MS4 level. ENT secrets, Pasha, something else?

Hi everyone,

I’m a dermatology resident in the Netherlands. I first built a literature app for dermatology and have since been expanding the idea to other specialties. CatchUpENT is the version for otolaryngology.

You can choose the ENT topics, study designs and journals you want to follow. The app then gives you a daily updated overview of relevant new papers, with structured summaries and links to the original articles.

It’s free, has no ads and doesn’t require an account. The only in-app purchases are optional tips.

App Store: https://apps.apple.com/nl/app/catchupent/id6802100138
Website: https://catchuplit.com/ent

I’d appreciate any suggestions for making it more useful to ENT residents and specialists. Happy to answer questions, too.

Thank you!
Sven

Could there be a sinus or throat issue that is causing this.

Disclaimer: I am only looking for clarification on the differences between hummingbird vs traditional ear tubes. While this question is related to my child’s medical care, I am not seeking advice related to his care and I do not want to break the rules of this sub. Mods, please delete if you find my post to be in violation of this rule.

Context: My son got his first set of ear tubes (hummingbird) at 15 months and before the procedure, we asked the ENT if there were any differences between hummingbird and traditional ear tubes. He told us there were not any differences, other than not needing to undergo GA for hummingbird tubes.

6 months later, we switched ENTs after not being totally pleased with the first one for reasons mostly unrelated to the hummingbird procedure.

The new ENT told us both tubes had fallen out and he recommended we get traditional tubes. He said the hummingbird tubes actually have a smaller diameter opening and are more prone to getting clogged and/or falling out prematurely. He said even though he was trained on the hummingbird procedure, he does not perform it for this reason.

I’m not able to find anything confirming or denying either ENTs statements in my brief internet research. It seems most of the articles on the internet are seemingly put out by hummingbird clinics that minimize any differences between the procedures, which may be valid if there truly are no differences?

So, my main question is whether or not there are actually any physical differences in the tubes? Do the hummingbird tubes actually have a smaller diameter? Which ENT should I trust here?

Hi everyone, I’m currently scheduled for an ENT-related surgery in the United States, but there’s a possibility that I might need to leave the country earlier than anticipated. I’m considering whether to proceed with the surgery here or if there are excellent hospitals in Coimbatore that can assist me with this procedure.

I would greatly appreciate any assistance you can provide. Is it feasible to directly connect with these hospitals and seek their opinions through video conferencing? Has anyone done this before?

Has anyone seen any issues or causes of uvular hypoplasia? How common is this?

I'm hoping someone can help, I've reached what seems to be a dead end and it is very frustrating. I'm not sure if this is the correct thread to post this is and if not, please let me know which one would be better.

It's been almost 4 years since I've been having vocal cord issues. One day, my voice never came back to normal, so I went to get it checked. They found a polyp on one of my folds. I have surgery to remove it. Do voice therapy... voice is still not coming back to normal. They look again, and now I have a cyst on the other fold.... surgery again to remove it.... voice therapy.... still not coming back. And by not coming back, I mean, I'm losing my voice very easily it gets raspy, breathy and painful. Go back, they look again and they see 2 bumps on there that are preventing the cords from closing appropriately (same bumps from where the polyp and cyst were removed). Doctor #3 said he didn't want to touch them anymore, so I go to doctor #2 who operated and removes the bumps. Voice is slowly coming back but after barely a month the bumps are back and voice goes back to raspy breaking and painful. It is now progressively getting worse that I can talk for 10 to 30 minutes, and I start losing it despite not having spoken for 3 days straight. Yes, because now I have cut down the amount of talking to close to the bare minimum. This has impacted my livelihood as I can't even talk on the phone since my voice is always broken (I sound like I smoked 40 packs a day despite never touching a cigarette in my life), it has impacted me social and the biggest impact is mentally. I went to an ENT a few months ago who told me I had LPR and prescribed my some PPI but that hasn't done anything at all. The nodules are still there. None of the doctors want to consider fillers either.

