What is ENT?
If you find yourself complaining about symptoms in the ear, nose, or throat region, you need to visit a specialist called an otolaryngologist or an ear, nose, and throat (ENT) doctor.
According to the American Academy of Otolaryngology, ENT is one of the oldest medical specialties in the United States of America. Its recognition as a specialty dates back to the 19th century, when doctors first discovered and understood the intricate connections between the head and neck regions.
Education and training of an ENT
To become a board-certified otolaryngologist, one must complete 15 years of college and post-graduate training. After fulfilling these requirements, ENTs must pass the American Board of Otolaryngology exam, which includes an oral and written test. Doctors may continue their education with a one-year or two-year fellowship in a subspecialty of ENT. However, some ENTs may restrict their clinical work to just one of these seven specialties.
ENT subspecialties
Otolaryngology-head and neck surgery encompasses many subspecialties. Some include-
- Facial and reconstructive surgery: This specialty involves performing surgery to reshape structures in the head and neck, including ears, nose, cheekbone, and chin. It may be done to reconstruct the face after an injury by accident, a disease, or to change a feature present from birth. Facial plastic surgery may also be done to change the appearance of the face and neck cosmetically. Types of cosmetic surgeries done by ENT surgeons include a facelift, brow lift, face fillers, neck lift, and rhinoplasty (surgery that changes the shape of the nose.Â
- Head and neck surgery: These ENT specialists can treat many conditions of the head and neck, including tumors and cancers in the nose, sinuses, mouth, throat, upper esophagus, and voice box.They also treat thyroid conditions like Graves' disease, TMJ pain, and Bell's Palsy (injury or damage to the facial nerve by pressure or swelling).Â
- Pediatric otolaryngology: Infants, babies, and children often need special attention when ENT disorders affect them. Pediatric otolaryngologists treat many ENT problems, including ear infections, asthma, hearing loss, and tonsilitis, in children from the newborn stage to their teenage and young adult years. Additionally, pediatric ENT doctors also care for kids with congenital disabilities of the head and neck. Pediatric ENTs can also help determine if your child has a speech or language problem.
- Otology and neurotology: ENT doctors specializing in ear conditions are called otologists or neurotologists. These specialists are experts in diagnosing hard-to-treat or recurrent middle ear problems. They also treat complex ear diseases, acoustic neuromas (tumors in the ear), chronic ear infections, and vertigo that does not improve. They are also trained to perform complicated ear surgeries. Neurotologists treat neurological-related and inner ear concerns, such as skull base tumors, implantable hearing devices like cochlear implants, and bone conduction hearing aids.
- Laryngology: Laryngologists are ENT specialists who can assess in detail the disorders of the larynx, also called the voice box and vocal cords, which affect speech and swallowing.
- Sleep medicine: Problems during sleep, such as snoring, may be signs of severe underlying health issues, such as obstructive sleep apnea (OSA). OSA is due to partial obstruction to the airflow through the passages at the back of the nose and mouth. Such sleep disorders may be treated by an ENT specialist who is knowledgeable about sleep studies and treatments like continuous positive airway pressure (CPAP).
What do ENTs treat?
As their name suggests, ENT specialists treat conditions affecting the ear, nose, and throat regions through medical and surgical means. They are experts in a range of issues, including infections and disorders in the ears that can impact hearing and balance, obstructive and infective diseases of the nose that can affect breathing and smell, diseases that affect the larynx and esophagus, and infectious diseases in the head and neck area. Conditions in the head and neck region include:
Common ENT procedures
An ENT specialist is trained to perform the following ear, nose, and throat procedures:Â
- Sinus surgery
- Corrective breathing surgery
- Tonsil removal
- Snoring/sleep disorder surgery
The inflammation or swelling of the tissue lining the sinuses, causing fluid buildup, is called sinusitis. Surgery may be the only option when medical treatments fail to treat chronic sinus infections successfully. An ENT surgeon can carry out the procedure to enlarge and drain the sinuses, thereby enhancing sinus function and lowering the risk of infection. This minimally invasive sinus surgery is frequently done as an outpatient procedure. There are also other types of sinus surgeries, including:
- Endoscopic sinus surgery involves looking through a microscope at the sinus openings to remove any obstructive or unusual growths or tissues.
- Computed tomography and endoscopy are used in image-guided surgery to enhance the surgeon's ability to see the target area. Imagery is beneficial when performing procedures to correct previous sinus surgeries or to address abnormal sinus anatomy.
- The maxillary sinus, situated under the eye, may be operated on to improve drainage by removing irreparably damaged mucosa.
