What ENT disorders have physicians worried most? 2 ENTs share their concerns

The COVID-19 pandemic is the driver behind the ENT conditions that concern two physicians the most.

Here are the conditions they say they're most worried about in the next three years:

Note: Responses were lightly edited for style.

Charles Elmaraghy, MD. Chief of Pediatric Otolaryngology at Nationwide Children's Hospital (Columbus, Ohio): In pediatric ENT, masking and social distancing has made a significant difference in viral mediated diseases. The contribution of recurrent viral infections in recurrent ear infections, adenoid hypertrophy and chronic nasal congestion in children less than 4 has become more obvious as day cares and preschools have adapted to COVID-19 protocols.

Nicole Aaronson, MD. Pediatric Otolaryngologist at Alfred I. duPont Hospital (Wilmington, Del.): In pediatric ENT, I am most concerned about obstructive sleep apnea. While for many pediatric patients, obstructive sleep apnea is caused by enlarged tonsils and adenoids, there is a significant subset of patients who have small tonsils and adenoids but significant obesity. Obesity is an epidemic in the U.S., and for children who have been less active and struggled more with mental health during the pandemic, this problem has only worsened. I am concerned about a growth in frequency of this diagnosis due to an increase in obese children.

Among adults, I am still concerned about the high rates of head and neck cancer due to HPV. While treatments for this condition have markedly improved, rates of disease remain very high. While I am hopeful that more widespread vaccination will reduce rates of this disease in the future, this will take years before a positive effect is seen.

In both groups, I am very concerned about the rise in voice disorders including diagnoses like vocal fold nodules and vocal cord dysfunction. Increased remote work and telecommunication, social distancing and wearing masks have created different stressors on people's voices. Similarly, increased anxiety and social pressures have correlated with increased rates of vocal cord dysfunction. How quickly life returns to a pre-pandemic normal will likely affect how serious these problems become and how long-lasting they are.

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