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{{short description|Medical specialty of the head and neck}}
{{Multiple issues|
{{Redirect|Otolaryngology – head and neck surgery|the medical journal|Otolaryngology–Head and Neck Surgery{{!}}''Otolaryngology–Head and Neck Surgery''}}
{{refimprove|date=April 2010}}
{{globalize|date=July 2008}}
{{more citations needed|date=April 2010}}
{{Use dmy dates|date=July 2021}}
{{infobox medical speciality
| title = Otorhinolaryngology
| subdivisions =
| image =
| caption =
| system =
| diseases = [[Dizziness]], [[Head and neck cancer]], [[Sinusitis]], [[Chronic ear disease (disambiguation)|Chronic ear disease]], [[Hoarseness]], [[Nasal obstruction]]
| tests =
| specialist = Otorhinolaryngologist
| glossary = [[Glossary of medicine]]
}}
{{Infobox occupation
| name= Otolaryngologist
| image=
| caption=
| official_names=
* Physician
* Surgeon
| type= [[Specialty (medicine)|Specialty]]
| activity_sector= [[Medicine]], [[Surgery]]
| competencies=
| formation=
* [[Doctor of Medicine]] (M.D.) or [[Doctor of Osteopathic medicine]] (D.O.)
* [[Bachelor of Medicine, Bachelor of Surgery]] (M.B.B.S.)
* [[Bachelor of Medicine, Bachelor of Surgery]] (MBChB)
| employment_field= [[Hospital]]s, [[Clinic]]s
| related_occupation=
}}
}}
{{Use dmy dates|date=July 2012}}

[[File:Mani Zadeh MD Endoscopic Sinus Surgery.jpg|thumb|Otolaryngologist performing an endoscopic sinus surgical procedure]]
[[File:Sharplan 40C.jpg|thumb|A 40-watt CO<sub>2</sub> laser used in otorhinolaryngology]]
[[File:Sharplan 40C.jpg|thumb|A 40-watt CO<sub>2</sub> laser used in otorhinolaryngology]]
[[File:National Throat Nose and Ear Hospital London - geograph.org.uk - 984640.jpg|thumb|[[Royal National Throat, Nose and Ear Hospital]] founded in 1874, in [[London]]]]
[[File:National Throat Nose and Ear Hospital London - geograph.org.uk - 984640.jpg|thumb|[[Royal National Throat, Nose and Ear Hospital]] founded in 1874, in [[London]]]]


'''Otorhinolaryngology''' {{IPAc-en|oʊ|t|oʊ|ˌ|r|aɪ|n|oʊ|ˌ|l|æ|r|ə|n|ˈ|g|ɒ|l|ə|dʒ|i}} (also called '''otolaryngology''' and '''otolaryngology'''–'''head and neck surgery''') is a surgical subspecialty within medicine that deals with conditions of the '''ear, nose, and throat''' ('''ENT''') and related structures of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, ENT doctors, ENT surgeons, or head and neck surgeons. Patients seek treatment from an otorhinolaryngologist for diseases of the [[ear]], [[nose]], [[throat]], [[base of skull|base of the skull]], and for the surgical management of [[cancer]]s and [[benign tumor]]s of the head and neck.
'''Otorhinolaryngology''' ({{IPAc-en|oʊ|t|oʊ|ˌ|r|aɪ|n|oʊ|ˌ|l|ær|ɪ|n|ˈ|g|ɒ|l|ə|dʒ|i}} {{respell|oh|toh|RY|noh|LARR|in|GOL|ə|jee}}, abbreviated '''ORL''' and also known as '''otolaryngology''', '''otolaryngology{{nbsp}}–{{nbsp}}head and neck surgery''' ('''ORL–H&N''' or '''OHNS'''), or '''ear, nose, and throat''' ('''ENT'''){{Hair space}}) is a surgical subspecialty 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]], [[Human nose|nose]], [[throat]], [[base of skull|base of the skull]], 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]]s and [[benign tumor]]s and reconstruction of the head and neck as well as [[plastic surgery]] of the face, scalp, and neck.


