WHAT IS OTOLARYNGOLOGY?

Otolaryngology—commonly referred to as Ear, Nose and

Throat (ENT)—is the branch of medicine that specializes in
the diagnosis and treatment of a broad range of ear, nose,
throat, head and neck problems.
Some common examples are chronic ear infection, tonsillitis, sinus problems
and sleep apnea. However, otolaryngology also encompasses hearing loss,
various cancers of the head and neck, voice issues and reconstructive surgery
to repair injury or deformities.  Otolaryngologists are physicians and surgeons
who specialize in diagnosing and treating these disorders.

Within otolaryngology are a number of sub-specialties, which include:

 Otology, which deals with disorders of or trauma to the ear such as

hearing loss, dizziness, ear inflammation, perforated eardrum, etc.
 Rhinology, which primarily pertains to sinus disorders
 Laryngology, which focuses on issues such as hoarseness and vocal
cord problems
 Head and Neck, which includes the diagnosis and treatment of thyroid
cancer and cancer of the oral cavity, pharynx and larynx
 Facial plastic and reconstructive surgery

ENT Examination
 Richmond ENT
 Patient Information
 ENT Examination

At Richmond ENT, we take pride in performing a comprehensive history and specialty specific
examination, so that we can provide an integrated approach to ear, nose and throat disorders.  All
new patients will be asked to provide a complete medical history on the first visit.  After your first
visit, you will receive an invitation to join our secure web portal, so that we have a way of securely
contacting you with test results and follow-up appointments.
The most common services that we might provide on the first visit are:

 ENT examination
 Audiometric testing
 Nasal endoscopy
 Allergy testing
 CT scan
 Cultures and biopsies

Please be aware that your co-payment for an office visit applies to the ENT history and examination,
but does not include any of the additional diagnostic tests listed above.  These tests are billed
separately to your insurance company and you may be responsible for a portion or all of these
charges.

A complete ENT examination includes inspection of the face, ears, nose, throat and neck.  We
generally screen for hearing loss and we use pressure testing to examine the eardrum for fluid
(pneumatic otoscopy or tympanometry).  The specialty nasal examination is usually performed with a
headlight or mirror and a handheld speculum that allows us to examine the nasal septum and
turbinates closely.  The nose will often be examined before and after application of a decongestant
nose spray.  The most unique part of the ENT visit is an examination of the voice box and the back
of the nose using hand-held mirrors in the mouth.  Examination of the neck is performed with care
and includes the lymph nodes, salivary glands and thyroid gland.  Examination of overall health and
the cardiopulmonary system concludes the routine examination.  The ear, nose and throat
examination is not generally painful, although some patients find that examining the mouth makes
them gag.

Audiometric testing is commonly performed for patients with complaints of hearing loss, ringing in
the ears, or balance disorders.  The otoacoustic emissions test (OAE) is a pass-fail screening test
for normal hearing.  This 5-second test requires a quiet room, but no response from the patient, and
is routinely used for screening newborns in the nursery.  Patients who are cooperative enough to
follow instructions can be more precisely tested in our acoustically isolated testing booth.  The
audiologist records the quietest sounds you can hear at each frequency, in each ear.  The resulting
graph is called an audiogram.  Tympanometry is a quick and painless way to measure the
barometric pressure in the middle ear and to assess fluid behind the eardrum in small children.
Nasal endoscopy is the most commonly performed diagnostic procedure in patients with nasal,
sinus, or allergy complaints.  The nurse will spray your nose with a decongestant combined with
lidocaine, a local anesthetic.  The physician or nurse practitioner will then pass a small telescope
into the nostril to obtain a magnified view.  We can readily identify abnormal swelling, enlarged
turbinates, nasal polyps, septal deformities, and sinus drainage.  We are generally well equipped to
culture abnormal secretions or to biopsy abnormal findings.  If you have complaints in the throat,
such as hoarseness or swallowing difficulty, we may use a flexible scope so that we can examine
the back of the throat and voice box through the nose.  This is especially helpful for patients who
have difficulty sitting still for the mirror examination.  We even have an endoscope long enough to
pass all the way down the esophagus, into the stomach if necessary, the procedure called trans-
nasal endoscopy.  In most cases, we have the opportunity to display the endoscopic image on a
television monitor, so that you can better understand your condition.

Allergy testing is most commonly recommended for patients who are not satisfied with medical
management of their allergies, and those with asthma or nasal polyps.  Superficial skin pricks and
injections under the skin are performed with common airborne antigens and foods to determine your
sensitivity to the environment and to calculate a safe starting dose for immunotherapy.

Read more about allergy testing

CT scans of the sinuses and middle ear can be performed in our office and immediately interpreted
by your physician.  Richmond ENT is the first medical practice in central Virginia to offer this service,
as an alternative to scheduling a separate appointment at a radiology center and then returning
several days later to discuss the results.  The Xoran MiniCAT scanner exposes you to 80-90% less
radiation than full-size scanners at a hospital, and results are available in 60 seconds.

What’s the Best Treatment for an Ear Infection?

Ronilee Shye, PharmD, BCGP, BCACP, CDE
Ronilee Shye, PharmD, BCGP, BCACP, CDE, is a licensed pharmacist in Florida, Ohio,
and Pennsylvania.
November 26, 2018, 8:04AM (PT)

Ear infections are caused by either a bacteria or a virus, and most kids
get them before they turn two years old. Ear infections, which often
occur after a cold or throat infection, can be unpleasant or downright
painful. Here’s what you need to know about treatments.

What are symptoms of an ear infection?

Ear infections most often occur in the middle part of the ear. Ear infections in
children (as well as adults) commonly include the following symptoms:

 Pulling at one or both ears (due to ear pain)

 Crying

 Fever

 Trouble sleeping

 Drainage from the ear

 Reduced/fuzzy hearing

How are ear infections treated?

