The world of an ENT doctor

Glory Shatsha

English IIIl - Honors - 3

Mr. Piatak

February 23, 2017

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The purpose of this paper focuses on the world of the ear, nose, and throat (ENT) doctors.

This paper will look into what they do, their history, different branches within this field, what set

them apart from other physicians, their credentials, their schooling and training, their career path

as well as their salary. In doing this, this paper will lay down a clear understanding of what these

doctors do. However, no need to go any further without saying that these physicians have

dedicated their lives to helping people with problems in the area of ear, nose, and throat.

ENT doctors treat patients with diseases and disorders that concern the ear, the nose, the

throat, as well as any related medical issue. Within this field, physicians have to become experts

capable of providing the kind of help that patients need. For instance, when it comes to the eating

aspect of someone's health, ENT doctors go above and beyond our imagination as they provide

not only the treatment, but perform complicated surgeries. They treat hearing loss, ear infection,

cranial nerve and balance disorders, and they even repair new birth disorders of the outer and

inner ear (What is an .).

Every year, 35 million Americans develop chronic sinusitis, which makes it one of the

most common health issues in the United States (What is an .). A primary skill of an ENT

doctor requires knowledge of taking care of the basal cavity and sinuses on the nose. In also

treating problems in the nasal area include allergies, smell disorders, polyps, and nasal

obstruction (What is an .). Everyday activities such as communicating with people, singing,

and eating a meal all involve areas in the throat. ENT doctors manage diseases of the throat,

larynx also known as the voice box, the upper aero-digestive tract which relates with voice and

swallowing disorders (What is an .). In addition to learning how to treat these diseases, ENT

doctors learn how to treat benign and malignant tumors which may become cancerous, facial
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trauma, and deformities of the face. ENT doctors perform both cosmetic plastic and

reconstructive surgery to the head and neck.

As the oldest practice in the medical field, ENT has many contributors to what it has

become today. ENT comes from the field of otolaryngology, which separated before the

twentieth century. Before these two different fields combined, Otologist performed surgery while

laryngologist treated the disease of the ear, nose, throat, and the chest (Weir). Traditional

otologist used mirrors to look in the ears and throat and then later worn on the head as a

headband. Some contributors of the field of ENT include, Carl Nylen of Sweden who introduced

the microscope in 1921 which made it easier to look into the ears ( Weir). Hopkins in 1954

introduced a endoscopy and flexible fibrescopes used to examine the nose.

In 1946, a chairman of otolaryngology clinic at the University of Vienna Austria,

Unterberger began practicing at the county hospital in Klagenfurt while later on becoming the

head of the otolaryngology clinic in 1948. During his stay in Klagenfurt, Unterberger published

guidelines on treatment of injuries to the esophagus, research on the Otological microsurgery,

and surgical correction of fronto-basal head injuries ( Weir). Unterberger discovered that patients

with inner ear lesions displayed a slower body movement, particularly when they changed their

legs quickly. His healthy patients might have a slight forward movement in addition to a very

mild rotation after testing for several minutes ( Weir).

Tadashi Fukuda, born in Kitakyushu, Japan, graduated from Kyoto Imperial University

Faculty of Medicine in 1934 and became a resident in the Department of otolaryngology. He

helped further improve Unterberger's test (Neil). Fukuda found Unterbergers tests extremely

useful but modified the step to make them more understandable. . He called his modified version
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the Stepping Test which became widely used throughout Japan. The modification of Fukuda

used two circles with a radius of 0.5 millimeters and 1 millimeters drawn on the floor. Fukuda

divided the circle into sections by lines passing through the center at 15 or 30 angles ( Weir).

As in the Unterberger test, a person stands upright in the center of the circles with their feet close

together ( Weir).

In the 20th century, the field of ENT had witnessed great changes. By taking risks to

perform skilful surgery under conditions of primitive anaesthesia and no antibiotics. ENT doctor,

Dr. Harley talks about how the the field of ENT ENT has grown by the use of technology; for

example doctors who treat cancerous patients by using technology to make surgeries more

accurate. Leading to advances in technology and with them greater opportunities to explore new

and reshaping old surgical procedures. When asking Dr. Harley if technology plays a big part in

this field, he replied by saying Yes it is, many years ago everything was written down which

was more work for physicians, but now physicians use technology to write down all of their data

which makes items more accessible, for example seeing accurate exams. Although, some ENT

doctor in remote places still use handwritten notes to write data because they believe that they

will have more accurate data. The discovery of antibiotics has change in the field of ENT by

seeing a decline in the number of tonsillectomy and adenoidectomy operations.

To help patients with their concerns, the field of ENT provides a variety of specialists.

These fields consist of a head and neck specialist, laryngology specialist, neurology specialist,

rhinology specialist, pediatric otolaryngology specialist, allergy specialist, and a facial

plastic/reconstructive surgery specialist. A head and neck specialist treat cancerous and

noncancerous tumors located in the head or neck. These tumors can be found in the upper
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esophagus, the thyroid, and the parathyroid. When ead and neck specialist treat the thyroid they

look for lumps and cancer in the voice box (What is an .).