==Etymology==
==Etymology==
The term is a combination of [[New Latin]] [[classical compound|combining forms]] (''[[wikt:oto-#Prefix|oto-]]'' + ''[[wikt:rhino-#Prefix|rhino-]]'' + ''[[wikt:laryngo-#Prefix|laryngo-]]'' + ''[[wikt:-logy#Suffix|-logy]]'') derived from four [[Ancient Greek]] words: [[wikt:οὖς|οὖς]] ''ous'' ([[Genitive case|gen.]]: ὠτός ''otos''), "ear", [[wikt:ῥίς|ῥίς]] ''rhis'', "nose", [[wikt:λάρυγξ|λάρυγξ]] ''larynx'', "larynx" and [[wikt:-λογία|-λογία]] ''logia'', "study"<ref>"otolaryngologist" entry in: Peter Harris, Sue Nagy, Nicholas Vardaxis, ''[[Mosby's Dictionary of Medicine, Nursing & Health Professions]] - Australian & New Zealand Edition'', Elsevier Health Sciences, 2009.</ref> (cf. Greek ωτορινολαρυγγολόγος, "otorhinolaryngologist").
The term is a combination of [[Neo-Latin]] [[classical compound|combining forms]] (''[[wikt:oto-#Prefix|oto-]]'' + ''[[wikt:rhino-#Prefix|rhino-]]'' + ''[[wikt:laryngo-#Prefix|laryngo-]]'' + ''[[wikt:-logy#Suffix|-logy]]'') derived from four [[Ancient Greek]] words: [[wikt:οὖς|οὖς]] ''ous'' ([[Genitive case|gen.]]: ὠτός ''otos''), "ear", [[wikt:ῥίς|ῥίς]] ''rhis'', "nose", [[wikt:λάρυγξ|λάρυγξ]] ''larynx'', "larynx" and [[wikt:-λογία|-λογία]] ''logia'', "study"<ref>"otolaryngologist" entry in: Peter Harris, Sue Nagy, Nicholas Vardaxis, ''[[Mosby's Dictionary of Medicine, Nursing & Health Professions]] - Australian & New Zealand Edition'', Elsevier Health Sciences, 2009.</ref> (cf. Greek ωτορινολαρυγγολόγος, "otorhinolaryngologist").


==Training==
==Training==
Otorhinolaryngologists are [[physicians]] ([[Doctor of Medicine|MD]], [[Doctor of Osteopathic Medicine|DO]], [[MBBS]], [[MBChB]], etc.) who, in the United States, complete at least five years of surgical residency training. This is composed of six months of [[general surgery|general surgical]] training and four and a half years in specialist surgery. In Canada and the United States, practitioners complete a five-year residency training after medical school.
Otorhinolaryngologists are [[physicians]] ([[Doctor of Medicine|MD]], [[Doctor of Osteopathic Medicine|DO]], [[MBBS]], [[MBChB]], etc.) who complete both medical school and an average of five–seven years of post-graduate surgical training in ORL-H&N. In the United States, trainees complete at least five years of surgical residency training.<ref>{{cite web|title=Otolaryngology Specialty Description|publisher=American Medical Association|url=https://www.ama-assn.org/specialty/otolaryngology-specialty-description}}</ref> This comprises three to six months of [[general surgery|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, [[neurotology|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.<ref>{{Cite web|url=https://www.enttoday.org/article/crisis-in-otolaryngology-match/|title=Is There a Crisis in the Otolaryngology Match?|website=ENTtoday|language=en-US|access-date=2020-04-16}}</ref><ref>{{Cite web|url=https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/03/Advance-Data-Tables-2020.pdf|title=National Residency Match Program 2020|website=National Residency Match Program|access-date=2 April 2020|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828123610/https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/03/Advance-Data-Tables-2020.pdf|url-status=dead}}</ref>