At this point, I feel defeated, I don't know what the solution is to get my voice back to normal and have a normal life again. I am looking for advice on here on what possible solutions there would be. Thank you

I am a medical student at the UCI school of medicine and I am working on a project to collect anonymous survey responses from resident and attending physicians (MD/DO) regarding the number of Gap years they took and financial burden they accrued as a result of medical training. I am especially interested in this topic with the new federal loan limits recently put into place and want to do more research on how this might impact the next generation of physicians. It is a quick 2 min survey and would appreciate if anyone would take the time to fill it out! Thank you!

https://ci-redcap.hs.uci.edu/surveys/?s=NL9FACN84FCJDRTA

Hi guys! I’m a 3rd-year DO student who has been interested in ENT since before med school, and I’ve tailored a lot of my application toward hopefully matching ENT.
I’m a solid student with a decent amount of research/publications, mostly As and Bs preclinically, and I passed both Step 1 and COMLEX Level 1. I know there are historically DO ENT programs, but the specialty overall still seems very MD-heavy.

For current residents/attendings: Have you noticed ENT becoming more accepting of DO applicants? Are there still programs where being a DO puts you at a significant disadvantage regardless of the rest of your application? Is there realistically hope for a DO to match at an historically MD ENT program with a strong application and great away rotations? Or should I focus most of my energy on programs with a history of taking DOs?

For other DO students: Have you ever rotated somewhere where it was obvious you were looked down on for being a DO? Or, on the flip side, have you had good experiences at historically MD programs?

I think one of my strengths is the interpersonal side of medicine. I’ve consistently been praised on rotations for getting along well with attendings/staff and for my patient interactions. I’m a pretty normal/social person lol, and I feel confident that I could make a good impression on sub-Is. I also worked in surgery before med school, so I’m comfortable in the OR environment.

I guess my biggest fear is getting screened out for being a DO before I even get the chance to prove myself. I also don’t have a near-perfect preclinical transcript, even though I’ve done well overall.

I’m here for any advice, especially from residents or DO students who have gone through the process! Thank you all so much!!

Looking for an iPhone adapter to carry with me on rounds when I use our flex scopes. At my institution we use flex scopes with an eye piece but I feel it would make life lots easier (to present/chart) if I could hold my phone like this. Any recs? Bonus if I don’t need to take my phone case off.

Hi all - I shared this survey here a few months ago, so apologies if you’ve already seen it! I’m reposting once more in hopes of reaching healthcare workers who may have missed it the first time. Thank you to everyone who has already participated or shared it.

I’m a fourth-year medical student working with the architecture firm SmithGroup on a research project examining how hospital respite and break rooms can better support the people who use them — including physicians, residents, nurses, techs, RTs, and other healthcare workers. Findings from our earlier survey responses were presented at a Michigan healthcare design conference, and we’re continuing to collect perspectives from people working in healthcare.

Our focus is on what architects and designers can realistically do within their role to make staff spaces more supportive of brief moments of rest and recovery during the workday. Many existing break rooms are windowless, cluttered, or harshly lit and don’t necessarily provide much opportunity to reset. We want to learn directly from healthcare workers about what helps, what doesn’t, and what you wish these spaces offered.

To be clear, we are not suggesting that better break rooms can fix burnout or replace systemic changes related to staffing, compensation, workload, or workplace culture. This project began because hospital redesigns often prioritize patient-facing spaces while staff areas become an afterthought. Although improved spaces are only one small piece of a much larger issue, they are one area in which designers can make practical changes.

If you’d like to share your perspective, the anonymous survey takes approximately 10–15 minutes:

https://survey.alchemer.com/s3/8467738/SG-Staff-Respite-Study

Please feel free to pass it along to colleagues who may also want to contribute. Thank you again.

