Ear, nose, and throat (ENT) physicians treat disorders and diseases of the ears, nose, throat, sinuses, larynx (voice box), mouth, and structures of the neck or face. These conditions can range from sinus infections to tumors of the head or neck.
Some ENT problems like mild ear infections are annoying and painful, but are not serious concerns. However, there are other issues that can have a major impact on your child’s life. A breathing disorder called sleep apnea can lead to behavioral problems and learning difficulties and may increase your child’s risk of heart disease. Recurring ear infections can damage the ear, causing hearing loss.
Does My Child Need To See An ENT Specialist?
For a run-of-the-mill single ear infection, your child can probably be treated by a pediatrician. But there are times when your child might need a little more specialized care. Your pediatrician may refer you to an ENT specialist if your child:
- Has recurring ear infections, colds, sinus infections, or strep throat
- Experiences symptoms of an ear infection that lasts more than a few days
- Complains of severe pain in the ears, nose, or throat
- Seems to have difficulty hearing, speaking, or swallowing
- Snores or noisy breathing when asleep or awake
- Has slow or delayed speech development
Why Are Ear, Nose, And Throat Treated Together?
It’s all about biology.
The ear, nose, and throat are close to one another and are connected through several pathways. The pathways allow the parts to work together as a team, helping you breathe, smell, taste, and hear. But that also means that when one team player goes down, the others can too.
For example, the eustachian tube runs from the middle of the ear to the back of the throat. It is responsible for draining fluid made by the middle ear. If the tube becomes blocked at the throat, fluid cannot be drained and can build up in the ear. This can lead to ear infections and earaches.
What Sets Children’s Apart?
At Children’s Hospital & Medical Center, all of our ENT physicians are board-certified. This means that they have all been recognized for their exceptional expertise in the field. Since certification requires that physicians participate in continuing education courses, our physicians are always up-to-date on the latest advances in patient safety and quality care.
In addition to ENT physicians and nurses, your child’s care team may consist of:
- Pulmonologists: These are physicians who specialize in lung or breathing disorders. They work with ENT physicians when patients have difficulty breathing or suffer from sleep apnea.
- Gastroenterologists: These are physicians who specialize in problems of the digestive system. They may be part of the team if your child’s condition involves both the digestive system and the ears, nose, or throat (e.g. gastroesophageal reflux).
- Audiologists: These are physicians who specialize in evaluating, diagnosing, and treating hearing and balance (vestibular) disorders.
- Dietitians: Dietitians put together diet plans for children with throat and swallowing problems to ensure that they can eat comfortably and meet their nutritional needs.
- Speech and occupational therapists: These therapists help children overcome problems with speech, balance, or movement (e.g., walking) that are related to hearing loss.
- Respiratory therapists: Respiratory therapists work with patients whose ENT conditions have caused breathing problems, and help them find ways to improve breathing.
- Social workers: Social workers help children and families adjust to life with a chronic ENT condition, as well as work through any emotional health problems the condition may cause.
Conditions We Treat
Since treating ENT conditions involves many parts of the body — and since each of these parts have multiple parts within them — our physicians treat a wide variety of disorders.
Some of the most common ones we treat include:
AllergiesAllergies are one of the most common chronic conditions in children. They occur when the immune system — the body system that fights off infection — reacts to a usually harmless substance (allergen) as if it is dangerous. There are many types of allergens, such as certain foods, medicines, insects, or pollen.
While some allergy symptoms can be severe, or even life-threatening, the most common symptoms make children uncomfortable. These symptoms often include the ears, nose, or throat (e.g., runny nose, itchy throat).
Depending on the type and severity of the allergy, your child may be prescribed medication to reduce symptoms, allergy shots to decrease sensitivity to the allergen, or emergency medication to take during life-threatening allergic reactions.
Cleft Lip and PalateCleft lip and palate are conditions where there are openings or splits in the upper lip, palate (roof of the mouth), or both:
- Cleft Lip: The tissue that makes up the lip doesn’t completely join before birth, causing an opening in the upper lip
- Cleft Palate: The tissue that makes up the roof of the mouth doesn’t join together during pregnancy
- Submucous (Hidden) Cleft Palate: The mucous membrane tissue covers up the cleft (pink tissues in the mouth), making the cleft hard to see
Cleft lip doesn’t usually put children at a greater risk for hearing problems. However, cleft palate — or both cleft palate and lip — can cause middle ear problems, leading to hearing loss.