In the United Kingdom, entrance to higher surgical training is competitive and involves a rigorous national selection process.<ref>{{Cite web|url=https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/surgery/otorhinolaryngology-ear-nose-and-throat-surgery-ent/training-and-development|title=Training and development (otorhinolaryngology)|date=2015-04-16|website=Health Careers|language=en|access-date=2020-04-16}}</ref> 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.
Following residency training, some otolaryngologist-head & neck surgeons complete an advanced sub-specialty fellowship, where training can be one to two years in duration. 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.{{fact|date=May 2017}}


The typical total length of education, training and post-secondary school is 12–14 years. Otolaryngology is among the more highly compensated surgical specialties in the United States. In 2022, the average annual income was $469,000.<ref>{{cite web|url=https://www.medscape.com/slideshow/2022-compensation-otolaryngologist-6015158#2| title =Medscape, Otolaryngologist Compensation Report 2022}}</ref>
In the United Kingdom entrance to otorhinolaryngology higher surgical training is highly competitive and involves a rigorous national selection process.{{fact|date=May 2017}} 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.


==Sub-specialties==
==Sub-specialties==
{|class="wikitable"
{|class="wikitable"
|- style="text-align:center; font-weight:bold; vertical-align:top;"
|- style="text-align:center; font-weight:bold; vertical-align:top;"
| style="width:117px; height:12.75;"| Head and Neck Oncologic Surgery
| style="width:117px; height:12.75;"| Head and neck oncologic surgery
| style="width:100px;"| Facial plastic and reconstructive surgery*
| style="width:100px;"| Facial plastic and reconstructive surgery*
| style="width:43.5;"| Otology
| style="width:43.5;"| Otology
| style="width:117px;"| Neurotology*
| style="width:117px;"| Neurotology*
| style="width:117px;"| Rhinology and Sinus Surgery
| style="width:117px;"| Rhinology/sinus/anterior skull base surgery
| style="width:68.25;"| Laryngology and Voice Disorders
| style="width:68.25;"| Laryngology and voice disorders
| style="width:140.25;"| Pediatric Otorhinolaryngology*
| style="width:140.25;"| Pediatric otorhinolaryngology*
| style="width:43.5;"| Sleep Medicine*
| style="width:43.5;"| Sleep medicine*
|- style="text-align:center; vertical-align:top;"
|- style="text-align:center; vertical-align:top;"
| style="height:12.75;"| Surgical oncology
| style="height:12.75;"| [[Surgical oncology]]
| Facial cosmetic surgery
| Facial cosmetic surgery
| Ear
| Ear
| Middle and inner ear
| Middle and inner ear
| Sinusitis
| [[Sinusitis]]
| Voice disorders
| [[Voice disorders]]
| Velopalatine insufficiency
| Velopalatine insufficiency
|Sleep disorders
|[[Sleep disorders]]
|- style="text-align:center; vertical-align:top;"
|- style="text-align:center; vertical-align:top;"
| style="height:12.75;"| Microvascular
| style="height:12.75;"| Microvascular
Line 47: Line 74:
| Hearing
| Hearing
| Temporal bone
| Temporal bone
| Allergy
| [[Allergy]]
| Phono-surgery
| Phono-surgery
| Cleft lip and palate
| Cleft lip and palate
Line 62: Line 89:
|Sleep investigations
|Sleep investigations
|- style="text-align:center; vertical-align:top;"
|- style="text-align:center; vertical-align:top;"
| style="height:12.75;"| [[Endoscopic Endonasal Surgery|Endoscopic Surgery]]
| style="height:12.75;"| [[Endoscopic endonasal surgery|Endoscopic surgery]]
| Craniofacial surgery
| Craniofacial surgery
|
|
| Dizziness
| [[Dizziness]]
| Apnea and snoring
| Apnea and [[snoring]]
|
|
| Vascular malformations
| Vascular malformations
Line 76: Line 103:
|
|
|
|
| [[Cochlear implant]]/[[Bone-anchored hearing aid|BAHA]]
| Cochlear implant/BAHA
|}
|}


