Who is an ENT Specialist?

Our sense of smell, hearing, and taste add so much to the quality of our lives. Being able to talk to our friends and people we love, articulate our thoughts, singing, all of these ensure that we have a happy and fulfilling life. When any of these start to give you trouble, an otolaryngologist is precisely the kind of person you need to see. Don't let the big word intimidate you; otolaryngologists or ENT (ear, nose, throat) specialists are doctors who help people with hearing, balance, speech, sinuses, allergies, and sleep and breathing issues. The word otolaryngologist also has interesting root words. It comes from Greek words: otos which means ear, rhino or nose, laryngo, the windpipe, and finally logos which means science. The combination of these words implies that an otorhinolaryngologist has studied and treated patients with ear, nose, throat, neck, head, and face conditions.

Conditions Treated by an ENT Specialists

ENT doctors treat different nose, throat, ear, and head and neck conditions. Here are some important ones:

• Ear: ENT specialists diagnose and treat hearing loss, discharging ear, balance disorders, tinnitus (ringing or buzzing in one or both ears), nerve pain, ear infections, and facial and cranial nerve disorders. They also treat disorders like Bell's palsy, facial muscle weakness or paralysis, which is caused when the facial nerve or the seventh cranial nerve is impacted. ENT specialists can also manage congenital (present at birth) ear anomalies, which affect the shape and position of the ear.

• Nose: ENT specialists are experts in diagnosing and managing sinusitis or rhinosinusitis (inflammation of the tissue lining sinuses), allergies (of the nasal passages, sinuses, and airway), nasal polyps, and nasal obstruction due to a deviated septum and other causes. They also manage conditions like nosebleeds (epistaxis) and chronic rhinorrhea or runny nose.

• Throat: Otolaryngologists manage diseases related to the voice box or the larynx, such as laryngitis, vocal polyps, vocal cord paralysis, and vocal nodules. They can also diagnose and treat oesophagus-related conditions like gastroesophageal reflux disease (GERD), dysphagia or difficulty swallowing, throat tumours, tonsillitis, and other airway and vocal cord conditions.

• Head and Neck: ENT specialists treat infectious diseases, thyroid disorders like tumours (cancerous, and non-cancerous or benign), Grave's disease (an autoimmune disease that impacts the thyroid gland), parathyroid disease or hyperparathyroidism (an overactive thyroid gland), enlarged thyroid glands, deformities of the face, and facial trauma.

• Sleep: ENT doctors are also trained to treat sleep disorders like obstructive sleep apnea and snoring.

When to see an ENT Specialist?

You may need to see an ENT specialist if you have any of the following symptoms:

• Injury or pain in the ears, nose, or throat
• Congenital disabilities in the ears, nose, or throat
• Breathing problems or asthma
• Nerve-related problems in the ears, nose, or throat
• Problems with the voice
• Problems with smelling
• Problems with balance or dizziness
• An ear infection
• Nasal congestion
• Hearing impairment
• Tonsil infection
• Sore throat or hoarseness
• Swimmer's ear (It is an infection in the outer ear canal which causes redness, itching, and pain. It happens when someone spends too much time in the water)
• Tinnitus (constant ringing or buzzing in the ear)
• Nose bleeds
• Allergies (Common symptoms include frequent sinus infections, ear pressure or fullness, itching in the back of the throat, itchy or red eyes, or rashes)
• Sinus problems
• Any kind of growth in the ears, nose, or throat
• A deviated septum
• Drooping of the eyelids
• Problems with swallowing
• Gastroesophageal reflux disease (GERD)

Procedures

Ear procedures

• Ear tubes (tympanostomy) procedure
This is a surgical procedure where the ENT surgeon will create a surgical opening in the eardrum to drain infected fluid and place a small ear tube in the eardrum. This is usually done in children who have fluid in their ears for more than three months, which may cause hearing problems.

• Stapedotomy
In this procedure, the ENT surgeon creates a fenestra in the smallest hearing bone (stapes)and places a piston from the incus into the fenestra to improve hearing.

• Myringoplasty
This procedure is done to repair a small hole in the eardrum.

• Tympanoplasty (Eardrum Repair)
This procedure involves the reconstruction of the eardrum using a graft of the patient's own tissue along with the repair of hearing mechanisms like hearing bones.

• Tympanomastoidectomy
This procedure is used to treat recurring ear infections. It involves reconstructing the eardrum and removing the infected tissue and bone from the mastoid and middle ear.

Larynx Procedures

• Laryngoscopy with biopsy
Also called a direct laryngoscopy, this is used to take biopsy samples of the vocal cords under general anaesthesia using a laryngoscope. The surgeon also inspects the larynx or the voice box during this procedure.

• Microlaryngoscopy with biopsy
The surgeon uses an endoscope or microscope to visualise the larynx and related structures during this procedure. The pathology in the larynx is then removed using cold instruments or the LASER/ Coblation. This is performed under general anaesthesia, and the endoscope is inserted through the mouth.