Pain relievers

Treatment with an oral pain reliever like acetaminophen (Tylenol)

or ibuprofen (Motrin) usually helps alleviate fever and pain within a few
hours. Many doctors will actually recommend alternating between Tylenol and
Motrin for the best effect.

Antibiotics

If the infection is bacterial (rather than viral) you may receive a prescription for
an oral or topical antibiotic. Here are some of the antibiotics doctors prescribe
to treat an ear infection:

 Amoxil (amoxicillin)

 Augmentin (amoxicillin/potassium clavulanate)
  Cortisporin (neomycin/polymxcin b/hydrocortisone) solution or
suspension

 Cortisporin TC (colistin/neomycin/thonzonium/hydrocortisone)
suspension

 Ciprodex (ciprofloxacin/dexamethasone) suspension

 Cipro HC (ciprofloxacin/hydrocortisone) suspension

 Ciloxan (ciprofloxacin) solution

 Ocuflox (ofloxacin) solution

 Floxin (ofloxacin) solution

 Acetasol HC (hydrocortisone/acetic acid) solution

Your doctor will assess the type of bacteria likely causing your ear infection to
determine which antibiotic to give you. Most people begin feeling relief within
24 hours of starting a course of antibiotics, and symptoms should improve
significantly within 48-72 hours.

What’s the difference between antibiotic solutions and

suspensions?
Solutions are liquids where the active ingredients are dissolved. Suspensions
are liquids in which the particles are suspended, or scattered throughout the
liquid, and not quite dissolved. Some medications are stable as a suspension
but not as a solution.
 The main difference between the two is how irritating they might be. Antibiotic
solutions are generally more irritating than suspensions because solutions
have a more acidic pH of 3-4, whereas suspensions have a less acidic pH of
5. (The pH scale ranges from 0-14 where 0 is the most acidic or irritating, 7 is
neutral neither acidic or basic, and 14 is the most basic or least irritating.)

Solutions may also contain alcohol to help kill bacteria, but the alcohol can be
extremely irritating when these solutions are applied.

Emergencies
Ear, Nose and Throat Emergencies are rare, but can be life-
threatening. The most common emergencies are nosebleeds and
facial fractures, especially nose fractures. Peritonsillar abscess and
epiglottitis are two severe types of sore throat that may require
emergency treatment. Sudden changes in hearing, or any other
neurologic event should be evaluated immediately.

Self Assessment Hearing Test

 Richmond ENT
 Ears
 Hearing Loss
 Self Assessment Hearing Test

The onset of hearing loss is usually very gradual. It may take place over 25-30 years or it may
happen more rapidly if you are exposed to loud noises at work or through hobbies. Because it
usually does occur slowly, you may not even be aware you have a problem until someone else
brings it to your attention. Here is a simple test you can take to determine if you have a hearing
problem.

1. Do you have to turn the volume up on the television?

2. Do you frequently have to ask others to repeat?
3. Do you have difficulty understanding when in groups or in noisy situations?
4. Do you have to sit up front in meetings or in church in order to understand?
5. Do you have difficulty understanding women or young children?
6. Do you have trouble knowing where sounds are coming from?
7. Are you unable to understand when someone talks to your from another room?
8. Have others told you that you don’t seem to hear them?
9. Do you avoid family meetings or social situations because you “can’t understand”?
10. Do you have ringing or other noises (tinnitus) in your ears?

Scoring:

Answered Yes to less than 3 of the questions…

No significant hearing loss seems present

Answered Yes to between 3 and 5 questions…

You may have a slight hearing problem*

Answered Yes to between 5 and 7 questions…

You may have a moderate hearing problem*

Answered to more than 7 questions…

You may have a significant hearing problem*

*In order to determine the exact degree of hearing loss present, you should have your hearing
evaluated by a licensed hearing professional.

Bell’s Palsy
 Richmond ENT
 Head & Neck
 Bell’s Palsy

Disorders of the facial nerve can occur to men, women, and children, but they are more prominent
among people over 40 years old, people with diabetes, upper respiratory ailments, or weak immune
systems, or pregnant women. Cases of facial paralysis can be permanent or temporary, but in all
circumstances there are treatments designed to improve facial function.

What causes sudden facial paralysis?

Infections, injuries, or tumors can cause facial nerve disorders, but the most common cause of facial
weakness is Bell’s palsy. This disorder, which often comes on suddenly and reaches its peak within
48 hours, is probably due to the body’s response to a virus. When there is a virus, the facial nerve
within the ear (temporal bone) swells, and this pressure on the nerve in the bony canal damages it.

The paralysis is likely to affect only one side of the face, but in rare cases it affects both sides of the
face at once. Bell’s palsy may last from two to three weeks or longer. An early sign of improvement,
such as getting a sense of taste back, is often a good indication that there will be a complete
recovery.

What is the facial nerve?

The facial nerve resembles a telephone cable and contains 7,000 individual nerve fibers. Each fiber
carries electrical impulses to a specific facial muscle. Information passing along the fibers of this
nerve allows us to laugh, cry, smile, or frown. When half or more of these individual nerve fibers are
interrupted, facial weakness occurs. If the nerve fibers are irritated, movements of the facial muscles
appear as spasms or twitching. The facial nerve not only carries nerve impulses to the muscles of
the face, but also to the tear glands, the saliva glands, and the muscle of the stirrup bone in the
middle ear (the stapes). It also transmits taste from the front of the tongue.

How does the facial nerve affect facial expression?

The facial nerve passes through the base of the skull in transit from the brain to the muscles that
control facial expressions. After leaving the brain, the nerve enters the temporal bone through the
internal auditory canal, a small bony tube, in very close association with the hearing and balance
nerves. Along its inch-and-a-half course through a small canal within the temporal bone, the facial
nerve winds around the three middle ear bones, in back of the eardrum, and then through the
mastoid (the bony area behind the part of the ear that is visible).

