My second rotation- an Ear, Nose, and Throat clinic- is officially over and I have moved on to mental health! While I learned so much over the last month, I will say that I’m glad to be through with ENT. It is so detailed and important, but I just don’t think it is for me. I learned so much about hearing loss, sinus conditions, sleep apnea, and even reflux during this rotation! Let me take you through my day.
The clinic day started at 8:00 for me. I would arrive at the clinic and sign in to the EMR to prepare for the day. Patient appointments started at 8:20, and there were two patients per time slot for the rest of the day (which makes for a very busy clinic). Thankfully there was another student with me, and we worked together to room patients. During rooming, we would take the patient’s vitals and history of present illness, and review any medications and update history for new patients as needed. We would then present the patient to the doctor and shadow him throughout the patient encounter. Many patients would get an audiogram before their appointment, so this was also reviewed before the doctor talked to the patient.
Each encounter was unique- there were many procedures and diagnostics that could be performed in-office, so there was always plenty to do! Some of the things that the doctor might ask for during an appointment include audiography, rigid nasal endoscopy, flexible laryngoscopy, and a CT scan. He may also remove wax and debris from the ears or nose during the appointment. Occasionally, he would decide to perform a procedure in office- commonly a myringotomy, tube placement, tube removal, or cauterization of a vessel in the nose. We would assist him with these throughout the day!
The doctor performed surgeries on Wednesday mornings. On these days, we would show up early and get right to work! He would perform 3-5 cases a day, ranging from tube removals and placements, tonsillectomy and adenoidectomy, sinus surgeries, myringoplasty, septoplasty, cholesteatoma removals, and cauterization of nose bleeds. As students, we just observed these surgeries, but most of them required a camera due to the confined spaces of the procedures- so we had plenty to see!
Here are some of the conditions I saw during my time in ENT:
- Tinnitus
- Sensorineural hearing loss
- Conductive hearing loss
- Hypertrophy of nasal turbinates
- Deviated nasal septum
- Nasal mucositis
- Impacted cerumen
- Nasal congestion
- Chronic sinusitis (maxillary, ethmoidal, pansinusitis)
- Allergic rhinitis
- Vasomotor rhinitis
- Obstructive sleep apnea
- Tonsillitis
- Tonsil and Adenoid hypertrophy
- Gastro-esophageal reflux disease
- Laryngo-esophageal reflux disease
- Nonsuppurative otitis media
- Perforation of the tympanic membrane
- Otalgia, otorrhea,
- Serous otitis media with effusion
- Otitis externa
- Dizziness
- Benign paroxysmal vertigo
- Meniere’s disease
- Acute tonsillitis
- Epistaxis
- Hoarseness
- Eustachian tube dysfunction
- Cholesteatoma
Procedures
- Flexible endoscopy
- Rigid endoscopy
- Vivaer
- Tonsillectomy, Adenoidectomy
- Myringotomy with tube insertion
- Tube removal
- Tympanoplasty
- Cholesteatectomy
- Maxillary anterostomy
- Ethmoidectomy
- Submucous resection of turbinates
- Vocal cord stripping
- Closed reduction of nasal fracture
I would love to hear your experiences with ENT- as a patient or a provider! Please reach out if you have any questions or comments 🙂