When you arrive in the Duke Otolaryngology, Head & Neck,
ENT clinic, please check in with the clinic service
coordinators at the front desk. If you have not completed a
new patient
form (PDF, 111 KB), you will be asked to complete this, as
well as read and sign a HIPAA information brochure. HIPAA
stands for Health Insurance Portability and Accountability Act.
This is required by the U.S. Government.
The nurse will call your name when an exam room is
available. We do our best to keep on schedule, but can
sometimes get delayed by unforeseen circumstances. In general,
please try to arrive 15 minutes before your appointment.
When your name is called, the nurse will put you into one of
the ENT examination rooms. There she will ask you a few
questions and take your vital signs. Advise the nurse of any
allergies that you may have and medications you are taking.
After the vital signs are completed, the nurse will likely
spray your nose with a mixture of Tetracaine and Afrin. This is
a local anesthetic and a nasal decongestant. The anesthetic and
Afrin combination has a bad taste, but will not harm you if
swallowed. It does give a sensation of numbness to the throat,
and some patients complain of a runny nose for several hours
after the anesthetic is applied.
We recommend that you do not eat or drink for approximately
30 to 45 minutes after the anesthetic is applied to avoid any
swallowing problems. Almost every new patient will have a
complete head and neck examination, which includes flexible
laryngoscopy. The anesthetic and decongestant allows for this
to be accomplished in the most comfortable manner.
Once the nurse is completed, the doctor will come in and ask
you about relevant history concerning your complaint which you
are wanting evaluated that day. Unfortunately, often it is
impossible to address every complaint due to time restraints,
so please have a priority as to what you would specifically
like addressed at that visit.
After the doctor speaks to you, he will examine your ears
using an otoscope, examine your nose, look thoroughly at your
mouth, tongue and oral cavity, and finally feel your neck. A
full head and neck exam will be completed regardless of your
particular complaint.
If the doctor chooses to perform fiberoptic laryngoscopy (or
nasopharyngoscopy), he will use a small flexible telescope that
is passed through your nose to examine the sinus drainage
pathways, the back of the nose, the back of the tongue and
throat, as well as the voice box and the top of the swallowing
tube. This procedure is performed in nearly all smokers or
people with a history of smoking. While mildly irritating to
the nose, the procedure is accomplished quickly, and allows the
physician to fully evaluate and explore problems in these
areas.
Once the examination is completed, the doctor will explain
to you his assessment of your problem, as well as the proposed
treatment options.
Follow-up Appointment
If you have a follow-up appointment, please arrive 10
minutes before your scheduled time. If you have not done so,
you will be asked to complete a follow-up visit form (PDF, 118 KB).
This is to update your current medical history within our
medical records.
You can expect that your vital signs will be taken before
the doctor sees you. Based upon your previous evaluation, your
physical exam will be tailored to focus on your problem area.
An assessment of how you have responded to your previous
treatment will be made, and then you will be able to discuss
further treatment options if needed, concerns, or outcomes at
the conclusion of your appointment.
Further appointments will be scheduled as needed.
