Pediatric Otolaryngology

Pediatric patients will often have problems with airway obstruction involving the nose, throat and lungs. Enlarged tonsils and adenoid lymph tissue behind the nose is often the culprit. The tonsils and adenoids may also become chronically infected and unresponsive to antibiotics. The infection and congestion may spread and involve the ears and lungs. Sometimes the chronic tonsillitis remains somewhat subdued and ejects foul smelling tonsilliths (off-white concretions) from within the tonsils through tonsillar crypts. The body’s immune system cannot clear the infection. These tonsils need to be removed to cure the infection. Sometimes, an acute tonsillitis is so severe that it forms a peritonsillar abscess. This would require drainage of the abscess and subsequent tonsillectomy. Using the latest surgical technique – Coblation, a more exacting and safer removal of the tonsils and adenoids is performed. This technique can result in a speedier recovery.

Congestion and infection the ears will cause hearing loss, distorted and sometimes painful hearing, tinnitus, dizziness, delayed language, sleep disturbance and cognitive delay. If medicines prove ineffective, the outpatient removal of the middle ear effusions and the placement of tiny ventilation tubes can fix the problem quickly and definitively. These ventilation tubes will extrude on their own over time. These patients will need to monitored periodically to assess for any recurrent hearing loss.

Correction of allergies is very important since pediatric airways are narrower and often more reactive. Allergies contribute to 90% of asthma problems and must be controlled consistently with available antihistamines, inhaled corticosteroids, and possibly long acting bronchodilators so that acute attacks are minimized. Allergy testing and immunotherapy are important tools that can tame a hypersensitive immune system and prevent symptoms. The gold standard - intradermal skin testing can be performed on children as young as 5 years old. There is no pain at all when a topical numbing cream is applied to the testing site prior to the testing. See the Allergy page for more details.

Pediatric patients frequently suffer nasal trauma secondary to sports injuries and accidents. It is important to stabilize the fracture with closed or open reduction so the healing can occur favorably in the midline. There can be late effects of the fracture including deviated nasal septum and nasal deformities, which may require functional as well as cosmetic surgical solutions. Definitive procedures may be delayed until physical maturation has occurred. Careful evaluation is necessary. Congenital nasal deformities can be corrected once the patient has reached physical maturity.

Congenital Auricular deformities (lop ear deformities) should be corrected prior to starting school to avoid undue and often extended psychological trauma. The procedure can correct both ears at the same time. Medical insurance will cover the reconstruction of these congenital deformities if psychological problems are documented.