A laryngology specialist treats disorders in the throat. Laryngologist specialists give

treatment to voice or swallowing disorders. Professional speakers, teachers, and singer

commonly get treated for voice disorders. Symptoms of having voice disorders include changing

in voice quality, chronic cough and/or throat clearing, and breathing problems (Voice and

Swallowing Disorders). Coughing and choking when eating or drinking, feeling something

stuck in the throat, and discomfort while swallowing (Voice and Swallowing Disorders) occur

when having swallowing disorders.

Neurology specialists treat diseases of the ear, which include trauma, infection, benign

tumors, and nerve pathways disorder. Nerve pathways disorder affects hearing and balance to the

body, since fifty percent of dizziness comes from the ears. (What is an .). Neurology

specialist commonly have swimmers as clients due to their hearing loss. Many swimmers

experience dizziness and ringing in the tinnitus located in the ears. Rhinology specialists treat

people who struggle with disorder of the nose and sinuses. Rhinology specialists treats sinus

disorders such as nose bleed, stuffy nose, loss of smell, polyps, and tumors (What is an .).

Pediatric otolaryngology specialists treat disease with children that concern the ear, the

nose, or the throat. Pediatric otolaryngology specialist tend to ear infections, tonsil or adenoid

infection, airway delays, asthma and allergy/sinus disease, and neck tumors (What is an .).

Tonsil infection has become a common treatment among pediatric otolaryngology specialist,

commonly found among four to seven year olds. Triggered by viruses and bacteria on the

tonsillitis result into strep throat, difficulty in swallowing, or the throat getting inflamed
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(Pediatric ENT).

Allergy specialists only treats by medication whether from avoidance of pollen which

affect the ear, the nose, or the throat, or from allergy shots called immunotherapy. Allergy

specialist also treat hay fever, seasonal and perennial rhinitis, chronic sinusitis, sore throat, and

dizziness (What is an .). Treatment of avoidance becomes the first step of treating allergies.

Once the physician informs the patient of their allergies, they should try their best to eliminate

contact with whatever gives them the allergic reaction. Physicians believe that avoidance may

become more suitable for patients because eliminating the cause of an allergic reaction becomes

very difficult to do. (Allergy Relief Doctors ). Allergy specialists will generally suggest

immunotherapy when allergies seen uncontrollable. By injecting a patient's allergies, this

specialist can determine medicine usage to the patient. (Allergy Relief Doctors ).

Facial plastic and reconstructive surgery specialists focus on cosmetic and reconstructive

surgical treatment of abnormalities of the face and neck and ear (What is an .). This

specialist treats deviated septum when occurs with someone having difficulty of breathing, and

has more knowledge on, face lifting, cleft palate, drooping eyelids, hair loss and other ear

deformities.

In contrasting to other physicians, ENT doctors learn in both the medicine and surgery.

This practice gives physicians the opportunity to perform surgery on their patients if needed,

which also provides patients with one on one care (Surgery - In Office ...). ENT doctors use

advanced technology and a broad range of surgical procedures when ENT doctors treat disease

or disorders that concern the ear, the nose, the throat, or any structure of the head and neck

(Surgery - In Office ...). ENT surgeries, very straightforward and not complex, have a good
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repuation.

Tonsillectomy has become a common surgical procedure in the field of ENT. This

procedure involves the removal of the tonsils located on the back of the throat and the adenoids

located high in the throat behind the nose and the roof of the mouth, which doctors can only see

with special instruments. Tonsils and adenoids work together as the bodys immune system by

filtering germs that attempt to invade the body (Surgery - In Office ...). When someone

experiences recurrent throat infection, enlarged tonsils, difficulty breathing, or swallowing

problems this person has become a candidates for this surgery. Children commonly experience

symptoms for tonsillectomy surgery. During tonsillectomy surgery patients fall under general

anesthesia. To successfully remove the tonsils and adenoids, surgeons use special tissue to cut

out the tonsils and adenoids and then seal them by blood vessels to control bleeding. After

surgery, patients may resume daily activities between one or two weeks. Symptoms that may

arise include difficulty of swallowing, vomiting, throat pain, or ear pain (Surgery - In Office

...).

Myringotomy or PE Tubes surgery, a common procedure for ear infections, consist of a

small surgical incision into the eardrum to drain fluid to relieve pain(Surgery - In Office ...).

Surgeons place ventilation tube or also called PE tube in the incision to prevent fluid to improve

hearing. The surgeon who performs the procedure selects a ventilation tube that remains in

middle ear infection for improvement. Ths procedure takes several week to a month to heal.

Patients should stay away from water in the ear which could result to infection in the middle ear

while healing (Surgery - In Office ...). The Myringotomy surgery has allowed patients

who have suffered from severe ear infections in the past to the treated effectively.
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Nasal septum surgery involves the nasal septum, which divides the nose. The nasal

septum tends to bend to one side or the other as someone ages, nasal septum surgery straightens

the nose to the original position. Although no one has proven the history of injury to a bent nasal

septum, trauma to the nose can lead to septal deviation (Surgery - In Office ...). Nasal

septum surgery improves nasal breathing function and removal of nasal polyps, inflammation,

tumors, or bleeding (Surgery - In Office ...).