After the facial nerve leaves the mastoid, it passes through the salivary or parotid gland and divides
into many branches. The facial nerve has four components with several distinct functions: facial
expression, taste sensation, skin sensation, and saliva and tear production.

How are facial nerve disorders treated?

Since otolaryngologist—head and neck surgeons have special training and experience in managing
facial nerve disorders, they are the most qualified physicians to perform an in-depth evaluation of
abnormal movement or paralysis of the face. An evaluation will include an examination of the head,
neck, and ears, as well as a series of tests.

Some of the most commonly used tests are:

 Hearing Test – Determines if the cause of damage to the nerve has involved the hearing
nerve, inner ear, or delicate hearing mechanism.
 Balance Test – Evaluates balance nerve involvement.
 Tear Test – Measures the eye’s ability to produce tears. Eye drops may be necessary to
prevent drying of the surface of the eye (cornea).
 Imaging CT (computerized tomography) or MRI (magnetic resonance imaging) – Determines
if there is an infection, tumor, bone fracture, or other abnormality in the area of the facial nerve.
 Electrical Test – Stimulates the facial nerve to assess how badly the nerve is damaged. This
test may have to be repeated at frequent intervals to see if the disease is progressing.

The results of diagnostic testing will determine treatment. The goal of the treatment is to eliminate
the source of the nerve damage. Patients with less nerve damage have better chances of recovery.
Medications are often used as part of the treatment:

 If infection is the cause, then an antibiotic to fight bacteria (as in middle ear infections) or
antiviral agents (to fight syndromes caused by viruses like Ramsay Hunt) may be used.
  If swelling is believed to be responsible for the facial nerve disorder, steroids are often
prescribed.
 In certain circumstances, surgical removal of the bone around the nerve (decompression
surgery) may be appropriate.

What treatments are recommended for permanent

facial paralysis?
Patients with permanent facial paralysis may be rehabilitated through a variety of procedures,
including:

 Eyelid weights or springs

 Muscle transfers and nerve substitutions
 A special form of physical therapy called facial retraining
 Weakening the paralysis by chemical injection

How does the facial nerve affect the health of the

eye?
Remember, when the facial nerve is paralyzed, considerable attention must be given to maintaining
a healthy eye through a constant flow of tears. Tears are spread over the eye by blinking. Since
blinking is diminished or eliminated when facial nerve paralysis is present, special care must be
given to prevent drying, erosion, and ulcer formation on the cornea, which may result in possible loss
of the eye.

What are the common signs or symptoms?

 Twitching
 Weakness or paralysis of face
 Dryness of the eye or mouth
 Disturbance or loss of taste
 Drooping eyelid or corner of the mouth
 Difficulty in speaking
 Dribbling when drinking or after cleaning teeth
  Ear pain

Tips to help recovery

 Exercise the facial muscles in front of a mirror

 Massage the face
 Apply gentle heat to reduce pain
 Using a finger, regularly close the eye to keep it moist
 Tape the eye closed for sleeping
 Use protective glasses or clear eye patches to keep the eye moist and to keep foreign
materials from entering the eye
 Use doctor-recommended artificial tears or an ointment to keep the eye moist

When to See an Ear, Nose,

and Throat Specialist
From swimmer's ear to tonsillitis, otolaryngologists – or ENT specialists – help treat
problems of the ears, nose, and throat.
By Krisha McCoyMedically Reviewed by Pat F. Bass III, MD, MPH
Last Updated: March 22, 2010
Medically Reviewed
Otolaryngology is the medical specialty that deals with disorders and conditions of the
ear, nose, and throat (ENT) region, and related areas of the head and neck. If you have
a problem that is related to your ear, nose, or throat, you may need to see an ENT
specialist, who is also called an ear, nose, and throat doctor or an otolaryngologist.

What Does an ENT Specialist Do?

In addition to graduating from medical school (usually four years), a board certified ENT
specialist has completed at least five years of specialty training and passed a
certification examination for the American Board of Otolaryngology. ENT specialists are
experts in both the medical and surgical management of the following:

 Conditions of the ear. You may need to see an ear, nose, and throat doctor if
you have an ear disorder or condition, such as a hearing impairment, ear infections,
 disorders that affect balance, tinnitus (ringing in the ears), or pain in your ear. ENT
specialists can also treat congenital disorders of the ear (disorders you were born with).
 Conditions of the nose. ENT specialists often manage and treat problems that
affect the nose, nasal cavity, and sinuses. These problems can affect smell, breathing,
and physical appearance.
 Conditions of the throat. Disorders and conditions that affect the throat can
affect speech, singing, eating, swallowing, and digestion. ENT specialists can diagnose,
manage, and treat these problems.
 ENT-related conditions of the head and neck. ENT specialists are trained to
manage diseases, tumors, trauma, and deformities of the head, neck, and face. ENT
specialists can perform cosmetic and reconstructive surgery in these areas. They can also
manage problems with the nerves in the head and neck that control sight, smelling,
hearing, and facial movements.

Many ENT specialists have also completed an additional one to two years of extensive
training in one of the following subspecialty areas of otolaryngology:

 Pediatric otolaryngology (specializing in ENT problems in children)

 Otology/neurotology/audiology (specializing in ears, balance, and tinnitus)
 Allergy
 Facial plastic and reconstructive surgery
 Head and neck surgery (specializing in tumors of the head and neck)
 Laryngology (specializing in the throat, voice, and swallowing)
 Rhinology (specializing in the nose and sinus cavity)

Some otolaryngologists also have sub-certifications in sleep medicine.

Who Needs to See an ENT Specialist?

