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Otorhinolaryngology (ENT surgery)

Otorhinolaryngology (ENT surgery) is a medical and surgical specialty that involves the diagnosis and treatment of conditions affecting the head and neck, including the ears, nose, throat, and respiratory system. Doctors who specialize in this area are known as otorhinolaryngologists, otolaryngologists, head and neck surgeons, ENT surgeons or ENT specialists. 

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The term "otorhinolaryngology" comes from the Greek words oto (ear), rhino (nose), larynx (throat), and -ology (the study of). Otolaryngologists treat a wide range of conditions in various ages, including: allergies, congenital anomalies, injuries, neoplasms, and hearing and voice disorders. 

Otolaryngologists can perform a variety of procedures on the above areas of the body.  Because the field of ENT is so wide, and because of the advance of technology and detailed knowledge, ENT Specialists increasingly sub-specialise in a specific area of the field in which they have an interest or have developed special skill.

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To become an otolaryngologist, a doctor must complete at least 12 years of study and training, including six years of undergraduate medical school, a year of internship, and five or more years of clinical specialty training.

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Following training as an ENT Surgeon, some otolaryngologist-head & neck surgeons complete an advanced sub-specialty fellowship, where training can be one to two years in duration. Fellowships include head and neck surgical oncology, rhinology and sinus surgery, otology / neurotology, pediatric otolaryngology, laryngology/voice and facial plastic surgery.

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Topics by subspecialty

Head and neck surgery

  • Head and neck surgical oncology (field of surgery treating cancer/malignancy of the head and neck)

    • Head and neck mucosal malignancy (cancer of the pink lining of the upper aerodigestive tract)

      • Oral cancer (cancer of lips, gums, tongue, hard palate, cheek, floor of mouth)

      • Oropharyngeal cancer (cancer of oropharynx, soft palate, tonsil, base of tongue)

      • Larynx cancer (voice box cancer)

      • Hypopharynx cancer (lower throat cancer)

      • Sinonasal cancer

      • Nasopharyngeal cancer

    • Skin cancer of the head & neck

    • Thyroid tumours

    • Salivary gland tumours

    • Endocrine surgery of the head and neck

    • Thyroid surgery

    • Parathyroid surgery

    • Skull base surgery

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Otology and neurotology

Study of diseases of the outer ear, middle ear and mastoid, and inner ear, and surrounding structures (such as the facial nerve and lateral skull base)

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  • Outer ear diseases

    • Otitis externa – inflammation/infection of the outer ear

    • Exostoses or Surfer’s Ear are bony growths in the outer ear canal

  • Middle ear and mastoid diseases

    • Otitis media – inflammation/infection of the middle ear

    • Perforated eardrum (hole in the eardrum due to infection or trauma)

    • Mastoiditis

  • Inner ear diseases

    • Vertigo:

      • BPPV - benign paroxysmal positional vertigo

      • Labyrinthitis

      • Vestibular neuritis

      • Ménière's disease/Endolymphatic hydrops

      • PPPD

      • Vestibular migraine
         

    • Acoustic neuroma / vestibular schwannoma

  • Facial nerve disease

    • Idiopathic facial palsy (Bell's Palsy)

    • Ramsay Hunt Syndrome

    • Traumatic injury of then facial nerve

    • Facial nerve tumours

  • Symptoms

    • Hearing loss

    • Tinnitus (subjective noise in the ear)

    • Aural fullness (sense of fullness in the ear)

    • Otalgia (pain referring to the ear)

    • Otorrhea (fluid draining from the ear)

    • Vertigo

    • Imbalance
       

  • Rhinology
    ​Rhinology includes nasal dysfunction and sinus diseases.

    • Nasal obstruction

      • Inferior turbinate hypertrophy

      • Nasal septum deviation

      • Chronic sinusitis with nasal polyps

    • Sinusitis – acute, chronic

    • Environmental allergies

    • Rhinitis

    • Pituitary tumour

    • Empty nose syndrome

    • Severe or recurrent epistaxis
       

  • Pediatric otorhinolaryngology

    • Adenoidectomy

    • Caustic ingestion

    • Cricotracheal resection for subglottic stenosis

    • Decannulation

    • Laryngomalacia

    • Laryngotracheal reconstruction

    • Myringotomy and tubes

    • Obstructive sleep apnoea – paediatric

    • Tonsillectomy

       

  • Laryngology

    • Dysphonia/hoarseness

      • Laryngitis

      • Reinke's edema

      • Vocal cord nodules and polyps

      • Spasmodic dysphonia

      • Tracheostomy

      • Cancer of the larynx

      • Vocology – science and practice of voice habilitation
         

  • Facial plastic and reconstructive surgery

Facial plastic and reconstructive surgery is an area shared by Plastic Surgeons, ENT Surgeons, Maxillo-facial Surgeons and Dermatologists – who may work together on specific cases.  Procedures done by ENT surgeons generally include:

  • Rhinoplasty and septoplasty

  • Otoplasty

  • Injectable cosmetic treatments

  • Trauma to the face

    • Nasal bone fracture

    • Mandible fracture

    • Orbital fracture

    • Frontal sinus fracture

    • Complex lacerations and soft tissue damage

  • Skin cancer (e.g. Basal Cell Carcinoma)

     

  • Sleep surgery

Sleep surgery encompasses any surgery that helps alleviate obstructive sleep apnea and can anatomically include any part of the upper airway.

  • Nasal cavity / nasopharynx

    • Septoplasty

    • Adenoidectomy (especially in paediatrics)

  • Oral cavity / oropharynx

    • Tonsillectomy (especially in paediatrics)

    • Uvulopalatopharyngoplasty

    • Transoral midline glossectomy

    • Genioglossus advancement

  • Other

    • Hyoid suspension

    • Maxillomandibular advancement

    • Hypoglossal nerve stimulator implant (Inspire)

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