Other common ENT surgeries include inserting a tube into the ear to drain fluid buildup in the middle ear. Doctors may suggest this procedure as accumulated ear fluid can cause chronic infections and even has the potential to damage hearing. Reconstructive eardrum surgery, also known as tympanoplasty, is performed to fix holes in the eardrum that have failed to heal on their own. An ENT may recommend a stapedectomy, which involves removing at least a portion of the middle ear bone to improve hearing.
What is an outer ear infection? How is it caused?
An outer ear infection, also termed otitis externa, is a disorder that affects the ear canal and the outer ear opening, which connects the exterior of the ear to the eardrum. This type of infection is often caused by exposure to moisture and is particularly common in individuals who spend considerable time swimming, including children, teenagers, and adults. One of the most common forms of otitis externa is "swimmer's ear."
Frequent swimming, bathing, or showering may result in an outer ear infection. The water inside the ear canal creates an ideal environment for bacterial growth. An injury to the thin layer of skin lining the ear canal, caused by intense scratching, using headphones, or putting cotton swabs in the ear, can also lead to an infection. When damaged and inflamed, this delicate layer of skin provides a conducive environment for bacterial growth. The earwax, scientifically known as cerumen, is the ear's natural defense against infection. Continuous exposure to moisture and scratching can diminish the amount of earwax, which can increase the risk of infections in the ear.
What are the signs and symptoms of an outer ear infection?
Otitis externa is a medical condition that presents with a range of symptoms. These symptoms include heat, swelling, pain or discomfort in the ear, discharge of pus, redness, itching, excessive fluid drainage, and muffled or diminished hearing. In some cases, severe pain in the face, head, or neck may indicate that the infection has progressed significantly. Accompanying symptoms such as fever or swollen lymph nodes may also signify an advancing infection. You should promptly seek medical attention from an ear, nose, & throat doctor near you if you experience ear pain or any of these symptoms.
What are the treatments for outer ear infections?
Outer ear infections have the potential to resolve themselves without any medical intervention. However, when the infection persists, antibiotic eardrops are the commonly prescribed treatment by medical practitioners. These eardrops can only be obtained through a prescription from a doctor. Doctors may combine antibiotics with steroids in ear drops to treat ear canal inflammation. The drops are used multiple times a day for 7-10 days.
When fungus is the root cause of an outer ear infection, medical professionals prescribe antifungal ear drops. It is essential to note that individuals with a compromised immune system or diabetes are at a higher risk for this type of infection.
Avoid exposing the ear to water during the healing process to alleviate the associated symptoms. Over-the-counter pain relief pills, such as ibuprofen or acetaminophen, are known to be effective in reducing pain. In instances of severe pain, however, prescription medication may be required to address the issue.
Understanding tonsillitis
Tonsils, scientifically known as palatine or faucial tonsils, are two, one on each side at the back of the throat. They are oval-shaped and comprise lymphatic tissue that helps fight infections in this region. When we inhale or ingest germs, our tonsils are the first defense against them. The swelling of the tonsils is known as tonsillitis. It is a prevalent infection. Almost 2% of ambulatory patients who visit an outpatient clinic complain of sore throat and are diagnosed with tonsillitis.
What causes tonsillitis?
Inflammation of the tonsils happens due to bacterial or viral attacks. Finding the cause of the infection is the first step in determining the course and success of treatment. Several viruses can cause tonsillitis. The viruses that cause milder infections, which rarely lead to complications when treated on time, include viruses causing the common cold, such as adenovirus, rhinovirus, coronavirus, and respiratory syncytial virus. However, some deadly viruses such as Hepatitis A, Epstein-Barr, Cytomegalovirus, HIV, and Rubella virus can cause complicated infections of the tonsils.
Both aerobic and anaerobic organisms cause bacterial tonsillitis. The common bacteria cultured in patients diagnosed with tonsillitis include Group A Beta-Hemolytic Streptococcus (GABHS). However, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenza have also been found in cultures and are responsible for causing infections.
How does tonsillitis present?
Some common symptoms that patients with tonsillitis present are a sore and scratchy throat, fever, tonsillar swelling, difficulty swallowing, stomach pain, swollen lymph nodes in the neck, stiff neck, headache, and red, white, or yellow patches on the tonsils.
In tiny kids who cannot describe their symptoms, the common signs to look for are drooling and fuzziness while swallowing food or liquids and refusing to feed.
