The otolaryngologist is a specialist doctor who deals with the medical and surgical treatment of ear, nose, throat and other related structures from head to neck as well as tonsil treatment, and audiology is a branch of medicine which deals specifically with diseases of the ear and the senses of hearing and balance and which became autonomous in 1960. Although they appear to be relatively unrelated, it is common for both branches to be treated by the same doctor as the disorders are affected jointly from an infection or that are affected by the same trauma.
The task of the otolaryngologist is to assess the hearing ability of a person and is useful for making a diagnosis of the location of the disease. The doctor, in order to best treat the patient and be able to recover from his symptoms, must undergo his otorhinolaryngologist visit, the medical exam that aims to identify possible pathologies affecting the ears, nose and throat as well as other structures belonging to the head and neck district. The otolaryngologist's visit is made up of two parts: in the first part, the doctor takes care of making a complete anamnesis on the patient, proceeding with an investigation on the patient's state of health as well as on the presence of the symptoms related to the organs of competence, to any treatment in progress and to any pathologies known to the patient. The second part, instead, consists in the actual visit and therefore the doctor submits the patient to all those examinations that can allow to identify the causes of the symptoms. In particular, the following are performed:
An accurate inspection of the oral cavity, the hypopharynx, the larynx and the oropharynx that are accurately evaluated through the use of rigid optical fibers or through the laryngoscopy that allows to visualize the functional clinical anatomical situation that highlights any anomalies and lesions;
Otoscopy, an examination that allows the evaluation of the tympanic membrane and the external auditory canal within the ear;
The rhinoscopy, an examination that is performed with a thin fiber optic endoscope that allows the exploration of the nose and the doors of communication with the paranasal cavities and the opening of the Eustachian tube;
Palpation of the neck in such a way as to exclude the presence of suspicious swellings;
The tonal and impedometric audiometric examination, a type of exam that allows to comprehensively study the auditory function of the patient giving information on the auditory threshold and on the capacity of vibration of the eardrum.
Another important non-widespread examination in the field of audiology is the vocal audiometry that is being contrasted with the tonal audiometric examination: in the tone audiometry pure sounds are presented to the patient and the patient is asked if he has heard them. In speech audiometry, instead, word, sentence or syllable recordings are used and the patient is asked to repeat them. The ability to recognize words and sentences is the priority function of the auditory system.
With these instruments, the otolaryngologist takes care of treating the most common diseases:
Pathologies affecting the microsurgery of the ear;
Tympanic perforation;
Vertigo (such as the Ménière syndrome, labyrinthitis, cupololithiasis, acoustic neuroma, etc.)
Deafness;
Cochlear implantology, the so-called bionic ear;
Otitis such as acute purulent otitis media, acute necrotic otitis media, etc.
In the field of rhinology, the otolaryngologist takes care of:
Nasal cavities and paranasal sinuses;
Sleep apnea syndrome;
Sinusitis and rhinitis;
Nose-sinus polyposis;
Allergies with prevalent upper airway involvement.
As far as the field of laryngology and phoniatrics is concerned, the otolaryngologist takes care of:
Laryngeal carcinoma;
dysphonias;
Vocal nodules;
Tracheotomy;
Mutism.
In Italy, the training course to be undertaken to become a specialist in otorhinolaryngology and audiology is the Degree in Medicine and Surgery, a university course with a legal duration of 6 years and a specialization in otorhinolaryngology or in cervico-facial surgery, of the legal duration of 5 years. Then, as previously written, to become an otolaryngologist and audiologist it is necessary that the candidate be admitted to attend the faculty of medicine and surgery, a limited number faculty whose enrollment is subject to an entrance test which includes subjects of General Culture, Logic, Chemistry, Physics, Mathematics and Biology. After completing the degree, the candidate must submit to the state examination to be qualified for the medical profession and be enrolled in the official register of provincial surgeons. The state exam includes two written tests which provide for the resolution of ninety multiple-choice questions and a practical internship to be carried out directly in the ward for a period of three months which must be of a continuous nature in the department of medicine, in the surgery department and at the general medicine department. After gaining admission, the aspiring ENT doctor will have to enroll in the school of specialization in Otolaryngology and in cervico-facial surgery, a course lasting five years. The area of ??Otolaryngology foresees the diagnostic methodology as well as surgical type pertaining to otorhinolaryngology. To obtain, instead, after having acquired the qualification for the medical profession, the candidate must pursue the specialization school in audiology and phoniatrics, a course of study that has a legal duration of five years.