Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. The full name of the specialty is otolaryngology-head and neck surgery. Practitioners are called otolaryngologists-head and neck surgeons, or sometimes otorhinolaryngologists (ORL). A somewhat outdated, but nevertheless commonly used, term for this speciality is ENT (ear, nose and throat).

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Otolaryngologists are medical doctors who complete at least five years of surgical residency training (one year in general surgery, four years in otolaryngology - head and neck surgery). Following residency training, some otolaryngologists elect to complete advanced subspeciality fellowships which are usually one or two years in duration. As with all medical fellowships, acceptance is highly competitive.

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Impact of Tonsillectomy With or Without Adenoidectomy on the Acoustic Parameters of the Voice: A Comparative Study [Original Article]
Subramaniam, V., Kumar, P. Objective  To assess the effects of chronic tonsillitis with or without adenoiditis and the effects of tonsillectomy with or without adenoidectomy on the voice by means of acoustic analysis. Design  Prospective case-control study. Setting  Yenepoya Medical College Hospital, a tertiary referral hospital. Patients  Patients 5 to 26 years old with chronic tonsillitis with or without adenoiditis. Interventions  Tonsillectomies were performed under general anesthesia by surgeons using cold steel instruments via a standard capsular dissection technique, and adenoids were removed by curettage. Main Outcome Measures  Acoustic analysis of 6 parameters (fundamental frequency, jitter, shimmer, harmonics: noise ratio, long-term average spectrum, and nasalance) 4 weeks after surgery compared with 1 day before surgery. Results  Postoperatively, shimmer altered in males, and hypernasality was eliminated in almost all cases. None of the other associations were significant statistically. Conclusions  Chronic tonsillitis and tonsillar hypertrophy cause alterations in some acoustic measurements, which make the voice dysharmonic and harsh. Tonsillectomy eliminates nasalance and lowers shimmer. Overall, it does not significantly alter dysphonia owing to disease.
Influence of Single-Trial Results on Clinical Practice: Example of Adenotonsillectomy in Children [Original Article]
Rovers, M. M., Hoes, A. W., Klinkhamer, S., Schilder, A. G. M. Objective  To establish whether the results of a 2004 trial on the effectiveness of adenotonsillectomy in children with mild to moderate symptoms of throat infection or adenotonsillar hypertrophy affected physicians' beliefs about the benefits of the operation and influenced clinical practice. Design  Prospective prior-posterior study. Setting  Academic research. Participants  We evaluated beliefs prior and posterior to the 2004 trial regarding the benefits of adenotonsillectomy in a random sample of 120 Dutch otolaryngologists and 120 Dutch general practitioners. Main Outcome Measure  Physicians were asked to give their estimates of the probability of recovery during 1 year after adenotonsillectomy or a nonsurgical strategy in 3 scenarios of children aged 3 to 4 years with recurrent throat infection, upper respiratory tract infection (with or without fever), or sleep-related breathing disorder. Results  Ninety-four percent of otolaryngologists (n = 46) and 31% of general practitioners (n = 14) were familiar with the 2004 trial results. Posterior beliefs of otolaryngologists and general practitioners did not differ substantially from prior beliefs; overall expectations regarding the benefits of adenotonsillectomy remained high. Conclusion  Dissemination of the 2004 trial results did not seem to affect the beliefs of physicians regarding the benefits of adenotonsillectomy. Trial Registration  isrctn.org Identifier: ISRCTN04973569
Microcystic Lymphatic Malformations of the Tongue: Diagnosis, Classification, and Treatment [Original Article]
Wiegand, S., Eivazi, B., Zimmermann, A. P., Neff, A., Barth, P. J., Sesterhenn, A. M., Mandic, R., Werner, J. A. Objective  To describe a classification of microcystic lymphatic malformations of the tongue and to investigate different treatment methods. Design  Retrospective review of patients treated for microcystic lymphatic malformations of the tongue. Lymphatic malformations were classified into the following 4 groups according to their extent: isolated superficial microcystic lymphatic malformations of the tongue (stage I); isolated lymphatic malformations of the tongue with muscle involvement (stage II; stage IIA, involving a part of the tongue; stage IIB, involving the entire tongue); microcystic lymphatic malformations of the tongue and the floor of mouth (stage III); and extensive microcystic lymphatic malformations involving the tongue, floor of mouth, and further cervical structures (stage IV). Patients  Twenty patients with microcystic lymphatic malformation of the tongue. Main Outcome Measures  Medical records were reviewed for demographic data and extent and treatment of the lymphatic malformations. Results  Three patients had stage I disease; 5 patients, stage II; 3 patients, stage III; and 9 patients, stage IV. In 6 patients, the lymphatic malformations could be completely removed by carbon dioxide laser surgery; the remaining 13 patients had persistent disease. Conclusions  The initial stage seems to predict outcome. Carbon dioxide laser therapy provides good results primarily in stages I and IIA lymphatic malformations. In advanced lymphatic malformations (stages IIB, III, and IV), an interdisciplinary approach is necessary, because complete surgical excision is often impossible owing to the diffuse growth behavior, and therefore recurrence and persistence are common.
Duration-Related Efficacy of Postoperative Antibiotics Following Pediatric Tonsillectomy: A Prospective, Randomized, Placebo-Controlled Trial [Original Article]
Johnson, P. E., Rickert, S. M., Jones, J. Objective  To determine whether a 3-day course of postoperative antibiotics is as effective as a 7-day course in reducing pain and reducing time to resumption of a normal diet and level of activity following pediatric tonsillectomy. Design  A prospective, randomized, placebo-controlled trial. Setting  Academic medical center. Patients  Forty-nine patients were enrolled in the study. Preoperative demographic information was obtained. Interventions  Tonsillectomy with or without adenoidectomy was performed by the senior author (J.J.) using electrocautery. Patients were randomized to receive either a 3- or 7-day course of amoxicillin. Main Outcome Measures  Parents were asked to record the following information: analgesic use for the first 7 postoperative days, postoperative days the child initiated his or her usual diet and level of activity, and medical treatment for oral hemorrhage or dehydration. Results  Of the 49 patients, 26 were randomized to receive 7 days of postoperative antibiotics (group A) and 23 to receive 3 days of antibiotics, followed by 4 days of placebo (group B). Results were obtained for 47 of the enrolled patients (96%). No statistically significant difference was noted between the 2 groups with regard to postoperative pain or time to resumption of a normal diet and level of activity. Conclusion  A 3-day course of antibiotics following pediatric tonsillectomy is as effective as a 7-day course with regard to postoperative analgesic use and resumption of normal diet and level of activity. Trial Registration  clinicaltrials.gov Identifier: NCT00662987

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