Your life is made rich and fulfilled by a number of fundamental functions performed by your body. Therefore, if any of these basic functions are unable to perform in the manner that it should, then there are chances that complementary and supplementary body functions may be affected or diminished to some extent.
What is ENT or Otorhinolaryngology?
ENT or commonly referred to as ‘Ear, Nose and Throat’ constitute of these fundamental body functions that include balance and hearing, speech and swallowing, breathing, sleep issues, sinuses, allergies, skin disorders, head and neck cancer and possibly facial plastic surgery. To treat these conditions, there are specially trained medical professionals known as ENT or Otolaryngologists.
ENT or medically called Otolaryngology is a discipline of medicine that diagnoses and treats a wide array of ear, nose, throat, head and neck conditions. Chronic ear infection, tonsillitis, sinus, sleep apnoea are some of the common ENT conditions. Apart from these, there are several advanced conditions that encompass otolaryngology such as hearing loss, different cancers of the head and neck, voice issues and reconstructive surgery to mend injury or disfigurements.
ENT or Otorhinolaryngology – Areas of Care
The broad range of areas of care include the following:
Ear Conditions:
Otosclerosis which is an ailment that affects the middle ear causing hearing loss and possibly leading to subsidiary hearing conditions and deafness
Otitis media with effusion is a fairly prevalent childhood disease that also impacts the middle ear where it becomes blocked with fluid
Hearing loss related to age
Tinnitus is a condition where one experiences ringing of the ears
Nose Conditions:
Throat conditions:
Head and neck conditions:
Facial cosmetic surgery is also part of ENT surgery:
ENT surgeons in due course of time develop sub-specialities that may comprise of the following areas of care too:
Otology: This a sub-speciality that diagnoses and treats infections and conditions related to the ear. It also enhances hearing and balance. This branch of ENT additionally comprises of areas of care such as cochlear implant surgery which generally is implanting a tiny, complex electronic device in the inner ear. This insertion, in turn, stimulates the auditory nerve. For those who suffer from deafness, this can provide a sense of sound.
Rhinology: ENT surgeons specialising in the treatment of nose and sinus conditions such as allergy, infection, inflammatory conditions and tumour is known as Rhinology. Those surgeons who perform surgical procedures on rare tumours of the skull base and also pituitary tumours also need to be an expert in this sub-speciality.
Laryngology: This is a sub-speciality that treats diseases and disorders of the throat and the larynx including vocal fold nodules, voice condition such as overuse and misuse and possible cancer too.
Head and Neck Surgery: This sub-speciality involves the therapy of non-cancerous and cancerous tumorous conditions of the neck and head that also comprises of lymph, salivary, thyroid and parathyroid glands.
Skull base surgery or Neurotology: Disorders of the skull base along with acoustic neuromas are treated with ENTs with this particular sub-speciality.
Facial Plastics: Processes including Rhinoplasty and Pinnaplasty are part of this sub-speciality.
Thyroid and Parathyroid surgery: This sub-speciality helps ENTs in treating thyroid and parathyroid tumours.
Paediatrics: For those patients who require treatment from a very young age for conditions that are congenital are required to consult ENTs who have a paediatric sub-specialty.
Symptoms of Common ENT or Otorhinolaryngology Conditions
The ears, nose and throat are body parts that are used in the fundamental body functioning, every second of one’s life. For example, the ears are not just for hearing purpose alone; it also provides one with a sense of balance. On the other hand, the nose not only allows one to get a perspective of the smell but a partial sense of taste too. It additionally plays a critical role in humidifying the air that one breathes in and does it’s best to prevent germs from entering one’s body. The throat is actually the route for air to reach to one’s lungs and food and water to navigate towards the digestive tract.Thus, any dysfunction of the ear, nose and throat greatly impacts your daily life. In some rare cases, it may result in a medical emergency.
The common ENT disorders and their symptoms are as follows:
Tonsillitis: Tonsillitis is a condition that develops as a result of the inflammation or infections of the tonsils caused due to a common cold, mono or strep throat. The condition is widely prevalent and is distinguished by severe throat pain. Common signs of tonsillitis include:
Ear Infections: If germs in the ear become trapped, it can result in ear infections. The symptoms of ear infections constitute of:
You may see your child constantly tugging or pulling at their ears. This could be an effect of the ear infection going untreated for a substantial period of time. Ultimately, it may cause delays in development, such as speech and hearing.
