Appointments

I see children privately at Bedford Hospital South Wing, Cobham Clinic in Luton and The Spire Hospital in Harpenden.

Adenoid

The adenoid is a small gland in the back of a child’s nose.  It helps to fight infections in the early years of life but becomes redundant at about three years of age.  The adenoid then gets smaller over time.

In some children the adenoid is so large that it blocks the nose and the child appears to breathe only through their mouth.  This can cause snoring and problems breathing at night.  It can also block the tubes that connect the ears to the nose and contribute to the formation of “glue ear”.  This causes hearing loss and can make your child prone to ear infections.  Removing the adenoid can help treat these symptoms but there is a small risk of bleeding which must be considered.

If you would like more information on adenoid conditions please  CLICK HERE

Tonsils

The tonsils are small glands in the back of the mouth which help to fight infections in early childhood.  They then become redundant at approximately three years of age and then gradually shrink.  Like the adenoid they can become enlarged and contribute to snoring and problems breathing at night.

Most sore throats are viral and are fairly mild, only lasting a few days at a time.  They are often accompanied by a cough and runny nose and usually require no treatment other than paracetamol and ibuprofen.

Bacterial tonsillitis is much more severe and your child will usually refuse to eat and drink.  They will also have a high temperature, swollen glands in their neck and the tonsils will be coated in white spots.  A runny nose and cough are not usually present. If this occurs frequently and your child is missing lots of school then removing them can help.  There is a small chance of bleeding (1 to 2%) which must be considered.

If you would like more information on tonsils conditions please  CLICK HERE

Glue ear

When mucus accumulates behind the eardrum it is called “glue ear”.  It is very common in childhood and can cause problems with hearing, speech delay, behavioural problems and recurrent ear infections.  Most children will suffer with at some point in time and it only requires treatment if it does not resolve by itself.  I adopt a watch and wait policy before offering treatment, which is either grommets (small ventilation tubes which fall out after one year) or a hearing aid which is used for as long as the glue ear is present.  Removing the adenoid can also reduce the likelihood of the glue ear returning.

If you would like more information on glue ear conditions please  CLICK HERE

Protruding ears

Protruding ears is usually due to a weakness in part of the ear cartilage.  It can sometimes cause the child distress, especially if he or she is being teased at school.  Surgical correction called “pinnaplasty” can be performed but not usually before the child is six years old.  The cartilage is stronger and I like the child to be mature enough to understand what is happening to them as this makes for a smoother recovery and ultimately the best result.  The operation involves a general anaesthetic.  I make a cut behind the ear and create a natural looking fold in the cartilage which pulls the ear inwards towards the head.  A head bandage is then left in place for two weeks to help the ears heal in their new position.  This can be a little itchy and uncomfortable for the child and is another reason why I advocate waiting until they are at least six years of age so that they understand why they need to wear the bandage.  I then ask the child to wear an elasticated headband over their ears for another 4 weeks at night-time only.

If you would like more information on protruding ear conditions please  CLICK HERE

Snoring and sleep apnoea

Snoring in childhood is common and is usually caused by enlarged tonsils and/or adenoid.  Snoring is caused by blockage of the upper airways during sleep and ranges from "simple snoring" where there is no significant drop in the child's blood oxygen levels through to something called "obstructive sleep apnoea" where the child appears to stop breathing in their sleep for what appears to be a very long time.

ENT surgeons use the umbrella term "sleep disordered breathing" to describe all types.  Simple snorer's suffer no consequences and need no treatment and the child usually grows out of it.  This is also the case for children with very mild sleep apnoea.  Children with moderate to severe sleep apnoea often elicit behavioral problems like ADHD, bed-wetting and "failure to thrive".  These children can benefit from an operation to remove the adenoid and tonsils.  It is often difficult for a doctor to determine how severe a child's case is.  A sleep test may be requested but it is also helpful to video your child sleeping on your mobile phone.