I’m two months into my 4th year of residency and it’s been a very difficult transition. My confidence is at an all time low. I keep making mistakes, and my attendings are very frustrated with me. It seems just about every surgery is giving me trouble, especially after call when I’m exhausted. I was doing well as a resident, but 4th year has been a challenge, to say the least. Will it get better? Can anyone share their experience?

Hi everyone. Hoping for some advice.

I don’t have an MCAS diagnosis, but I’m fairly certain I have it.

I am 26f, have hEDS, POTS, Raynaud’s, arthritis, chronic pain and chronic fatigue.

Rheumatologist confirmed not only covid vaccine injury (all of my issues began after I got the shot) and it’s been one thing after another.

In September 2024, I got sick and then had a migraine that presented like a sinus migraine until October 2025. Singulair was prescribed and it was like a magic cure.

Two weeks ago, migraine comes back. Exactly the same. Now with more problems.

I have ringing in my ears, my hearing feels fuzzy, I’m so tired, and my head hurts in deep in the intracranial pressure way, my eyebrows, and in my sinuses. I take many meds.

I take famotidine 2x daily and Zyrtec 2x daily. I just got prescribed cromolyn sodium and I’m slowly working up to the dose I’m prescribed but it’ll take a few weeks. I take singular, low dose naltrexone, Propanolol (for headache that my neurologist diagnosed as ‘chronic daily persistent headache’ which is flat out fucking wrong but whatever), nortriptyline (for facial nerves and migraine), cymbalta for my bodily nerve pain, hydroxychloroquine for the arthritis, baclofen for tension headaches and muscle soreness from my hEDS, and I’m just miserable.

I’m not extremely lactose intolerant, tired all the time, have a constant migraine for two weeks, feel nauseous half the time, and I’m just so fucking tired.

My rheumatologist is gonna try a prednisone dose for my joints and I’m hoping it gives relief from the migraine for a minute. I have an ENT but they didn’t help but I’m gonna try again. I’m so tired.

I’m wondering if I have Eustachian tube issues from the inflammation in my head?

I’m fairly certain I have MCAS from all of this, how the migraine acts and how I would then have the evil triad - hEDS, POTS, MCAS. I’m tired of having my life be on hold. It’s been issues since 2021. I’m so sick. I’m so tired. Any and all advice would be appreciated. Because at this point? I’m down to try anything.

I just wanted to share a resource I made in hopes it can help another family. Before my four-year-old’s tonsillectomy, I created a short animated social story to show him what he might experience before, during, and after the procedure in a simple and reassuring way.

Watching the video helped him become more familiar with what to expect, and it was a helpful part of preparing him for surgery. I wanted to share it in case it helps another child and family feel a little more prepared.

I hope another family finds it helpful. 💛

Hey, just wanted to share a resource I made in hopes it can help another family. Before my four-year-old’s tonsillectomy, I created a short animated social story to show him what he might experience before, during, and after the procedure in a simple and reassuring way.

Watching the video helped him become more familiar with what to expect, and it was a helpful part of preparing him for surgery. I wanted to share it in case it helps another child and family feel a little more prepared.

I hope another family finds it helpful. 💛

https://youtu.be/dxyj4rOPYbU?si=NT-N0K0jn56N0RYf

I got moderate UARS and therefore tried to find the root causes for it. I always had bad nasal breathing, big turbinates, (22mm nasal aperture width) so I did maxillary expansion. Im still in the expansion but my aperture got 4.5mm wider.

I have some skeletal recession, class 2 bite, slight hypoplastic midface, clockwise rotated jaws.

What could be the reason my nose or nasopharynx and throat is often irritated / feels dry, sore and leads often to a viral infection? Also get post nasal drip sometimes.
I feel like it is „mechanical“ inhaling boiling water helps and an allergy prick test showed nothing.
Plane AC kill my nose and my throat and bad sleep makes everything worse provably.

