An Ear, Nose, and Throat doctor, formally known as an Otolaryngologist, is a surgical specialist focused on the diagnosis and treatment of disorders affecting the head and neck. This medical specialty covers a vast anatomical region, encompassing the ears, nose, sinuses, mouth, throat, larynx, and structures of the neck. Otolaryngologists are trained in both medicine and surgery to manage conditions responsible for fundamental human functions like hearing, breathing, speaking, and swallowing. Their scope deals with everything above the shoulders, excluding the eyes, brain, and teeth.
Ear Conditions and Hearing Care
The ear is responsible for both hearing and balance, and Otolaryngologists, particularly those with subspecialty training in Otology and Neurotology, manage the full spectrum of its disorders. Hearing loss is addressed through advanced diagnostics and a range of treatments, from prescribing hearing aids to surgical solutions for sensorineural deafness.
For patients with profound hearing loss, an ENT physician may implant a cochlear device. This electronic system bypasses damaged parts of the inner ear to directly stimulate the auditory nerve, requiring precise surgery to place the electrode array within the cochlea. Chronic middle ear infections, particularly in children, are often treated surgically with a myringotomy, which involves inserting small ventilation tubes into the eardrum to equalize pressure and facilitate drainage.
Disorders of balance, such as vertigo caused by Meniere’s disease, also fall under the Otolaryngologist’s care since the inner ear houses the vestibular system. Treatment for Meniere’s disease often begins with medical management. For severe vertigo attacks, surgical interventions are an option, including intratympanic injections of steroids or gentamicin to control symptoms. In end-stage cases, a labyrinthectomy may be performed to permanently stop the vertigo.
Addressing Nose and Sinus Issues
The practice of rhinology focuses on conditions affecting the nasal cavity and the paranasal sinuses. Chronic sinusitis, defined as inflammation lasting twelve weeks or more, is a frequent reason for consultation when medical treatments fail. The ENT’s goal is to restore proper airflow and sinus drainage, which is often obstructed by inflamed tissues, polyps, or structural issues.
A common structural repair is a septoplasty, a procedure to straighten a deviated septum (the wall dividing the two nasal passages). Straightening the septum improves breathing and enhances the effectiveness of other treatments by opening the nasal airway. Nasal polyps, non-cancerous growths that block the sinuses, may be removed through a polypectomy or as part of a more extensive surgery.
Functional Endoscopic Sinus Surgery (FESS) is the standard minimally invasive technique for chronic sinusitis, utilizing a thin, lighted tube called an endoscope to visualize and operate within the nasal passages. During FESS, the surgeon removes diseased tissue, polyps, or enlarges the natural drainage pathways of the sinuses to promote ventilation and drainage. This modern approach often incorporates an image-guidance system, which uses pre-operative CT scans to increase precision and safety within the complex anatomy of the skull base.
Treating Throat, Voice, and Swallowing Problems
The specialty of laryngology addresses the throat, voice box (larynx), and the upper digestive tract, managing conditions that impact communication and nutrient intake. Common procedures include a tonsillectomy or adenoidectomy, performed for recurrent infections or significant airway obstruction. In children, enlarged tonsils and adenoids are a primary cause of obstructive sleep apnea (OSA), often requiring surgical intervention when the upper airway repeatedly collapses during sleep.
Voice disorders, such as chronic hoarseness, are investigated using a nasolaryngoscope to visualize the vocal cords for issues like nodules, polyps, or paralysis. Treatment for these lesions ranges from voice therapy and medical management to precise microlaryngeal surgery to remove growths while preserving the vocal cord tissue.
Difficulties with swallowing, medically termed dysphagia, are evaluated and managed by the ENT, as swallowing involves complex coordination of muscles and nerves. The ENT specialist also treats adult OSA, offering surgical options when continuous positive airway pressure (CPAP) is not tolerated. These treatments include procedures to stiffen or reduce tissue in the soft palate or, in select cases, the implantation of a hypoglossal nerve stimulator to keep the airway open during sleep.
Head, Neck, and Facial Surgery Expertise
The ENT’s training extends beyond the three main conduits to encompass the surrounding structures of the head and neck, focusing on masses, trauma, and reconstruction. They manage neck lumps and tumors, including those affecting the endocrine and salivary glands. For instance, an Otolaryngologist performs a thyroidectomy (removal of the thyroid gland) for cancer or large nodules.
Procedures like a parotidectomy (removal of the parotid salivary gland) are routine, requiring careful dissection to avoid damage to the facial nerve that runs through the gland. The ENT surgeon is often the primary specialist managing facial trauma, such as fractures of the cheekbones or jaw, requiring precise realignment and fixation to restore function and appearance.
Many Otolaryngologists subspecialize in facial plastic and reconstructive surgery, performing reconstructive work following trauma or cancer removal. These surgeons perform cosmetic procedures like rhinoplasty, which may be done for aesthetic reasons or in conjunction with a septoplasty to improve both the form and function of the nose. The comprehensive training allows them to address a wide variety of conditions, from cancers to subtle cosmetic deformities.