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Otorhinolaryngology

(Redirected fromOtolaryngology)
"Otolaryngology – head and neck surgery" redirects here. For the medical journal, seeOtolaryngology–Head and Neck Surgery.
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Otorhinolaryngology (/tˌrnˌlærɪnˈɡɒləi/oh-toh-RY-noh-LARR-in-GOL-ə-jee, abbreviatedORL and also known asotolaryngology,otolaryngology  head and neck surgery (ORL–H&N orOHNS), orear, 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.

Otorhinolaryngology
SignificantdiseasesDizziness,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, inLondon

Patients seek treatment from an otorhinolaryngologist for diseases of theear,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 ofcancers andbenign tumors and reconstruction of the head and neck as well asplastic surgery of the face, scalp, and neck.

Etymology

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The term is a combination ofNeo-Latincombining forms (oto- +rhino- +laryngo- +-logy) derived from fourAncient Greek words:[1] (cf. Greekωτορινολαρυγγολόγος'otorhinolaryngologist').

  1. οὖς (ous),'ear', whosegenitive isὠτός (otos)
  2. ῥίς (rhis)'nose'
  3. λάρυγξ (larynx)'larynx'
  4. -λογία (logia)'study'

Training

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Otorhinolaryngologists arephysicians (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 ofgeneral 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

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Head and neck oncologic surgeryFacial plastic and reconstructive surgery*OtologyNeurotology*Rhinology/sinus/anterior skull base surgeryLaryngology and voice disordersPediatric otorhinolaryngology*Sleep medicine*
Surgical oncologyFacial cosmetic surgeryEarMiddle and inner earSinusitisVoice disordersVelopalatine insufficiencySleep disorders
Microvascular

reconstruction

Maxillofacial surgeryHearingTemporal boneAllergyPhono-surgeryCleft lip and palateSleep apnea surgery
Endocrine surgeryTraumatic reconstructionBalanceSkull base surgeryAnterior skull baseSwallowing disordersAirwaySleep investigations
Endoscopic surgeryCraniofacial surgeryDizzinessApnea andsnoringVascular malformations
Cochlear implant /BAHACochlear implant/BAHA

(*Currently recognized byAmerican 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 andNeurotology

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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Main article:Sleep surgery

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 performing 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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Wikimedia Commons has media related toOtorhinolaryngology.
  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. Retrieved30 October 2024.
  3. ^Hamaker, Amy E. (11 June 2018)."Is There a Crisis in the Otolaryngology Match?".ENTtoday. Retrieved16 April 2020.
  4. ^"National Residency Match Program 2020"(PDF).National Residency Match Program. Archived fromthe original(PDF) on 28 August 2021. Retrieved2 April 2020.
  5. ^"Training and development (otorhinolaryngology)".Health Careers. 16 April 2015. Retrieved16 April 2020.
  6. ^"Medscape, Otolaryngologist Compensation Report 2022".Medscape.
  7. ^"Exostoses (Surfer's Ear)".Stanford Medicine Healthcare. Retrieved21 July 2024.
  8. ^"Microvascular Head and Neck Reconstruction - Conditions & Treatments".ucsfhealth.org. Retrieved6 December 2018.

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