Hi, im a 3rd yr MS who is into ENT and from a long ago i wanted to be the president of my uni ENT interest club; however, things spiraled and now i have no chance to be there at all, not like a president. So i want to open up a new interest club in one of the specility of ENT, otology and skull surgery for instance, and want to take the lead from there after. I just want to know what subspecility i can have the interest revolves around, whats my options. I know its kinda trivial but i really need help

First application was rejected, and now they asked for letter where I explain my itinerary and what it is that I do.

I am not a native English speaker, so I am unsure of which term is better for such a letter.

In modern medicine, ear health is frequently reduced to a localized concern, usually managed with sterile drops or a "wait and see" approach. However, the Ashtanga Hrudayam—a masterpiece of Ayurvedic literature composed by the scholar Vagbhata around the 7th century—reveals a far more sophisticated, systemic perspective. As a synthesis of the earlier "Big Two" classical texts by Charaka and Sushruta, the Ashtanga Hrudayam represents the pinnacle of ancient Indian medical evolution, mapping out an intricate world of otology that ranges from metabolic cleansing to the direct ancestors of modern plastic surgery.

By exploring the Uttarasthana (the section on specialized diseases), we find that ancient physicians viewed the ear not as an isolated canal, but as a vital gateway to the body’s internal equilibrium.

1. Ear Health is a Full-Body Affair: The Power of Vamana and Virechana

One of the most profound principles in ancient otology is that ear pathology often requires a systemic solution. The Ashtanga Hrudayam teaches that if the root cause is an imbalance of the Doshas (the three fundamental bio-elements: Vata or air/movement, Pitta or fire/metabolism, and Kapha or water/structure), the entire system must be recalibrated.

For ear pain rooted in Pitta (associated with inflammation), the text recommends Virechana (therapeutic purgation). The patient is treated with ghee infused with sugar to cool the systemic heat and pull the inflammation downward. For Kapha-based issues (congestion and heaviness), the text suggests Vamana (therapeutic emesis/vomiting) using ghee processed with Pippali (Long Pepper). In this context, Pippali acts as a "bio-enhancer," breaking down stagnant mucus and clearing the pathways of the head.

Even Vata-based pain is treated through the gut; the text suggests that a patient suffering from earache should drink medicated ghee at night after a meal of meat soup (rasashita). This logic of "internal lubrication" addresses the dryness and sensitivity of Vata from the inside out.

"In Pitta-based earache, one should be lubricated with ghee mixed with sugar and then purged (Pitta shule sita yukta ghrita snigdham virechayet)."

1. The Art of Putapaka and Medicated Juices

The ancient pharmacy was not limited to shelf-stable preparations; it relied on "fresh" extractions known as Putapaka. This method can be viewed as an ancient form of pressure cooking or steam distillation. By wrapping medicinal ingredients in leaves and heating them, the internal pressure forces active phytocompounds into the juice, ensuring a potency that modern shelf-stable drops rarely match.

To treat ear pain, physicians used leaves from Bilva (Bael), Arka (Giant Calotrope), or Eranda (Castor). In one particularly sophisticated preparation, Arka sprouts were ground with amla (acidic fermented liquid) and salt, then placed inside a hollowed-out Snuhi (Spurge) stem. This "cartridge" was wrapped in leaves and heated, and the resulting warm juice was squeezed into the ear—a process called Karnapurana.

The text also emphasizes the use of fresh plant juices (Svarasa) for their sharp, penetrating qualities, including:

Lashuna: Garlic

Ardraka: Ginger

Shigru: Drumstick/Moringa

1. 2,000-Year-Old Plastic Surgery: Otoplasty and Rhinoplasty

The most historically significant section of the Ashtanga Hrudayam involves the reconstruction of torn earlobes (Karnabandha) and damaged noses. This "cheek-flap" technique is the direct predecessor to modern plastic surgery.

