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A child’s medical needs can be demanding and there may be times when parents need to seek the advice of a specialist.

A pediatric ENT specialist can play an important role in a child’s care and treat a variety of conditions.

Because the spectrum of these conditions overlaps with those treated by a pediatrician, it can be confusing for parents. The following guidelines are a guide to common conditions that are likely to require additional treatment. It is never a bad idea for parents to consult their child’s pediatrician first.

Ear Infections

One of the most common reasons parents seek help for their child is ear infections. In most cases, children with a few episodes of otitis media during the first 3 years of life will be examined by their pediatrician and will not need further investigation.

Reasons for parents to consult an ENT specialist with expertise in children are as follows:

• more than 4 ear infections per year, ear infections in children with speech delay
• fluid remaining in the ears (secretory otitis) for more than 3 months
• rupture of the eardrum during an ear infection
• ear infections that do not respond to standard antibiotics
• children who have problems taking antibiotics (such as drug allergies, severe diarrhea, nausea and/or vomiting), or children who cannot take oral medications, and foul-smelling fluid discharge from the ear without pain.

Other infections

As the Infections of the nose, sinuses, and tonsils are quite common in children, and the first step is to have them examined by their pediatrician. However, when they are causing problems in a child’s quality of life, it would be wise for the child to be evaluated by a pediatric ENT specialist and further investigation. Situations in which this approach would be helpful include frequent inflammation of the nose and sinuses, recurrent tonsillitis, and frequent school absences due to sore throats or sinus infections.

Nosebleeds

Children who experience nosebleeds regularly may need treatment by an ENT specialist to reduce the frequency of bleeding events. Although pediatricians are well-versed in such cases, a child who continues to have significant bleeding should be referred to a pediatric ENT specialist.

Snoring and/or obstructive episodes during the night

Children may snore at night, but when this occurs for many months, their sleep quality is disturbed due to frequent awakenings. Also, if there is concern that the child is stopping breathing at night, a complete evaluation of their airway by a pediatric ENT specialist is necessary.

Swellings in the throat

Swellings in the throat of a child can cause anxiety for both parents and the child themselves, when it comes to older children. Often, these are lymph nodes that swell in the attempt of the immune system – which encounters antigens for the first time and learns to deal with them – to fight an infection.

Evaluation is necessary to determine whether or not these lumps should be removed in any neck mass that is growing progressively, whether this growth is associated with a change in skin color, or whether it is congenital (i.e., the child was born with it).