Among the conditions that are commonly treated by an ear, nose, and throat doctor are:

 Injury to your ears, nose, or throat

 Nerve problems in your ears, nose, or throat
 Balance problems
 Dizziness
 Hearing impairment
 Ear infection
 Tonsil or adenoid infection
 Swimmer's ear
 Pain in your ears, nose, or throat
 Tinnitus
 Ear, nose, or throat birth defects
 Breathing problems
 Down's syndrome
 Asthma
 Allergy
 Sinus problem
 Growth or tumor in your ears, nose, or throat
 Deviated septum
 Undesired appearance of the nose or face
 Cleft palate
 Drooping of the eyelids
 Hair loss
 Nose bleeds
 Nasal congestion
 Problems with smell
 Voice or swallowing problems
 Sore throat
 Hoarseness
 Gastroesophageal reflux disease (GERD)

If you are dealing with one of these conditions or another problem that affects your ears,
nose, throat, or a related area, ask your primary care doctor if an ENT specialist may be
able to help.
What is the difference between
an otolaryngologist and an
ENT?
January 28, 2020
So, you have an earache, a sore throat, and a headache. Where do
you go? Chances are, your primary care doctor will refer you to a
physician that specializes in otolaryngology.
Otolaryngology is one of the oldest medical specialties (practiced
since the 19th century) that involves the diagnosis and treatment of
patients with diseases and conditions of the ears, nose, throat, head,
and neck. Physicians trained in otolaryngology are called by many
names. They include:

 Otolaryngologists
 Ear, nose, and throat doctors
 ENTs

In other words, there is no difference between an otolaryngologist and

ENT. They are one and the same, with the latter being the shorthand
version that’s much easier to recall and pronounce. Another example
is the gastroenterologist, commonly known as the GI.

Otolaryngology
Doctors in the 19th century found that the head and neck have
interconnected systems. They developed tools they could use to
examine the systems, in an effort to diagnose and treat problems that
affect the head and neck, which eventually formed the medical
specialty known as otolaryngology. Otolaryngologists are not just
trained in medical treatment but also surgical procedures related to
the head and neck.
An otolaryngologist can have various specializations such as
otology/neurotology, pediatric otolaryngology, facial plastic and
reconstructive surgery, laryngology, rhinology, and head and neck
diseases. An otolaryngologist typically does not need to refer you to a
specialist should diagnostic results show that you have a condition
that needs surgery. Otolaryngologists can typically provide you both
medical and surgical care.

What Do Otolaryngologists Or ENT Doctors

Treat?
ENT doctors can treat conditions that affect the head and neck
systems. That includes ear problems like pain, itchiness, burning,
leaking, swimmers’ ear, infection, hearing loss, sudden deafness, and
tinnitus. Any issues that affect the nose such as allergies, sinusitis,
and any other obstruction that can affect breathing and sense of smell
are also treated by ENTs.
Throat issues such as difficulty swallowing, pain, tonsillitis, voice
changes, diseases of the larynx, and mouth and throat cancer are also
diagnosed and treated by ENTs. Head and neck pain could be a sign
of infection, cranial nerve disorder, or tumor (benign or malignant).
ENT doctors can also address facial trauma and deformities as a
result of growth abnormalities. Congenital malformations and cancers
that affect the ears, neck, and threat can also be addressed by ENTs.

Top Otolaryngologists/ENT Specialists in

Bradenton and Sarasota, FL
If you are experiencing issues with your ears, nose, throat, neck, and
head, the Otolaryngologists or ENT Specialists at Intercoastal Medical
Group are ready to help.
Our compassionate ENT doctors provide the highest level of care to
our patients suffering from health issues. We understand how ear,
nose, and throat issues affect your quality of life, which is why we use
our expertise and experience to help you find relief.
Additionally, To maintain optimum overall health and well-being,
hearing tests should be performed annually by an audiologist. You can
visit our hearing center and Dr. Renee Collins today. Dr. Collins is a
certified audiologist that can detect and treat a number of conditions
including hearing loss, tinnitus, and vertigo. She takes appointments
at both the Cattleridge and Lakewood Ranch II offices.
For your convenience, we have two locations – our Catteridge location
in Sarasota, Florida and our Lakewood Ranch II location in Bradenton,
Florida.
To schedule an appointment with our more than 100 highly
credentialed physicians, call us at 941-379-1800 for Cattleridge or
941-538-0018 for Lakewood Ranch II. Our friendly staff is happy to
assist!
 What is an ENT
and when should I
talk to one?
/ ENT Physicians



If you’ve ever gone to your family doctor with a chronic sore
throat, an ear infection, or sinus problems, you may have been
referred to a specialist called an ENT. Or, this may be your first
time hearing about this medical specialty. So what is an ENT,
and when is it helpful to consult with one?
“ENT” simply stands for “ear, nose, throat,” and that’s the job
description of an ENT specialist: treating those parts of patients’
bodies. ENT doctors—also known as otolaryngologists—have a
wealth of highly specific training and experience. While primary
care physicians are absolutely crucial as the first line of defense
against all kinds of illness, ENT specialists focus on the sinuses
in detail. This means they are the best-qualified professionals to
see when you have a chronic or a complicated problem with
these interconnected parts of the body, and a good person to
see if you have chronic sinusitis. Depending on the details of
your condition, you may also be referred to an allergist.

The path to becoming an ENT doctor

Ear-nose-throat specialists go through up to 15 years of

specialized training before they take full senior positions
practicing their specialty.[1]
In the United States, an ENT doctor must undergo the
following stages of training:
 college (typically at least four years)
 medical school (typically four years)
 ENT residency training (five years, minimum)
After all this training, an ENT can become board-certified. To
become a board-certified ENT specialist, the physician must
then pass the American Board of Otolaryngology exam. A
specialist can then elect to train on one or more of the
following sub-specialties within the ENT field:
 allergy
 facial plastic and reconstructive surgery
 head and neck (cancers and tumors in the head and neck)
 laryngology (throat)
 otology/neurotology (ears, balance, and tinnitus)
 pediatric otolaryngology (children)
 rhinology (nose)
 sleep disorders
ENT doctors who have trained specifically in one of these eight
areas might limit their practice to their subspecialty or they
might treat a variety of patients.

