Otolaryngologists, specialists who treat the head and neck, including the ears, nose and throat, help their patients experience some of the most important things in life, says UCLA Health’s Maie St. John, MD, PhD.
Dr. St. John, professor and chair of the Department of Head and Neck Surgery at the David Geffen School of Medicine at UCLA, said that can mean the ability to hear, kiss a loved one or enjoy socializing at meals with friends and family.
Dr. St. John, a member of the UCLA Health Jonsson Comprehensive Cancer Center, answered questions about the ways UCLA Health otolaryngologists care for a wide spectrum of patients.
Q: What does an otolaryngologist do?
Dr. St. John: The specialty covers everything from what we call the dura, the lining of the brain, to the pleura, which is the lining of the lungs. We operate in very specific and sensitive areas that define one’s specific defining features, such as how we look, listen and speak.
We have several subspecialties:
Rhinology and skull-base surgery involves patients who have disease of the sinuses, whether benign or malignant. Our interventions can help people breathe better. Our specialists also treat and resect tumors in sinuses or under the eyes. (The skull base sits at the bottom of the cranial cavity, separating the brain from other facial structures such as the nose, ears and eyes.)
Pediatric otolaryngology involves all diseases of the ear nose and throat in children. This includes complex pediatric airway surgery, surgeries that can help children hear, treatments of congenital lesions, as well as tonsillectomies and adenoid surgery and placement of pressure equalization tubes in the ears.
Laryngologists are specialists in disorders of the airways, voice and swallow function. People can have tumors or benign conditions that can affect how air flows from behind their nose to their trachea. We have specialists that deal with professional vocalists and the health of their voice.
My subspecialty is head and neck cancer. Our team treats people with benign and malignant growths, including of the salivary glands, lips, tonsils, throat, floor of the mouth, and endocrine disorders including thyroid and parathyroid surgery.
Otology/neurotology specialists manage disorders related to hearing, balance and tumors of the skull base. We are very fortunate to have specialists here at UCLA that are helping create and design the next generation of cochlear implants. It’s really exciting to see a young child turn on their implant and experience sound for the first time. (A surgically installed cochlear implant receives sounds from an externally worn transmitter.)
Q: How can patients determine whether they might need to see a specialist in head and neck?
Dr. St. John: Generally, when patients have an initial symptom of something that doesn’t feel right, they often proceed to their primary care physician or their dentists. If they have any symptom in their face, throat or neck areas, they should bring that to their primary care specialist and get referred to an otolaryngologist as indicated.
Q: How much additional training does a head and neck surgeon receive?
Dr. St. John: Otolaryngology and head and neck surgery is considered a very competitive field. It’s a pretty small specialty but if we look at the credentials of applicants to Otolaryngology-Head and Neck surgery residency programs, the average candidate already has 12 publications.
It’s four years of medical school, then residency for five years. The first year is general surgery and ICU rotations. When a trainee chooses to subspecialize, it’s one to two years of fellowship beyond residency.
Q: How did you choose this field?
Dr. St. John: For me, my story really began when I was a preschool child. My grandfather was a doctor in a small town. He would take me with him when he saw patients. There was a woman with a very large growth on her face. He said it was cancer. Of course, at that age I had no idea what cancer was, but I knew I wanted to dedicate my life to helping patients with that condition.
I really like using my hands. I decided I wanted to combine surgery with cancer. When I found out there was this area to work in with such critical nerves that requires very delicate but precise surgeries, that really spoke to me. I wanted to be able to help patients undergo surgeries that would precisely remove their cancers and preserve as much as possible.
Q: What makes the UCLA Health Department of Head and Neck surgery so renowned?
Dr. St. John: I think that our ethos is if you take care of the patients, everything else takes care of itself. We are here to do everything we can for every patient and touch every life as if they were family.
We are doing research ourselves. We are not just waiting for others to pass on the information. We put patients at the center. When you deliver ethical, compassionate evidence-based care that you’re passionate about, it allows you and your team to provide the best care in the world.
