These doctors, formally called otolaryngologists, treat conditions involving the ears, nose, throat, and much of the head and neck. That includes problems affecting your hearing, swallowing, breathing, and voice—and some that require urgent care. “A lot of people will think, ‘Oh yeah, there’s no emergencies at ENT,’ and there absolutely are,” says Dr. Ryan Salvador, an ENT surgeon at Sinus & Snoring Specialists in Austin.
You answer your phone and realize you can barely hear your friend’s voice out of your left ear. Switch to your right side, and everything sounds normal. It’s tempting to assume the muffled ear needs to pop, Salvador says. But an abrupt change in hearing can be a medical emergency.
An ENT can examine the ear and arrange a hearing test to find out what’s causing the loss. If it is sudden sensorineural hearing loss, steroids may help—but, as Salvador puts it, “the earlier the better.” Seek medical care immediately if you suddenly lose hearing, even if your ear just feels full or you’ve recently had a cold.
A neck lump that doesn’t hurt
Dr. Arnbjorn Toset, the director of head and neck surgery at Good Samaritan University Hospital and Catholic Health in New York, hears that reasoning from patients: “Doctor, it’s not hurting me. I don’t have any symptoms.” But pain isn’t a reliable way to judge a neck lump. It might be an enlarged lymph node, a thyroid nodule, or a growth in a salivary gland. But some lumps are cancerous.
A sore throat is hardly unusual. One that progresses from “this hurts” to “I can barely swallow” is another matter. Salvador pays particular attention when the pain keeps worsening and you’re also having trouble opening your mouth or your voice sounds muffled. “You talk like you’ve got a hot potato in your mouth,” he says.
Your partner says you stop breathing at night
Your partner hears you snoring. Then, suddenly, nothing. After a pause, you gasp and start breathing again. By morning, you may have no idea it happened.
Tell your doctor about the pauses, gasping, and any daytime sleepiness. A sleep study can show whether apnea is the cause. As Desai puts it, “Apnea is the bigger question, and that can be dangerous if not treated.”
“The only thing that separates the sinus cavity from the eye is a very thin plate of bone,” he says. Rarely, an infection spreads into the tissues around the eye. Salvador has treated patients whose infections formed pockets of pus that had to be drained to protect their vision.
Swelling under your jaw when you eat
Halfway through a meal, you notice a tender bump beneath your jaw. It settles down later—then returns the next time you eat.
If it keeps happening, have it examined. Toset says the cause is often benign, but an exam and sometimes imaging can distinguish a stone from another problem with the gland. If the swelling keeps returning, have the gland checked—even if it goes down between meals
Salvador remembers a teacher who was struggling to speak loudly enough for her class. “I can’t project,” she told him. When he examined her, he discovered that one of her vocal cords wasn’t moving properly because of a thyroid tumor. Persistent hoarseness can have other explanations, including irritation or a benign growth, but an ENT needs to look to find out.
Dentures that suddenly don’t fit comfortably
Your dentures fit fine last month. Now they rub the same spot every time you put them in, or they don’t sit quite right. You might need an adjustment—or someone to look at what’s going on underneath.
Ask your dentist to examine the tissue beneath the denture, especially if a sore hasn’t healed after two weeks. They can check what’s changed before adjusting the fit.
If your nose starts bleeding, lean forward and pinch its soft part with steady pressure for 15 minutes. If the bleeding is heavy or won’t stop, or you feel weak or lightheaded, seek emergency care.
Ear pain when nothing seems wrong
Your ear hurts, so you probably have an ear infection, right? Not necessarily. Sometimes an examination turns up nothing wrong with the ear itself. Nerves in the head and neck carry a signal from somewhere else, and sometimes, “your brain is tricking you” about where it started, Toset says.
Colds and allergies can make your whole nose miserable. A blockage that sticks around on just one side gets Desai’s attention. “When you can’t breathe out of one nostril, it’s always a little more concerning,” he says.
A sore on your tongue that won’t heal
Most small mouth sores clear up within a week or two. Toset is more concerned about one that stays put, grows, or becomes increasingly painful—particularly on the side of the tongue.
“I had a biopsy. Biopsy was negative, so I left it alone,” Toset recalls her telling him. He examined the sore and grew concerned. “I had to break it to her,” he says: “I think you have tongue cancer.” Another biopsy confirmed it; the swelling in her neck was where the cancer had spread.
“I’d rather see someone early on in the process where I can pick up on something that is possibly benign or an early type of cancer,” Toset says, than see them after a delay that makes treatment more difficult.
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