ENT doctors are also trained in both medicine and surgery, and
so they are familiar with advanced treatments for ear, nose,
throat, head, and neck disorders, and can advise patients on
what are the treatment options for their individual situations.

When might I consider consulting an ENT?

An ENT may be an appropriate physician to talk to for concerns

regarding disorders of the ears, nose, throat, head, and neck,
including growths, infection, and more. (Some ENT physicians
specialize in allergies and their link to sinus issues; for some
allergy problems, it is more appropriate to see an allergist. You
can receive advice on your individual case from your doctor.)
In particular, chronic sinusitis sufferers benefit considerably
from consulting with an ENT specialist. Primary care physicians
play a critical role in diagnosing and treating all kinds of health
problems including sinusitis. ENT specialists, however—like
specialists for other bodily systems or disorders—have the in-
depth knowledge and experience required to treat advanced
chronic sinusitis cases. This makes an ENT the appropriate
person to discuss chronic sinus issues with. So if you have
chronic sinusitis, you may be referred to an ENT specialist for
treatment.

Becoming an Ear, Nose and Throat Doctor

(ENT/Otolaryngologist)
Think of how irritating it is when you feel like you have water in your ear, but you’ve
been nowhere near a swimming pool. Or you are scheduled to give a speech and
suddenly develop a raspy throat. What about not being able to smell the aroma of
coffee, or taste the tartness of a lime? Then there’s the favorite irritant of a friend of
mine – her husband’s snoring. These are all ENT (ear, nose and throat) issues.

Although the practice of otolaryngology (ENT) involves more than just the ability to
use our senses, they are a substantial component. When our senses don’t work, we
miss much of the life that goes on around us. That’s one reason why these surgical
specialists are so crucial in the practice of medicine.
 Besides alleviating stuffy noses and migraine
headaches, these doctors also perform complex operations that restore hearing to
the middle ear, opens blocked airways, and removes head, neck, and throat
cancers. The ability to do surgery makes otolaryngologists unique among surgical
specialists because they are trained in both surgery and medicine, which means
they must treat patients medically and surgically. There is no need to refer patients
to a surgeon if an operation is required. As a result, an ENT can recommend and
provide the most appropriate care for each patient.

To be qualified to perform in this dual role, in addition to medical school, a person

must undergo five to eight years of intensive, post-graduate training. Some ENTs
say that in exchange for the years of education, they work within the best surgical
subspecialty available in medicine. There is no equivalent counterpart in
healthcare.

Listen to what an ENT says about this unique medical discipline: What’s an ENT?

ENT treats a range and severity of conditions for people of all ages. They include:

 Allergies and sinuses.

 Head and neck cancers.
 Hearing, which affects balance.
 Skin disorders.
 Sleep disruptions, which include snoring, breathing and sleep apnea.
 Swallowing, which interferes with speech.

Surgeries include:

 Cochlear implants (to restore hearing).

 Deviated septums (repair of areas of nasal passages).
 Plastic and maxillofacial surgeries.
 Tonsillectomies (removal of the tonsils and adenoids).
  Removal of tumors.
 Reconstructive surgeries.

Typical skills and interests

Like most doctors and surgeons, ENT’s need a unique skill set that incorporates
personal qualities. These include:

 Ability to work as part of a team, and to manage and supervise others.

 Excellent vision and visuospatial awareness.
 Expert listening skills and the ability to work effectively with people who have
communication difficulties.
 Good organizational capacity.
 Outstanding hand-eye coordination and manual dexterity.
 Stamina to sustain a busy and demanding role.

If you like working with your hands, and participating in a more action-oriented
branch of medicine, you may discover ENT is the ideal healthcare profession for
you.

ENT subspecialties
Some ENTs consider themselves to be in a general practice which means they don’t
limit themselves to any one portion of the head and neck. They treat a variety of
conditions. However, other ENTs consider themselves specialists in a specific area
and obtain additional training to do so. If you’re interested in otolaryngology and
want to focus within the discipline, consider one of the following specialties:

 Ears (otology/neurotology) – If you have difficult hearing, or have trouble

balancing, you may have a problem in your inner ear. ENTs who focus their
practice on the ear treat conditions like ear infections, hearing loss, dizziness,
and tinnitus.
 Nose (rhinology) – Our noses help keep our airways clear by filtering out
dust, allergens, and other agents. ENTs who specialize in treating areas of the
nose can help with deviated septums, rhinitis, sinusitis, sinus headaches and
migraines.
 Throat (laryngology) – If you’re unable to speak or swallow properly, you
can imagine the impact on your life. ENT specialists see patients with sore
throats, hoarseness, gastric reflux disease, throat tumors, and more.
  Head and Neck/Thyroid – Think about your head and neck and all the vital
organs they hold. ENTs practicing this specialty treat cancers of the head and
neck, enlarged thyroid glands, and other disorders affecting the head, neck
and thyroid.
 Sleep – Lack of sleep, interrupted sleep and other sleep disorders plague
many people throughout the world. When we don’t get enough rest, it is
difficult to enjoy life and to focus on work. ENT sleep specialists treat sleep-
disordered breathing, nasal and airway obstructions, snoring and sleep
apnea.
 Pediatrics – Healthcare professionals obtain special education to
understand the needs and development of children. In addition to tonsillitis,
ear infections and allergies, ENTs who specialize in pediatrics also treat birth
defects of the head and neck as well developmental challenges.

Typical practice characteristics

ENTs maintain a private, self-owned offices or hospital-based spaces. They can be
self-employed or serve on the staff of a hospital or university. They see patients in
their offices, but retain surgical privileges in outpatient clinics and hospitals. During
a typical day, an ENT may see as many as 25-35 patients. Throughout the year they
may perform 250-300 surgeries.

