Common Childhood ENT Problems and Surgery

As any parent knows, the ear, nose and throat regions are trouble spots for children, with a high frequency of infections and other problems. Sometimes, the problems can be serious ones, leading to major problems like hearing loss, breathing difficulties, sinus infections, vocal cord paralysis or tonsillitis, which may require corrective surgery. Repair of facial and neck injuries in children requires specialized surgery. Some types such as tonsillectomies are very common, while others like ear drum reconstruction are less common and have a lower rate of success.

Ear infections and hearing loss
Ear infections are a common childhood problem and as many as 90% of all children will have experienced one by age two. And by the time they are three years old, five out of six or 83% of all children will have experienced at least one ear infection. Of these, one child out of three or 30% will have experienced multiple episodes with ear infections.
A more serious case of ear problems affecting children concerns hearing loss. Hearing loss may be due to a number of factors, including infections experienced by the mother during pregnancy, genetic factors, and complications and infections after birth. Genetic factors account for hearing loss among 50% to 60% of the children who experience it.
When the cause of hearing loss is damage to the eardrum, corrective surgery is possible, carried out by surgeons specializing in the repair of facial and neck injuries. Such surgeries however have a success rate of only around 85-90%.

Enlarged tonsils and tonsillectomies
Enlarged tonsils are one of the most common ENT problems in children. They can lead to a number of problems like chronic throat infections, breathing problems and sleep disordered breathing. Enlarged tonsils make it 3.7 times more likely that the affected child will experience symptoms of sleep disordered breathing. Around 2-4 % of the pediatric population is estimated to be suffering from Obstructive Sleep Apnea (OSA). OSA can lead to numerous other problems, such as chronic fatigue and susceptibility to disease.
Tonsillectomies are one of the commonest childhood surgeries and recent statistics provided by the government show that 300-400,000 tonsillectomies are performed on children and adolescents each year. The reasons for carrying out tonsillectomies have changed over the years. Thirty years ago, most tonsillectomies, or about 90% of them, were done to prevent recurrent infections. Now, as many as 80% of tonsillectomies are done to correct obstructive sleep problems (OSA) and only about 20% are done to prevent recurrent infections.

Childhood ENT problems and surgery
While specialized surgeons can carry out procedures for the repair of facial and neck injuries, childhood surgery in general should be an emergency option of the last resort. Many childhood disorders can be treated with medications and therapy, and sometimes children just grow out of problems as their ENT passageways become larger and less susceptible to problems. For serious problems like hearing loss and OSA, surgery may be able to help children lead normal lives.