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Otolaryngology (pronounced oh/toe/lair/in/goll/oh/jee) is the oldest medical specialty in the United States. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. They are commonly referred to as ENT physicians.
Otolaryngologists diagnose and manage diseases of the sinuses, larynx (voice box), oral cavity, and upper pharynx (mouth and throat), as well as structures of the neck and face, as well as many ENT primary care problems in both children and adults.
The ears: Hearing loss affects one in ten North Americans. The unique domain of otolaryngologists is the treatment of ear disorders. They are trained in both the medical and surgical treatment of hearing, ear infections, ear noise (tinnitus), nerve pain, and facial and cranial nerve disorders. Otolaryngologists also manage congenital (birth) disorders of the outer and inner ear.
The nose: About 35 million people develop chronic sinusitis each year, making it one of the most common health complaints in America. Care of the nasal cavity and sinuses is one of the primary skills of otolaryngologists. Management of the nasal area includes allergies and sense of smell. Breathing through, and the appearance of, the nose are also part of otolaryngologists' expertise.
The throat: Communicating (speech and singing) and eating a meal all involve this vital area. Also specific to otolaryngologists is expertise in managing diseases of the larynx (voice box) and the upper aero-digestive tract or esophagus, including voice and swallowing disorders.
The head and neck: This center of the body includes the important nerves that control sight, smell, hearing, and the face. In the head and neck area, otolaryngologists are trained to treat infectious diseases, both benign and malignant (cancerous) tumors, facial trauma, and deformities of the face. They perform both cosmetic plastic and reconstructive surgery.
Otolaryngologists are ready to start practicing after completing up to 15 years of college and post-graduate training. To qualify for certification by the American Board of Otolaryngology, an applicant must first complete college, medical school (usually four years), and at least five years of specialty training. Next, the physician must pass the American Board of Otolaryngology examination. In addition, some otolaryngologists pursue a one or two year fellowship for more extensive training in one of eight subspecialty areas.
These subspeciality areas are pediatric otolaryngology (children), otology/neurotology (ears and tinnitus), allergy, facial plastic and reconstructive surgery, head and neck, laryngology (throat), rhinology (nose), and sleep. Some otolaryngologists limit their practices to one of these eight areas.
Your primary care physician will refer you to a surgeon they are familiar with and respect and whom they trust to manage your disease. The local and state medical societies also keep lists or directories of physicians in their regions. There are also listings of board-certified otolaryngologists on several websites. Local magazines may also publish "best doctor" lists that you can consult. Other people with sinus problems may also be a good resource.
Important factors to take into account when selecting a surgeon are the amount of experience they have performing the surgery, how often they perform the surgery, and the rapport they establish with you.
If you have already had sinus surgery and the problem has returned or gotten worse, you may wish to seek out the opinion of an otolaryngologist who has additional training in the subspecialty of rhinology. Though there are relatively few fellowship-trained specialists in rhinology, they can usually be found in larger cities and university medical centers.
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