I’m rotating through otorhinolaryngology, and it’s been an eye opening experience. Perhaps that’s not the best phrase to describe it, as the eyes are the one orifice of the face that isn’t typically addressed by ENT. Although, given that I was in the OR yesterday for a DCR surgery to drain blocked tear ducts into the nose, I have to acknowledge that ENT’s also do things related to the eyes.
I knew that ear, nose, and throat doctors did a lot of head and neck surgery, but I don’t think I had such a good sense of the extent of all that they do. Through my medical training I have seen that most specialities are much more diverse than I might have originally thought, but I can’t think of a residency which is quite as diverse as ENT. The lay person might think of things like kids with recurrent ear infections or adults with sinus problems and sleep apnea. However, the same specialty covers procedures as diverse as cochlear implants, thyroid/endocrine cancer surgery, facial plastics including everything from elective nose jobs to treating severe facial trauma/fracture, treating vocal cord nodes of singers, endo-nasal approaches to pituitary tumors, and so many other things as well.
I don’t think I’ll end up being an otorhinolaryngologist, however, I understand now why it is very popular and has a good range of options an ENT can do.
It’s also worth mentioning something about ENT which I enjoyed tremendously, which was a bit of a surprise to me, and that is sinus surgery. Having had some problems with allergies and sinusitis as a young person, I can certainly relate to the misery of feeling all stuffed up. So, when witnessing endoscopic approaches to the sinuses which drained material causing pain and congestion, it was immensely satisfying. Seeing nasty, goopy, infectious material being sucked out definitely leaves you feeling like that patient is better off and will feel a lot better. It can also be important to extract material that is doing things like invading into the eye sockets or other key areas, for example there is a great video here (with exciting music) of an endo-nasal surgery to remove a mucocele invading into the eye socket: https://www.youtube.com/watch?v=PonTWaAXlZg
There was a general surgeon who spoke to the preclinical medical students during my early part of medical school, and she told us that her favorite procedure was draining a perirectal abscess. Of course, this was greeted with a near uniform “Ewww” from the audience, but she made some good points: namely that it was a very simple procedure, with little risk of complication, that almost immediately gave the patient a lot of relief, and it was likely something that would lead to good outcomes in that patient. I think I can understand a lot of that sentiment now. It’s nice to see something nasty taken out of a patient; there is a good feeling of having helped them in a very concrete way.