Income and outlook

According to the Medical Group Management Association (MGMA) 2013 Physician
Compensation and Production Survey, the average annual income for ENTs is about
$442,119. Since they are specialists and perform surgeries, ENTs are a

According to the American Association of Medical Colleges (AAMC), the job outlook

for all physicians is stable, with shortages predicted through the year 2020 and
beyond. The growing population in the U.S., as well as the increasing average age of
the nation’s population are two primary factors contributing to this.

Education and training

Since otolaryngologists are medical doctors, they must first obtain a medical
degree. In the United States, the education track for otolaryngologists takes about
15 years. The breakdown of credentials is as follows:

 Undergraduate degree, preferable in biology or science – 4 years.

  Medical degree – 4 years.
 Residency training – 5 years.

o 3 years of otolaryngology residency.

o 1 year of general surgery training.
o 1 additional year of training.
 Optional fellowship training in an ENT subspecialty – 2 years.

Certification and licensure

Along with all other physicians in the United State, otolaryngologists must pass
the USMLE (United States Medical Licensing Exam). Additionally, board certification
in otolaryngology by the American Board of Medical Specialties (ABMS) is expected
although not always required.

Like many healthcare professionals ENTs must also obtain a state license to
practice medicine in the state where they work. Check with your individual state for
requirements.

Ongoing CMEs (clinical medical education hours) are required for ENTs to maintain
their license. There is also a license renewal process that must be completed
routinely. Individual states and the specific ENT specialty boards set the renewal
cycle, but it is generally every 7-10 years. Completion of minimum CME
requirements are almost always included as part of the renewal, so keeping up with
those hours is critical to maintaining your hard-won license.

American Board of Otolaryngology

Otolaryngology is one of the oldest medical specialties in the

United States.

The American Board of Otolaryngology (ABOHNS) was established in 1924 and is

one of the oldest medical specialty boards in the country. Their mission is to, “Serve
the public by assuring that diplomates meet our standards of training, knowledge
and professionalism through initial and continuing certification.”

In 1978, the ABOHNS changed its name so that it better reflected the field –
otolaryngology – head and neck surgery. The change was needed to reflect all the
kinds of head and neck surgery included in an ENT’s expertise.

In the ABOHNS, when you meet training requirements and have passed the
qualifying and written examinations for otolaryngology, you are considered “board
certified” by the ABOHNS and are referred to as a “Diplomate.”

Like many careers in the field of medicine, becoming an ENT is a rewarding and
fulfilling profession. If you want to specialize as a medical doctor, studying to
become an ENT is a great option.

Oct

What Causes Ear, Nose and Throat Infections?

 By The Harley Stre...  ENT Specialist, Ear, Nose, Throat  0 Comments

Ear, nose and throat infections are very common. The symptoms are usually relatively mild, but
infections can sometimes cause problems that need to be treated by an ENT specialist. What
can cause an infection in your ears, nose or throat, and when should you visit an ENT clinic for
advice?

Common Ear, Nose and Throat Infections

When we talk about ear, nose and throat infections, we often do it in terms of the location of
the problem rather than the specific viral or bacterial infection that is causing the problem. This
is because infections in different areas tend to produce different symptoms. We can tell where
the infection is based on these symptoms.

 Ear infections can be outer, middle or inner ear infections. Inner ear infections are less
common as it is harder for viruses and bacteria to reach this part of the ear.
 Nasal infections often affect the nasal passages (rhinitis), but they can also affect
connected areas like the sinuses (sinusitis).
  Throat infections can be named according to their location, for example tonsillitis in the
tonsils or laryngitis in the larynx (voice box).

Sometimes the location of the infection is all we need to know in order to manage the
symptoms. However, in some cases it may be possible to identify the specific infection that is
responsible. It’s particularly important to do this when the symptoms are severe, there’s a
chance that the infection could be bacterial, or other parts of your body are affected too.

Lots of different infections can affect your ears, nose, or throat:

 The common cold and flu viruses can affect all three of these areas, although they most
often affect your nose or throat
 Infections in other parts of your body (such as the chest or airways) can sometimes
spread to your ears, including serious infections such as measles
 Mononucleosis and mumps can both affect the throat and may spread to the ears in
some cases
 Strep throat is an infection caused by a specific type of bacteria known as Streptococcus

Any part of the ears, nose and throat can be affected by many of the same viruses and bacteria.
However, certain types of infection are more likely to happen in different areas and the
symptoms can also be a little bit different, depending on exactly where the infection is located.

Viral vs. Bacterial Infections

The germs that can cause ENT infections can be viruses or bacteria. It can be important to know
whether your infection is viral or bacterial because it can affect the symptoms and the
treatment options:

 Viral infections are more common as they include colds and the flu, both of which can
cause infections in the ears, nose and throat.
 Bacterial infections don’t happen as often, but they can be more serious. However, if an
ear, nose or throat infection is caused by bacteria then it may be possible to treat it with
antibiotics. Antibiotics only work against bacteria, so they can’t help with viral infections.

You probably won’t be able to tell which kind of infection you have as the symptoms can be
very similar, but if you visit an ENT specialist they may be able to diagnose a specific infection. It
can be useful to find out if the infection is bacterial, because this means it may be possible to
treat it with antibiotics.

Symptoms of Ear, Nose and Throat Infections

Ear, nose and throat infections are often caused by the same kinds of bacteria and viruses.
However, the symptoms can be different depending on where the infection is located:

 Ear infections can cause earache, wax or discharge, hearing loss and balance problems.
 Nose infections are likely to cause a runny or blocked nose and sneezing. Infections that
reach areas such as the sinuses can also cause other symptoms such as headaches.
 Throat infections can cause a sore or scratchy throat and pain or difficulty swallowing.
You may also be able to feel swollen glands in your neck.