• Esophagoscopy
Also called upper GI endoscopy, this involves examining and biopsies from the esophagus using an esophagoscope. This is also done under brief general anaesthesia.

• Laryngoplasty
This procedure treats vocal cord paralysis or hoarseness caused by weak or paralysed vocal cords.

Nasal and Sinus Procedures

• Septoplasty
A septoplasty is a surgery to repair or straighten a deviated septum. It is a common surgery and is also performed under general anaesthesia.

• Turbinate reduction
The turbinates (small structures in the nose which cleanse and humidify air) in the nose can become swollen due to infections or allergies, which can cause nasal obstruction and overproduction of mucus. Turbinate reduction aims to reduce the swelling as well as the size and make it easier for patients to breathe.

• Nasal valve reconstruction
This procedure is used to correct troubled breathing and widen nasal valves located in the nose. This controlled air flows in and out of the nose. If a nasal valve collapses, it can block airflow and make breathing harder. Nasal valve repair reshapes the inner nose to improve and makes living easier without changing how the nose looks outside.

• Functional endoscopic sinus surgery
It is a general surgery to treat chronic sinus infections and restore sinus ventilation. Endoscopic Sinus Surgery (FESS) involves using a magnifying endoscope to remove affected tissue and bone from sinus areas. It is often done along with a septoplasty for best results.

• Nasal fracture reduction (closed)
This procedure is used to straighten nasal bone features after an injury. This involves using instruments to move displaced bones back into position without incisions.

• Rhinoplasty
A rhinoplasty is a cosmetic procedure used to reshape the nose. This can be done to improve breathing or make the nose look aesthetically more pleasing.

Neck Procedures

• Biopsy neck mass (Superficial)
This involves collecting tissue samples from the neck mass, which a pathologist examines to check for the type of pathology.

• Neck Mass Biopsy (Deep)
This procedure involves an incision to remove abnormal neck mass under general anaesthesia.

• Parotidectomy
This is the removal of a part of the whole parotid glands, large salivary glands situated in front of each ear, due to tumours.

Throat/Thyroid

• Tonsillectomy
This is the surgical removal of tonsils or soft tissue masses located on each side of the back of the throat. This is used to treat chronic sore throats, snoring, or sleep apnea.

• Parathyroidectomy
This surgery removes the parathyroid glands (located behind the thyroid gland) or parathyroid tumours. It is used to treat hyperparathyroidism.

• Thyroidectomy
A thyroidectomy is the excision of a part of the whole thyroid gland to remove nodules or remove goitres. It can also be done to treat thyroid cancer.

• Thyroidectomy with lymph node excision
This procedure is conducted to treat cancer of the thyroid gland. It involves the removal of the thyroid gland along with the lymph nodes around it.

Meet Dr Satinder Singh, one of the best ENT specialists in Delhi

Dr. Satinder Singh is an ENT specialist with more than two decades of clinical experience in treating ear, nose, and throat disorders. Dr Singh completed his MBBS at NRS Medical College, Kolkata, and has a post-graduate diploma in Otorhinolaryngology from Dayanand Medical College, Ludhiana. He got his DNB from Sir Ganga Ram Hospital, New Delhi, and has done a visiting fellowship focusing on laryngology at Emory University Hospital, Atlanta in the U.S.

Technology and Tools

Here are some advanced technologies used by ENT surgeons:

Cochlear Implant surgery
Cochlear implants are for patients with sensorineural hearing loss caused by damage to the cochlea, the spiral cavity of the inner ear. Cochlear Implant is an electronic device placed in the patient's ear via surgery. It creates a sensation of hearing by stimulating the auditory or the cochlear nerve. Radio Frequency Tonsillectomy This procedure uses low-temperature radiofrequency and saline to decrease the size of a patient's tonsils. This involves less operative time, is safer, and causes less postoperative pain than traditional tonsillectomy. Advanced Videostroboscopy This is a state-of-the-art procedure in which surgeons use advanced video stroboscopy equipment and take high-res photographs and slow-motion videos of the vocal cords of a patient's vocal cords to evaluate abnormalities. This is used in cases of persistent laryngitis, hoarseness, and vocal cord dysfunction. Electronystagmography (ENG) or electrooculography Electronystagmography is used to diagnose vertigo and specific other hearing and vision disorders. It involves placing patches (electrodes) above, below, and the sides of a person's eyes and recording electrical activity. It helps determine whether a person has a problem within the ear or nerves that supply the ear and brain. Ear microscopy This involves a detailed examination of the external canal of the ear and the eardrum with a microscope. The surgeon can also perform microsuction or clearance of the ear canal. Balloon Sinuplasty it is a minimally invasive treatment for chronic sinusitis. Balloon Sinuplasty involves inserting a balloon catheter into a patient's sinus passage and inflating it slowly to widen the passageway. The balloon is then deflated; the procedure helps restore normal sinus function.