Children’s ENT Conditions

Tonsillitis is inflammation of the tonsils and commonly refers to an infection by viruses or bacteria. This causes swelling, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck. It is most common in children of all ages but frequently occurs between preschool ages and the mid-teens. It can occur when children have a cold, runny nose and a cough. Appropriate treatment for tonsillitis depends on the cause, so it’s important to get a prompt and accurate diagnosis. A Tonsillectomy to remove tonsils is a common treatment, however, it is usually only performed when tonsillitis occurs frequently or doesn’t respond to other treatments or causes serious complications such as an abscess. Frequent infections can also impact quality of life and result in significant time off school.

Ear infections are common in young children, and most are not serious and get better quickly. Babies and infants have smaller Eustachian tubes (which connect the ears to the nose/throat), making them more susceptible to infections than older children. There are two types of ear infections in children: middle ear (otitis media) and outer ear (otitis externa). Viruses, bacteria, and fungi can cause ear infections. Middle ear infections occur behind the eardrum and typically start from a cold or flu. This results in fluid accumulation and bulging of the eardrum. When severe, pus can accumulate, and the eardrum can burst. Signs of infection may include fever, irritability, and ear tugging. In most middle ear infections, the fluid resolves, but occasionally, it may persist for several months and form glue ear. This can result in hearing loss, speech and language delay, and may be a reason your child requires grommets, especially if they experience frequent infections. Grommets are tiny hollow tubes that ventilate the middle ear, improving hearing and reducing the frequency of infections. Outer ear infections, also known as ‘swimmer’s ear,’ often occur after exposing the ear to water, moisture, or from trauma such as scratching or using earbuds. Your child may have ear discharge and severe pain, especially when the ear is touched. If the infection is severe, it can spread to involve the external ear and earlobe.

Snoring is common in children, affecting approximately 15%. If the snoring is loud and your child has pauses in breathing or difficulty breathing during sleep, they may have OSA. Other features of OSA include choking, gasping, snorting, restless and sweaty sleep. Your child may also sleep in unusual positions with their mouth open and neck extended. They may wake tired or irritable in the morning and often feel tired during the day. OSA disrupts sleep, potentially leading to learning, behavioural, or medical problems.

Snoring and OSA are caused by narrowing or blockage in the airway, commonly due to enlarged tonsils, adenoids, and turbinates in the nose. The tonsils and adenoids grow the quickest between ages 2-8, so treatment for snoring and OSA often involves surgical removal. Other causes of OSA include obesity, small facial or jaw structures, or medical conditions such as Down syndrome, which leads to weak or low muscle tone. If you suspect your child has OSA, take them to see your GP. Dr Floros has a specialist interest in managing children of all ages who snore and have OSA. He works closely with other specialists at the Sydney Children’s Hospital to care for these children.

A blocked nose is common in children and may be a sign of enlarged adenoids or turbinates, which are structures in the nose. It can also be associated with snoring, sleep apnoea, or allergic rhinitis (hay fever). Children will often breathe with their mouth open and sound nasally. Other features of allergy include sneezing, itching of the nose, eyes, or roof of the mouth, a runny or stuffy nose, and watery, red, or swollen eyes (conjunctivitis). These symptoms may be more prominent during spring due to seasonal allergies.

A blocked or runny nose can significantly impact your child’s quality of life, dental hygiene, and sleep. There are several treatment options available, but an accurate assessment is important to determine the cause. Nasal sprays, specific allergy treatments, and surgery all play a role in alleviating these symptoms. Dr Floros treats children of all ages with nasal blockage, runny nose, and allergies.

Among children, a nosebleed is often related to simple trauma, including nose picking, which affects the front of the nose where delicate blood vessels are easily ruptured. High blood pressure and inherited bleeding disorders can also contribute to nosebleeds, and in rare cases, it may indicate a more serious issue, such as a growth.

Most nosebleeds can be easily controlled with pressure and other measures. However, large, recurrent, and difficult-to-stop nosebleeds may require cauterisation.