Otolaryngology is a branch of medical specialty that focuses on treatments of the ear, nose, throat, and head and neckdisorder. A practitioner of otolaryngology can also be called an ear, nose and throat doctor, or ENT for short. Although the brain and the eyes are situated in the head, these two body parts are not included in otolaryngology.

According to the American Academy of Otholaryngology, the specialty is the oldest medical specialty in the United States. It dates back to the 19th century, when doctors recognized that the head and the neck had a number of interconnected systems. 
Subspecialties in ENT include head and neck surgery, facial plastics, otology, neurotology, rhinology, sinus, laryngology, and sleep otolaryngology. It is one of the most competitive fields for physicians to enter into, but also highly competitive.

Ear & Hearing Impairment

Hearing Impairment is a condition when the ability to hear some frequencies of the sound or all abilities (deafness) are impaired or lost. The main causes of hearing impairment or loss may come from long-term exposure to noise level of more than 70dB, genetic disorders, diseases or illness, medication, exposure to Ototoxic Chemicals, or Trauma.

Causes of Ear Impairment

Otitis Media

Otitis Media is an ear infection that is more common in kids and teens and it is an infection caused by pus or fluid that builds up in the eardrum that can cause difficulties in hearing. Usually this is only temporary and hearing is restored after fluid is removed.

Environmental Factors

Exposure to environmental noise over the level of 75dB (such as conditions of those living near the airport) for a prolonged period can lead to hearing loss. Other loud noises that may cause ear impairment could include hair dryer noises, lawn and maintenance equipments, construction sites, car stereos, or power tools. Injuries to the ear or head can also result in loss of hearing.

Genetic Factors

Hearing impairment could be an inherited trait as a result of genetics. DFNB1, also known as Connexin 26 deafness is the most common type of genetic hearing impairment. Some genes are dominant and recessive so that even though a parent may not show signs of deafness, two recessive genes could show up as deafness in a child. Pendred syndrome is one of the most common recessive disorder while Stickler syndrome is a common dominant disorder. Microtia is a congenital defect that can result in full or partial deafness.

Diseases or Illness

Diseases or illness that may damage ear nerves can also be a cause of hearing loss. Measles or meningitis are examples of diseases that damages the nerves. Other autoimmune diseases such as Wegener’s granulomatosis, diseases such as HIV or AIDS could also have an effect of impacting hearing abilities.

Ototoxic Chemicals

Metals such as lead, asphyxiants, or solvents are industrial ototoxic chemicals that can have an additive effect that leads to hearing loss. First a person loses hearing abilities in high frequency range and starts to damage the cochlea until hearing loss is not repairable. The intake of Antioxidants may help prevent ototoxic hearing loss to some degrees though.

Ear & Hearing Impair Treatments

If a normal ear infection such as otitis media is the cause of hearing impairment, then it can be cured by medication. If the ear is damaged in a structural way, a hearing aid may be needed. A hearing aid is a device usually hooked to the ear to help increase the volume of the sound. If a hearing aid can not help, then surgery may be needed and cochlear implants could be needed.

Cochlear Implants are small microphones that are surgically implanted into the ears and placed pass the damaged inner ear to be hooked up to the auditory nerve. Signals are sent from environmental sound as impulses that are sent to the auditory nerve, which translate them into sounds for the patient.

Nose Treatment (Rhinology)

Rhinology is a field that is concerned with medical and surgical diseases of the nose and nasal passages. It also includes the study and treatment of sinuses, which is the space inside the bones of the skull that connects to the nasal cavity.

Sinusitis

There are three types of sinusitis categorized by the duration of occurance. An acute sinusitis usually is in effect for less than four weeks, if it is from 4-8 weeks is subacute, and anything more than eight weeks is considered a chronic sinusitis.

Acute Sinusitis

An acute sinusitis is usually caused by viral infections that occur in the upper respiratory tract. The three most common cause of acute sinusitis are streptococcus pneumoniae, Haemophilus influenza, and moraxella catarrhalis. Acute sinusitis can also be caused by chemical irritation such as those from cigarettes or chlorine fumes. On rare occasions, it also be caused by a tooth infection.

Chronic Sinusitis

The cause of chronic Sinusitis can be attributed to many factors such as allergy, bacterial infection, fungal reaction, vasomotor rhinitis, or abnormally narrow sinus passages. Symptoms of chronic Sinusitis can be a combination of nasal congestion, facial pain, headache, night-time coughing, green or yellow discharge, aching teeth, or halitosis. It is suspected that fugus development may play a big part in chronic sinusitis.

Treatments for Sinusitis

Treatments for Sinusitis could vary from antibiotics such as the commonly distributed amoxicillin to corticosteroids. Sometime anti-microbial nose sprays are also prescribed. For more severe cases, a nasal surgery may be recommended. Usually surgery would be the last resort for treating Sinusitis but recently there has been an advanced development of a type of surgery called functional endoscopic sinus surgery (FESS) where the structural or the diseased obstruction is removed without having to make incisions but focuses on draining out the obstruction by the use of gravitational force. Another treatment under the category of physical treatment is the balloon sinuplasty, which is when balloons are used to enlarge the cavities of the sinuses to open up the nose enough to perform surgery in a less invasive manner.

