ENT Problems in Children

Tonsillectomy 

This common operation is performed for kids or adults who suffer many bouts of tonsillitis or in those where the tonsils get so large they block the throat and cause difficulty with eating, breathing and sleeping. Tonsillectomy used to be done very routinely but we are more selective nowadays, and take many different factors in the history and examination into account before recommending surgery. Most tonsillectomies are done in little kids aged 3-7 and in young adults aged 16-20. Occasionally people over 30  or under 3 need tonsillectomy. The surgery is done using very precise instrumentation and is very safe. Blood loss is usually around the same as a routine blood test and local anaesthetic put in during surgery makes the recovery well tolerated. Mr Cook has performed over 2000 tonsillectomies. Most kids and adults stay overnight after surgery but some fit and well adolescents do very well going home on the same day as the operation. Prior to planning any surgery the risks and the expected course of recovery will be explained to the patient and/or their parents.

Adenoidectomy 

This may be done on its own, or combined with tonsillectomy, grommets or other nasal surgery. Adenoids are lymph glands that live behind the nose and sometimes get too big or get infected too often. This causes nasal discharge, a blocked nose or recurrent sinusitis in kids. If the enlarged adenoids block the openings to the drainage tubes from the ears (Eustachian tubes), ear infections and hearing loss can sometimes happen (see grommets below). Adenoids are not an important structure, and removing them certainly does not affect any immune function. Adenoidectomy is performed with a small curette (through the mouth) or with a precision electrocautery device. Recovery is usually a day or so and the procedure is usually done as a day procedure.

Grommets 

These are small plastic tubes that help ventilate the part of the ear under the eardrum (middle ear). They are sometimes placed for children or adults with recurrent ear infections, hearing loss or both. Young children have under-developed middle ear drainage tubes (Eustachian tubes) which occasionally get blocked and lead to fluid build up with subsequent pain, infection or hearing loss. The condition is less common in adults but can occasionally occur. In those kids with a blocked or snotty nose in conjunction with blocked ears, adenoidectomy is sometimes performed at  the same time as grommet insertion. A hearing test is needed prior to tube placement to help ascertain if there is any hearing loss. Tubes are placed in the ear drums under general anaesthetic using a microscope. The procedure is quick and relatively pain-free and can be done as a day procedure. Most patients are "back to normal" in a day or two.

While grommets can let fluid drain out and air in, water can also occasionally cause concern in those with grommets. To get a better understanding of grommets and water exposure, please click here.