If your child has cleft lip or palate, they may also work with our colleagues in Plastic & Reconstructive Surgery.
Cochlear ImplantIf a traditional aid is not giving your child the help they need, your child may be eligible for a cochlear implant.
A cochlear implant is different from a traditional hearing aid. A traditional aid picks up sound via a microphone. It then makes the sound louder and sends a signal — called an acoustic signal — through the auditory system.
Cochlear implants use a different type of signal — an electric signal. This stimulates the hearing nerve and transports information to your child’s brain.
Ear Infections (Otitis Media)Ear infections can happen to anyone, but they are especially common in children. In fact, five out of six children have at least one ear infection by the time they turn 3 years old.
Ear infections are inflammation (swelling) of the middle year. They are generally caused by bacteria that forms when there is a buildup of fluid behind the eardrum.
There are three main types of ear infections:
- Acute otitis media: This is the most common type of ear infection. It occurs when parts of the middle ear become infected and swollen, trapping fluid behind the eardrum. The infection causes ear pain, and may also cause a fever. Acute otitis media is usually caused by a common cold. It can go away on its own, but physicians may prescribe antibiotics.
- Otitis media with effusion (secretory otitis media): This infection typically occurs when an acute ear infection has run its course, but fluid from the infection remains trapped behind the eardrum. Most children do not experience any pain, but the fluid can impair hearing. While it usually clears up on its own, some children may need surgery to install a tube that ventilates the ear.
- Chronic otitis media with effusion: If fluid stays in the ear for a long time, or it builds up over and over again when there isn’t an infection, your child may have chronic otitis media with effusion. This makes it more difficult for them to fight new infections in the future, and can impair hearing. Children with chronic otitis media with effusion may need tubes to ventilate their ears.
Head And Neck TumorsA tumor is a mass of tissue. It can be either malignant (cancerous) or benign (noncancerous).
Biopsies may be performed to remove tissue from the tumor and examine it for signs of cancer. If the tumor is cancerous, Children’s oncologists (cancer physicians) develop a care plan that is customized for your child’s needs.
Hearing LossHearing loss can be permanent or temporary, complete or partial, present at birth or acquired over time. If untreated, it can contribute to delays in speech development. Corrective surgery or hearing aids, such as cochlear implants, allow some children to improve their hearing and speech.
Children with severe or total hearing loss that cannot be restored may learn other ways to communicate, such as sign language.
Non-allergy Related Nose And Sinus DiseasesThere are many diseases that affect the nose and sinuses (air-filled spaces around the nose) that are not caused by allergies, such as rhinitis and sinusitis.
These diseases can cause many of the same symptoms as allergies, such as chronic sneezing, runny nose, or congestion. However, they are different than allergies because they do not involve the immune system reacting to a substance.
Often, there is no treatment — the disease just needs to run its course. However, your child may be able to take certain medications to reduce symptoms.
Sleep ApneaDuring a normal night’s sleep, every muscle in the body relaxes. When relaxed, certain muscles keep the throat open to allow air to flow in and out of the lungs.
Sleep apnea occurs when that airway becomes narrowed or partly blocked. This causes pauses in breathing. After these pauses, children may sound like they are choking, snorting, or gasping for air. Children with sleep apnea often snore, have restless sleep, wake up frequently, or feel tired during the day.
Sleep apnea has several different causes. In children, it is often due to the tonsils or adenoids blocking the airway.
Small jaws, large tongues, poor muscle tone (due to conditions such as cerebral palsy or Down syndrome), or certain shapes of the roof of the mouth can raise the risk of developing sleep apnea.
Obesity is also a risk factor for sleep apnea.
It is important to get sleep apnea treated. Children with sleep apnea may have learning difficulties, behavioral problems, and poor growth. Left untreated, sleep apnea increases the risk of serious medical conditions, such as heart disease, diabetes, or depression.
Treatment for sleep apnea is different for each child. Common treatments include:
- Surgery to remove adenoids or tonsils, correct problems with facial structures, or remove excess tissue at the back of the throat
- Continuous positive airway pressure (CPAP) device, which pumps air through a mask and into the airway during sleep, keeping the airway open
- Medications, such as inhaled nasal steroids
- Dental devices that keep the jaw forward and the airway open
- Weight loss
SnoringSnoring occurs when the air that passes through the back of the mouth is blocked during sleep. Although snoring isn’t always a cause for concern, loud, regular snoring in an otherwise healthy child should raise a few red flags. It could be a sign of an allergy, stuffy nose, or a respiratory infection.