(* Currently recognized by American Board of Medical Subspecialties)
(*Currently recognized by [[American Board of Medical Specialties|American Board of Medical Subspecialties]])


==Topics==
==Topics by subspecialty==


===Head and neck oncology===
=== Head and neck surgery ===
* Head and neck surgical oncology (field of surgery treating cancer/malignancy of the head and neck)
* [[Squamous cell carcinoma]] of the oral cavity, pharynx and larynx
** Head and neck mucosal malignancy (cancer of the pink lining of the upper aerodigestive tract)
* [[Oral cancer]]
* [[Skin cancer]] of the head & neck
***[[Oral cancer]] (cancer of lips, gums, tongue, hard palate, cheek, floor of mouth)
***Oropharyngeal cancer (cancer of oropharynx, soft palate, tonsil, base of tongue)
* [[Thyroid cancer]]
***Larynx cancer (voice box cancer)
* Endocrine surgery of the head and neck (thyroidectomy, parathyroidectomy)
***Hypopharynx cancer (lower throat cancer)
* [[Microvascular free flap reconstruction]]
***Sinonasal cancer
* [[Skull base surgery]]
* [[Salivary gland cancer]]
***Nasopharyngeal cancer
**[[Skin cancer]] of the head & neck
**[[Thyroid cancer]]
**[[Salivary gland cancer]]
**Head and neck sarcoma
* Endocrine surgery of the head and neck
**Thyroid surgery
**Parathyroid surgery
*[[Flap (surgery)|Microvascular free flap reconstructive surgery]]
*Skull base surgery


===Otology and neurotology===
===Otology and neurotology===
{{Main article|Otology|Neurotology}}
{{Main|Otology|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)
* [[Dizziness]]

** [[BPPV]] – benign paroxysmal positional [[vertigo]]
* Outer ear diseases
** [[Labyrinthitis]]/[[Vestibular neuronitis]]
**[[Otitis externa]] –
** [[Ménière's disease]]/[[Endolymphatic hydrops]]
***[[outer ear]] or [[ear canal]] inflammation
** [[Perilymphatic fistula]]
**Exostoses or [[Surfer's ear]] are bony growths in the outer ear canal<ref>{{Cite web |title=Exostoses (Surfer’s Ear) |url=https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/exostoses.html |url-status=live |access-date=2024-07-21 |website=Stanford Medicine Healthcare}}</ref>
** [[Acoustic neuroma]]
*Middle ear and mastoid diseases
* [[Hearing loss]]
**[[Otitis media]] – [[middle ear]] inflammation
* [[Mastoiditis]]
**Perforated [[eardrum]] (hole in the eardrum due to infection, trauma, explosion or loud noise)
* [[Otitis externa]] – [[outer ear]] or [[ear canal]] inflammation
**[[Mastoiditis]]
* [[Otitis media]] – [[middle ear]] inflammation
*Inner ear diseases
* Perforated [[eardrum]] (hole in the eardrum due to infection, trauma, explosion or loud noise)
**[[BPPV]] – benign paroxysmal positional [[vertigo]]
* [[Ear surgery]]
**[[Labyrinthitis]]/[[Vestibular neuronitis]]
**[[Ménière's disease]]/[[Endolymphatic hydrops]]
**[[Perilymphatic fistula]]
**[[Acoustic neuroma]], vestibular schwannoma
*Facial nerve disease
**Idiopathic facial palsy (Bell's Palsy)
**Facial nerve tumors
**[[Ramsay Hunt Syndrome]]
* 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===
Rhinology includes nasal dysfunction and sinus diseases.
Rhinology includes nasal dysfunction and sinus diseases.

