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You have probably heard of general internist, general practice doctors and maybe even a gerontologist (one who specializes in the care of the older patient).
Someday, there will be a full-fledged specialty called geriatric otolaryngology — the specialty of caring for the ear, nose and throat problems of the older patient.
At the time of this dictation, there are probably 7,000 general practices or internists who specialize in geriatric medicine, but probably only a handful of ear, nose and throat doctors who focus on this problem.
This is certainly not enough to take care of the 80 million baby boomers who will be turning 65 or older through the next few years.
Twenty or 30 years ago, there were a few ear, nose and throat doctors who decided this was an up-and-coming specialty. As a result of their pioneer work and interest in this field, young ENT residents are getting more training for the aging ENT patient.
This is particularly true if one’s practice is in a retirement area, like Florida.
It would make sense that a specialist who is treating an 80- or 90-year-old should be well versed on what goes wrong with 80- or 90-year-old patients, ENT and otherwise. Just as there are problems and diseases that are common to pediatric patients, there are some that are very common to older folks, and the ENT doctor needs to incorporate this thinking.
Geriatric-related problems that the ENT doctor will typically see include the most common issue of hearing and hearing loss issues, but also we see a great deal of balance disorders and dizziness. Impairment of sense of smell and taste is commonly seen as well as swallowing disorders that are related to many different causes, including stroke.
Diseases and problems in the older patient are quite challenging for the primary care doctors and equally, if not more complicated for specialists who are trying to focus on a particular disease process such as cancer in the head and neck area while trying to balance the problems of what we call co-morbidities.
Co-morbidities are problems that include obesity, blood pressure problems, diabetes, heart disease, dementia, just to name a few. They can complicate the medical and surgical treatment of the primary problem which the ear, nose and throat doctor is seeing the patient for.
To treat the “whole patient,” the ENT doctor must understand the unique qualities and problems associated with the older ear, nose and throat patient, but also must work in partnership with the primary care physicians who are much more familiar with the patient and together come up with the best treatment course for the patient, taking in to account not only longevity but quality of life.
I am thankful for the pioneers of 20 or 30 years ago who thought about the importance of geriatric otolaryngology. As a result of their efforts and continuing strides in training programs and medical schools, we are able to utilize the disseminated information and knowledge that will help us treat the older ENT patient.
Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.