Otolaryngology - Otorhinolaryngology

A branch of clinical medicine. In the West, ear diseases have long been treated by surgeons, while diseases of the nose and throat have been treated by internists. However, with the development of the head mirror in the 19th century, specialization progressed and the two fields gradually became integrated, and by the 20th century they had been integrated into otorhinolaryngology in every country, becoming a branch of surgery. The head mirror is a band fixed to the forehead with a reflecting mirror attached. Artificial light is reflected by the concave mirror and collected, and the illuminated deep areas are viewed through a hole in the center. In contrast to the internist's stethoscope, the head mirror has been considered the symbol of the otorhinolaryngologist.

Since the areas covered by otolaryngology are the organs that control the senses of hearing, smell, taste, and other functions, as well as speech and language, maintaining and rehabilitating these functions is particularly important in treatment. With advances in medicine, it has become possible to perform surgery on areas that were previously inaccessible, and the areas that otolaryngologists must treat have gradually expanded to include not only the oral cavity, orbit, and neck, but also the inside of the skull for the removal of acoustic neuroma and pituitary tumors, and the base of the skull for the removal of tumors in the infratemporal fossa and jugular foramen. As a result, the name otolaryngology no longer covers all of these areas, and it has become common to change the name to head and neck medicine or head and neck surgery, or to list both.

On the other hand, in contrast to this expanding range of expertise, it is impossible for one doctor to study everything in depth, and as with other medical fields, the field is becoming more specialized.Currently, in Japan alone, in addition to the Otolaryngological Society of Japan, there are independent academic societies that are mainly made up of otolaryngologists, such as the Japan Otological Society, the Japan Audiological Society, the Japanese Society of Vertigo and Equilibrium Medicine, the Japanese Rhinologic Society, the Japanese Society of Oral and Pharyngological Sciences, the Japanese Society of Phonetic and Linguistic Medicine, the Japanese Tracheoesophageal Society, and the Japanese Society of Otolaryngological Infections.

[Masami Kawamura]

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

臨床医学の一分科。西洋では古くから耳の病気は外科医が、鼻や咽喉（のど）の病気は内科医がそれぞれ治療していたが、19世紀になって額帯鏡が開発されるとともに専門化が進み、しだいに統合されるようになり、20世紀にはどの国でも耳鼻咽喉科として統合され、外科系の一つの分科になった。額帯鏡は額に固定したバンドに反射鏡をつけたもので、この凹面鏡の反射によって人工光線を集め、照らし出された深部を中央の穴から見る。内科医の聴診器に対して、この額帯鏡は耳鼻咽喉科医のシンボルとされてきた。

　耳鼻咽喉科の対象となる部位が、聴覚、嗅覚(きゅうかく)、味覚などの感覚、あるいは発声や言語などの機能をつかさどる器官であるため、治療に際してはその機能の保持とリハビリテーションがとくに重要である。また医学の進歩に伴って、これまでは手術的に到達不能であった部位の手術も可能になってきて、耳鼻咽喉科医が取り扱わなければならない分野がしだいに拡大し、口腔(こうくう)、眼窩(がんか)内、頸(けい)部などはもちろんのこと、聴神経腫瘍(しゅよう)や下垂体腫瘍の摘出などで頭蓋(とうがい)内、あるいは側頭骨下窩や頸静脈孔腫瘍の摘出などで頭蓋底なども対象領域になってきており、耳鼻咽喉科という名称では対応できず、頭頸科や頭頸部外科という科名に変更、あるいは併記することが一般的になってきている。

　一方、このように守備範囲が広がるのとは対照的に、1人の医師がそのすべてを奥深く研究することが無理であり、他の医学分野と同じように細分化も進んできている。現在、日本の国内だけでも、耳鼻咽喉科医が主になっている独立した学会は、日本耳鼻咽喉科学会のほかに、日本耳科学会、日本聴覚医学会、日本めまい平衡医学会、日本鼻科学会、日本口腔・咽頭科学会、日本音声言語医学会、日本気管食道科学会、日本耳鼻咽喉科感染症研究会などがある。

［河村正三］

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