Core Curriculum Syllabus: Introduction to Otolaryngology - Head and Neck Surgery
Otolaryngology is a regional specialty, involving both medical and surgical management of problems in the head and neck. The American Board of Otolaryngology was formed in 1924 and is the second oldest surgical specialty in this country.
The term otorhinolaryngology is derived from the Greek words for ear, nose and larynx, and the abbreviated term "ENT" has been commonly used for many years. This appellation does not fully reflect the scope of a discipline which is concerned with disorders of the face, the ears, the oral cavity and pharynx, the upper respiratory tract, the neck, and even certain intracranial tumors. For this reason, "Head and Neck Surgery" was added to the official title.
Prior to the advent of sulfa drugs and penicillin, the otolaryngologist spent the bulk of his time treating suppurative conditions. Progress in surgery for deafness and disorders of the upper aerodigestive tract was limited by the high risk and grave consequences of secondary infections. The use of antibiotics greatly improved the safety and success rate of reconstructive surgery in these inherently contaminated spaces. Since the 1950's, significant advances have been made in the ability to restore function and aesthetic appearance to head and neck structures.
Post-graduate training in otolaryngology consists of five or six years of residency, sometimes followed by one or two years of fellowship. The first year or two are spent in general surgery, with the remaining residency time devoted to otolaryngology. Basic training includes otology, rhinology, laryngology, bronchoesophagology, head and neck oncology, facial plastic surgery, and allergy. Fellowship training can provide additional experience in one of the subspecialty areas.
Teaching of otolaryngology at the medical student level has two primary goals. The first is to ensure that all medical school graduates have a firm grasp of basic principles related to the specialty: the recognition and treatment of common disorders of the head and neck, the initial management of head and neck emergencies, and indications for specialist referral. Physicians engaged in primary care encounter a large number of head and neck problems. The second goal is to provide sufficient exposure to the specialty to assist in informed career planning. The basic two-week rotation through this service includes didactic lectures to provide essential factual information, and clinical assignments to provide practical experience.
This syllabus is intended to be a study guide, outlining information with which we feel all medical graduates should be familiar. For a more thorough discussion of selected topics, please refer to the reading list.