Called otolaryngologists, these specialized physicians treat a wide range of conditions.
If you struggled with acne, you’d visit a dermatologist. If you had stomach issues, you’d check in with a gastroenterologist. And if you developed an issue with your head or neck—including your ears, nose, sinuses, throat, voice box, thyroid and esophagus—you’d take a trip to an otolaryngologist.
An otolaryngologist, also called an ear, nose and throat (ENT) doctor, specializes in the care and treatment of the area below the brain and above the lungs (except for the eyes). But what is it about this part of the body that requires a special doctor?
“There’s an abundance of critical nerves and blood vessels that connect the brain to the rest of the body, and those all go through the head and neck,” says Adam J. Kimple, MD, PhD, a UNC Health Care otolaryngologist. “All the air we breathe, water we drink and food we eat goes through the head and neck.”
Otolaryngologists are trained in both medical and surgical management of diseases of the ears, nose and throat.
What Does an ENT Do?
Otolayrngologists, or ENTs, treat a wide range of head and neck conditions, including those related to:
- Ears, including hearing loss and ear tubes
- Tonsils and adenoids
- Voice box
- Smell and taste disorders
- Lesions or tumors in the mouth and throat
- Cancers in the head and neck
“At UNC, we see a lot of people who are referred by other ENTs for subspecialty care on complex problems,” Dr. Kimple says. “Either a person’s primary problem is very complex, like a bad tumor or terrible sinus disease, or it’s a simple problem in a patient who is medically complex. For example, people who have had a heart or lung transplant will need a higher level of care.”
Dr. Kimple was attracted to the field because ENTs are involved with smell, taste and hearing, he says.
“Communication is critical to humans, and both speech and hearing fall uniquely within our specialty’s domain. Additionally, humans assess their external environment and food through smell and taste, which uniquely falls into our realm as well.”
How Are ENTs Trained?
The bulk of ENT training is learning how to be a surgeon and take care of patients, Dr. Kimple says.
After medical school, those studying to be otolaryngologists will go through a year of experiences across the ENT, neurosurgery, critical care, anesthesia and general surgery fields.
“After that, it’s essentially four years of ENT training,” Dr. Kimple says. “In most programs, you’ll rotate through the different subspecialties.” At the UNC School of Medicine, that includes work in the following specialties:
- Head and neck, which covers cancers of the head and neck
- Laryngology (voice and swallowing)
- Rhinology (sinuses)
- Neurotology (ear surgery), which includes interdisciplinary care with neurosurgeons to access tumors through and around the ear
- Pediatrics, which encompasses all specialties as they relate to children
- Facial plastic and reconstructive surgery
What Makes Otolaryngology Different?
The critical importance of the structures ENTs operate on and around makes the specialty different, Dr. Kimple says.
“We are always operating on high-value real estate that can affect hearing, speech, swallowing, breathing, the eyes, the brain or the cosmetics of the face,” he says.
From a career standpoint, ENTs can tailor the job to their personal interests. Many ENTs see people in the clinic half the time and operate half the time. However, it is possible to develop a practice that is nearly all surgery or all clinical.
“I think otolaryngology is still fairly unique in that aspect,” Dr. Kimple says. “In other fields, like cardiology, you may see a cardiothoracic surgeon for your bypass surgery, but then you manage your heart disease with a cardiologist. Frequently in ENT, you have both the medical management and surgeon in one person.”