Rhinitis

Rhinitis is also known as runny nose and it is when the internal area of the nose is irritated or inflamed. Usually, this causes a large quantity of mucus to form as well as cause nasal dripping and not only affects the nose but can affect the throat and eyes as well to increase the production of fluids. There are three types of rhinitis categorized into infective rhinitis, acute rhinitis, and chronic bacterial infections. There are also two categories for the types of causes of Rhinitis separated into vasomotor rhinitis and rhinitis medicamentosa.

Vasomotor Rhinitis

Vasomotor Rhinitis includes non-allergic causes such as autonomic factors, hormonal, drug-related, atrophics, and gustatory reasons. It could also include rhinitis caused by stress, weather changes, or airborne irritants that do not cause allergic reactions and appears to be more commonly found in women than men.

Rhinitis Medicamentosa

Rhinitis Medicamentosa includes Rhinitis induced by allergic causes by allergic reactions to allergens such as pollen, mold, animal dander, dust, or other types of irritants. When an allergic reaction occurs, the body is triggered to produce antibodies, which contains a chemical called histamine. The release of Histamine could cause itching, swelling, or mucus production. Sometimes the pollens released by some seasonal plants can also cause an allergic reaction and this is known as Hay Fever, which can also be another cause of Rhinitis.

Treatments of Rhinitis

Usually, prevention of Rhinitis is more so recommended before it happens. In the case of Rhinitis Medicamentosa, if a person is aware of what they may be allergic to, they are advised to avoid the irritant at all cost. Vasomotor Rhinitis may be harder to prevent though because it may be cause by many unavoidable or unknown- at- the- moment factors such as weather changes. For allergic Rhinitis, some antagonistic drugs are usually prescribed including drugs such as antihistamines, cortisone, dexamethasone, or cromolym sodium. If a case of rhinitis is too severe, then allergy shots or nasal surgery may be in order. There are also alternative treatments such as the use of acupuncture for the treatments of allergic Rhinitis such as Hay Fever though scientific support may be lacking.

Empty Nose Syndromes (ENS)

The empty nose syndrome or also known as the wide nasal cavity syndrome is a rare syndrome that results from a complication from a medical treatment that can lead to dizziness, grogginess, or dyspnea (shortness of breath). The symptoms associated with Empty Nose Syndrome includes airflow obstruction, changes in the epithelial linings of some organs called known as squamous metaplasia, mucosal dryness, and sometimes signs of depressions or anxiety. 
 

Treatments for Empty Nose Syndrome

Non Surgical Treatments

Some non-surgical treatments for Empty Nose Syndrome include nasal moisturizing gels and creams and antidepressants for the depression. The nasal moisturizing sprays or gels contain saline which helps to keep the nasal passages moist. A cool mist humidifier may also be recommended in use of rooms when sleeping. Other alternative treatments may include acupuncture, shiatsu, or cranio-sacral therapy in order to improve the blood supply and nerve functions of the nose to reduce swelling.

Surgical Treatments

In cases where surgical operations are needed to restore the inner nasal contours to build up nasal resistance and strengthen it,
Prior to the surgical treatments, a cotton test is usually performed where saline soaked in cotton wool is placed where the implantation is supposed to take place to restrict and restore aerodynamics. This helps to locate the best location for the implants and estimate the shape and size of how it will look like.

Throat & Voice Treatments (Laryngology)

Laryngology is a medical specialty that focuses on voice disorders due to illness or injuries to the larynx area of the throat. Some of the treatments in this area involve the treatments of vocal cord polyps, nodules, laryngeal cancer, spasmodic dysphonia, laryngopharyngeal reflux, palillomas, and the abuse or over use of the voice.

Causes of Throat & Voice Disorders

Throat problems can arise from a common sore throat through viral infections or from allergies, bacteria infections, or gastric reflux. Throat problems can also be signs of infection such as Tonsillitis which occurs in the tonsil, pharyngitis (inflammation of the pharynx), or could sometimes be caused by cancer.

Commonly, voice disorder can come from abuse or overuse of the voice. Too much talking, screaming, singing, or smoking can create unnecessary stress on the vocal cords and create nodules, polyps, or sore. Other causes may also come from infections, gastric reflux, or diseases caused by virus or bacterias.

Treatments in Laryngology

In the case of larynx or the hypopharynx disorder, Laryngoscopy and microlaryngeal surgery are usually performed to fix the problems with the voice box and the lower portion of the throat. In the procedure, a microscope and surgical instruments are inserted into the throat through the mouth to remove, change, or biopsy the irregular areas of the throat.