What Is Otolaryngology? (2024)

Differences Between Otolaryngology and Otology

Otology is one subspecialty of otolaryngology. Specialists in the ears, otologists work with the balance system, the temporal bones of the ear, the skull base, and related structures of the head and neck. Otologists evaluate and treat issues such as dizziness, hearing loss, and tinnitus.

Specialized Training

Otolaryngologists are medical doctor (MDs) or doctors of osteopathic medicine (DOs) who specialize in diagnosing and treating issues of the ears, nose, and throat. Also called ENT doctors and ENT specialists, otolaryngologists are trained in both medicine and surgery. This is why the specialty is also known as otolaryngology - head and neck surgery. After earning their medical degrees, otolaryngologist trainees must complete a five-year otolaryngology residency. Some otolaryngologists-in-training complete additional fellowship training in a subspecialty. To become board-certified, otolaryngologists must pass the American Board of Otolaryngology exam.

The Otolaryngology/Body Connection

An otolaryngologist diagnoses and treats a wide range of problems in the head and neck, but not in the brain or the eyes. Medical problems in the ears, nose, or throat are often connected to the rest of the body.

For instance, poorly controlled diabetes can contribute to chronic sinus infections or worsen sinus infections. A chronic problem that seems like a cold may turn out to be bronchitis. Even though the bronchial tubes are not in the ear, nose, or throat, someone may initially see an otolaryngologist to help pinpoint the source of the issue.

An ENT doctor can help to improve quality of life and decrease symptoms. It’s important to seek help early to avoid a problem getting worse.

Treating a Broad Range of Ear, Nose and Throat Conditions

Otolaryngology covers a wide range of areas and can overlap with certain subspecialties. These include:

• Allergy: Some otolaryngologists diagnose and treat allergies, including performing allergy testing or giving patients allergy shots or other medications.
• Facial and plastic reconstructive surgery: Otolaryngologists may perform some types of facial reconstructive surgery and facial cosmetic surgery.
• Head and neck surgery: Otolaryngologists may surgically remove tumors (both cancerous and benign) that arise in the head or neck and surgically treat thyroid problems such as Graves' disease.
• Laryngology: Laryngology focuses on throat disorders, such as voice-box issues, swallowing problems, and gastroesophageal reflux disease (GERD, or “acid reflux”).
• Otology and neurotology: These related subspecialties focus on conditions of the ear, including disorders related to balance, hearing, ear pain, and face pain.
• Pediatric otolaryngology: Because children have unique ear, nose, and throat concerns when compared to adults, they may benefit from seeing a pediatric otolaryngologist (“ENT doctor”). These doctors diagnose and treat a variety of issues common in children, including ear infections, allergy/sinus disease, asthma, and problems with the tonsils and adenoids.
• Rhinology: This subspecialty focuses on disorders of the nose and sinuses. Common include stuffy nose, nosebleed, sinus headaches, and loss of smell.
• Sleep concerns: Poor sleep and lack of sleep are growing health issues. ENT doctors who subspecialize in sleep disorders see people for snoring, sleep apnea, and other types of sleep-disordered breathing.

Otolaryngology comprises a spectrum of ear, nose, and throat conditions and concerns. The type of medical care someone should seek depends on the nature and symptoms of the problem, pain severity, and their overall health. Some people require a visit to a hospital emergency department or urgent-care facility, an urgent appointment with an otolaryngologist, or a non-urgent ENT appointment.

