The anatomical area of the head and neck is extremely complex and there is hardly a medical specialty that is not at least partially responsible here. Neurology and neurosurgery are responsible for the brain in very different ways, ophthalmology for the sense of sight. But endocrinology, spinal surgery, cosmetic plastic surgery and angiology also have their competences in the head and neck area. And even urology used to be present here, when interventions on the parathyroid gland were still performed by urologists.

But the lion's share is probably claimed by ENT doctors, in that they are responsible not only for the sensory organs but also for infectious and other diseases of the upper respiratory tract and the upper digestive tract. The ENT doctor is therefore typically the first point of contact, quasi the general practitioner, for problems in the head and neck region, then triages the patients if necessary and ensures transparent consultative cooperation among the specialties.

In the head and neck area, problems often focus on deeper organs and only become manifest here. It is no coincidence that the general practitioner's rule of thumb used to be that the tongue is the mirror of the stomach. Another example is the lymphatic system, which is responsible for the removal of harmful substances and is easily accessible for examination, especially in the head and neck area. Examinations of the lymph nodes located here allow conclusions to be drawn about deeper hidden processes.

Conversely, the lymphatic system in the throat and larynx forms a barrier against penetrating harmful substances. In this area, the air and food pathways cross and even before that is the lymphatic pharyngeal ring consisting of the various tonsils, which as the spearhead of the immune system intercepts intruders from both pathways. A pollutant overload of this protective gate can be one of the reasons for the removal of the tonsils, the tonsillectomy.

The intersection of the air and food pathways exists in all vertebrates and its structure allows conclusions to be drawn about hunting and feeding behaviour in prehistoric skull finds. It is a significant difference and an evolutionary advantage whether one only has to hold one's breath briefly when swallowing, or cannot breathe during the entire chewing process. The same applies to the presence of vocal cords and thus the possibility of acoustic communication, which, depending on the source, first became possible in terrestrial vertebrates 100-200 million years ago. The paths between the ear and the nose also cross. The connection is a thin tube, named after Bartolomeo Eustachi, who was the first to recognise its true function in 1562. Today, its name is most familiar to divers.

Due to its location and as a frequent first examiner, the ENT doctor is also responsible for the thyroid gland, especially since the thyroid gland is very superficial and ultrasound and laboratory are always at hand in every ENT practice. The thyroid hormones regulate the protein, fat and carbohydrate metabolism, which makes it a typical candidate for interdisciplinary treatment.

Anatomically a circumscribed region. A gigantic and complex field when it comes to its importance in the midst of human medicine.

Your ENT doctor.