ENT or Plastics?

[dexterous]

Hi, i hope this isn't a spicy topic for too many, but,

what are the big differences between plastics, specifically facial, and otolaryngology head and neck surgeons?

i am in my third year and have conducted research that i guess would qualify for both fields, but i can't seem to get a feel for which direction i would prefer to go

ent seems to offer the chance to do more clinical/pathologic related work, and has one year less of residency (5 v. 6), but i thought some insiders might have the scoop on jobs or whatever else i have missed

plastics seems to afford the diversity of the entire body if wanted, while ENT seems to have diversity of the head and neck operations performed (cosmetic, biomedical devices, cancer, etc...)

are the work hours, pay, patients, excitement, or general levels of satisfaction different between the two?

thanks for the help

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[TheThroat]

On the whole, PRS and Oto are as different as Uro and Ortho. OK, maybe thats a little bit of an exaggeration. There is some overlap, especially in the facial plastics realm and recon, but the average PRS will do a variety of whole body plastics stuff, including hand, burns, recon, and also cosmetic (both face and body)

Oto's do some cosmetic facial plastics, but also do: peds, cancer excision, head and neck recon, otology, neuro-otology, sinus, voice, facial trauma.

"are the work hours, pay, patients, excitement, or general levels of satisfaction different between the two? "

In a word: yes

 

[toofache32]

ENT also has a little more of a medicine side to it than Plastics, in my observation. This can be good or bad depending on your preferences.

 

[Celiac Plexus]

On the whole, PRS and Oto are as different as Uro and Ortho. OK, maybe thats a little bit of an exaggeration. There is some overlap, especially in the facial plastics realm and recon, but the average PRS will do a variety of whole body plastics stuff, including hand, burns, recon, and also cosmetic (both face and body)

Oto's do some cosmetic facial plastics, but also do: peds, cancer excision, head and neck recon, otology, neuro-otology, sinus, voice, facial trauma.

that's an interesting assessment. i think that prs and oto have significant overlap in the head and neck recon cases. for example, there is a pediatric craniofacial guy at my institution who pretty much handles all of the pediatric recon, sinus, facial traums etc...

and the microvascular prs guy works closely with oto on major adult head and neck recons, often performing complex mandible, palate, pharynx, and esophageal flap recons. a recent case comes to mind... a gsw to the face in a young patient requiring extensive reconstruction including bone grafting, a radial forearm flap, and full thickness skin grafting. this was done almost exclusively by the microvascular guy, with oto providing some elements of recon for one of the ear canals.

on another case i can recall, oto did most of the recon with our microvascular guy doing a bone graft to reconstruct part of the mandible.

i think there is a lot of overlap in the facial reconstruction arena. then again, my institution may be atypical.

 

[toofache32]

that's an interesting assessment. i think that prs and oto have significant overlap in the head and neck recon cases. for example, there is a pediatric craniofacial guy at my institution who pretty much handles all of the pediatric recon, sinus, facial traums etc...

and the microvascular prs guy works closely with oto on major adult head and neck recons, often performing complex mandible, palate, pharynx, and esophageal flap recons. a recent case comes to mind... a gsw to the face in a young patient requiring extensive reconstruction including bone grafting, a radial forearm flap, and full thickness skin grafting. this was done almost exclusively by the microvascular guy, with oto providing some elements of recon for one of the ear canals.

on another case i can recall, oto did most of the recon with our microvascular guy doing a bone graft to reconstruct part of the mandible.

i think there is a lot of overlap in the facial reconstruction arena. then again, my institution may be atypical.

Do the ENTs their not do their own free flaps?

 

[TheThroat]

that's an interesting assessment. i think that prs and oto have significant overlap in the head and neck recon cases. for example, there is a pediatric craniofacial guy at my institution who pretty much handles all of the pediatric recon, sinus, facial traums etc...

and the microvascular prs guy works closely with oto on major adult head and neck recons, often performing complex mandible, palate, pharynx, and esophageal flap recons. a recent case comes to mind... a gsw to the face in a young patient requiring extensive reconstruction including bone grafting, a radial forearm flap, and full thickness skin grafting. this was done almost exclusively by the microvascular guy, with oto providing some elements of recon for one of the ear canals.

on another case i can recall, oto did most of the recon with our microvascular guy doing a bone graft to reconstruct part of the mandible.

i think there is a lot of overlap in the facial reconstruction arena. then again, my institution may be atypical.

Yes, there is overlap in facial recon, but the average oto and the average plastics guy will not have practices that look anything alike. The average oto will do a recon case every month or so, and a trauma every 3-4 weeks, but will mainly do sinus, peds, benign head and neck, medical and less commonly surgical otology. They will probably do a little recon for skin ca's occasionally. A plastics guy will likely see none of these things except for the skin ca recon and the trauma.

 

[droliver]

Do the ENTs their not do their own free flaps?

There's a number of training programs with no ENT microsurgeons as I understand it. In the four metro areas (each over 1,000,000 popl.) I spent time during school & training, only one ENT program (Vanderbilt) had someone doing their own microsurgery.

 

[TheThroat]

There's a number of training programs with no ENT microsurgeons as I understand it. In the four metro areas (each over 1,000,000 popl.) I spent time during school & training, only one ENT program (Vanderbilt) had someone doing their own microsurgery.

I agree. There are a number of oto residencies where they have the plastics guys do their microvascular recons.

 

[LSU-Tech]

I agree. There are a number of oto residencies where they have the plastics guys do their microvascular recons.

I just saw on a link that another user supplied that says that AOA (DO) ENT residencies include Facial Plastic and Reconstructive Surgery. I bet those guys see more than a few cases a month. There appears to be around 18 of these programs. Check out this link.

http://opportunities.aoa-net.org/search/search_results.cfm?CFID=91684&CFTOKEN=72662201

 

[TheThroat]

I just saw on a link that another user supplied that says that AOA (DO) ENT residencies include Facial Plastic and Reconstructive Surgery. I bet those guys see more than a few cases a month. There appears to be around 18 of these programs. Check out this link.

http://opportunities.aoa-net.org/search/search_results.cfm?CFID=91684&CFTOKEN=72662201

To clarify, I was comparing the average oto in private practice and the private practice plastics guy. In an academic setting, things are completely different. We average between 2-3 free flap reconstructions a week and are flooded with other, smaller recon cases each week.

I would be very surprised if the DO ENT residencies do their own free flaps, but obviously I don't know for sure. I am sure that they do some recon cases, though.