Published: Feb. 19, 2010
Updated: Feb. 19, 2010
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.
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.