All three types of infections can also cause more general symptoms of infection, such as a fever,
and it is common for infections to spread between these areas. For example, an infection that
starts with a sore throat might start to cause other symptoms such as earache when it spreads
from your throat to your ear.

Managing Your Symptoms

The symptoms of ear, nose and throat infections are usually mild and they should start to
improve within just a few days. It can take a couple of weeks for the infection to clear up
completely, but you should gradually start feeling better.

You should usually be able to manage the symptoms at home. Taking an over the counter
painkiller like paracetamol or ibuprofen can help to relieve any pain. It can also reduce the
inflammation that is causing many of your symptoms and may help to bring down your fever, if
you have one. There are some other simple remedies that you can try to cope with the
symptoms of ear, nose and throat infections too:

 Holding a warm compress against your ear can help to relieve ear ache
 Nasal sprays and decongestants may help with a blocked or runny nose
 A warm drink with honey in it should soothe a sore throat
 Wearing a hat and scarf can also help if you need to go out in cold weather when you
have an infection- cover your ears or nose if they’re affected, or wrap up your throat to
keep it warm.
When to See a Doctor?
Although ear, nose and throat infections aren’t usually anything to worry about, you should
consult a doctor if your symptoms are severe, they last longer than expected, or if you keep
getting the same kind of infection. An ENT specialist can find out what’s causing the infection
and look for any underlying problems. You might be prescribed a treatment like antibiotics to
clear up a bacterial infection or advised on how to prevent the symptoms from returning.

Do you have any other tips for people with ear, nose or throat infections?

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Otorhinolaryngology (ear, nose and

throat surgery, ENT)
Otorhinolaryngologists (also known as otolaryngologists or
ear, nose and throat or ENT Surgeons) are surgical
specialists who diagnose, evaluate and manage a wide
range of diseases of the head and neck, including the ear,
nose and throat regions.
This page provides useful information on the nature of the work, the common
procedures/interventions, sub-specialties and other roles that may interest you.
 Nature of the work
ENT surgeons often treat conditions that affect the senses such as hearing and balance
disorders or smell and taste problems. They also treat patients with conditions that
affect their voice, breathing and swallowing as well as those with head and neck
tumours including the skull base and interface with the brain.

ENT surgeons may treat people of all ages from newborn babies to elderly people. They
see more children than most other surgeons, apart from paediatric surgeons. One of the
attractions is that they treat a wide spectrum of ages and diseases.

A proportion of an ENT surgeon’s time is spent in outpatient clinics and managing

conditions medically without the need for surgery. The use of microscopes &
endoscopes in outpatients allows treatment/ diagnosis in the clinic. ENT has possibly
the widest range of operations of any speciality from major head & neck procedures
with flaps & complex reconstructions to microsurgery on the ear.

ENT surgeons treat a very wide range of conditions. These include:

 ear conditions
 nose conditions
 throat conditions
 head and neck conditions
 facial cosmetic surgery

Ear conditions include:

 otosclerosis  (a condition of the middle ear that causes hearing loss) and other
problems with hearing and deafness
 otitis media with effusion – a common condition of childhood (also known as glue
ear) in which the middle ear becomes blocked with fluid
 age related hearing loss
 tinnitus (ringing in the ears) and eustachian tube dysfunction
 dizziness and vertigo
 ear infections
 perforated ear drum and cholesteatoma
 protruding ears

Nose conditions include:

 sinus infection and rhino-sinusitis, including in children

 nasal injuries
 nasal polyps
 tumours of the nose
 nasal obstruction
 disorders of the sense of smell

Throat conditions include:

 adenoid problems – surgical removal of these small glands in the throat at the
back of the nose is sometimes needed, and is usually performed in childhood
 tonsillitis, sometimes requiring surgical removal of the tonsils, usually in
childhood
 hoarseness and laryngitis
 swallowing problems
 upper airway breathing problems
 snoring and obstructive sleep apnoea (when breathing stops during sleep)

Head and neck conditions include:

 cancer affecting the mouth, oral cavity, throat (pharynx), voice box (larynx),
salivary glands, skull base, or the nose and sinuses
 thyroid and parathyroid problems
 facial skin lesions including skin cancer

Facial cosmetic surgery is also part of ENT surgery and includes:

 rhinoplasty (nose surgery)
 otoplasty (ear surgery)
 blepharoplasty (removal of excess skin and fat pads around the upper and lower
eyelids)
 facial reconstruction following trauma or cancer

“ENT is an extremely varied specialty and my role has given me the opportunity to work
on the ward”.  Francesca Kum, Trainee in core surgical training, Guy’s and St Thomas’s
NHS Foundation Trust.

Read Francesca’s story

Common procedures
ENT surgeons use many different surgical procedures including:

 insertion of grommets for glue ear – this involves a very small incision in the ear
drum and is typically carried out on children. The grommets help to ventilate the middle
ear and resolve middle ear effusions
 tonsillectomy (removal of tonsils) or adenoidectomy (removal of adenoids), most
often in children
 septoplasty – correction of nasal septum to prevent obstruction and enable clear
breathing
 microlaryngoscopy – a short metal tube (laryngoscope) is inserted into the larynx
(voice box). This is used for examination and can also be used to perform a biopsy or
surgery
 oesophagoscopy – a long metal or flexible tube (oesophagoscope) is inserted
through the mouth into the oesophagus
 endoscopic sinus surgery – a tiny telescope is inserted into the nasal passages
to diagnose and treat difficult sinus conditions. Technically refined instruments are then
used to restore proper function
 tympanomastoid surgery to reconstruct and remove epithelial inclusions
(cholesteatoma) within the middle ear
 open operations to remove neck lumps, and salivary gland tumours
 tracheostomy

ENT surgery has been at the forefront of the latest medical technologies and minimally
invasive procedures are common. This has many benefits including less scarring and
shorter recovery periods 

