Fact Sheet - ENT Surgery

What is ENT Surgery?

ENT Surgery is the specialty concerned with the medical and surgical treatment of the ears, nose, throat. ENT Surgeons skills include diagnosing and managing diseases of the sinuses, larynx (voice box), oral cavity, and upper pharynx (mouth and throat) and adjacent structures of the head and neck.

Their specialty encompasses:

  • Management of patients with loss of hearing and balance,
  • Endoscopic examination of air and food passages,
  • Treatment of allergic, sinus, laryngeal, thyroid and oesophageal disorders.

What Do ENT Surgeons Treat?

  • The Ears: The unique domain of ENT Surgeons is the treatment of ear disorders. They are trained in both the medical and surgical treatment of hearing, ear infections, balance disorders, ear noise (tinnitus), nerve pain, and facial and cranial nerve disorders. ENT Surgeons also manage congenital (birth) disorders of the outer and inner ear.
  • The Nose: Chronic sinusitis is one of the most common health complaints in Australia. Care of the nasal cavity and sinuses is one of the primary skills of ENT Surgeons. Management of the nasal area includes allergies and sense of smell. Breathing through, and the appearance of, the nose are also part of ENT Surgeons' expertise.
  • The Throat: Communicating (speech and singing) and eating a meal all involve this vital area. Also specific to ENT Surgeons is expertise in managing diseases of the larynx (voice box) and the upper aero-digestive tract or oesophagus, including voice and swallowing disorders.

What makes ENT Surgeons the most appropriate physicians to treat disorders of the ears, nose, throat?

These specialists differ from many physicians in that they are trained in both medicine and surgery. ENT Surgeons do not need to refer patients to other physicians when ear, nose, throat, or head/neck surgery is needed and, therefore, can offer the most appropriate care for each individual patient.

Diagnosis and Treatment in Seven Areas of Expertise

Otology/Neurotology: diseases of the ear, including trauma (injury), cancer, and nerve pathway disorders, which affect hearing and balance. Examples:

  • ear infection
  • swimmer's ear
  • hearing loss
  • ear, face, or neck pain
  • dizziness
  • ringing in the ears (tinnitus)

Paediatric Otolaryngology: diseases in children with special ENT problems including birth defects in the head and neck and developmental delays. Examples:

  • ear infection (otitis media)
  • tonsil and adenoid infection
  • airway problems
  • Down’s syndrome
  • asthma and allergy/sinus disease

Rhinology: disorders of the nose and sinuses. Examples:

  • sinus disorder
  • nose bleed
  • stuffy nose
  • loss of smell

Laryngology: disorders of the throat, including voice and swallowing problems. Examples:

  • sore throat
  • hoarseness
  • swallowing disorder
  • gastroesophageal reflux disease (GERD)

Allergy: treatment by medication, immunotherapy (allergy shots) and/or avoidance of pollen, dust, mould, food, and other sensitivities that affect the ear, nose, and throat. Examples:

  • hay fever
  • seasonal and perennial rhinitis
  • chronic sinusitis
  • laryngitis
  • sore throat
  • otitis media
  • dizziness.

How Does the Ear Work?

The ear has three main parts: the outer, middle, and inner ear. The outer ear (the part you can see) opens into the ear canal. The eardrum separates the ear canal from the middle ear. Small bones in the middle ear help transfer sound to the inner ear. The inner ear contains the auditory (hearing) nerve, which leads to the brain.

Any source of sound sends vibrations or sound waves into the air. These funnel through the ear opening, down the ear canal, and strike your eardrum, causing it to vibrate. The vibrations are passed to the small bones of the middle ear, which transmit them to the hearing nerve in the inner ear. Here, the vibrations become nerve impulses and go directly to the brain, which interprets the impulses as sound: music, a slamming door, a voice, etc.

nerve endings in the inner ear. As the exposure time to loud noise increases, more and more nerve endings are destroyed. As the number of nerve endings decreases, so does your hearing. There is no way to restore life to dead nerve endings; the damage is permanent.

Noise, Ears & Hearing Protection

Excessive noise exposure is the most common cause of hearing loss. Noise can be dangerous. If it is loud enough and lasts long enough, it can permanently damage hearing. The damage caused by noise, called sensorineural hearing loss or nerve deafness, can be caused by several factors other than noise, but noise-induced hearing loss is different in one important way––it can be reduced or prevented altogether. People differ in their sensitivity to noise. As a general rule, noise may damage your hearing if you have to shout over background noise to make yourself heard, the noise hurts your ears, it makes your ears ring, or you have difficulty hearing for several hours after exposure to the noise.

Frequency and Decibels

Frequency is measured in cycles per second, or Hertz (Hz). The higher the pitch of the sound, the higher the frequency.

Human speech, which ranges from 300 to 4,000 Hz, sounds louder to most people than noises at very high or very low frequencies. When hearing impairment begins, the high frequencies are usually lost first, which is why people with hearing loss often have difficulty hearing the high pitched voices of women and children. Loss of high frequency hearing also can distort sound, so that speech is difficult to understand even though it can be heard. People with hearing loss often have difficulty detecting differences between certain words that sound alike, especially words that contain S, F, SH, CH, H, or soft C sounds, because the sound of these consonants is in a much higher frequency range than vowels and other consonants.

Intensity of sound is measured in decibels (dB). The scale runs from the faintest sound the human ear can detect, which is labelled 0 dB, to over 180 dB, the noise at a rocket pad during launch.

Decibels are measured logarithmically. This means that as decibel intensity increases by units of 10, each increase is 10 times the lower figure. Thus, 20 decibels is 10 times the intensity of 10 decibels, and 30 decibels is 100 times as intense as 10 decibels.

Many experts agree that continual exposure to more than 85 decibels is dangerous without proper hearing protection devices, which decrease the intensity of sound that reaches the eardrum. They come in two forms, earplugs and earmuffs.

Approx. Decibel Level Example
0 Faintest sound heard by human ear.
30 Whisper, quiet library.
60 Normal conversation, sewing machine, typewriter.
90 Lawnmower, shop tools, truck traffic; 8 hours per day is the maximum exposure to protect 90% of people.
100 Chainsaw, pneumatic drill, snowmobile; 2 hours per day is the maximum exposure without protection.
115 Sandblasting, loud rock concert, auto horn; 15 minutes per day is the maximum exposure without protection.
140 Gun muzzle blast, jet engine; noise causes pain and even brief exposure injures unprotected ears. Maximum allowed noise with hearing protectors.