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An otolaryngologist, or ENT (ear, nose and throat) doctor, is a physician who has completed intensive specialty training in the medical and surgical treatment of the diverse disorders affecting the head and neck. The term that has been used in the past is otorhinolaryngologist, and this has been shortened to otolaryngologist. Otolaryngology is a broad field, but has been subdivided into several subspecialty areas, given the complex nature of the disorders of the head and neck, and their surgical treatment. Subdivisions include: 1) general otolaryngology, 2) head and neck surgery, 3) otology, 4) facial plastics, and 5) pediatric otolaryngology. The General Otolaryngology Service, in conjunction with the Department of Radiology, the Voice Laboratory, and the Thyroid Clinic, provide a full range of services for patients with general otolaryngologic disorders.
The Department of Otolaryngology provides services at three different levels of care - primary, secondary and tertiary.
At the primary level, initial screening and diagnosis of many otolaryngologic disorders are performed by the General ENT (Ear, Nose and Throat)Service.
At the secondary and terciary care level, patients are referred to subspecialty services. The subspecialty services provide four functions -
The General Otolaryngology Service deals with the medical and surgical treatment of a wide variety of head and neck disorders, including infectious, inflammatory, and neoplastic lesions. These can be broken down into several groups:
The Facial Nerve Center was established in 1989 for the evaluation and
treatment of facial nerve disorders. The facial nerve carries
impulses from the brain to the facial muscles, allowing for facial
expression and movement. In addition, portions of the facial nerve
activate the tear and salivary glands and carry taste sensations
from the tongue to the brain. When these nerve impulses are
interrupted, any or all of these functions may be affected.
Thousands of people suffer from disorders of the facial nerve,
often resulting in substantial disfigurement and impaired function.
Diagnosis and treatment is provided by a multidisciplinary team of
otolaryngologists, ophthalmologists, neurosurgeons, neurologists,
electrophysiologists, physical therapists and social
workers.
The Head and Neck Oncology
Service specializes in the treatment of patients with cancerous and
non-cancerous tumors of the head and neck. The service provides
care in conjunction with the Massachusetts General Hospital, from
screening and diagnosis to treatment and follow-up.
The service
coordinates all patient care needs including surgery, medical
treatment, radiation therapy, chemotherapy, social services, dental
services, and rehabilitation services such as physiotherapy and
speech pathology. In addition, the service draws on the expertise
of outside home health care, visiting nurse, and hospice
programs.
Recently, Otolaryngology created a new Division of Laryngology within MEEI. This
division specializes in the study and management of the larynx and
voice-related communication disorders. Expert services are
available for the spectrum of disorders and diseases that affect
the larynx and voice. This includes all phonosurgical procedures
and voice therapy to treat lesions of the vocal folds, vocal-cord
paralysis, and other neurological problems (i.e., spasmodic
dysphonia), as well as reconstructive procedures to rectify
laryngeal airway narrowing.
A group of individuals has been brought
together to integrate excellence in patient care, education,
training, and research. A dedicated team has also been organized to
address the comprehensive management needs of the professionals and
performing voice.
Within the Otology Service, physicians treat a wide variety of ear and related problems, including conductive and sensori-neural hearing loss, balance and facial nerve disorders, congenital and genetic hearing loss, toxic diseases, drug effects, noise injuries, skull fractures, and infections.
The Infirmary provides care for infants and children in Pediatric Otolaryngology (ENT) and when a
hospital stay is needed, in a separate outpatient Pediatric Unit. In addition, the Infirmary's
otolaryngology staff provides care for the Children's Service at
the Massachusetts General Hospital.
A full range of specialty
medical and surgical care - including otology and facial nerve
disorders, rhinology and sinus disorders, laryngology and
bronchoesophagology, pediatric head and neck malignancies and skull
base lesions, congenital deformity, and other related problems - is
provided to infants and children.
The Otolaryngology Department provides outpatient ancillary services, including audiology, auditory evoked response, hearing aid fitting, and vestibular (balance) testing.
Improved techniques in otolaryngology have occurred in the inpatient as well as the outpatient arena involving procedures such as skin grafts used in reconstructive surgery and neuro-otology (the combination of neurology and otology).
In otolaryngology, the delivery of services can be particularly advantageous in a specialty facility. Otolaryngologists practicing at a general acute-care hospital must compete for time in the operating room against general surgeons and surgical subspecialists who often treat patients with more life-threatening conditions than those of the otolaryngologists.
Consequently, the availability of the Infirmary's operating rooms, the specialized equipment it possesses to treat otolaryngologic cases, and the specialized expertise of its medical and professional support staff permit it to meet the ongoing demand for complex inpatient otolaryngologic cases.
Meltzer Auditorium, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
Offered by:
Massachusetts Eye and Ear Infirmary, Department of Otolaryngology
Massachusetts General Hospital, Departments of Radiation and Medical Oncology
Course Directors: Daniel G. Deschler, MD, Paul M. Busse, MD, PhD, and John R. Clark, MD
This course will provide a review of the current state-of-the-art strategies and innovations in the management of head and neck cancer. As the course will be based on a multidisciplinary approach to these challenging disease processes, with representative faculty from Otolaryngology-Head and Neck Surgery, Medical Oncology and Radiation Oncology, the educational focus will be directed at practitioners and trainees from all these specialties. Participants will be presented the latest medical and surgical evaluation and treatment algorithms by national and world leaders in the care of head and neck cancers.
Seats are limited, so register now.
To see program and to register: www.cme.hms.harvard.edu/courses/headneck
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