![National Throat Nose and Ear Hospital London - geograph](https://upload.wikimedia.org/wikipedia/commons/5/59/National_Throat_Nose_and_Ear_Hospital_London_-_geograph.org.uk_-_984640.jpg)
Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical and medical management of conditions of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients seek treatment from an otorhinolaryngologist for diseases of the
ear
An ear is the organ that enables hearing and, in mammals, body balance using the vestibular system. In mammals, the ear is usually described as having three parts—the outer ear, the middle ear and the inner ear. The outer ear consists of ...
,
nose
A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes ...
,
throat
In vertebrate anatomy, the throat is the front part of the neck, internally positioned in front of the vertebrae. It contains the pharynx and larynx. An important section of it is the epiglottis, separating the esophagus from the trachea (windpip ...
,
base of the skull
The base of skull, also known as the cranial base or the cranial floor, is the most inferior area of the skull. It is composed of the endocranium and the lower parts of the calvaria.
Structure
Structures found at the base of the skull are for ...
, head, and neck. These commonly include functional diseases that affect the senses and activities of eating, drinking, speaking, breathing, swallowing, and hearing. In addition, ENT surgery encompasses the surgical management of
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
s and
benign tumor
A benign tumor is a mass of cells (tumor) that does not invade neighboring tissue or metastasize (spread throughout the body). Compared to malignant (cancerous) tumors, benign tumors generally have a slower growth rate. Benign tumors have re ...
s and reconstruction of the head and neck as well as plastic surgery of the face and neck.
Etymology
The term is a combination of
New Latin
New Latin (also called Neo-Latin or Modern Latin) is the revival of Literary Latin used in original, scholarly, and scientific works since about 1500. Modern scholarly and technical nomenclature, such as in zoological and botanical taxonomy ...
combining forms (''
oto-'' + ''
rhino-
This is a list of common affixes used when scientifically naming species, particularly extinct species for whom only their scientific names are used, along with their derivations.
*a-, an-: ''Pronunciation'': /ə/, /a/, /ən/, /an/. ''Origin'' ...
'' + ''
laryngo-'' + ''
-logy'') derived from four
Ancient Greek
Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic p ...
words:
οὖς ''ous'' (
gen.: ὠτός ''otos''), "ear",
ῥίς ''rhis'', "nose",
λάρυγξ ''larynx'', "larynx" and
-λογία ''logia'', "study" (cf. Greek ωτορινολαρυγγολόγος, "otorhinolaryngologist").
Training
Otorhinolaryngologists are
physicians (
MD,
DO,
MBBS,
MBChB
Bachelor of Medicine, Bachelor of Surgery ( la, Medicinae Baccalaureus, Baccalaureus Chirurgiae; abbreviated most commonly MBBS), is the primary medical degree awarded by medical schools in countries that follow the tradition of the United Kin ...
, etc.) who complete medical school and then 5–7 years of post-graduate surgical training in ORL-H&N. In the United States, trainees complete at least five years of surgical residency training. This comprises three to six months of
general surgical training and four and a half years in ORL-H&N specialist surgery. In Canada and the United States, practitioners complete a five-year residency training after medical school.
Following residency training, 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, facial plastic surgery, rhinology and sinus surgery, neuro-otology, pediatric otolaryngology, and laryngology. In the United States and Canada, otorhinolaryngology is one of the most competitive specialties in medicine in which to obtain a residency position following medical school.
In the United Kingdom entrance to otorhinolaryngology higher surgical training is highly competitive and involves a rigorous national selection process. The training programme consists of 6 years of higher surgical training after which trainees frequently undertake fellowships in a sub-speciality prior to becoming a consultant.
The typical total length of education and training, post-secondary school is 12–14 years. Otolaryngology is among the more highly compensated surgical specialties in the United States. In 2019, the average annual income was $461,000.
Sub-specialties
(* Currently recognized by American Board of Medical Subspecialties)
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
Oral cancer, also known as mouth cancer, is cancer of the lining of the lips, mouth, or upper throat. In the mouth, it most commonly starts as a painless white patch, that thickens, develops red patches, an ulcer, and continues to grow. When on ...
