Paediatric Otorhinolaryngology

Great friends


Children are affected by a variety of infections of the ear, nose and throat. These infections are more common in preschoolers and in children in the first years of school. The symptoms of ENT problems in childhood may be obvious such as ear pain, nasal obstruction, hearing loss or recurrent pain in the neck. Sometimes the signs and symptoms are less obvious. For example, speech problems, inattention and behavioral problems may be due to loss of hearing. Sleep problems may be due to oversized tonsils or adenoids.


The tonsils and adenoids are part of the immune system and help to create the immune defence of the child’s early years. After the age of 3 they do not have a particular important function. Tonsils and adenoids can grow in size and cause obstruction of respiration. This may manifest itself as snoring. In severe cases, children may choke or gasp when they sleep. This increases the likelihood of Obstructive Sleep Apnea (OSA), which can cause health problems generally.


In these cases the adenoidectomy (removal “adenoids”) and tonsillectomy (total tonsil removal) or tonsillotomy (partial tonsil removal) effectively cures the problem and restores breathing.


The tonsils can be a problem when inflamed repeatedly. Bacterial tonsillitis is a condition associated with failure of ingestion of food and intense pain in the neck. There is often fever and antibiotic treatment is frequently required.


If a child suffers from recurrent tonsillitis crises, then tonsils removal is recommended. The frequency and severity of attacks are decisive factors for the indication of surgery. Where there is a problem because only of the size of the tonsils without the presence of recurrent inflammations (tonsillitis), the partial removal of the tonsils is recommended. This type of surgery is associated with far fewer complications compared to tonsillectomy and can be done in younger children, when the indication is present.


Many children suffer from frequent infections of the middle ear at the beginning of their lives. Often the child wakes up in the middle of the night crying. When pus occurs in the ear canal, the pain disappears as the perforated eardrum releases the pus from the middle ear cavity.


In other children, the middle ear is filled with a thick fluid that causes hearing loss. This is a condition called secretory otitis. It is painless, but the hearing loss affects speech and progression. This pathology is usually associated with oversized adenoids ( “adenoids”). When the problem is chronic, appropriate surgical treatment is needed.


“As former director of the ENT pediatric department of Städtisches Klinikum Karlsruhe in Germany (about 21 surgeries in children a week) I was able to cope with a very large number of children with disorders in the full range of ENT. As a parent, I fully understand the anguish and the willingness of each parent, for the best possible treatment of their child by the medical and nursing staff. With love, a lot of time and patience, I will do all best for each child and parent who seek my help. ”


Dr. Evangelos J.. Giotaki, ENT – Facial Plastic Surgeon