Go to the Emergency Department (ED)

People should go immediately to the nearest hospital emergency department if they experience or suspect any of the following:

• Facial fracture
• Jaw fracture
• Nasal fracture
• Ramsay Hunt syndrome, a condition caused by shingles (herpes zoster oticus) that impacts the facial nerve and can affect hearing
• Severe facial injury
  

Go to an Urgent-Care Practice or See an Otolaryngologist for an Urgent Appointment

People should promptly make an urgent appointment with an ENT specialist or go to a nearby urgent-care provider if they experience or suspect any of the following:

• Acute sinus infection
• Cancers of the ear, face, head, neck, or thyroid gland
• Earache
• Ear infection
• Fungal sinusitis
• Melanoma of the head and neck
• Neck mass
• Ruptured eardrum
• Salivary gland infection (sialadenitis)
• Skull-base tumors
• Sore throat
• “Swimmer’s ear” (otitis externa)

See an Otolaryngologist for a Non-Urgent Appointment

People should make a an appointment with an otolaryngologist if they experience or suspect any of these — typically after seeing their primary care team for an initial evaluation:

• Acoustic neuroma
• Allergies
• Bell’s palsy
• Benign paroxysmal positional vertigo
• Cholesteatoma
• Chronic nosebleeds
• Cleft lip and cleft palate
• Cricopharyngeal muscle dysfunction (swallowing problems)
• Deviated septum
• Dysphagia
• Earwax
• Feeding disorders
• Gastroesophageal reflux disease (GERD, or “acid reflux”)
• Geriatric rhinitis
• Goiter
• Graves’ disease
• Hearing loss
• Hoarseness
• Hyperacusis (intolerance to sound)
• Hyperthyroidism
• Hyposmia and anosmia (decreased and absent sense of smell)
• Inner-ear disease
• Laryngeal disorders
• Laryngopharyngeal reflux
• Ménière’s disease
• Middle-ear disease
• Nasal obstruction
• Nasal polyps
• Otosclerosis
• Paragangliomaof the head and neck
• Post-nasal drip
• Rhinitis
• Rhinosinusitis
• Salivary-gland disorders
• Sinus disorders
• Sleep apnea
• Snoring
• Spasmodic dysphonia
• Temporomandibular joint (TMJ) pain
• Thyroid nodules
• Tinnitus
• Tonsillitis
• Vocal-cord cysts
• Vocal-cord nodules
• Vocal-cord paralysis
• Vocal-cord polyps
• Zenker’s diverticulum

Otolaryngology Tests, Procedures, and Surgeries

Because otolaryngologists cover a wide range of ear, nose, and throat conditions, they perform a variety of related tests, procedures, and surgeries. These include:

• Allergy testing: Not all otolaryngologists perform allergy testing or provide immunotherapy (allergy shots). However, those who do will do testing to find out what kinds of allergies you have. This testing is more likely done in a person with asthma, frequent sinus infections, or nasal polyps. Allergy testing is often done using a series of skin pricks that contain a small amount of material of common allergens. Some otolaryngologists also may use a blood test. The doctor will evaluate your body’s reaction to determine your allergies.
• Computed tomography (CT) scans: ENT specialists may use a sinus CT scan to evaluate the sinuses or ears or confirm the cause of chronic sinus problems. CT imaging of the temporal bones — located on the sides and base of your skull — can help diagnose hearing loss and other ear problems. Magnetic resonance imaging (MRI) scans may also be used for certain indications.
• Nasal endoscopy: An otolaryngologist may perform nasal endoscopy to determine the cause of frequent nasal congestion, nasal polyps, or nosebleeds. Nasal endoscopy involves the doctor inserting a thin tube with a tiny camera (the endoscope) into the nose and through the nasal and sinus passages to visualize them.
• Tympanometry: This test measures how well the eardrum moves and shows the otolaryngologist whether there is, for example, fluid in the middle ear, a hole in the eardrum, an ear infection, or a buildup of earwax. Tympanometry involves the doctor putting probes into the ears and pushing air into them.