(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
Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. There are three main types of skin cancers: basal-cell skin cancer (BCC) ...
of the head & neck
**
Thyroid cancer
Thyroid cancer is cancer that develops from the tissues of the thyroid gland. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. Symptoms can include swelling or a lump in the neck. C ...
**
Salivary gland cancer
Salivary gland tumours, also known as mucous gland adenomas or neoplasms, are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibu ...
**Head and neck sarcoma
* Endocrine surgery of the head and neck
**Thyroid surgery
**Parathyroid surgery
*
Microvascular free flap reconstructive surgery
*Skull base surgery
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)
* Outer ear diseases
**
Otitis externa
Otitis externa, also called swimmer's ear, is inflammation of the ear canal. It often presents with ear pain, swelling of the ear canal, and occasionally decreased hearing. Typically there is pain with movement of the outer ear. A high fever is ...
–
***
outer ear
The outer ear, external ear, or auris externa is the external part of the ear, which consists of the auricle (also pinna) and the ear canal. It gathers sound energy and focuses it on the eardrum (tympanic membrane).
Structure
Auricle
Th ...
or
ear canal inflammation
*Middle ear and mastoid diseases
**
Otitis media
Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, ...
–
middle ear
The middle ear is the portion of the ear medial to the eardrum, and distal to the oval window of the cochlea (of the inner ear).
The mammalian middle ear contains three ossicles, which transfer the vibrations of the eardrum into waves in the ...
inflammation
**Perforated
eardrum (hole in the eardrum due to infection, trauma, explosion or loud noise)
**
Mastoiditis
Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear. Specifically, it is an inflammation of the mucosal lining of the mastoid antrum and mastoid air cell system inside the mastoid process. The ma ...
*Inner ear diseases
**
BPPV
Benign paroxysmal positional vertigo (BPPV) is a disorder arising from a problem in the inner ear. Symptoms are repeated, brief periods of vertigo with movement, characterized by a spinning sensation upon changes in the position of the head.
* T ...
– benign paroxysmal positional
vertigo
Vertigo is a condition where a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties w ...
**
Labyrinthitis
Labyrinthitis is inflammation of the labyrinth – a maze of fluid-filled channels in the inner ear. Vestibular neuritis is inflammation of the vestibular nerve – the nerve in the inner ear that sends messages related to motion and position t ...
/
Vestibular neuronitis
**
Ménière's disease
Ménière's disease (MD) is a disease of the inner ear that is characterized by potentially severe and incapacitating episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. Typically, only one ear is affected initi ...
/
Endolymphatic hydrops
Endolymphatic hydrops is a disorder of the inner ear. It consists of an excessive build-up of the endolymph fluid, which fills the hearing and balance structures of the inner ear. Endolymph fluid, which is partly regulated by the endolymph sac, ...
**
Perilymphatic fistula
**
Acoustic neuroma
A vestibular schwannoma (VS), also called acoustic neuroma, is a benign tumor that develops on the vestibulocochlear nerve that passes from the inner ear to the brain. The tumor originates when Schwann cells that form the insulating myelin sheath ...
, vestibular schwannoma
*Facial nerve disease
**Idiopathic facial palsy (Bell's Palsy)
**Facial nerve tumors
**
Ramsay Hunt Syndrome Three different neurological syndromes carry the name of Ramsay Hunt syndrome. Their only connection is that they were all first documented by the famous neurologist James Ramsay Hunt (1872–1937).
* Ramsay Hunt syndrome type 1, also called ''Rams ...
* 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
Nasal congestion is the blockage of nasal breathing usually due to membranes lining the nose becoming swollen from inflamed blood vessels.
Background
In about 85% of cases, nasal congestion leads to mouth breathing rather than nasal breathin ...
*
Nasal septum deviation
Nasal septum deviation is a physical disorder of the nose, involving a displacement of the nasal septum. Some displacement is common, affecting 80% of people, mostly without their knowledge.
