The Anatomy Of the ENT

Anatomy of ENT

The ear, nose and throat appear to have different structures and different functions but did you know that they are all internally connected?

You probably didn’t know that dizziness, gastric reflux and TMJ (Temporo-Mandibular Joint) pain can be treated by one specialist. This specialist is officially known as an otolaryngologist but commonly referred to as an ear, nose and throat (ENT) specialist. Sunway Medical Centre’s Consultant ENT, Head and Neck surgeon, Dr. Shailendra Sivalingam reveals what you need to know about taking care of your ear, nose and throat.

These structures perform a myriad of tasks such as breathing and detecting smells and odours (nose), hearing and balance (ears) and breathing, speech and swallowing (throat). “The ear, nose and throat are grouped together because they are all part of the upper aerodigestive tract”. The upper aerodigestive tract that Dr. Shailendra refers to can be seen in Image 1. Problems in one area may affect other parts as well,” says Dr. Shailendra, adding that the nose and throat are part of a single aerodigestive pathway. “The ear is connected to the posterior part of the nose via the Eustachian tube which allows equalisation of pressure in the ears.” See Image 2 for a clearer picture on what the Eustachian tube looks like and its placement.

Common suspects

There are a few problems that crop up quite commonly in the ENT area. Dr. Shailendra says that the nose is commonly affected by nasal allergy, sinusitis (cavities around the nasal passages become inflamed) and congestion. As for the throat, it is usually affected by pharyngitis (inflammation of the throat that causes a sore throat), tonsillitis and hoarseness of the voice.

As for our ears,  impacted ear wax, ear infections (otitis externa and otitis media) along with balance disorders such as Meniere’s Disease (disorder of the inner ear that causes vertigo) and Positional Vertigo (dizziness and a spinning sensation with certain head movements) are common culprits, he says.

Other than the ‘run of the mill’ infections such as sinusitis and allergies, Dr. Shailendra states that ENT specialists can treat salivary gland infections and hearing problems. As long as there is a problem in the head and neck area, an ENT specialist is the medical professional to see. “In addition, we also treat tumours and cancers affecting the salivary glands, thyroid, nose, larynx, neck, tongue and oral cavity,” Dr. Shailendra adds.

The big ‘C’

Dr. Shailendra says that in Malaysia, ENT problems such as allergic rhinitis, sinusitis, ear infections, hearing loss, vertigo and tumours are present and similar types of problems occur in the rest of the world. He also reveals that the top ENT cancers in Malaysia are nasopharyngeal (upper region of the throat) carcinoma, salivary gland carcinomas, laryngeal carcinomas and thyroid carcinomas.

While there is no method that provides 100 percent certainty when it comes to preventing cancer, leading a healthy lifestyle by having a balanced diet and incorporating plenty of exercise will certainly go a long way in keeping cancer at bay. Kick habits such as smoking and drinking excessive amounts of alcohol as these habits may increase your risk of laryngeal cancer, among other serious health problems.

Aeroallergen avoidance

 “Avoidance of aeroallergens and irritants such as cigarette smoke, dust, and haze will help keep the nose and throat healthy. Other than that, avoid picking and digging your ears,” advises Dr. Shailendra. Additionally, pushing cotton buds deep into the ear canal is to be avoided at all costs as this will push ear wax further into the ear canal and cause earwax impaction.

It is important for those who have nasal allergies to identify their triggers (allergens). Common allergens such as dust mites, pet dander and pollen can be removed from your environment by vacuuming your home every week and mopping the floors. If possible, getting an air filter is also a great way to keep the air clean in your home. Air filters can trap dust, dander and even adjust the humidity of your home in order for you to breathe easily.

Dr. Shailendra advises that the moment you suspect there’s something amiss with your ears, nose or throat, you should visit an ENT specialist. This will prevent the problem from festering. Catching any problem early will also ensure that proper treatment can be administered. If you’re thinking of seeing an ENT specialist, Dr. Shailendra suggests that you prepare for your appointment, by bringing along any previous test results and scans as well as your previously prescribed medications. This is so that the specialist is able to see the whole picture and suggest an appropriate course of treatment.

What is ototoxicity?

Ototoxicity results in hearing loss and can be caused by certain prescription and over-the-counter medicine. These include medicine used to treat serious infections, cancer, and heart disease. Sometimes, the effects of the drugs such as hearing and balance problems caused by the consumption of these drugs can be reversed when the drug therapy is stopped. However, the damage can also be permanent.

Drugs known to cause permanent damage to your hearing include aminoglycoside antibiotics like gentamicin (used to treat bacterial infections) and cancer chemotherapy drugs such as cisplatin and carboplatin. If it is deemed necessary for you to undergo treatment with ototoxic medication, make sure that your doctor monitors your balance and hearing before and during treatment. This will track whether there is a decline in your hearing so steps can be taken by an audiologist, who is trained to diagnose, manage and/or treat hearing, tinnitus or balance problems, to manage the effects.


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