Otolaryngologists perform many types of procedures and surgeries. Common ones include:

• Adenoidectomy and tonsillectomy: An adenoidectomy is the removal of the adenoids, which are at the very top of the throat and behind the mouth and nose. This area is sometimes called the soft palate. In children, adenoid removal can help prevent against chronic earaches. Tonsillectomy is the surgical removal of the tonsils. In adults, adenoid or tonsil removal is sometimes done due to a possible cancer or tumor.
• Cleft lip and cleft palate repair: Otolaryngologists often help to surgically repair cleft lips and cleft palates, common congenital defects.
• Cochlear implants: ENT doctors place cochlear implants, tiny devices that improve hearing in patients with certain types of hearing loss.
• Facial surgery: Some otolaryngologists perform reconstructive facial surgery (to treat birth defects or trauma, for example) and/or certain cosmetic facial surgery, such as facelifts, rhinoplasty (“nose job”), or surgery for a deviated septum.
• Ear-tube placement: An otolaryngologist may place ear tubes to help open up the middle ear and prevent fluid accumulation behind the eardrum. Ear tubes are typically used to treat children who get frequent ear infections.
• Septoplasty: Otolaryngologists perform this surgery to correct a deviated (off-center) nasal septum, the bone and cartilage “wall” that separates the inside of the nose. Up to 80 percent of the population is thought to have a deviated septum, which can cause symptoms such as difficulty breathing and nosebleeds. Septoplasty is performed through the nostrils.
• Tympanoplasty: This surgery is done to repair the eardrum, which can be damaged by injury, infection, or ear tubes that have fallen out. Tympanoplasties are performed more commonly in children than in adults.

In addition, otolaryngologists may perform many other procedures, such as parathyroidectomy, thyroidectomy, biopsy and removal of head/neck cancers, and biopsy of larynx.

Major Professional Societies for Otolaryngology

Major professional organizations within and closely related to otolaryngology include:

• American Academy of Facial Plastic and Reconstructive Surgery
• American Academy of Sleep Medicine
• American Broncho-Esophagological Association
• American Head and Neck Society
• American Laryngological Association
• American Laryngological, Rhinological and Otological Society (“The Triological Society”)
• American Neurotology Society
• American Otological Society
• American Rhinological Society
• American Society of Pediatric Otolaryngology
• Canadian Society of Otolaryngology
• The American Academy of Otolaryngic Allergy
• Society of University Otolaryngologists, Head and Neck Surgeons

Latest News and Information on Otolaryngology

Stay informed about promising research findings, clinical advances, and other information related to otolaryngology with online resources such as:

• ENThealth (American Academy of Otolaryngology - Head and Neck Surgery)
• Ear, Nose and Throat (Medline Plus)

Common Questions Patients Ask About Otolaryngology

What is otorhinolaryngology?
Otorhinolaryngology is another name for otolaryngology. “Oto” pertains to the s ears, “rhino” refers to the nose, and “laryng” relates to the throat.

When should someone see an otolaryngologist for sinus problems?
Primary care doctors can diagnose and treat some sinus problems, but patients who aren’t feeling better after about a week might want to see an otolaryngologist. People should also consider seeing an otolaryngologist if sinus problems affect their vision or make them very tired. Patients may also explore seeing an allergy and immunology specialist if their sinus condition is believed to be more related to allergies and immunologic issues.

What’s the difference between an acute sinus infection and chronic sinusitis?
An acute sinus infection commonly improves within a few days to a few weeks, while chronic sinusitis lasts longer than three months and often recurs. Chronic sinusitis can require surgery in addition to medication.

What questions should I ask when visiting an ENT?
Questions to ask during a visit to an otolaryngologist might include:

• What’s the cause of my problem?
• Is my problem connected to other parts of my body?
• Is this a common problem?
• What treatments are available?
• What can I do to prevent this problem in the future?

What’s causing my dizziness or vertigo?
Dizziness and vertigo can have many different causes — from motion sickness and inner-ear problems to certain medications and health conditions. Specific reasons for dizziness or vertigo can include low blood sugar, low blood pressure, anxiety disorders, migraine, and some brain conditions.

Health problems such as benign paroxysmal positional vertigo and Ménière’s disease also can cause someone to feel like the objects around them are spinning or moving.

An otolaryngologist can help diagnose the cause of dizziness or vertigo. Before the appointment, patients should keep notes about when they feel dizzy and how long the sensation lasts.

