A child's health care needs can be challenging and there may times when parents need to seek consultation with a specialist. Ear, Nose, and Throat (ENT) specialists can play an important role in a child’s care and treat a variety of conditions. Because this care may overlap with a pediatrician’s, it can be confusing for parents. Here are guidelines to help parents make decisions about when their child should see an ENT.
One of the most common reasons parents bring their child to a health care provider is ear infections. Many children will see a pediatrician for an episode of otitis media during the first 3 years of life and if these are isolated cases, there is no need to go beyond this initial care.
Reasons to consult with an ENT provider for ear infections include:
More than 4 infections per year
Ear infections in children with speech delay
Persistent fluid in the ears (more than 3 months)
Rupture of the ear drum during an infection
Ear infections requiring multiple antibiotics
Children who haveissues when taking antibiotics such as medication allergies, severe diarrhea or nausea and vomiting, or children unable to take oral medications well
In addition to ear infections, other infections that may necessitate consultation with an ENT include multiple sinus infections in a year, recurrent tonsillitis or frequent school absences due to sore throats or sinus infections. Both sinus and tonsil infections are common in children and seeing the pediatrician is a good first step. When these cause problems with a child’s quality of life, it may be valuable to visit an ENT.
Children who get nosebleeds regularly, and specifically without any incident having caused them, may need to be treated by an ENT specialist to decrease the frequency of the bleeding events. Although pediatricians may be comfortable with initial treatment, a child who continues to have significant bleeding should seek consultation from an ENT physician.
Children may snore at night but when they have been doing it for more than several months, it disrupts the quality of their sleep with frequent awakenings, or if there is concern that the child stops breathing at night, a full evaluation of their airway by an ENT specialist is warranted. This requires a thorough office exam and may involve the physician placing a camera in the child's nose to look at the upper airway. An ENT doctor is able to treat this both medically and surgically, if necessary.
Growths or Masses
Neck masses or lumps in a child can be anxiety provoking. Often these are lymph nodes helping a child fight an infection. An evaluation with a surgeon to determine if masses need to be removed should be done for:
Any neck mass that is progressively growing
The growth is associated with skin discoloration
If it is congenital (the child was born with it)
There are many conditions that an ENT specialist treats and this is not meant to be an exhaustive list, but rather a guide to common conditions that have a high likelihood of needing additional treatment. It is never wrong to consult a pediatrician first.
To learn more about Ear, Nose and Throat services at Nationwide Children’s Hospital, click here.
Charles A. Elmaraghy, MD, is chief of the Department of Otolaryngology at Nationwide Children’s Hospital and an active faculty member in the Department of Otolaryngology – Head and Neck Surgery and a professor of Clinical Otolaryngology at The Ohio State University College of Medicine.
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