ENT problems of the general population: a health centre experience

INTRODUCTION

In recent years, emphasis is being laid in improving the quality of care in primary health centres, community health centres, health centers in urban setup as they are the first point of contact for the general public with the healthcare system. Integrating ear and hearing care into primary healthcare, empowering healthcare providers with the necessary knowledge and skills is the need of time to achieve Universal Health Care (UHC) by 2030 in all countries.¹

In the specialty of otorhinolaryngology, a new emerging subspecialty which is gaining attention is community otorhinolaryngology. Very few medical institutes /ENT Hospitals in the world have a dedicated community otorhinolaryngology setup or a peripheral outreach clinic. While patients can always visit the main specialty Outpatient department of a hospital, in few instances it has been found that patients will prefer to visit the nearest health centre located near the residential area for first aid or treatment of minor clinical conditions. Especially the geriatric population due to various comorbidities find it easier to visit a clinical setup which is nearer to their residence. Also, most of the studies on the various ENT disorders have been conducted in medical colleges and hospitals and limited data is available from the health centres.

Hence it was decided to do clinical study on the topic of ENT complaints/ENT Pathologies for which patients visited the health centre attached to main hospital and located near a residential area.

Aim of the study

The main objective was to have an experience of the ENT complains/ENT pathologies for which a patient visits a health centre.

METHODS

A small pilot study was conducted for a duration of 3 months From June 2025 to August 2025 at the Health Centre located in city and attached to the Main Hospital. Every month, 3 hours per day for 3 days a week was spent in the Health Centre to get an idea about the types of ENT cases coming to the Health Centre. Convenience Sampling was used to select the participants of the study.

Inclusion criteria

Patients presenting with ear, nose and throat complaints at the Health Centre attached to SAIL–ISP Burnpur Hospital.

Exclusion criteria

Patients who had already taken treatment from doctors who are not attached/affiliated to SAIL-ISP Burnpur Hospital were excluded from the study.

RESULTS

The gender distribution of cases shown in Table 1 showed more percentage of female patients (61.11%) compared to male patients (38.88%).

The ENT cases evaluated at the Health Centre are shown in Table 2 and includes URTI (64.44%), balance disorders (11.11%), Apthous ulcer (5.55%), itching of ears (3.33%), allergic rhinitis (3.33%), CSOM (2.22%), Presbycusis (2.22%), LPRD (2.22%), facial trauma (2.22%), leukoplakia (1.11%), neck swelling (1.11%), retention cyst of lip (1.11%).

DISCUSSION

Very few studies have been done which have reported the experience of ENT cases reported in a community health centre.

A survey conducted by Pristyn care on individuals across Indian cities like Delhi, Meerut, Faridabad, Noida, Ghaziabad, Rohtak, Chandigarh, Kanpur, etc. found that 55% of them reported ENT problems like hearing loss, sore throats, and nasal irritation or congestion. Yet 68% of those affected didn’t consult a healthcare provider. As the ENT specialists of the country prefer to practice more in urban areas compared to rural areas, hence improving the quality of patients’ lives by early detection and treatment - is an ENT health Challenge.^1,2

A research article gives us an idea about various ENT diagnoses being made at a student-run community clinic for uninsured patients. The specialized ENT clinic is hosted on the third Thursday night of each month to treat patients with ear, nose, and throat concerns. Throat was the most common ENT system to be affected followed by ear, nose, and other. Balance problems, reflux, and allergic rhinitis were the most common individual ENT diagnoses.³

According to a research article, the common ENT complaints of patients assessing a visiting otolaryngology team at Meno Ya Win Health Centre were hearing loss, nasal obstruction, vertigo, tinnitus and Adentonsillar disease. The visiting otolaryngology team approach helped in building professional relationship with local primary care providers, streamlining communication, and facilitating diagnostic and treatment planning.⁴

According to a research article at the Family Medicine Unit attached to tertiary hospital, on average 12.89% of patients presented with ENT problems, and 2.39% (1205) of the total 50461 patients were seen by ENT specialists at the outreach clinic over 12 months. Weekly ENT services are provided in the Family Medicine Unit and the various ENT services includes outpatient services, consultation for inpatients, minor procedures, and selected ENT operations.⁵

According to a research study conducted to identify the common ENT diseases in its ten community health centers in district IV of Bamako (Mali), Tonsillitis and otitis media with respectively 35.26% and 31% were the frequent ENT disorders.⁶

As per our study the important ENT ailments were upper respiratory tract infections, balance disorders, apthous ulcers, allergic rhinitis, CSOM, presbycusis etc. The Health Centre was also utilized to create awareness among the patients about oral cancer and safe hearing. A Health Centre even though having limited resources as compared to main hospital may be utilized for clinical teaching purposes, hands on training and providing services to people who are unable to come to the ENT Department of the main hospital (Figure 1).

A list of proposals is given below on the subject of how we can improvise ENT healthcare and academic research in our health centres.

Proposals

A collaborative model of academic research should be followed with MOU between ENT Department of medical colleges/NBEMS Accredited ENT institutes and health centers (Figure 2).

Postgraduate thesis case studies may include health centre as a site of study if feasible.

A scheduled visit of ENT postgraduates to health centre once during postgraduation for independently attending the ENT cases and carrying out minor procedures at the health centre.

Clinical teaching classes. PowerPoint presentations and awareness session for the doctors and other staff of the health centre by the postgraduates and staff of ENT Department, so that the quality of ENT health care may improve at the health centre.

National ENT conferences may include at least 1 original study/E poster based on cases evaluated at health centre.

More original ENT clinical trials involving community health workers must be conducted.

Fellowship courses in community otorhinolaryngology/ post-doctoral certificate course in community otorhinolaryngology may be introduced in eminent ENT institutes.

Conducting CME on otorhinolaryngology disorders at the health centres if feasible.

Creating mobile ENT care units, so that services can be provided in ambulance van wherever feasible.

Limitation

Small study population, small duration of study

CONCLUSION

The content of this pilot study will give direction to the ENT faculty, ENT postgraduates, MBBS students, interns, medical officers to carry out extensive collaborative research study on ENT pathologies in the health centres across the country which will help in promoting and advancing the subspecialty of community otorhinolaryngology along with providing healthcare services to those population who cant visit the main hospital. In addition to that the content of the pilot study may be discussed with policymakers in NMC and NBEMS and the topic of community otorhinolaryngology may be added in the Recent Advances Section of the Undergraduate and Postgraduate Course curriculum of the ENT specialty.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

1. 1. Suresh K. ENT health needs to come to Center stage- INDIA case study, J Clin Otorhinolaryngol. 2025;7(3).
2. 2. Common ENT-problems & solutions, H. Vardhan Available at: https://www.miracleshealth.com/. Accessed on 19 May 2025.
3. 3. Quinlan BP, Tan W, Coblens O, McKinnon B. Otolaryngology Diagnoses at a Student-Run Community Clinic. Cureus. 2024;16(9):e70155.
4. 4. Campisi ES, Hong CJ, Monteiro E, Lin V, Russell B, Campisi P. A visiting otolaryngology team in northern Ontario - demographics, clinical presentation and barriers to access. Rural Remote Health. 2024;24(1):8574.
5. 5. John M, Parsons A, Abraham S. The value of an ENT specialist outreach service in a Family Medicine Unit for the urban poor in India. J Family Med Prim Care. 2016;5(1):67-72.
6. 6. Baba SH. Community ENT Health Promotion: Concepts and Perspectives in Mali. Int Res J Pharma Med Sci. 2023;6(2):38-40.