Sinus Infections:
Vocal resonance is a result of sinuses which are typically cavities in the skull surrounding the eyes and the nose regions. If the cavities become infected by a virus or bacteria or develop an inflammation as a result of allergies or any other condition, it can cause sinusitis. The most prevalent signs of sinus infections include:
Sleep Apnoea:
A transitory interruption of breathing whilst sleeping is a condition referred to as sleep apnoea. This disorder can affect both adults and young children alike. Common reasons why this condition occurs are:
Sleep apnoea requires medical attention and treatment at the right time. If the condition is neglected, sleep apnoea may lead to more severe and possibly fatal conditions such as heart failure, depression and mood swings. Therapy also includes making several lifestyle and dietary transformations.
Diagnosis
There are several diagnostic screenings that may be recommended in order to detect ENT-related conditions. However, the first round of consultation will begin with your appointment with your ENT specialist. You may be asked some of the following questions by your consulting otolaryngologist:
If a child is being affected by the ENT condition, then the parents may be subjected to some supplementary questions for the duration of the consultation that may include:
Has the child undergone nausea or vomiting? If yes, does the child continue to wet diapers?
Have the parents become aware of the child being unusually fussy or lethargic?
Does the child seem to have difficulties in balancing?
Have there been any visible alterations in the child’s eating or drinking behaviours?
Have the parents witnessed any signs of trouble in the child’s hearing skills, for example, delayed or no response to their name or not getting startled at loud noises?
Post the initial consultation, here are the common ENT disorders and their methods of diagnostic screenings:
Diagnosing Ear Infections:
Your doctor will use an Otoscope to be able to envision your outer ear and eardrum if he feels that there are any indicative symptoms of an ear infection. With the presence of an infection in the ear, it may appear to be swollen and red in colour with a possible fluid discharge. While in the case of the majority of infections, the type of bacteria causing the condition is detectable. That is not the case with an ear infection. This is because it is a difficult task to collect a sample of from the ear which can be later tested under laboratory conditions for the type of bacteria causing the infection. As a result, your doctor will recommend antibiotics that are most likely to cover all types of bacterial causing organisms.
Diagnosing Sinus Infections:
An endoscope will probably be used if a sinus infection is suspected. This instrument will be inserted through the nose and will be able to generate an image of the opening into the sinus cavity. It can additionally collect a sample of the sinus culture. Via this procedure, your consulting doctor will be on the lookout for any signs of inflammation and/or discharge. If this procedure does not provide any definite result, your healthcare provider may request for additional screenings, generally the Four View X-rays or a CT Scan.
Diagnosing Strep Throat:
A throat culture is prescribed if your doctor suspects a strep throat where it causes an enlargement of the reddened tonsils. It may also result in white patches on the tonsils. Generally, the throat culture is simple and quick causing minimal discomfort, more like a gagging sensation for a short period of time.
The cotton swab is typically brushed on the back of the throat to collect the culture sample which is sent to the laboratory for testing for streptococcal bacteria which causes strep throat.
Diagnosing Sleep Apnoea:
This is a condition where you may stop breathing for short durations of time during sleeping. The initial diagnostic step for the doctor is to have a comprehensive understanding of your medical history before ordering a sleep study. You may also be asked the following questions by your healthcare provider to understand your condition better:
Apart from the consultation, the doctor will take a look inside your mouth for signs of enlarged tonsils, uvula or any other structures that may be possibly blocking the airway. If sleep apnoea is suspected, the doctor will order a sleep study.
During the study, a monitor is attached to you that measures the concentration of oxygen in your blood after you fall asleep. An alternative sleep study uses a polysomnogram that is able to measure the amount of oxygen in your blood, brain activity, eye movement, and muscle activity, as well as your breathing and heart rate.
Treatment. Here are some of the common treatment routes for a select few ENT disorders:
Tonsillectomy:
This condition requires surgical intervention by removing the tonsils. In case the tonsils are recurring and have the tendency to become inflamed, getting a tonsillectomy done is the only way to prevent them from coming back.
Surgical treatment for hearing loss:
There can be two types of hearing loss – Sensorineural and Conductive.
Sensorineural hearing loss generally occurs as a result of the damage to the hair cells inside the cochlea. It may also happen if the hearing nerves cause an obstruction in the transmission of nerve signals from the inner ear to the brain. This hearing loss condition is hard to treat. However, hearing aids and cochlear implants may help to a certain extent.
