Paediatric ENT

Paediatric ENT (ear, nose and throat) focuses on diagnosing and treating children’s ear, nose, throat, head and neck problems from infancy through the teenage years. Children are not just “small adults” – their airways, immune systems and growth patterns are different, and they need care tailored to their age and stage of development.

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Early assessment and treatment can improve sleep, speech, hearing, behaviour and overall quality of life for both the child and family.

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Common Ear Problems in Children

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Recurrent Ear Infections (Otitis Media)

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Recurrent middle ear infections are very common in young children. They may present with:

• Ear pain, irritability or pulling at the ears

• Fever

• Disturbed sleep

• Temporary hearing loss or “not listening”

 

Management may include:

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• Careful examination of the ears

• Appropriate antibiotics when needed

• Monitoring of hearing and middle ear fluid

• In selected cases, grommet (ventilation tube) insertion to reduce infections and improve hearing

 

Glue Ear and Hearing Loss

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“Glue ear” (otitis media with effusion) occurs when thick fluid collects behind the eardrum, often after infections. Children may:

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• Turn up the TV

• Mis-hear or ask for repetition

• Speak loudly or have delayed speech

 

Treatment options include:

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• Observation and repeat hearing tests

• Treating nasal allergy or adenoid problems

• Grommet insertion, sometimes combined with adenoid surgery, to improve hearing and reduce fluid.

 

Common Nose and Sinus Problems

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Blocked Nose, Allergic Rhinitis and Sinus Issues

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Children may develop blocked nose, mouth breathing, sneezing, runny or itchy nose due to infections or allergies. Persistent nasal obstruction can affect sleep, facial growth and concentration.

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Assessment usually includes examination of the nasal passages and adenoids. Management may involve:

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• Saline rinses or sprays

• Allergy control and nasal sprays

• Treating sinus infections when present

• Considering adenoidectomy if enlarged adenoids are causing significant blockage or contributing to ear problems

 

Throat, Tonsils and Adenoids

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Recurrent Tonsillitis and Sore Throats

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Frequent throat infections or recurrent tonsillitis can affect school attendance, sleep and overall wellbeing.

Features include:

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• High fevers, sore throat and difficulty swallowing

• Swollen glands in the neck

• Bad breath

 

Treatment is usually with pain relief and, when appropriate, antibiotics. In children with very frequent, severe episodes or complications, tonsillectomy may be discussed.

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Enlarged Tonsils and Adenoids

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Large tonsils and adenoids can contribute to:

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• Loud snoring

• Mouth breathing

• Swallowing difficulties

• Sleep-disordered breathing and obstructive sleep apnoea in children

 

In such cases, adenotonsillectomy (removal of tonsils and adenoids) is often an effective treatment to improve breathing, sleep quality, behaviour and growth.

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Head & Neck Problems in Children

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Neck Lumps and Swellings

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Neck lumps in children are usually benign and often related to infections or congenital (present from birth) conditions, but they should always be assessed.

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Common causes include:

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• Enlarged lymph nodes after infections

• Congenital cysts or fistulas

• Less commonly, tumours or other unusual growths

 

Assessment may include:

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• Detailed examination

• Ultrasound scan or other imaging

• Blood tests or, occasionally, biopsy

 

Treatment depends on the cause and may range from observation and antibiotics to surgical removal.

 

Sleep Problems and Obstructive Sleep Apnoea in Children

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Sleep problems in children can be related to ENT issues, especially when there is snoring or disturbed breathing at night.

 

Snoring and Sleep-Disordered Breathing

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Signs of sleep-disordered breathing or paediatric obstructive sleep apnoea include:

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• Loud, regular snoring

• Pauses in breathing, gasping or restless sleep

• Mouth breathing and drooling

• Bedwetting, morning headaches or difficulty waking

• Daytime tiredness, hyperactivity, poor concentration or behavioural changes

 

Evaluation may involve:

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• Detailed history and sleep questionnaire

• Examination of the nose, tonsils, adenoids and jaw

• Overnight sleep study in selected children

 

Treatment options:

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• Managing nasal allergies or infections

• Adenotonsillectomy when enlarged tonsils/adenoids are the main cause

• Weight management where appropriate

• In specific cases, CPAP (continuous positive airway pressure) or other specialised therapies

 

Improving sleep quality can have a major impact on growth, learning and behaviour.

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Management and Treatment Options in Paediatric ENT

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Treatment is always individualised. Options may include:

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• Watchful waiting with regular review for mild or improving conditions

• Medication – such as nasal sprays, ear drops, allergy treatments or antibiotics when appropriate

• Hearing tests and speech assessment for children with suspected hearing loss or speech delay

• Minor procedures such as grommet insertion to manage glue ear and recurrent ear infections

• Adenoid and tonsil surgery for sleep-disordered breathing or recurrent infections

• Surgery for neck lumps or congenital lesions when needed

• Close collaboration with paediatricians, speech therapists, audiologists and other specialists

 

When Should Parents Seek a Paediatric ENT Assessment?

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You should consider an assessment with a paediatric ENT specialist if your child has:

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• Frequent ear infections, persistent ear fluid or suspected hearing loss

• Constant mouth breathing, blocked nose or recurrent sinus problems

• Regular snoring, disturbed sleep, pauses in breathing, or daytime behavioural changes

• Recurrent tonsillitis or difficulty swallowing

• Any persistent neck lump or swelling

 

Early specialist input can help protect hearing and speech, improve sleep and behaviour, and support healthy growth and development.