Sub-specialties
Most ENT surgeons develop a sub-specialty and these include:
 otology – diagnosis and treatment of infection, disease and damage to the ear to
improve hearing and balance. This includes cochlear implant surgery, which is the
implantation of a small complex electronic device in to the inner ear (cochlea) which
stimulates the auditory nerve. This can provide a sense of sound for deaf people
 rhinology – treatment of all aspects of nose and sinus disorders including allergy,
infection, inflammatory conditions and tumours. Specialists will also operate on rare
tumours of the skull base including pituitary tumours.
 laryngology – treatment of diseases and disorders of the larynx and throat, such
as vocal fold nodules, voice problems (including overuse/misuse) and cancer
 head and neck surgery – the treatment of benign and malignant diseases of the
head and neck, including lymph, salivary, thyroid and parathyroid glands
 skull base surgery/neurotology – treatment of disorders of the skull base and
acoustic neuromas (benign, non-cancerous growths on the vestibulocochlear nerve
which controls hearing and balance)
 facial plastics – aesthetic procedures including rhinoplasty (correcting and
reconstructing the form, function and aesthetic appearance of the nose) and pinnaplasty
(correction of protruding ears). The work also includes reconstruction of facial defects.
Plastic and oral and maxillofacial surgeons may also perform this type of surgery
 thyroid and parathyroid surgery – diagnosis and surgical treatment of thyroid and
parathyroid tumours
 paediatrics – some  ENT conditions are congenital and treatment is needed at a
very young age. Treatments are wide ranging and include cochlear implants and other
implantable hearing devices, head and neck surgery and treatment for rare conditions
including choanal atresia (where the back of the nasal passage is blocked by bone or
tissue)

What’s an ENT?

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ENTs Treat the Fundamental Functions of Life

Imagine a singer not being able to sing, or you not being able to hear her beautiful music.

Imagine not being able to smell the earth after a spring rain, or not being able to taste and enjoy your
favorite holiday meal.

Imagine not being able to sleep through the night next to your loved one because they snore.

These are some of the fundamental functions of life that make living so rich and wonderful. Yet when
one or more of these functions no longer work the way they should, living is diminished or even
jeopardized.
Hearing and balance, swallowing and speech, breathing and sleep issues, allergies and sinuses, head and
neck cancer, skin disorders, even facial plastic surgery are just some of the conditions that “ENT” (ear,
nose, and throat) specialists treat. Professionally, ENT specialists are called “otolaryngologists”
(pronounced: oh/toe/lair/in/goll/oh/jists), but it’s easier just to say “ENT.”

What's an ENT?

ENTs Treat the Simple to Severe

Did you know that nearly half of patients going to primary care offices have some sort of ENT issue?

Think about it. Almost everyone has had a stuffy nose, clogged ears, or sore throat, but ENT specialists
treat a diverse range of conditions and disorders of the ears, nose, throat, head, and neck region—from
simple to severe, for all persons, at all stages of life.

ENT specialists are not only medical doctors who can treat your sinus headache, your child’s swimmer’s
ear, or your dad’s sleep apnea. They are also surgeons who can perform extremely delicate operations
to restore hearing of the middle ear, open blocked airways, remove head, neck, and throat cancers, and
rebuild these essential structures. This requires an additional five to eight years of intensive, post-
graduate training beyond medical school.

Organized ENTs have been setting the treatment standards that pediatric and primary care providers
have been following since 1896, making otolaryngology one of the oldest medical specialties in the
United States.

“I like to say that ENT specialists treat pretty much everything from the collarbone up, except for the
brain and eyes. So much of this work, medical and surgical, affects how people perceive themselves as
human beings, and it is a unique privilege to care for my patient’s ENT health due to the personal and
profound nature of this specialty.”

- WILLIAM R. BLYTHE, MD

What Conditions Do ENTs Treat?

General otolaryngologists do not limit their practice to any one portion of the head and neck, and can
treat a variety of conditions. Some ENT specialists, however, pursue additional training in one of these
subspecialty areas:

Ear (otology/neurotology)—Hearing and balance are critical to how we conduct our daily lives. ENT
specialists treat conditions such as ear infection, hearing loss, dizziness, ringing in the ears (called
tinnitus), ear, face, or neck pain, and more.

Nose (rhinology)—Our noses facilitate breathing by helping to keep out potentially harmful dirt,
allergens, and other agents. In addition to allergies, ENT specialists treat deviated septum, rhinitis,
sinusitis, sinus headaches and migraines, nasal obstruction and surgery, skull-base tumors including
those inside the cranial cavity, and more.

Throat (laryngology)—Disorders that affect our ability to speak and swallow properly can have a
tremendous impact on our lives and livelihoods. ENT specialists treat sore throat, hoarseness,
gastroesophageal reflux disease (GERD), infections, throat tumors, airway and vocal cord disorders, and
more.

Head and Neck/Thyroid—The head and neck include some of our body’s most vital organs, which can be
especially susceptible to tumors and cancer. In addition to cancers of the head and neck, ENT specialists
treat benign neck masses, thyroid disorders such as benign and malignant tumors, Grave’s disease,
enlarged thyroid glands, parathyroid disease, and more.

Sleep—Being able to breathe and sleep well through the night has an impact on the way we experience
life and perform our work. ENT specialists treat sleep-disordered breathing, nasal and airway
obstruction, snoring and sleep apnea, and more.

Facial Plastic and Reconstructive Surgery—Facial trauma and the resulting change in appearance caused
by an accident, injury, birth defect, or medical condition side effect can be distressing. ENT specialists in
facial plastic surgery treat cleft palates, drooping eyelids, hair loss, ear deformities, facial paralysis,
trauma reconstruction, head and neck cancer reconstruction, and cosmetic surgery of the face.

Pediatrics—Children and their developing bodies and senses often need special attention. ENT
specialists treat birth defects of the head and neck, developmental delays, ear infection, tonsil and
adenoid infection, airway problems, asthma and allergy, and more.