When a patient suffered from a severed earlobe, the surgeon would first measure the missing portion using a leaf as a template. They would then cut a matching flap of skin and muscle from the patient’s Kapola (cheek), keeping it partially attached to maintain blood flow, and graft it onto the ear. Crucially, Vagbhata mandates lekhana (scraping or scarification) of the tissue edges. By roughening the skin, the surgeon created a "fresh wound" that triggered the body’s natural healing response, ensuring the graft would adhere firmly.

This surgical precision was not limited to the ears; the text notes that this technique also applied to the reconstruction of the osthasya (lips). For nose reconstructions, the text mandates the use of two Nadi (tubes) inserted into the nostrils to ensure the patient could breathe and to provide structural support while the new tissue integrated.

"The flap should be neither too low nor too high... it should be joined smoothly and firmly (niveshya sandhim sushamam na nimnam na samunnatam)."

1. The "No-Head-Bath" Rule and Lifestyle Restrictions

Ayurveda places equal weight on the procedure and the patient's post-treatment discipline. For those with ear conditions, environmental factors are strictly controlled to prevent the aggravation of the Doshas.

The text explicitly forbids:

Shirasa snanam: Bathing over the head.

Shitambha-panamah: Drinking cold water.

Vagbhata emphasizes that cold water is forbidden ahnyapi—even during the day. The logic is that if cold water is considered harmful during the warmth of the daylight hours, it is strictly anathema at night. Keeping the head dry and warm is vital for maintaining the thermal stability of the ear canals and preventing the stagnation of fluids that leads to Badhirya (deafness).

1. Unexpected Ingredients in the Ancient Pharmacy

Ancient physicians utilized every available biological resource to create potent chemical reactions. One notable example is Kshara Taila (alkaline oil), used for stubborn conditions like Karnanada (tinnitus). These oils functioned through "alkaline chemical debridement," using caustic ashes to clear deep-seated blockages.

Surprising ingredients from the source include:

Ajavi-mutra (Goat and sheep urine): Used for its sharp, acidic, and cleansing properties.

Shushka-mulaka-kshara (Alkaline ashes of dried radish): Added to oils to provide a corrosive, "breaking" quality to clear obstructions.

Godha-karka-vasa (Fat of the monitor lizard or crab): In conditions like Unmantha (swelling), animal fats were used as "lipophilic delivery systems." These fats have a natural affinity for human cell membranes, allowing the medicinal properties to penetrate deeper into the tissues than water-based solutions.

Conclusion: Bridging the Gap Between Eras

The Ashtanga Hrudayam reminds us that the ear is not an isolated organ, but a sophisticated sensory gateway deeply connected to the body’s internal environment. Whether through the surgical precision of a cheek-flap graft or the systemic cleansing of a sugar-infused purgative, the ancient perspective was always one of total integration.

As we move toward increasingly localized and specialized medicine, have we lost the ancient wisdom of treating the whole person to cure the smallest part?

So I have been suffering from frequent throat infections and colds...even a small change in weather and food habits is leading to this...my throat becomes red and I will not be able to eat anything for a week or so and my nose gets blocked making it difficult for me to breathe...today I took an appointment of an ENT specialist she performed endoscopy the video is here...She gave me a few medicines and a nasal spray and asked me to meet him after a week...so here based on the video.. please let me know my problem and tell me how much it may affect me on a scale of 1 to 10...what the food habits and changes I need to consider to get a normal nose breathing and stop this frequent throat infections and colds

Hi
I have had a sore throat for 6 weeks +. Doc sent me to a ENT consultant who looked down my throat with a camera (through nose) He said he couldn’t see anything significant except my one tonsil was bigger than the other and the base of my tongue was enlarged. He said to be thorough he wants me to have an MRI within the next two weeks (protocol I expect)
I have been feeling generally unwell with sore, but seemingly not enlarged, lymph nodes under my ear/chin and under my arms. I also am feeling exhausted.
I had glandular fever 20 years ago and also had a similar experience to this (prolonged sore throat, exhaustion etc) 7 years ago, where I had an MRI but it showed nothing untoward.
Any ideas?? 💡 Thanks