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Our otolaryngologists can treat the full range of ear, nose and throat illnesses. Whether you have swimmers ear, a sore throat, trouble swallowing or hearing loss, our physicians will work with you to achieve your optimal health. Below is included a brief discussion of common ENT problems and how they are approached in our office. All evaluations begin with full discussion of history of the illness, consideration of pertinent past medical history and appropriate medical examination. We also work closely with your primary care provider to coordinate your care. Our office is fully computerized with a high quality Electronic medical record system. This system allows access to medical information from the Lifespan network of hospitals (Rhode Island Hospital, Newport Hospital, Miriam Hospital, Bradley Hospital). Prescriptions are filled electronically and sophisticated methods are available to track ordered tests and best care paradigms.

  • Hearing loss: otomicroscopy (exam of the ear with an operating ear microscope) is a standard part of the evaluation. A complete audiological analysis can be performed for children and adults.Hearing evaluations are performed in a soundproof booth. Hearing status can assessed with standard behavioral audiometry, tympanometry, otoacoustic emission test (especially helpful in children) and brainstem evoked response audiometry (useful to assess site of origin the hearing loss). These tests are performed by licensed audiologists. All treatment of hearing loss, including medication, surgery and amplification (hearing aids) are presented to the patient. Our audiologists, through the Aquidneck Hearing Center, can determine if new, technologically advanced hearing instruments can be helpful options.
  • Tinnitus: tinnitus (ringing/noise in the ear) evaluation involves a full ear and audiological assessment. Treatment options (medication, counseling, hearing aids) are discussed with the patient.
  • Dizziness: thorough understanding of the history of the process is often the most critical factor in diagnosing causes of dizziness. Otomicroscopy as well as a full ENT and neurological exam are performed. More advanced evaluation includes audiological testing, videonystagmography (computerized video analysis of eye movements that reflects inner ear function) and radiological evaluation (CT scan, MRI). Therapy options are chosen based on the source of the balance disorder and can include medication, dietary changes, exercises, positioning maneuvers and Physical Therapy.
  • Ear infections: treatment of outer ear infections involves assessment of ear canal skin condition. Meticulous ear cleaning using the otomicroscope as well possible application of topical medication can be performed in the office. Middle ear infections, especially common in children, are treated with antibiotics if appropriate. Surgical therapy (ear tubes, adenoidectomy, adenotonsillectomy) is discussed for patients with recurrent or persistent ear infections. Inner ear infections need thorough evaluation to determine best course of therapy.
  • Sinus/nasal disease: consideration of medical disease, including allergies, is an important first step. Nasal examination is performed including nasal decongestant sprays to improve visualization of the nose. Endoscopy of the nose (using telescopes to examine the deeper aspects of the nose) is often performed to better evaluate the situation. Xray evaluation (plain sinus films, CT scan or MRI) may be ordered to assess presence of sinus disease. Allergy evaluation may be ordered as well. Various forms of medical therapy (nasal rinse, steroid nasal sprays, antihistamine/decongestants, antibiotics) as well as surgery may be recommended to control nasal/sinus problems.
  • Facial rejuvenation: analysis of patient concerns about facial wrinkles, loss of facial volume is undertaken. The options, including botox and facial fillers, to ameliorate the effects of aging on the face are offered to the patient.
  • Snoring/sleep apnea: these represent a continuum of a disease process from simple snoring to sleep disordered breathing including sleep apnea. Assessment of degree of degree of daytime fatigue can be calculated with the Epworth sleepiness scale. Full upper airway evaluation is performed including facial/skeletal exam, tongue size/position and endoscopic exam of the throat. Additional studies may be ordered including cephalometric xrays, dental evaluation, dietary consultation and fully monitored sleep study. The full range of treatment options (dietary intervention, exercise, positioning maneuvers, dental appliance, breathing machines, surgery) are reviewed with the patient to help them arrive at a decision for treatment.
  • Thyroid disorders: thyroid disorders (nodules, goiter) are undertaken in collaboration with the primary care physician. Ultrasound examination is an important aspect of the assessment. Fine needle aspiration of thyroid masses may be performed in the office or under ultrasound guidance.
  • Head and Neck cancer: office evaluation will involve complete ENT exam as well as possible directed biopsy of accessible lesions including fine needle aspiration. XRay evaluation may include CT scan, MRI or PET/CT scan. Close collaboration with oncologist and radiation therapists is undertaken for patients with cancer of the Head and Neck.
  • Sore throat: analysis of the many sources of throat irritation is performed (environmental factors, allergies, acid reflux, voice abuse, medication use, smoking, recurrent infections). Depending on the cause of the problem, further evaluation can include laboratory blood tests, throat culture, Xrays (CTscan, sinus films, barium swallow). For patients with recurrent throat infections, consideration of adenotonsillectomy is an option.
  • Nosebleeds: nasal examination will be performed to ascertain possible bleeding sites as well as whether any medical issues are involved (medications, bleeding disorders, illnesses). Options for care including humidification, packing, cautery (chemical or electrical) and/or control of medical issues are discussed with the patient.
  • Smell and taste disorders: evaluation with nasal endoscopy is often performed in the office. The 40 item forced choice smell identification test is used to determine the degree of smell impairment. Xray evaluation including CT scan and/or MRI of the head is often performed.
  • Nasal fractures: nasal injuries are evaluated. Surgical treatment of an out of position nose post injury can be performed in the office under local anesthesia or in the operating room under general anesthesia depending on the clinical situation.
  • Voice disorders: medical illness (asthma, acid reflux, thyroid disease, neurological disorders) and medication use are important factors in voice disorders. Evaluation of the patients habits (hydration, caffeine intake, alcohol use, smoking) and vocal hygiene (singing patterns, history of vocal abuse) are analyzed. Sophisticated methods are available in the office to visualize the larynx including rigid/flexible laryngoscopy (fiberoptic telescope used to visualize the vocal cords) and videostroboscopy (high speed video analysis of vocal cord motion to detect subtle pathology). Referral to a speech therapist can be appropriate.
  • Swallowing disorders: upper airway assessment is undertaken after consideration of medical and neurogical disease as it affects swallowing. Upper airway endoscopy may be performed in the office including flexible laryngoscopy and videostroboscopy. Radiological evaluation may be obtained such as barium swallow, video swallow and thyroid ultrasound. Referral to a speech therapist may be ordered to help treat swallowing issues.