Most of the time, no. That said, certain managed-care insurance plans may require a referral from your primary care physician. It’s always best to check your insurance first or check with your primary care physician’s office to see if a referral may be needed.

This is not a concern unless other symptoms of allergy are present such as runny nose, nasal congestion and frequent nasal and eye (ocular) itching. If other allergy symptoms are present, evaluation for possible allergies would be reasonable.

Most of the time, the ears are “self-cleaning” in that the wax and dead skin produced in the ear canal gradually works its way out on its own. Periodically, small amounts of wax just fall out. Therefore, most people really don’t need to clean or do anything in particular with their ears. However, if a buildup of wax occurs and hearing becomes muffled, there are commercial products available at most drug stores to safely flush out the wax. Brand names include Debrox and Murine. Usually, an oily substance is dripped into the ear canal to soften the wax and then it is flushed out with water. Make sure the water is at about body temperature to avoid getting very dizzy while irrigating the ear. Instruments sold to manually remove the wax are not recommended as you cannot see in your ear and blindly inserting an instrument can cause harm. If flushing out the wax doesn’t work or hearing remains diminished, it is best to schedule an appointment with an ENT physician who can evaluate the situation and remove the wax if necessary.

Yes. The thyroid is a gland in the neck that produces a hormone called thyroid hormone. Evaluating a patient’s thyroid hormone levels and treating conditions of the thyroid that may result in too much or too little thyroid hormone levels is usually done by primary care physicians and specialists called endocrinologists rather than ENT doctors. However, if there is a lump or mass in the thyroid gland, ENT doctors become involved. This may include performing a biopsy (sample) of the lump as well as removing it if surgery is needed.