Signs and symptoms
The nasal septum is the bone and ...
*
Sinusitis
Sinusitis, also known as rhinosinusitis, is inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include thick nasal mucus, a plugged nose, and facial pain. Other signs and symptoms may include fever, head ...
– acute, chronic
* Environmental
allergies
Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermat ...
*
Rhinitis
Rhinitis, also known as coryza, is irritation and inflammation of the mucous membrane inside the nose. Common symptoms are a stuffy nose, runny nose, sneezing, and post-nasal drip.
The inflammation is caused by viruses, bacteria, irrita ...
*
Pituitary tumor
Pituitary adenomas are tumors that occur in the pituitary gland. Most pituitary tumors are benign, approximately 35% are invasive and just 0.1% to 0.2% are carcinomas.[Empty nose syndrome
Empty may refer to:
Music Albums
* ''Empty'' (God Lives Underwater album) or the title song, 1995
* ''Empty'' (Nils Frahm album), 2020
* ''Empty'' (Tait album) or the title song, 2001
Songs
* "Empty" (The Click Five song), 2007
* ...]
* Severe or recurrent
epistaxis
A nosebleed, also known as epistaxis, is bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significant that low bl ...
Pediatric otorhinolaryngology
*
Adenoidectomy
Adenoidectomy is the surgical removal of the adenoid for reasons which include impaired breathing through the nose, chronic infections, or recurrent earaches. The effectiveness of removing the adenoids in children to improve recurrent nasal sympto ...
*
Caustic ingestion
* Cricotracheal resection
*
Decannulation
*
Laryngomalacia
Laryngomalacia (literally, "soft larynx") is the most common cause of chronic stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction. It can also be seen in o ...
*
Laryngotracheal reconstruction
*
Myringotomy and tubes
*
Obstructive sleep apnea – pediatric
*
Tonsillectomy
Tonsillectomy is a list of surgical procedures, surgical procedure in which both palatine tonsils are fully removed from the back of the throat. The procedure is mainly performed for recurrent tonsillitis, throat infections and obstructive sleep ...
Laryngology
*
Dysphonia
A hoarse voice, also known as dysphonia or hoarseness, is when the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch. A hoarse voice, can be associated with a feeling of unease or scratchiness in the ...
/hoarseness
**
Laryngitis
**
Reinke's edema
Reinke's edema is the swelling of the vocal cords due to fluid (edema) collected within the Reinke's space. First identified by the German anatomist Friedrich B. Reinke in 1895, the Reinke's space is a gelatinous layer of the vocal cord located un ...
**
Vocal cord nodules and
polyps
A polyp in zoology is one of two forms found in the phylum Cnidaria, the other being the medusa. Polyps are roughly cylindrical in shape and elongated at the axis of the vase-shaped body. In solitary polyps, the aboral (opposite to oral) end i ...
*
Spasmodic dysphonia
Spasmodic dysphonia, also known as laryngeal dystonia, is a disorder in which the muscles that generate a person's voice go into periods of spasm. This results in breaks or interruptions in the voice, often every few sentences, which can make a pe ...
*
Tracheostomy
Tracheotomy (, ), or tracheostomy, is a surgical airway management procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the trachea (windpipe). The r ...
*
Cancer of the larynx
*
Vocology – science and practice of voice habilitation
Facial plastic and reconstructive surgery
Facial plastic and reconstructive surgery is a one-year fellowship open to otorhinolaryngologists and plastic surgeons who wish to specialize in the aesthetic and reconstructive surgery of the head, face, and neck.
*
Rhinoplasty
Rhinoplasty ( grc, ῥίς, rhī́s, nose + grc, πλάσσειν, plássein, to shape), commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two typ ...
and
septoplasty
Septoplasty sɛp.toˌplæ.sti(Etymology: L, saeptum, septum; Gk, πλάσσειν plassein – to shape), or alternatively submucous septal resection and septal reconstruction, is a corrective surgical procedure done to straighten a deviated ...
