Pediatric otolaryngology
The ears, nose, and throat function as one interconnected system, so a problem in one area often affects another. Recurrent ear infections may be linked to enlarged adenoids, persistent nasal congestion to impaired nasal breathing, and frequent tonsillitis to chronic inflammation of the tonsils. A pediatric otolaryngologist evaluates the entire ENT system, identifies the underlying cause of symptoms, and recommends the most appropriate treatment for children from birth.
Why do ear infections keep coming back?
Acute otitis media is one of the most common reasons parents seek a pediatric otolaryngologist. While most children recover without long-term problems, recurrent ear infections should never be viewed as a condition that simply "runs its course." When infections return repeatedly, it is important to identify the underlying cause rather than treating each episode individually.
Children are naturally more prone to middle ear infections because their Eustachian tubes are shorter, narrower, and more horizontal than those of adults. During a cold or viral upper respiratory infection, swelling of the nasal passages can easily block the normal ventilation of the middle ear. As fluid builds up behind the eardrum, the risk of recurrent inflammation increases.
Enlarged adenoids are another common contributing factor. They can obstruct the opening of the Eustachian tubes, preventing proper air circulation and drainage from the middle ear. This is why some children continue to develop ear infections several times a year despite receiving appropriate treatment for each episode.
Hearing may not return to normal immediately after an ear infection. If your child starts asking people to repeat themselves, turns up the television volume, seems less responsive to quiet sounds, or appears inattentive, fluid may still be present behind the eardrum. Persistent middle ear fluid and temporary hearing loss can affect speech development, concentration, and learning if they remain undetected.
If ear infections recur or hearing does not fully recover after an illness, a pediatric otolaryngology consultation is recommended. When a more detailed assessment of the adenoids, nasopharynx, or Eustachian tube openings is needed, your doctor may also recommend a Pediatric Otolaryngology Consultation with Endoscopic Examination to identify the underlying cause and plan the most appropriate treatment.
Do adenoids always need to be removed?
Adenoids are a collection of lymphoid tissue located high in the nasopharynx behind the nose. They are part of a child's immune system and help detect bacteria and viruses entering through the nose and mouth, playing an important protective role during early childhood.
Frequent viral infections, allergies, and individual anatomical factors can cause the adenoids to enlarge. This condition is known as adenoid hypertrophy. Enlarged adenoids alone are not a disease and do not automatically require surgery. Many children have enlarged adenoids without any symptoms and need only regular observation.
Problems develop when enlarged adenoids block the airway behind the nose. Children may begin breathing through their mouth, snore during sleep, wake up frequently at night, develop recurrent ear infections or sinus infections, and experience hearing problems because the enlarged adenoids interfere with the normal function of the Eustachian tubes.
The decision to remove the adenoids is based on symptoms and their impact on the child's health rather than on size alone. Surgery may be recommended if conservative treatment is unsuccessful, ear infections continue to recur, hearing is affected, nasal obstruction is severe, or sleep-disordered breathing and episodes of obstructive sleep apnea are present.
During the consultation, the pediatric otolaryngologist evaluates both the child's symptoms and the degree of airway obstruction. Endoscopic examination is considered the most accurate way to assess the adenoids because it allows the doctor to directly visualize the nasopharynx, determine the size of the adenoids, and identify whether they are responsible for the child's symptoms. In many cases, this examination helps avoid unnecessary surgery or confirms when surgical treatment is truly indicated.
FAQ
Why does my child snore during sleep?
Regular snoring is not considered normal in children. During sleep, the muscles of the upper airway relax. If airflow through the nose or nasopharynx is partially blocked, the vibrating tissues produce the sound of snoring. Occasional snoring during a cold is common, but persistent snoring that occurs most nights should be evaluated to identify the underlying cause.
The most common cause of snoring in children is enlarged adenoids. They narrow the airway behind the nose, making it difficult for the child to breathe through the nose and leading to mouth breathing. Other possible causes include enlarged tonsils, allergic rhinitis with chronic nasal swelling, persistent rhinitis, and, less commonly, structural abnormalities of the nasal cavity.
If your child snores regularly, breathes through the mouth, wakes frequently during the night, or has persistent nasal congestion, a Pediatric Otolaryngology Consultation is recommended.
Why has my child's hearing become worse after a cold?
Some parents notice that after a cold or viral upper respiratory infection, their child begins asking people to repeat themselves, does not respond to quiet voices, or turns up the television volume. In many cases, this is not permanent hearing loss but a temporary problem involving the middle ear that develops after the illness.
During a cold, swelling of the nasal passages and nasopharynx can interfere with the normal function of the Eustachian tube, which equalizes pressure between the middle ear and the outside environment. When the tube does not function properly, fluid may collect behind the eardrum. This condition is known as otitis media with effusion (OME) or serous otitis media. Unlike an acute ear infection, it often causes no pain or fever, making it easy to overlook.
In many children, hearing returns to normal as the middle ear gradually clears. However, if hearing problems persist for several weeks, recur after every respiratory infection, or are accompanied by repeated ear infections, a pediatric otolaryngology evaluation is recommended. Long-standing middle ear fluid can interfere with speech development, learning, and everyday communication.
Schedule a pediatric otolaryngology consultation
You can schedule an appointment online through our website or by calling +380 97 312 92 91. During the booking process, one of our administrators will ask about your child's symptoms and help you choose the most appropriate type of consultation.
No special preparation is required before the consultation. If your child has previously received treatment or undergone medical examinations, please bring any available medical records, laboratory test results, CT or MRI scans, X-rays, or other relevant investigations. These documents help the physician assess your child's medical history and avoid unnecessary repeat examinations.
If you are unsure whether your child needs to see a pediatric otolaryngologist, you may first schedule a Pediatric Consultation. The pediatrician will perform an initial assessment and refer your child to an ENT specialist if needed.
