ENT consultation: indications, procedure, price, reimbursement

The ENT sphere (otolaryngology) refers to all the organs and structures located in the head and neck area, which are related to hearing, voice, swallowing, taste and smell, breathing, balance and facial expression. It includes the ear (external, middle and internal), mouth and throat, nose and sinuses, face, salivary glands, neck, vocal cords, thyroid gland, etc.

It is therefore a vast and complex whole which requires the expertise of specialized doctors: otolaryngologists, better known as ENT doctors. When and why consult them? How to prepare for a consultation? What are the prices and repayment terms ? Insights from Dr. Laurent Gaillardin, doctor specializing in otolaryngology (ENT) and head and neck surgery.

As indicated above, the ENT sphere plays an essential role in our ability to communicate, breathe, eat and hear. In fact, specialists in the ENT sphere, otolaryngologists, are responsible for diagnosing and treating yourubles related to organs and structures of the ENT sphere in newborns, children, adolescents, adults and the elderly.

“This specialization is one of the few that combines both medicine and surgery,” says Dr. Gaillardin. In other words, otolaryngology professionals are both doctors and surgeons of the neck and face (cervicofacial surgery). They may prescribe medication, offer hearing aids/hearing implants, or schedule restorative or reconstructive surgery.

Due to the complexity of the area of ​​intervention, they can also specialize according to the organs or structures in question, points out Dr Gaillardin: there are several ENT specialtiessuch as otology, rhinology, laryngology, audiometry, aesthetic head and neck surgery, tumor surgery, phoniatry, etc.

ENT practitioners also work in collaboration with many other professionalssuch as audiologists, audiologists, speech therapists, occupational therapists, etc.

ENT doctors can take care of different pathologies:

• a infection ;
• a inflammation ;
• A trauma ;
• a tumor ;
• a congenital malformation ;
• a paralysis (facial or cervical);
• a auditory or verbal degeneration ;
• etc

They may also be requested in the context of plastic and / or aesthetic surgeries.

Several symptoms may motivate a consultation with an ENT doctor:

• of the pain or discomfort in the throat, ears, nose or sinuses ;
• a hearing loss or a ringing sensation in the ear ;
• A discharge of pus or blood at the level of the ears / nose;
• recurrent otitis, angina or sinusitis ;
• of the tinnitus ;
• of the recurring dizziness ;
• of the balance disorders ;
• of the snoring or a Sleep Apnea ;
• a loss of smell and/or taste ;
• a excessive salivation or a dry mouth feeling ;
• pain and/or difficulty swallowing ;
• the appearance of a mass or lesions in the mouth, throat or neck;
• a change or loss of voice ;
• language delay or difficulty ;
• etc

Among the pathologies most frequently treated by ENT specialists, we find:

• sinusitis;
• ear infections;
• tonsillitis ;
• tonsillitis;
• pharyngitis;
• laryngitis;
• deafness ;
• tinnitus;
• otalgia (ear pain);
• gastroesophageal reflux;
• language disorders;
• loss of voice;
• salivation disorders;
• swallowing disorders;
• sleep disorders;
• removal of vegetation;
• thyroid problems;
• hearing loss (also called hypoacusis or hearing loss);
• presbycusis (age-related hearing loss);
• tumors and infections of the mouth and tongue;
• certain cancers (cancer of the larynx, for example);
• etc

We are all susceptible to developing ENT disorders. But certain habits / certain factors increase the risks tenfold, in particular:

• THE smoking ;
• a excessive alcohol consumption ;
• I’exposure to chemicals, various pollutants and/or allergens ;
• a significant exposure to noise ;
• a immunosuppression which increases the risk of viral and bacterial infections.

Moreover, age is an important factor in ENT disorders : Hearing loss and chronic conditions are particularly common among the elderly. Similarly, children are regularly plagued by certain ENT conditions such as ear infections.

It is possible to make an appointment spontaneously with an ENT doctor. But the ideal is to go through your doctor or a general practitioner who will redirect you to an ENT if necessary, as part of the coordinated care pathway. This makes it possible to be reimbursed by Social Security, but also to shorten the time taken for treatment. “Most often non-specialist general practitioners are able to sort out the situation and help you relieve certain symptoms before you can consult another expert,” says Dr Gaillardin.

Before any first ENT consultation, remember to bring the following documents:

• your vital card ;
• the prescription from your attending physician and your other prescriptions in progress ;
• THE results of analyzes and examinations that your attending physician may have already prescribed for you ;
• your health record or any document retracing your significant medical history ;
• etc

If in doubt, do not hesitate to contact your doctor to find out about the necessary documents and any precautions to take before the examination.

The ENT consultation takes place in several stages. The doctor always starts with a precise interrogation which allows you to learn about your family and personal history, but above all to describe your symptoms precisely: their recurrence, their context and their order of appearance, their persistence, their factors of aggravation or improvement, their impact on your daily life, etc

Then comes the time to clinical examination of your head and neck. The doctor uses specific instruments (spatula, speculum, otoscope, etc.) to examine the inside of your ears, nose and throat. He may also use a stethoscope to listen to your breathing and heart rate.

If necessary, he can request additional examinations, such as an audiogram to assess your hearing, an endoscopy to take a closer look inside your nose and throat, afibroscopy Or an MRI.

Depending on the results of the clinical examination and tests, the ENT can then recommend some lifestyle advice and prescribe a treatment that potentially includes medication, wearing a hearing aid and/or surgery, for example. In some cases, it can also refer you to another medical specialist.

ENT consultations – as well as the various examinations carried out by the ENT doctor – are covered by Social Security, provided you have followed the course of care. In other words, provided you have consulted a general practitioner or your attending physician who will have redirected you, if necessary, to an ENT specialist.

The price of consultations with an ENT specialist varies according to the specialty of the doctor, the acts performed and the tariff sector (sector 1 or 2). IF you have followed the coordinated care pathway, fees are reimbursed by health insurance up to 70%. Be careful, however, if you consult a sector 2 approved doctor, the rates are free and the reimbursement base increases to 23 euros. Before making an appointment, remember to check the details of your medical coverage and your reimbursements with your doctor and your health insurance.