Surgeons recommend tympanoplasty surgeries when the eardrum can not heal on its own.

This procedure requires incision from the back of the ear to take tissue to patch the eardrum

allowing it to heal. Surgeons commonly use a dissolvable packing behind the eardrum and into

the ear canal, which spends up the healing process. Dissolvable packages stay in for six to eight

weeks, but drops help the package to disintegrate (Surgery - In Office ...). While recovering

from surgery, surgeons advise that patients avoid putting water in their ear. Patients should avoid

air traveling or any activities that increase pressure in the ear; examples include holding back

sneezes or blowing the nose. (Surgery - In Office ...). When repairing the eardrums and

improving hearing tympanoplasty surgery has become the most successful.

In order to become a ENT doctor, certain requirements must take place. Requirements

for a certified ENT specialist entails a four year medical degree followed by a five year ENT

residency program. However the educational path begins by receiving a Bachelors degree in an

credible college and or university("How to become ."). While in college, ENT specialist focus

on sciences and interaction skills of their education course study

While in college a future ENT doctor has a broad range of what they would like to major

in as along as they follow the guidelines of whatever medical school they would like to attend.
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Undergraduates can major anywhere between biology, physics, chemistry with a written and oral

communication course ("How to become ."). While still studying as a undergraduate, students

should do programs that relates to the medical field. Activities such as joining a pre-medical

organization, doing community service, shadowing a physician, and studying for the medical

college admission test ("How to become ."). These programs will look good when applying to

a medical school.

Colleges with strong science programs in the United States include Stanford University,

Massachusetts institute of Technology, University of California, and California institute of

Technology. Stanford University located in Stanford, California has become the number one

school for science programs (Top 10 schools..).This university ranks first in chemistry,

computer science, physics, and earth science courses. Located in Cambridge, Massachusetts,

Massachusetts Institute of Technology ranks second in science programs. This university ranks

number one in computer science, and physics. The University of California located in Berkeley,

California ranks third in the best science programs and second in biological science. California

Institute of Technology ranked fourth for science programs, is located in Pasadena, California.

This university ranks number one in chemistry and earth science ( Top 10 Schools).

When Applying to a medical school, students should which apply to a school best fits

their future specialty. Top medical schools for the field of ENT remain in John Hopkins

University School of Medicine, University of Michigan Medical School, Emory University

School of Medicine, and Oregon Health Science University School of Medicine ("NIH Awards

for 2005) These medical school rank the highest because of how many graduates from this

school go into the field of ENT.

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In medical school, future ENT doctors spend their first year in the classroom, learning

course like anatomy, histology, pathology, biochemistry, psychology, and preparing the clinical

exam ("How to become ."). The second year medical students learn clinically focused topics.

In the third and fourth years of medical school students have a hands on experience in a

clinic,by doing this students gain knowledge of what specialty they have found interest in.

("How to become ."). After medical school, future ENT doctors must complete five years of

residency, where graduates will train in issues of the ear, the nose, and the throat ("How to

become .").

After residency future ENT doctors must secure a licence. Becoming licence varies by

state and what kind of doctor someone choses, in addition to getting licences a future physicians

must take the state examination in which every state they choose to practice their field ("How to

become ."). For this reason many doctors take the state examination in the state they trained

for their residency. When becoming a board certified ENT doctor certain requirement have to

take place. This requirements entail graduating from a medical school in the United States,

earning a valid license to practice in at least one state, finishing training for ENT specialist, and

last pass a test only for future ENT doctors called the ABOto for Otolaryngology ("How to

become .").

A big percentage of ENT doctor work in private practice, hospitals, or clinics. However,

a majority of ENT doctor do not spend their time performing surgeries but have private practices

("How to become ."). ENT doctors get paid $336,844 a year. Fifty percent of doctor visits in

the Unites States have become ENT related. By the year of 2022 this field will grow by eighteen

percent. ("How to become ."). Through the years ENT doctors have become very valuable in
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the United States.

Finally, the ear, nose, and throat doctors play a very important role in the medical

practice these days. They have contributed in treating every problem in the areas of the hearing,

smelling, and swallowing. Society should respect ENT doctors because of their extant studies

earlier,their lives remain busy most of the time as they begin their day around five in the morning

and do not end it until late in the evening. Having a career as an ENT doctor can definitely have

rewards as far income and making a difference in society.

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Work Cited

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<http://www.science20.com/community_connections/top_10_schools_science>

("Duties and Benefits") UF Health, Department of Otolaryngology

ent.ufl.edu/residency-program/duties-benefits/. Accessed 16 Jan.2017.

<http://ent.ufl.edu/residency-program/duties-benefits/>

Harley, Robert . Personal interview. 15 Feb. 2017

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<http://doctorly.org/how-to-become-an-ent-specialist/ >

("NIH Awards for 2005 Otolaryngology Department.") Resident Physicians. Accessed 14 Feb.

2017.

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<http://www.soundhealthservices.com/pediatric-ent/ >

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specialists, South Texas ENT Consultants, Accessed 16 Jan.2017.

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