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Who is an ENT?

ENT is a medical subspecialty that manages conditions in the ears, nose, throat, and nearby head and neck regions, except for the brain and eyes. The doctors are referred to as ENT specialists, otolaryngologists, or otorhinolaryngologists. They are specialists in diagnosing and treating disorders using medical and surgical modalities.

The term “otorhinolaryngology” is derived from three Greek root words: oto stands for ear, rhino stands for nose, and larynx stands for throat.

What conditions do otolaryngologists treat?

• Hearing loss: There are numerous reasons for loss of hearing, and ENT specialists are experts in diagnosing and treating all of them. Some common reasons for changes in hearing include recurrent ear infections, fluid collection in the middle ear, eardrum rupture, pain in the ears, dysfunction of the eustachian tube, build-up of too much earwax, and ear tumors. Otolaryngologists manage hearing loss by prescribing medications, hearing aids, and surgical placement of cochlear implants.
• Balance disorders: The vestibular system, also known as the organ of balance, is located within the inner ear. Any infections or obstructions in the ear lead to vertigo (feeling like your body is spinning), lightheadedness or dizziness, feeling like you are about to faint, and instability or a loss of body balance.
• Ear Infections: Ear infections are common and usually resolve independently in about four days. If the conditions keep recurring, it could lead to hearing loss and require an ENT specialist’s intervention. An ENT is trained to remove the excess fluid collected in the ears by placing tiny tubes inside the ear canal.
• Tinnitus: Patients describe tinnitus as a ringing, buzzing, roaring, whistling, hissing, or clicking sound in the ears. These sounds, which the patients can hear without any external source, can adversely affect their everyday lives, leading to stress, anxiety, and even depression.
• Nose and sinus disorders: Nasal disorders can range from allergies, infections such as rhinitis and sinusitis, obstructions such as nasal polyps or nasal tumors, uncontrollable nosebleeds, deviated nasal septum, and smell disorders.
• Problems in the head and neck: ENT specialists are trained to surgically remove benign and malignant cancerous growths in the head and neck region, except the brain and eyes. They also perform tonsillectomy (surgical removal of the tonsils), adenoidectomy (surgical removal of the adenoid glands), reconstruction of the face and neck following an accident or other trauma, and plastic surgeries for aesthetic improvement.

Head and neck cancer

Head and Neck neoplasms may begin in the cellular lining of the mouth, throat (pharynx), voice box (larynx), salivary glands, nasal and paranasal sinuses, muscles, or nerves in this region. Some of the causes of cancer in the head and neck region are the use of tobacco and alcohol, Human Papillomavirus (HPV) infection, Epstein-Barr virus infection, consuming betel nuts and leaves, occupational exposure to wood dust, asbestos, and synthetic fibers, exposure to radiation, and genetic conditions such as Fanconi anemia.

Symptoms usually present as a lump in the neck, red or white sore in the mouth, pain and difficulty swallowing that doesn’t regress, pain and trouble breathing and speaking, chronic and recurrent sinus infections, swelling under the jawbone, or partial or complete paralysis of the face and neck region.

Treatment modalities for head and neck neoplasms include surgery, radiation, chemotherapy, targeted therapy, and immunotherapy. Successful treatment requires collaboration between many specialists, such as otolaryngologists, oncologists, neurosurgeons, endocrinologists, plastic surgeons, and speech pathologists.

Dysphagia

Dysphagia, a condition marked by challenges in the process of swallowing, is not a standalone diagnosis but rather a notable symptom. Although prevalent across various age groups, it is more common among older adults. Most factors causing dysphagia are generally non-life threatening and temporary; however, some cases may signal more severe conditions, including tumors or neurological disorders.

Swallowing is an integral aspect of daily activities involving ingesting solid foods and liquids and swallowing the mucus and saliva produced by the body. It is a multi-stage process comprising four interconnected phases: 

• Oral preparation stage: In the initial phase, food or liquid is prepared in the mouth, chewed, and gathered in order to be swallowed.
• Oral stage: The swallowing response is initiated in the second stage when the tongue pushes the liquid or food to the rear of the mouth.
• Pharyngeal stage: In the third stage, the processed material from the mouth passes through the pharynx, or throat, and enters the esophagus, the food pipe.
• Esophageal stage: Food or liquid travels through the esophagus and into your stomach during the final stage.

Notably, this process's third and fourth stages occur involuntarily, without conscious thought. Consulting with an ENT doctor near you is essential to effectively identify and address potential concerns impacting this complex physiological function.