Conductive hearing loss develops if sounds are unable to pass freely to the inner ear. This condition can be treated, and hearing abilities may be improved medically or via surgical procedures.
Translabyrinthine surgery: Tumorous growths on the nerve referred to as acoustic neuroma is removed via this surgery.
Tinnitus:
For tinnitus, the focal point of the treatment if the underlying cause is known could be by removing the earwax that has built up or through a surgical procedure for otosclerosis. There are additional methods of self-help, for example, recreation, listening to music, diversion through interests and establishing regular sleep patterns.
In order to manage the condition on a day to day basis, complementary therapies such as sound therapy wherein natural sounds fill the silence should ideally divert any sounds created by the tinnitus. Counselling along with cognitive behavioural therapy and tinnitus retraining therapy also helps in managing the disorder effectively and efficiently.
Sinus disease:
Sinus is a widely prevalent ENT condition that may be controlled by medical treatment, surgery and other self-help remedies.
In order to unblock the sinus and enhance the drainage of the mucus, surgery may be performed. For this, an apt surgical procedure is a FESS or the Functional Endoscopic Sinus Surgery. It uses a thin, flexible telescope-like instrument known as an Endoscope that is inserted and can generate images of the inside of your sinuses. It additionally removes the bone and mucous membrane that eventually unblocks the sinuses.
General anaesthesia is required to be administered in order to perform this procedure. An alternative type of Sinusitis Surgery is the Balloon Sinuplasty which is also performed under general anaesthesia. A tiny, flexible tube-like instrument is inserted by the operating surgeon into the sinus. A balloon is inflated inside, that does the work of unblocking the sinus.
Sleep apnoea:
Several factors such as the patient’s symptoms, current health condition and preferences help in determining the treatment of the sleep apnoea condition. Lifestyle changes are also required, for example, losing weight, reducing smoking and alcohol consumption and keeping away from using any sedatives.
With a mild sleep apnoea condition, the recommended course of treatment is through a MAD or Mandibular Advancement Device.
This is a dental appliance worn by the patient over the teeth whilst sleeping. The design of the device has been done in a manner that it is able to hold forward the jaw and tongue to create additional space for the patient to breathe.
Often, the first line of treatment is CPAP or Continuous Positive Airway Pressure if the sleep apnoea condition is rated between moderate to severe. While the patient sleeps, pressurized air is blown in the upper airways. This, in turn, helps to keep the airways open.
There are several other surgical options, for example, removing tonsils or adenoids, inserting a tube into the patient’s neck that permits free breathing, or weight loss surgery in case of obesity, that may be recommended to treat sleep apnoea conditions.
Snoring:
In order to treat snoring, lifestyle changes are recommended such as losing weight, regular exercising, decreasing alcohol consumption and reducing smoking. There are anti-snoring devices available over the counter, for example, mouth guards and nasal strips that may also effectively help in treating a snoring disorder.
If anti-snoring devices have not been effective, surgery can be an option.
During the surgical procedure, the soft tissue is wither removed that causes the snoring or works towards restricting the tissue from vibrating that leads it to tighten. There may be other anatomical reasons that may contribute to snoring. If tonsils are a contributing factor, then a tonsillectomy may be advised.
About the Department:
The Department of Otorhinolaryngology at Fortis Hospital in Chennai is a leading ENT treatment centre in Tamil Nadu with some of best ENT specialists associated with the organisation. The department has one of the advanced clinical practices in South India with specialists dedicated to offering tailor-made medical and surgical treatment and patient care. Our ENT experts at Fortis, Chennai are adept at modern techniques of diagnosing, treating and the daily management of ENT conditions and disorders in both adult and children.
Common disorders include a bloody nose, sore throat or ear infection to head and neck cancer. All patient treatments at our facility are personalised, comprehensive and 100% patient-centric. Along with the latest techniques, your consulting ENT will discuss a treatment plan including ways to control and care for the condition through long-term ways. In combination with the ongoing therapy, your consulting ENT at Fortis Hospital, Chennai will also discuss and encourage preventive mechanisms and patient education.
The ‘Mecca of Medicine’, Fortis Hospital has enriched the lives of many Chennaites, and has earned a reputation of delivering world-class healthcare services at their modern facilities.
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