Pediatric otolaryngology

The most common reasons for referral

Recurrent ear infections and persistent middle-ear fluid — that liquid behind the eardrum which dulls hearing without necessarily causing pain — top the list. Next come problems related to the tonsils and adenoids: snoring, mouth breathing, pauses in breathing during sleep, repeated bouts of tonsillitis. Chronic nasal obstruction, nosebleeds, neck lumps and concerns about hearing or speech development complete the picture.

An examination suited to the child’s age

Examining a two-year-old is nothing like examining a teenager. Otoscopy and examination of the nose and throat proceed gradually, with a small child sitting on a parent’s lap. A flexible nasal endoscopy may be needed to see the adenoids or the larynx; it is brief and well tolerated. Hearing assessment is adapted to age and does not always require the child’s cooperation.

Treatment

Many situations settle with time and simple monitoring: middle-ear fluid, for instance, often clears on its own within a few weeks. When it persists and affects hearing or speech, ear tubes restore ventilation of the middle ear. Removal of the adenoids and of the tonsils is considered according to specific criteria — the number of documented infections, and the effect on sleep or breathing.

When to seek an assessment

If your child snores every night, pauses in breathing, has ear infections that keep returning, is slow to speak, or if you have any doubt about their hearing, an ENT assessment is warranted. A referral from your physician or paediatrician is required to obtain an appointment.