*
Facelift
A facelift, technically known as a rhytidectomy (from the Ancient Greek () "wrinkle", and () "excision", the surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are mul ...
(rhytidectomy)
*
Browlift
*
Blepharoplasty
*
Otoplasty Otoplasty ( el, οὖς, , "ear" + , , "to shape") denotes the surgical and non-surgical procedures for correcting the deformities and defects of the pinna (external ear), and for reconstructing a defective, or deformed, or absent external ear, co ...
*
Genioplasty
* Injectable cosmetic treatments
*
Trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
to the face
**
Nasal bone fracture
**
Mandible
In anatomy, the mandible, lower jaw or jawbone is the largest, strongest and lowest bone in the human facial skeleton. It forms the lower jaw and holds the lower teeth in place. The mandible sits beneath the maxilla. It is the only movable bone ...
fracture
**
Orbital fracture
Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures ...
** Frontal
sinus
Sinus may refer to:
Anatomy
* Sinus (anatomy), a sac or cavity in any organ or tissue
** Paranasal sinuses, air cavities in the cranial bones, especially those near the nose, including:
*** Maxillary sinus, is the largest of the paranasal sinuses, ...
fracture
** Complex lacerations and soft tissue damage
* Skin cancer (e.g.
Basal Cell Carcinoma
Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raise ...
)
Microvascular reconstruction repair
Microvascular reconstruction repair is a common operation that is done on patients who see an Otorhinolaryngologist. Microvascular reconstruction repair is a surgical procedure that involves moving a composite piece of tissue from the patient's body and moves it to the head and or neck. Microvascular head and neck reconstruction is used to treat head and neck cancers, including those of the larynx and pharynx, oral cavity, salivary glands, jaws, calvarium, sinuses, tongue and skin. The tissue that is most commonly moved during this procedure is from the arms, legs, back, and can come from the skin, bone, fat, and or muscle.
When doing this procedure, the decision on which is moved is determined on the reconstructive needs. Transfer of the tissue to the head and neck allows surgeons to rebuild the patient's jaw, optimize tongue function, and reconstruct the throat. When the pieces of tissue are moved, they require their own blood supply for a chance of survival in their new location. After the surgery is completed, the blood vessels that feed the tissue transplant are reconnected to new blood vessels in the neck. These blood vessels are typically no more than 1 to 3 millimeters in diameter which means these connections need to be made with a microscope which is why this procedure is called "microvascular surgery."
See also
*
Plastic and Reconstructive Surgery
''Plastic and Reconstructive Surgery'' is a peer-reviewed medical journal and the official publication of the American Society of Plastic Surgeons. It covers all aspects of plastic and reconstructive surgery
Reconstructive surgery is surgery p ...
*
Audiology
Audiology (from Latin , "to hear"; and from Greek , ''-logia'') is a branch of science that studies hearing, balance, and related disorders. Audiologists treat those with hearing loss and proactively prevent related damage. By employing vario ...
*
Head and neck anatomy
This article describes the anatomy of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat.
Structure Bones
The head rests on the top part of the vertebra ...
*
Head and neck cancer
Head and neck cancer develops from tissues in the lip and oral cavity (mouth), larynx (throat), salivary glands, nose, sinuses or the skin of the face. The most common types of head and neck cancers occur in the lip, mouth, and larynx. Symptoms ...
*
Head mirror
A head mirror is a simple diagnostic device, stereotype, stereotypically worn by physicians, but less so in recent decades as they have become somewhat obsolete.
A head mirror is mostly used for examination of the ear, nose and throat. It compr ...
*
Oral and maxillofacial surgery
*
Surgeon
*
Speech–language pathology
Speech-language pathology (or speech and language pathology) is a healthcare field of expertise practiced globally. Speech-language pathology (SLP) specializes in the evaluation, diagnosis, treatment, and prevention of communication disorders ...
References
{{DEFAULTSORT:Otolaryngology
Surgical specialties