* Nasal obstruction
*[[Nasal obstruction]]
* [[Sinusitis]] – acute, chronic
**Inferior turbinate hypertrophy
**[[Nasal septum deviation]]
**Chronic sinusitis with nasal polyps
*[[Sinusitis]] – acute, chronic
* Environmental [[allergies]]
* Environmental [[allergies]]
* [[Rhinitis]]
*[[Rhinitis]]
* [[Pituitary tumor]]
*[[Pituitary tumor]]
* [[Empty nose syndrome]]
*[[Empty nose syndrome]]
* Severe or recurrent [[epistaxis]]
* Severe or recurrent [[epistaxis]]


===Pediatric otorhinolaryngology===
===Pediatric otorhinolaryngology===

* [[Adenoidectomy]]
* [[Caustic ingestion]]
*[[Adenoidectomy]]
*[[Caustic ingestion]]
* Cricotracheal resection
* Cricotracheal resection
* [[Decannulation]]
*[[Decannulation]]
* [[Laryngomalacia]]
*[[Laryngomalacia]]
* [[Laryngotracheal reconstruction]]
*[[Laryngotracheal reconstruction]]
* [[Myringotomy|Myringotomy and tubes]]
*[[Myringotomy|Myringotomy and tubes]]
* Obstructive [[sleep apnea]] – pediatric
*[[Obstructive sleep apnea]] – pediatric
* [[Tonsillectomy]]
*[[Tonsillectomy]]


===Laryngology===
===Laryngology===
{{main|Laryngology}}
* [[Dysphonia]]/hoarseness
*[[Dysphonia]]/hoarseness
** [[Laryngitis]]
** [[Reinke's edema]]
**[[Laryngitis]]
**[[Reinke's edema]]
** [[Vocal fold nodule|Vocal cord nodules]] and [[Vocal cord polyp|polyps]]
**[[Vocal fold nodule|Vocal cord nodules]] and [[Vocal cord polyp|polyps]]
* [[Spasmodic dysphonia]]
*[[Spasmodic dysphonia]]
* [[Tracheostomy]]
*[[Tracheostomy]]
* [[Cancer of the larynx]]
* [[Vocology]] – science and practice of voice habilitation
*[[Cancer of the larynx]]
*[[Vocology]] – science and practice of voice habilitation


===Facial plastic and reconstructive surgery===
===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.
Facial plastic and reconstructive surgery is a one-year fellowship open to otorhinolaryngologists who wish to begin learning the aesthetic and reconstructive surgical principles of the head, face, and neck pioneered by the specialty of Plastic and Reconstructive Surgery.

* [[Rhinoplasty]] and [[septoplasty]]
*[[Rhinoplasty]] and [[septoplasty]]
* [[Rhytidectomy|Facelift]] (rhytidectomy)
*[[Rhytidectomy|Facelift]] (rhytidectomy)
* [[Browlift]]
* [[Blepharoplasty]]
*[[Browlift]]
* [[Otoplasty]]
*[[Blepharoplasty]]
* [[Genioplasty]]
*[[Otoplasty]]
*[[Genioplasty]]
* Injectable cosmetic treatments
* Injectable cosmetic treatments
* [[Physical trauma|Trauma]] to the face
*[[Physical trauma|Trauma]] to the face
** [[Nasal bone]] fracture
**[[Nasal bone]] fracture
** [[Human mandible|Mandible]] fracture
**[[Human mandible|Mandible]] fracture
** [[Orbital fracture]]
**[[Orbital fracture]]
** Frontal [[Sinus (anatomy)|sinus]] fracture
** Frontal [[Sinus (anatomy)|sinus]] fracture
** Complex lacerations and soft tissue damage
** Complex lacerations and soft tissue damage
* Skin cancer (e.g. [[Basal Cell Carcinoma]])
* 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 [[pediatrics]])
* [[Oral cavity]] / [[oropharynx]]
** [[Tonsillectomy]] (especially in [[pediatrics]])
** [[Uvulopalatopharyngoplasty]]
** Transoral midline [[glossectomy]]
** [[Genioglossus advancement]]
* Other
** [[Hyoid suspension]]
** [[Maxillomandibular advancement]]
** [[Hypoglossal nerve stimulator]] implant (Inspire)

