Extraordinary Care Begins here
ENT Partners of Texas Blog

ENT Partners of Texas Blog

A Quick Bit on Oral Cancer

Once a year, Dr Theilen and I participate in a Men’s Health Fair at Baylor Medical Center in Irving (Highway 183 and MacArthur). We typically will see between 100-200 men, screening them for any oral / head and neck cancer. I thought it might be instructive to go over some of the common signs and symptoms of oral head and neck cancer.

  • A lump or sore that does not heal
  • A sore throat that does not go away
  • Persistent swollen glands (lymph nodes) in the neck
  • A lump or mass in the neck
  • Difficulty swallowing (dysphagia)
  • Difficulty moving your jaw or tongue
  • A change or hoarseness in the voice
  • White or red patches on the gums, tongue, or lining of the mouth
  • Changes in denture fit
  • Unexplained facial pain or persistent pain in the ear
  • Loss of smell
  • A bloody nasal discharger or coughing up blood
  • Persistent nasal congestion that does not improve

Though these all may point to cancer, they also may be less serious conditions. A doctor or dentist should check any of these symptoms.

I recently spoke of actor Michael Douglas’ case of tongue cancer for Baylor which you can view by clicking here.

Comments ((Disabled)) | Trackbacks (0) | Permalink

ENT Goes By Another Name

Ear, Nose, and Throat (ENT) is officially known by its Latin name otolaryngology. This is pronounced “oh/toe/lair/in/goll/oh/jee”. An alternative pronunciation of otolaryngology is “ear/nose/and/throat”.
Otolaryngology is the oldest medical specialty in the United States. An otolaryngologist from Kansas in 1896 called the initial meeting that in 1903 became the American Academy of  Ophthalmology  Oto-Laryngology. (At this time, the scope of practice included the care of the eye – ophthalmology.) Committees were formed to improve graduate education of its members and the American Board of Ophthalmology was formed in 1913 and the American Board of Otolaryngology in 1924. Now, if a physician wished to practice this type of medicine, he had to pass tests these boards provided, and become “board certified”. In 1978, after years of preparatory discussions, the specialty split into The American Academy ofOtolaryngology and the American Academy of Ophthalmology. (Occasionally, an older patient will incorrectly still refer to me as an “eye, ear, nose and throat” doctor). In 1980, the Academy changed its name to the American Academy of Otolaryngology – Head and Neck Surgery.
One of the most appealing aspects of being an ENT surgeon is the privilege of being involved in the entire medical journey of our patients. We meet them. We diagnose them. We treat them medically if appropriate. The majority of cases are handled in this manner and hopefully, we are successful. Sometimes, the condition does not call for medical therapy or perhaps medical therapy has been ineffective. Then, we operate.
You see, many people do not understand that when you visit an ENT, you are seeing a surgeon. Like every other surgical specialty (orthopedic, neuro-, urology, etc.), after four years of college and four years of medical school, ENT’s  completed a general surgical internship in which we learned how to care for a wide variety of surgical ailments. We had our turn at appendectomies, removal of gallbladders, amputations, care of burn victims, repair of hernias, etc. These surgical internships usually last for one year. This was the case for my business partner Frank Theilen M.D., who completed his general surgery internship in Galveston, Texas. Mine, however, was for two years, spent in UT Southwestern in Dallas, Texas.
After one’s internship, the ENT surgeon spends four years learning his craft concentrating solely on medical and surgical treatment of all of the medical conditions affecting the head and neck minus the eyes, brain, and certain problems of the cervical spine. After successfully completing one’s residency, one takes the board exam in Chicago and awaits the results. If you pass, you can start to work as a board certified  ENT OR choose to study one to three additional years in one of the specialty’s fellowships such as facial plastics, ear, voice, allergy, pediatric ENT, sleep apnea, oncology / head and neck surgery, or rhinology / sinus.
So, just a short 9-12 years after college, you too can call yourself an ENT.
Comments ((Disabled)) | Trackbacks (0) | Permalink

A Famous Song About ENT

Today, I’d like to highlight one of the great Ear, Nose, and Throat songs of all time.
I first heard Lou Carter’s “If I had a Nose Full of Nickles” on a Saturday morning driving home from a night on call at Parkland Hospital in Dallas somewhere around 1989. It was playing on KPBC, an “oldies”station which at that time was found at 1040 on the AM dial. It would take me a long time before I was able to secure a copy of the song and now I have the chance to share it with you.

