The most common ENT problems in children are enlarged adenoids and tonsils, middle ear infection and fluid in the ear. Ear, nose and throat specialist Op. Dr. Süleyman Kumbasar, whose practice is in Bahçelievler, Istanbul, carries out an age-appropriate examination and, if needed, adds a fine endoscope, tympanometry and hearing tests. Most problems improve with medical treatment and follow-up; surgery is only considered when guideline criteria are met, for example for recurrent infections or sleep-disordered breathing.
Which ENT problems are common in children?
Ear, nose and throat conditions are common in childhood; the main reasons are the developing immune system, frequent respiratory infections and the larger size, at these ages, of tissues such as the adenoids. The most common topics are:
- Enlarged adenoids and tonsils: blocked nose, sleeping with the mouth open, snoring and recurrent throat infections
- Ear infections: acute middle ear infection and hearing loss from fluid in the ear
- Snoring and pauses in breathing during sleep (see snoring and sleep apnoea)
- Allergic rhinitis and a long-lasting runny nose
- Nosebleeds and foreign objects pushed into the nose or ear
- Prominent ears: an ear shape difference usually assessed from the age of 5–6
Which symptoms need an ENT consultation?
- Snoring every night, pauses in breathing during sleep or sleeping with the mouth open
- Throat or ear infections that come back several times a year
- Responding late when called, turning the TV up, or delayed speech
- A blocked nose for weeks, or a one-sided, foul-smelling nasal discharge
- A nasal voice or difficulty swallowing
What is the examination like?
Children are examined step by step, according to their age and how cooperative they are. The eardrum is examined with an otoscope and the front of the nose with a lighted instrument. If the adenoids need assessing, a short examination with a fine endoscope can be done after an anaesthetic spray is applied in the nose. If fluid in the ear is suspected, a measurement of middle ear pressure (tympanometry) and age-appropriate hearing tests are requested.
When is surgery considered?
Most ENT problems in children improve with medical treatment and follow-up. Surgery is considered in the situations defined by international guideline criteria: throat infections above a certain number, sleep-disordered breathing from large tonsils, or fluid in the ear lasting more than three months and affecting hearing. Op. Dr. Süleyman Kumbasar makes the decision about surgery taking into account the examination, the frequency of infections and hearing tests.
Which situations are urgent?
- Swelling and redness behind the ear, with the ear pushed forwards
- Marked difficulty breathing or noisy breathing
- Bleeding from the mouth after a tonsil operation
- A button battery or magnet swallowed or pushed into the nose
In these situations, go to an emergency department without delay.
Frequently asked questions
From what age can a child have an ENT consultation?
An ENT examination can be done at any age. Babies with abnormal newborn hearing screening are assessed in the first months, and other problems at the age they appear.
What can it mean if a child sleeps with their mouth open?
Sleeping with the mouth open over a long period usually indicates a blocked nose. In children, the most common cause is enlarged adenoids; allergic rhinitis and nasal inflammation can also cause it.
Should a child who is often ill have their tonsils removed?
Not every frequent illness means the tonsils need surgery. Guidelines consider surgery an option when the number of documented throat infections is high (for example, seven or more in the past year). The decision depends on how often infections occur and the child’s general health.
Does fluid in the ear affect hearing?
Yes. Fluid in the middle ear can cause temporary hearing loss and, if it lasts a long time, affect speech development. Most fluid clears on its own within three months; in persistent cases, treatment is planned together with a hearing test.
Are nosebleeds in children dangerous?
Most nosebleeds in children come from the blood vessels at the front of the nose and stop with simple measures. If they happen often, last a long time or come with blockage on one side, an examination is needed.
Can children have an endoscopic examination?
Yes. After an anaesthetic spray is applied in the nose, a short examination with a fine endoscope can be done. The examination is planned according to how cooperative the child is.
Related treatments
Sources
- Mitchell RB et al. Clinical Practice Guideline: Tonsillectomy in Children (Update). Otolaryngology–Head and Neck Surgery, 2019.
- Rosenfeld RM et al. Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology–Head and Neck Surgery, 2016.
- Lieberthal AS et al. The diagnosis and management of acute otitis media. Pediatrics, 2013.
The information on this page is for general guidance only; diagnosis and treatment decisions are made by the doctor after a consultation. Results of surgical and interventional procedures vary from person to person.