What is sleep apnea, and why should I get it treated?
Sleep apnea is a condition in which someone stops breathing in their sleep. This can happen hundreds of times at night without people being aware of it. They may feel the symptoms, however, such as not feeling well rested, waking up with a headache, or falling asleep during the day.

Untreated sleep apnea is associated with high blood pressure, accidents, diabetes, depression, stroke, and heart disease. Otolaryngologists are one type of medical specialist who can help diagnose and treat sleep apnea. People who suspect they have sleep apnea should see a physician trained in diagnosing and managing it. Many patients are referred by their primary doctor to a sleep medicine specialist first, who is often also dual-trained in pulmonary medicine.

Q&A with Castle Connolly Top Doctor Peter D. Costantino, MD

Dr. Peter Costantino is the Executive Director and Senior Vice President of the New York Head and Neck Institute and the Otolaryngology-Head and Neck Surgery Service Line of the North Shore-LIJ Health System, and the Director of the New York Head & Neck Institute s Center for Cranial Base Surgery.

Q: What can people try to relieve sinus symptoms?
A: Sinus symptoms generally fall into four categories: nasal congestion, facial pain and headache, nasal discharge, and post-nasal drip. Some, or all, of these symptoms can be present in both acute sinusitis (symptoms less than four weeks) and chronic sinusitis (symptoms present for more than two months to years). When seeking relief from sinus symptoms it is most important for the patient ask themselves the question: How long have my symptoms been present?

• Acute sinus: Most sinus symptoms lasting less than four weeks are the result of either “a cold” (viral infection) or less commonly a bacterial infection. It is important to realize that less than 2 percent of acute sinusitis is due to bacteria, and that the vast majority of acute sinusitis (greater than 98 percent) are viral. Antibiotics do not work on viral sinusitis and can actually make things worse with their side effects. The truth is that antibiotics are vastly overprescribed for acute sinusitis. Instead of antibiotics you need three things: decongestant medications (over-the-counter decongestants or nasal steroids), daily nasal hygiene (saltwater nasal spray), and time (usually 2-6 weeks). If you simply use the over-the-counter products available in all drug stores, keep your nose clean by using saltwater nasal spray 2-3 times per day, and give your symptoms some time to resolve, you will likely get better without antibiotics or a trip to the doctor.
• Chronic sinusitis: If your sinus symptoms have lasted more than 6-12 weeks, then you’re going to need to see a doctor. The cause could be a viral infection that has converted to a chronic bacterial infection requiring antibiotics to clear, or your symptoms could have an environmental cause (allergies or air pollution). In any case, you’ll likely need the help of a professional to sort through the appropriate treatment. They may order a computed tomography (CT) scan of your sinuses to see what’s inside — such as fluid or polyps. They may order allergy testing, suggest the purchase of room air purifiers, or give recommendations on controlling dust mites, which are a common cause of chronic nasal and sinus symptoms. Ultimately, though, greater than 70 percent of chronic sinusitis cases can be resolved medically. The remaining 20-30 percent of patients require some type of surgery to durably resolve their symptoms. For this type of care, you will need an otolaryngologist (ENT surgeon).

Q: What lifestyle adjustments can people make to help improve their outcomes?
A: As mentioned above, what you need to do to feel better depends upon why you are having “sinus symptoms” and how long those symptoms have been present. That said, from a lifestyle standpoint — and especially if you are allergic to dust mites — is useful to use dust mite covers on mattresses, purchase pillows that are designed to be cleaned in a washing machine on a monthly basis, consider purchasing an in-room air purifier, avoid dusty or moldy environments, and treat colds (viral infections) with over-the-counter decongestants so that they do not evolve into chronic infections requiring antibiotics or surgery.

Q: Who should be on a person’s health team besides an otolaryngologist?
A: It is important to remember that an otolaryngologist is a sub-specialist. Because of this, it is critical that you have a PCP (primary care provider) who can look after “the whole you,” rather than just your nose and sinuses. The PCP will serve as the quarterback for your healthcare team, utilizing your ENT or an allergist as needed, depending upon the situation.