=== Microvascular reconstruction repair ===
Microvascular reconstruction repair is a common operation that is done on patients who see an otorhinolaryngologist. It is a surgical procedure that involves moving a composite piece of tissue from the patient's body and 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, and back, and can come from the skin, bone, fat, and/or muscle.<ref>{{Cite web|url=https://www.ucsfhealth.org/treatments/microvascular_head_and_neck_reconstruction/|title=Microvascular Head and Neck Reconstruction {{!}} Conditions & Treatments {{!}} UCSF Medical Center|website=ucsfhealth.org|access-date=2018-12-06}}</ref> 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 that these connections need to be made with a microscope, which is why the procedure is called "microvascular surgery".{{citation needed|date=June 2022}}


==See also==
==See also==
{{col div|colwidth=27em}}
{{col div|colwidth=27em}}
* [[Audiology]]
* [[American Board of Otolaryngology]]
* [[American Osteopathic Board of Ophthalmology and Otolaryngology]]
* [[Head and neck anatomy]]
* [[Head and neck anatomy]]
* [[Head and neck cancer]]
* [[Head and neck cancer]]
* [[Head mirror]]
* [[Head mirror]]
* [[Oral and maxillofacial surgery]]
* [[Plastic and Reconstructive Surgery]]
* [[Speech–language pathology]]
* [[Surgeon]]
* [[Surgeon]]
* ''[[Otolaryngologic Clinics of North America]]''
* [[Audiology]]
* [[Oral and maxillofacial surgery]]
* [[Speech-language pathology]]
{{colend}}
{{colend}}
==External links==

* {{commonscat-inline}}
==References==
==References==
{{reflist}}
{{reflist}}


{{Cleft lip and palate}}
{{Cleft lip and palate}}
{{medicine}}

{{Authority control}}
{{Authority control}}


{{DEFAULTSORT:Otolaryngology}}
{{DEFAULTSORT:Otolaryngology}}
[[Category:Auditory system]]
[[Category:Otorhinolaryngology| ]]
[[Category:Surgical specialties]]
[[Category:Surgical specialties]]
[[Category:Otorhinolaryngology]]
[[Category:Medical specialties]]

Latest revision as of 23:29, 9 September 2024

"Otolaryngology – head and neck surgery" redirects here. For the medical journal, see Otolaryngology–Head and Neck Surgery.

Otorhinolaryngology
Significant diseasesDizziness, Head and neck cancer, Sinusitis, Chronic ear disease, Hoarseness, Nasal obstruction
SpecialistOtorhinolaryngologist
GlossaryGlossary of medicine
Otolaryngologist
Occupation
Names
  • Physician
  • Surgeon
Occupation type
Specialty
Activity sectors
Medicine, Surgery
Description
Education required
Fields of
employment
Hospitals, Clinics
A 40-watt CO2 laser used in otorhinolaryngology
Royal National Throat, Nose and Ear Hospital founded in 1874, in London

Otorhinolaryngology (/oʊtoʊˌraɪnoʊˌlærɪnˈɡɒlədʒi/ oh-toh-RY-noh-LARR-in-GOL-ə-jee, 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 subspecialty 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, nose, throat, base of the skull, 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 cancers and benign tumors and reconstruction of the head and neck as well as plastic surgery of the face, scalp, and neck.

Etymology

[edit]

The term is a combination of Neo-Latin combining forms (oto- + rhino- + laryngo- + -logy) derived from four Ancient Greek words: οὖς ous (gen.: ὠτός otos), "ear", ῥίς rhis, "nose", λάρυγξ larynx, "larynx" and -λογία logia, "study"[1] (cf. Greek ωτορινολαρυγγολόγος, "otorhinolaryngologist").