In some cases, snoring could be a symptom of sleep apnea — especially if your child is overweight or obese. Sleep apnea is a disorder where the airways become blocked at night, causing pauses in breathing. Untreated, it can increase the risk of serious medical problems, such as heart attack or diabetes.
There isn’t a single cure for snoring. For some children, losing weight or simply changing the position they sleep in will reduce snoring. If the cause of the snoring is sleep apnea, devices such as a continuous positive airway pressure (CPAP) machine can often reduce snoring, as well as help children get a better night’s sleep.
For more information, learn about our sleep medicine team.
Throat InfectionsThere are several types of throat infections. In children, we commonly see:
- Strep throat: A disease caused by infection with a germ called group A streptococcus bacteria.
- Tonsillitis: Swelling of the tonsils (lumps of tissue in the back of the throat), usually caused by a virus.
Both strep throat and tonsillitis can cause severe sore throat, fever, pain with swallowing, and swollen neck glands.
While strep throat can usually be cured with an antibiotic, tonsillitis isn’t always quite as simple. If the cause of the tonsillitis is a virus, there is no treatment — it just has to run its course. But if it’s due to a bacterial infection, your child may be able to take an antibiotic.
If your child constantly gets tonsillitis, has bacterial tonsillitis that isn’t cured by antibiotics, or has tonsils that are so big that they’re causing problems with breathing or swallowing, they may need to have their tonsils surgically removed (tonsillectomy).
ThyroidInformation coming soon.
Voice DisordersEveryone’s voice is unique, but there are certain “norms” for different ages, genders, geographic locations, and cultural backgrounds. If the quality, volume, or pitch of your child’s voice are different than these norms, they may have a voice disorder.
There are many ways in which a voice can be considered different. The voice may be hoarse, shrill, shaky, or breathy. Your child may run out of breath quickly, constantly cough or clear their throat, or have throat pain. In some cases, they may experience aphonia — completely losing their voice.
Voice disorders have numerous causes, including talking too much, screaming, infections, acid reflux disease, viruses, cancer, or diseases that paralyze (freeze) the vocal cords.
The ear, nose, and throat physicians at Children’s work closely with the Audiology Department.
Audiologists specialize in diagnosing and treating hearing problems in infants and children through age 21. Together, ENT physicians and audiologists determine the cause of your child’s hearing loss, and decide on the best course of treatment.
Our audiologists are the only providers in the state that focus solely on children. Every provider has been certified by the American Speech and Hearing Association for excellence in the field and providing high-quality care.
One of our main services is fitting children with hearing aids. We have several different types of hearing aids available to fit your child’s needs.
If your child has partial hearing loss, has damaged ear canals, or often gets ear infections, we may use a bone anchored hearing aid (Baha®). Baha® works by bypassing the damaged outer or middle ear and bringing sound directly to the inner ear.
Children’s is one of the beta testing sites for Baha® SoundArc. This is a stretchy plastic headband that goes around the back of the head, stimulating the hearing nerve directly through your child’s skull and into the inner ear. The Baha® SoundArc doesn’t just improve hearing — it can also improve speech, language, and behavior.
We also provide cochlear implants for children with severe hearing loss who need more help than they could get with a traditional hearing aid.
Additionally, we provide:
- Hearing assessments: Screenings and evaluations to determine how well your child hears
- Conditioned play audiometry: Playing fun, interactive games to test hearing in toddlers and preschool-aged children ages 2-5
- Conventional pure-tone audiometry (air conduction testing): Finds the quietest sound your child can hear at different pitches
- Tympanometry: Detects problems of the inner ear by testing how it reacts to different sounds and levels of air pressure
- Otoacoustic emission testing: Determines how well the inner ear (cochlea) works and can find blockages in the outer or middle ear
- Auditory brainstem response: Tests the functioning of the inner ear (cochlea) and the pathways of the brain that are used for hearing
What To Do Next
Make An Appointment
Patients do not need a referral to see one of our ENT physicians. To make an appointment, call 402-955-6370.
For Referring Providers
The Physicians’ Priority Line is your 24-hour link to pediatric specialists at Children’s for referrals, emergency and urgent consults, physician-to-physician consults, admissions, and transport services. Call 855-850-KIDS (5437).
Learn more about referring patients.