Louis Carter was a jazz pianist for many years He performed under the name of Lou Carter with several big bands, including Jimmy Dorsey and Glenn Gray. He also appeared on national television, including the Perry Como show as Louie the Cabbie.



Here is some information on the singer from his son:


I’m Lou Carter’s son and I’m delighted that people are still enjoying my father’s music. He did indeed make three “cabbie” albums: Louie’s Love Songs, Louie Writes Again, and How Deep is Which Ocean? During that time, he made several appearances on the Perry Como Show. We actually still have a couple of the original scripts.

He also co-wrote, with Johnny Frigo and Herb Ellis, the jazz standard, “Detour Ahead” and another song, “I Told You I Love You, Now Get Out.” The former was recorded by everyone from Billie Holiday to Bill Evans; the latter was sung by Cybill Sheperd in an old Moonlighting episode.

Shortly after the Como appearances, he settled down and began a successful career writing and producing radio jingles. He would spend part of the week in his New York office writing and arranging and the rest of the week in the studio producing, playing piano and singing on the commercials. On occasion, my brother and I would accompany him to the studio. We’d see a parade of A-list musicians and singers — such as Ron Carter and Marlene Ver Planck — come through the door.

Throughout the years, he also regularly played jazz piano at local venues and was very much in demand. He would often fulfill requests to do a “cabbie” tune or two. He continued to play professionally well into his 80s.

Despite his accomplishments, he was a very humble man who always maintained a great sense of humor. I remember once when he was probably about 84 years old, he returned from a gig for which the audience was made up of people bussed in from retirement homes. When I asked him how it went, he said, “I gotta tell you John, senior citizens are just the worst!”


Louis Carter died Sept. 25, 2005 in Mountainside Hospital, Glen Ridge, NJ at the age of 87.

Lou, here’s hoping you finally have that nose full of nickels you so long desired.

Comments ((Disabled)) | Trackbacks (0) | Permalink

A Day in the Life of an ENT

Today, I’m sitting down to establish a blog covering various aspects of the Ear, Nose, and Throat (ENT) medical / surgical specialty, both in general, and also from the perspective of the physicians in the ENT Partners of Texas practice. Note the modifier “medical / surgical”. There is probably no other specialty that requires the combined skill and knowledge of both aspects of medicine as much as ENT. It is estimated that 60% of the patients that enter a general practitioner’s office have complaints dealing with the head and neck. This makes our specialty very challenging, but also keeps it very interesting, for you never know what particular problem lies behind that next door.

I thought it might be illustrative to give you a typical list of patients I might see during a routine morning in the office and a typical day in the operating room.

Here’s a typical Monday morning in my practice:

  1. 14 yr old male (M), follow-up (f/u) from tonsillectomy and adenoidectomy I performed last week
  2. 45 yr old female (F) initial snoring evaluation
  3. 2 yr old F 2 weeks f/u placement of ear tubes for recurrent ear infections
  4. 11 yr old M with very painful otitis externa (swimmer’s ear) not better on antibiotics from primary care physician (PCP)
  5. 69 yr old F with tinnitus (ringing in the ears)
  6. 34 yr old F with a thyroid nodule
  7. 34 yr old F with obesity who is scheduled for bariatric surgery (obesity surgery) who needs a sleep study and evaluation to make certain she does not have sleep apnea.
  8. 5 yr old F for 5 minute, routine 6 month f/u after tubes placed 18 months ago.
  9. 11 yr old M needs wax cleaned from ears.
  10. 26 yr old F f/u of sinus surgery 3 weeks earlier
  11. 8 yr old M failed a hearing test at school
  12. 52 yr old M for monthly f/u (8 months) after surgical removal of tonsil cancer followed by radiation
  13. 58 yr old M to discuss upcoming surgery for sleep apnea
  14. 19 yr old F with recurrent sinus infections

Normally Tuesday is surgery day. A typical surgery day would consist of the following:

  1. 4 yr old tonsillectomy / adenoidectomy (T&A)
  2. 6 yr old T&A
  3. 19 yr old T&A
  4. 45 yr old sinus surgery
  5. 52 yr old removal of small tongue cancer
  6. 54 yr old thyroidectomy with central neck dissection for cancer

As you can see, things are never boring.

Comments ((Disabled)) | Trackbacks (0) | Permalink