The manifestations of dysphagia are diverse, including symptoms like drooling, a sensation of food or pills sticking in the throat, coughing or choking, a perceived "lump" in the throat, unintended weight loss, susceptibility to lung infections like pneumonia, alterations in voice, and, in severe cases, coughing up blood.

Comprehensively addressing dysphagia entails a collaborative effort among healthcare specialists. ENT specialists collaborate with gastroenterologists, neurologists, and speech-language pathologists to accurately diagnose and effectively treat the underlying causes of swallowing difficulties.

The diagnostic process involves meticulously exploring the patient's medical history and thoroughly examining the mouth and throat. Procedures such as flexible laryngoscopy or flexible endoscopic evaluation of swallowing (FEES) may be employed to gain a detailed view of the throat, tongue, and voice box. Additional tests, including barium swallow, modified barium swallow, trans-nasal esophagoscopy (TNE), upper endoscopy, and pressure testing (manometry), may be recommended to assess different aspects of the swallowing process.

Timely treatment for dysphagia is crucial to prevent potential complications such as malnutrition, dehydration, and pneumonia. This interdisciplinary approach aims to enhance diagnostic precision and treatment effectiveness, ensuring a comprehensive and effective management of this challenging symptom.

GERD and LPR

Acid reflux happens when the acidic liquid in the stomach flows backward into the swallowing tube (also called the esophagus), which connects the throat with the stomach.

When acid reflux repeatedly occurs in the esophagus, it is identified as gastroesophageal reflux disease or GERD. When the acidic contents reach the throat and the voice box (called the pharynx and larynx), the ailment is called laryngopharyngeal reflux or LPR.

Both conditions may happen simultaneously, or people may sometimes experience symptoms of either GERD or LPR. If the symptoms occur two times a week or more, you need to see an ENT doctor for further diagnosis.

Symptoms of GERD and LPR include:

• Belching
• Heartburn
• Bitter taste
• Excess mucus
• Difficulty swallowing
• Throat soreness or burning sensation
• Frequent coughing or throat-clearing
• Choking episodes while sleeping
• Difficulty breathing
• Change in voice or hoarseness

Causes: Physical causes and lifestyle factors can lead to GERD and LPR. Primary physical causes include abnormal or weak muscles in the lower area of the esophagus, which is connected to the stomach. These muscles act as barriers and stop the contents in the stomach from reentering the esophagus. Slow stomach emptying, abnormal esophageal spasms, and hiatal hernia are other physical causes. Lifestyle and eating habits like overeating, lying down after eating, eating late, and consuming alcohol or tobacco can also cause acid reflux.

Primary care doctors refer such patients to an otolaryngologist or ENT (ear, nose, throat) specialist for a detailed evaluation, diagnosis, and proper treatment of the related symptoms.

Treatment: The ENT doctor may conduct various screening tests, such as a special X-ray, endoscopic exam, biopsy, esophageal motility testing, gastric emptying study, and a 24-hour test (to check the acidic liquid flow from the stomach into the esophagus).

Treatment options include diet and lifestyle modifications, medications, and surgery (in rare cases). ENT doctors may prescribe ulcer medications, antacids, foam barrier medications, or proton pump inhibitors for 30 days for effective outcomes. For some patients, doctors may prescribe medicines for two or three months to treat the conditions.

Finding the best ENT doctor near you

ENT specialists can help you overcome several concerns, but how can you find the best ones? Zocdoc can aid your decision-making. Our elaborate list of ENT specialists mentioned, along with their qualifications, certifications, and years of experience, can help you select the right ones. Searching is easy, too. Just type in your conditions (e.g., ear pain) and your city (e.g., San Jose), and Zocdoc will help you find a qualified ENT doctor near you.

Zocdoc also includes patient reviews with all practitioner profiles, enlisting their experiences, specialties, research, and recognition, amongst other information, so that you can make the most intelligent and informed choices best suited for your needs and requirements.

All bookings on Zocdoc are free, fast, and secure.

Head and neck cancer in the US and California

As per the American Cancer Society’s publication Cancer Facts and Figures 2022, almost 4% of all cancers diagnosed in the United States are head and neck. In 2022, an estimated 48,520 men and 17,950 women may be diagnosed with head and neck neoplastic disorders. As per the same report, approximately 15,050 deaths will occur in the United States this year due to head and neck cancer.

The estimates for oral and oropharyngeal cancers in the United States for the year 2022 state that 54,000 new cases will be diagnosed this year, and the number of deaths due to oral and oropharyngeal cancer will be a staggering 11,230.

Sources

National Center for Biotechnology Information

American Cancer Society

Cancer.Net

National Cancer Institute

Mayo Clinic

WebMD

Healthline

ENThealth[1]

ENThealth[2]

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 immediately.