Training

[edit]

Otorhinolaryngologists are physicians (MD, DO, MBBS, MBChB, etc.) who complete both medical school and an average of five–seven years of post-graduate surgical training in ORL-H&N. In the United States, trainees complete at least five years of surgical residency training.[2] 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.[3][4]

In the United Kingdom, entrance to higher surgical training is competitive and involves a rigorous national selection process.[5] 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, training and post-secondary school is 12–14 years. Otolaryngology is among the more highly compensated surgical specialties in the United States. In 2022, the average annual income was $469,000.[6]

Sub-specialties

[edit]
Head and neck oncologic surgery Facial plastic and reconstructive surgery* Otology Neurotology* Rhinology/sinus/anterior skull base surgery Laryngology and voice disorders Pediatric otorhinolaryngology* Sleep medicine*
Surgical oncology Facial cosmetic surgery Ear Middle and inner ear Sinusitis Voice disorders Velopalatine insufficiency Sleep disorders
Microvascular

reconstruction

Maxillofacial surgery Hearing Temporal bone Allergy Phono-surgery Cleft lip and palate Sleep apnea surgery
Endocrine surgery Traumatic reconstruction Balance Skull base surgery Anterior skull base Swallowing disorders Airway Sleep investigations
Endoscopic surgery Craniofacial surgery Dizziness Apnea and snoring Vascular malformations
Cochlear implant/BAHA Cochlear implant/BAHA

(*Currently recognized by American Board of Medical Subspecialties)

Topics by subspecialty

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Head and neck surgery

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  • 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 cancer
    • Salivary gland cancer
    • 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

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Main articles: 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)

Rhinology

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Rhinology includes nasal dysfunction and sinus diseases.

Pediatric otorhinolaryngology

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Laryngology

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Main article: Laryngology

Facial plastic and reconstructive surgery

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Facial plastic and reconstructive surgery is a one-year fellowship open to otorhinolaryngologists who wish to begin learning the aesthetic and reconstructive surgical principles of the head, face, and neck pioneered by the specialty of Plastic and Reconstructive Surgery.

Sleep surgery

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

Microvascular reconstruction repair

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Microvascular reconstruction repair is a common operation that is done on patients who see an otorhinolaryngologist. It is a surgical procedure that involves moving a composite piece of tissue from the patient's body and 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, and back, and can come from the skin, bone, fat, and/or muscle.[8] 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 that these connections need to be made with a microscope, which is why the procedure is called "microvascular surgery".[citation needed]

See also

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References

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  1. ^ "otolaryngologist" entry in: Peter Harris, Sue Nagy, Nicholas Vardaxis, Mosby's Dictionary of Medicine, Nursing & Health Professions - Australian & New Zealand Edition, Elsevier Health Sciences, 2009.
  2. ^ "Otolaryngology Specialty Description". American Medical Association.
  3. ^ "Is There a Crisis in the Otolaryngology Match?". ENTtoday. Retrieved 16 April 2020.
  4. ^ "National Residency Match Program 2020" (PDF). National Residency Match Program. Archived from the original (PDF) on 28 August 2021. Retrieved 2 April 2020.
  5. ^ "Training and development (otorhinolaryngology)". Health Careers. 16 April 2015. Retrieved 16 April 2020.
  6. ^ "Medscape, Otolaryngologist Compensation Report 2022".
  7. ^ "Exostoses (Surfer's Ear)". Stanford Medicine Healthcare. Retrieved 21 July 2024.{{cite web}}: CS1 maint: url-status (link)
  8. ^ "Microvascular Head and Neck Reconstruction | Conditions & Treatments | UCSF Medical Center". ucsfhealth.org. Retrieved 6 December 2018.
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