The first doctor's appointment with an ENT doctor
When doctors suspect infection in your tonsils, they begin their evaluation with a thorough medical history. Carry all the information about the medications you take regularly. This includes prescribed medications, over-the-counter drugs, and dietary supplements. The doctor will also inquire about your personal or family history of allergies to food or other substances, adverse reactions to anesthesia, and a known history of bleeding and clotting disorders.
A physical examination follows the medical history. The doctor feels the neck and looks for lymph node swelling. A lighted instrument is used to visualize the tonsils directly to check for enlargement, redness, or pus in the region. If direct visualization is impossible, a CT scan is performed to obtain an image of the tonsils. Some laboratory tests for diagnosing tonsillitis are a complete blood count (CBC), a Basic Metabolic Panel, a throat swab culture test, and rapid antigen testing.
Treatment options for tonsillitis
The treatment options for tonsillitis depend on its cause and severity.
- At-home care: Home care is needed to improve the treatment of uncomplicated viral tonsillitis. This includes adequate rest, plenty of fluids, salt water gargling, lozenges to soothe the throat, humidifying the air, and symptomatic relief with anti-analgesics and antipyretics for pain and fever.
- Antibiotics: If tonsillitis is due to a bacterial infection, antibiotics are prescribed for at least ten days.
- Surgery: Tonsillectomy is a surgical procedure that is performed for complicated tonsillitis. Tonsillectomy involves surgically removing one or both tonsils. Some reasons for performing tonsillectomy are frequent tonsillitis (more than five episodes of tonsillitis in a year), tonsillitis resistant to antibiotic treatment, tonsillitis leading to obstructive sleep apnea, difficulty in breathing or swallowing, formation of an abscess in the tonsillar region that does not respond to medical treatment, and malignant tumor in the tonsils.
Risks of tonsillectomy
Some common risks associated with tonsillectomy are adverse reactions to anesthesia, swelling of the tongue and roof of the mouth leading to breathing and swallowing difficulties, severe bleeding during and after surgery, and post-surgical infections.
Complications of tonsillectomy
After having your tonsils surgically removed, if you experience any of the following complications, such as bleeding from the nose and mouth, a high fever (102 degrees F or higher), severe dehydration, or difficulty breathing, it's important to seek immediate care and treatment at the nearest emergency room.
Find the best ear, nose, & throat doctor near you in Tampa, FL
While the symptoms of ENT conditions can range from mild to severe, the treatment depends on timely and proper intervention. This is where the elaborate Zocdoc database can help you overcome the initial but crucial hiccup of finding the right ENT for you. Zocdoc takes special care in curating and filtering only the best ENT doctors in Tampa. Detailed information is available for every doctor listed on Zocdoc. The profiles include the practitioner's qualifications, certifications, work experience, and subspecialties. In addition, Zocdoc also provides verified patient reviews with practitioners to help you make informed choices.
You can also search for ENT doctors who accept your insurance. If you cannot find your insurance plan listed on Zocdoc, you can try uploading a photo of your insurance card and letting Zocdoc scan the image of your card to show you your likely plan. Note that this service is available only for medical insurance cards. Dental or vision insurance cards are excluded. If you need assistance uploading your medical insurance card, contact Zocdoc's dedicated service team, available 365 days a year, to help you solve any issues or queries regarding the platform. You may also access Zocdoc's patient help center for more insurance-related information.
Using Zocdoc, bookings with a top-rated ear, nose, and throat doctor near you become free, fast, and secure.
ENT-related statistics
According to the National Center for Biotechnology Information, tonsillitis accounts for around 1.3% of outpatient visits in the U.S. The report also stated that the most common bacterial tonsillar infections are caused by group A beta-hemolytic Streptococcus (GABHS), which accounts for 15 to 30% of cases of tonsillitis in patients aged 5 to 15.
Another report by the same organization stated that tonsillectomy is one of the most commonly performed surgical procedures. In the U.S., approximately 500,000 surgeries are performed yearly on children under 15.
According to the Florida Department of Health, the head and neck cancer rate per 100,000 in Hillsborough County was 17.6 in 2021; this was slightly lower compared to the whole of Florida (18.4).
Sources
Healthline
Columbia University Irving Medical Center
National Center for Biotechnology Information[1]
National Center for Biotechnology Information[2]
Mayo Clinic[1]
Mayo Clinic[2]
Mayo Clinic[3]
News Medical Life Science
WebMD
Indiana University School of Medicine
Mayo Clinic[4]
Mayo Clinic[5]
Duke Health
HealthyChildren.org
ENT Health[1]
ENT Health[2]
Florida Department of Health
