potential causes including, exposure to excessively loud noises, heart conditions, stroke, aging, viruses, head injuries and tumors. This can result in a gradual loss of hearing.
Tinnitus: Tinnitus usually lasts for a minimum of five minutes. This condition causes the individual to hear sounds that are not there. The more serve form of the condition is called bothersome tinnitus. This often distresses the individual so much the quality of their life suffers and their functional health deteriorates.
Adenoid or Tonsil Infection: A portion of the immune system are the adenoids and tonsils. Their purpose is the sampling of viruses and bacteria entering the body by the mouth and nose. When there are consistent infections, surgery may become necessary.
Voice Disorders: There are numerous conditions classified as voice disorders. This includes viruses, injuries impacting the vocal cords, chronic acid reflux and cancer. All of these disorders can result in a decreased vocal pitch, completely losing the voice, persistent hoarseness and vocal fatigue.
What is ENT Common Procedures and Surgeries?
The following are the most common procedures and surgeries performed by an ENT physician.
Excision and Biopsy: A biopsy is performed by an ENT surgeon for the identification of suspicious tumors and lesions. The development can occur anywhere on the body. The correct identification is critical for determining the right treatment. In some cases, a local anesthetic is used for the removal of superficial skin cancers and small lesions on an outpatient basis.
Blepharoplasty: This procedure is used to repair excessively droopy eyelids. The excess fat, muscle or skin impairing vision is removed. This procedure is generally for cosmetic reasons. No hospital stay is usually necessary.
Septoplasty: Deviated septums can be corrected with this surgery. Once the polyps are removed, the nasal access of the nose increases. This surgery is performed using either general or local anesthetic. The ENT surgeon separates the underlying cartilage from the nasal passage lining. The bent cartilage can then be straightened.
Endoscopic Sinus Surgery: This surgery is performed by an otolaryngologist for the treatment of inflammatory or infectious sinus diseases including polyp growth and chronic sinusitis. The instrument inserted into the nose by the ENT surgeon is called an endoscope. This allows the surgeon to clearly see the sinuses. This enables the insertion of other surgical instruments such as lasers. The removal of the material causing a blockage in the sinuses is then possible. This procedure requires either general or local anesthesia.
Tympanoplasty: This surgery is performed for the repair of eardrum defects through the use of a graft. Bone disease of the middle-ear can also be treated. The surgery closes perforations, eliminates any trace of the disease in the middle ear and improves the hearing. This surgery is often performed on an outpatient basis.
Facial Plastic Surgery: This surgery is performed for both cosmetic and reconstructive reasons. The surgeon is trained to repair congenital anomalies, and conditions resulting from skin cancer, previous surgeries, injuries and accidents in addition to cleft palates. The surgery can improve the aesthetics of the facial structure such as correcting wrinkles.
Thyroid Surgery: The thyroid is located right under the larynx. All or a portion of the thyroid glands can be removed by the surgeon. This surgery is performed for suspicious lumps, hyperthyroidism, thyroid cancer and when the esophagus or windpipe becomes obstructed.
Tracheostomy: The neck is used for the creation of an opening into the windpipe during this procedure. A tube is then inserted by the otolaryngologist to remove secretions in the lungs or create an airway. This procedure is performed for the treatment of numerous health issues such as advanced laryngeal disease and cancer in the neck.
Myringotomy and PE Tube Placement: A specialist is capable of performing many different types of ear surgeries. A loss of hearing can result from consistent infections in the middle ear or fluid within the ear. Tubes can be placed by the surgeon through the eardrum. This enables air to reach the middle ear. A PE tube can be used for either a long or short-term solution. During the procedure, a small incision is made by the otolaryngologist in the eardrum. The pressure in the eardrum caused by the fluid build-up is then relieved. Puss accumulating in the middle ear can also be drained during the procedure.
Surgery for OSA or Snoring: There are several different surgeries for the correction of (OSA) obstructive sleep apnea and snoring. The airway can be opened up through the removal of excessive soft palate tissue. The bulk of the tissue can be decreased by using radiofrequency thermal ablation. The palate can also be made stiffer with the insertion of a stiffening rod to decrease the risk of collapse and reduce vibration. In some cases, injections are effective.
Neck Dissection: This is considered major surgery performed using general anesthetic for the removal of cancerous lymph nodes located on the neck. The spread of the cancer determines how extensive of a surgery is necessary. One of the most major surgeries is a radical neck dissection. All of the tissue from the collarbone to the jawbone is removed in addition to the nerves, major blood vessels, muscles and salivary glands located in the area.
Adenoidectomy or Tonsillectomy: During a tonsillectomy, the surgeon removes the tonsils. An adenoidectomy involves removing the adenoids. Both of these procedures are often performed for breathing issues and recurring infections. In most cases, a general anesthetic is necessary. A hospital stay is usually not required.
What is ENT Training and Certification
Approximately fifteen years of training and education is necessary. This includes an undergraduate program, a medical program, a minimum of five years of specialty training and a residency. The physician must then pass both written and oral examinations. A fellowship may be pursued if the physician is interested in training for a subspecialty. Subspecialties include:
• Pediatric otolaryngology
• Reconstructive and facial plastic surgery
• Sleep medicine
• Neck and head surgery
If you are a student interested in becoming an ENT specialist, we encourage you to apply to our Pre-Medical Internship Program.