Why there is a common specialist for ear, nose and throat?

Ear, nose and throat of the human body are interlinked through a complex system of tubes and passages; hence, a health issue in one part has the potential of impacting the other. Because these three organs are interconnected, they are medically treated by the same specialist known as an ENT doctor or in accurate medical terminology called an otolaryngologist. 

What is an otolaryngologist?

An otolaryngologist has medical specialities in diagnosing and treating disease, injuries, infections and other problems related to the ear, nose or throat. 

Some of the common problems that come under the purview of ENT specialists or an otolaryngologist include (but are not limited to):

  • Infections of the ear nose and throat
  • Hearing loss
  • Trouble with balance
  • Tonsillitis
  • Dizziness
  • Asthma
  • Allergy
  • Deviated Septum
  • Hair loss
  • Nose bleeds
  • Nasal congestion
  • Smell problems
  • Cleft palate
  • Breathing problems
  • Swimmer’s ear
  • Nerve problems of the ear, nose and throat
  • Problems in swallowing or drinking
  • Vocal issues
  • Strep Throat
  • Sinusitis
  • Infections and tumours of the head and neck
  • Snoring issue
  • Obstructive sleep apnea

An otolaryngologist specialised training in the branch of medical science called otolaryngology, which involves diagnosing and treating conditions and problems related to any of the below organs such as:

  • Ears: All infections, allergies, hearing disorders, etc.
  • Nose: Problems such as chronic sinusitis, nasal cavity issues, allergies, problems of smell, etc.
  • Throat: Diseases and issues related to the laryngeal and upper oesophagal, as well as vocal issues, swallowing problems
  • Head and neck: Otolaryngology also involves treating problems of the face, head and neck including infections, bacterial infections, trauma, injury, deformities and tumour. However, for some specific problems, a multi-speciality approach may be required.

An otolaryngologist can also have specialist training in one of the below areas:

  • Allergic treatment through medication, immunotherapy, etc.
  • Surgery of the face, neck, ear for various reasons such as cosmetic, functional or reconstruction
  • Tumour removal
  • Throat management
  • Ear disorders and problems such as tumours, nerve issues affecting hearing and balance’
  • ENT specialist for children
  • Nose and sinus disorder management

 What are the common procedures undertaken by an otolaryngologist?

Some of the common procedures performed by an otolaryngologist to treat various conditions and problems related to the nose, ear, throat or other related structures include:

Blepharoplasty: An ENT specialist performs this procedure to repair dropping eyelids. This is done by removing extra skin, muscle or fat tissue which clouds the eyelid. A blepharoplasty also helps to improve vision and overall appearance.

Endoscope Sinus Surgery: An otolaryngologist can treat infectious and inflammatory sinus issues by inserting a flexible instrument called an endoscope. The doctor uses this instrument to see the sinus and then guides various surgical instruments such as laser to remove the blockage.

Biopsy: An ENT specialist is also equipped to perform a biopsy to assess for cancer, tumour or any other abnormal growth by taking a piece of tissue from the concerned organ.

Plastic Surgery: When required, an otolaryngologist can also perform plastic surgery for reconstructive or cosmetic purposes; however, this requires additional training. Such surgeries are performed to treats conditions involving cleft palates, congenital deformities, remove accident scars, etc.

Myringotomy and pressure equalization (PE): An ENT doctor recommends this procedure for patients who tend to experience frequent ear infections or are suffering from a loss of hearing due to building up of excessive fluid in the ear. The doctor uses a tube and passes it through the eardrum to release the pressure of it.

Septoplasty: A surgical procedure performed to correct a deviated septum or allow more nasal access, enabling removal of polyps. A septoplasty involves separating the nasal passage from the surrounding cartilage to correct the deviation.

Surgery for sleep-related issues: Sleep-related issues such as snoring and obstructive sleep apnea can be effectively treated by an otolaryngologist through surgery. In the case of snoring, the doctor will remove the excess soft palate tissue, allowing proper functioning of the airway. Alternatively, the surgeon can also inject the palate or insert rods to make it stiffer and reduce vibration respectively.

Thyroid Surgery: An ENT specialist can treat thyroid problems by removing a part or whole of the thyroid gland, as per the need of the case. This surgical procedure is very useful in treating thyroid cancers, suspicious lumps, obstruction of the oesophagus, and others.

Tonsillectomy: In this surgical procedure, the specialist removes the tonsils or problematic adenoids to treat infection and breathing problems respectively.

Tracheostomy: In this procedure, the surgeon inserts a tube through the neck to reach the windpipe and make an opening of an airway or remove lung secretions. 

Apart from these, an ENT specialist can perform several other procedures to cure problems related to the ear, nose, throat and related structures. 

Earwax Blockage – Overview, Diagnosis and Treatment

Earwax is produced by the ear canal glands and is a natural part of the body’s defences. Earwax is useful since it helps to clean, lubricate and protect the ear canal from dirt and bacteria. It traps dust and bacteria, as well as other small particles and prevents them from reaching and infecting the eardrum. In a normal course, the ear wax dries up and falls out of the ear itself along with trapped dust and other particles. However, in cases when the ear wax does not wash away naturally and becomes too hard, it is referred to as earwax blockage. In this condition, earwax also known as cerumen accumulates in the ear causing problems. This can be caused because of excess production of earwax by the body or when existing earwax is pushed too far into the ear canal. In many cases, the earwax blockage causes hearing problems in the affected area but it only lasts till the earwax is removed. Earwax blockage is very common and can be easily treated with some simple steps to remove the wax safely.

Symptoms of Earwax Blockage

One of the most prominent symptoms of earwax blockage is the reduction in the hearing ability from the affected ear. However, the impact is temporary and can easily be restored by the doctor through the removal of wax. 

Other common earwax blockage symptoms include:

  • Pain in the ear
  • A feeling of fullness in the impacted ear
  • Ringing, buzzing or other absurd noises in the ear
  • Dizziness
  • Unexplained cough

In most cases, the earwax blockage occurs only in one ear; however, in case both the ears are impacted, the doctor will diagnose for any other causes of the problem. 

Diagnosis

Upon experiencing any of the above symptoms, it is best to seek medical help. The doctor will analyse for any earwax blockage by looking into the ear with a special instrument known as an otoscope. An otoscope helps to see inside the inner ear by lighting and magnifying the inner ear. 

Treatment of Earwax Blockage

Earwax blockage can be easily treated by the doctor. The doctor can use the following methods to remove excessive wax:

  • Use a curet – a small, curved instrument to remove the wax
  • Use suction to pull out the wax while examining the ear
  • Use water pick or rubber-bulb syringe to put some warm water to soften the wax to be pulled out easily

In case, the build-up of earwax is a recurring or frequent problem, the doctor will also advise some targeted wax removal medications. Most of these medicines are to be used with proper direction and utmost precaution since they can irritate the eardrum and ear canal.

Another form of treatment that is used to remove earwax blockage involves using ear candling. In this technique, a lighted, hollow, thin, cone-structured candle is placed into the ear to melt the earwax so that it can be removed easily. The heat from the flame helps to form a vacuum seal, which causes the earwax to melt. However, this technique is found to be not very effective and can also cause injuries and ear canal obstructions. Hence, it is important to consult a doctor, before proceeding with any form of debatable treatment option.

Apart from medical treatment methods, you can apply these following steps to remove the earwax blockage:

Soften the wax block: Foremost, it is critical to soften the wax causing the blockage. Use a dropper to release a few drops of baby oil, glycerine or hydrogen peroxide in the ear canal; this will soften the wax and help you remove it easily.

Use warm water: After the ear has rested for 2-3 days and the wax has softened, use a rubber bulb syringe to softly put some warm water in the ear canal. Once the warm water is squirted, tilt your head and pull the outer ear up and back to ensure the water reaches inside the ear canal. Once the ear canal is completely lubricated, move your head to the side to allow the water to come out. 

Clean and dry the ear canal: Once, this is done, softly dry out your ear with a towel or use a dryer. It is important to keep the canal dry to avoid infections.

These steps should be followed as many times as required to make the earwax fallout from the ear. One major drawback of this method is that this process may only soften the outer layer of the wax lump and instead cause the rest of the block to go even deeper into the canal or against the eardrum. This can aggravate the issue further, in some cases. Hence, in cases where the symptoms do not improve after some days, it is best to seek medical help. There are also multiple earwax removal kits available in the market, which should only be used after consultation with a doctor on how to safely use these alternative treatments. 

Overall, as a general rule, it is advised to not dig out the hardened earwax with items such as cotton swabs, hairpins, paper clip, etc. These instruments push the wax deeper into the ear canal instead of removing it from the ear. Moreover, using such items can also damage the lining of the eardrum and ear canal. Hence, in cases of earwax blockage, it is always advisable to seek medical treatment to avoid any injuries and problems.

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