The problems parents most often bring
A large share of childhood illness is ear, nose and throat related, and much of it settles on its own. The value of a paediatric ENT assessment is in identifying which problems need active treatment, which need only observation, and which are quietly affecting hearing, speech or growth while looking unremarkable.
Recurrent ear infections
Common in the early years because the eustachian tube is shorter and more horizontal in children. Most episodes resolve with appropriate treatment; the concern is a child having frequent episodes, or fluid that persists between them.
Glue ear (fluid behind the eardrum)
Fluid can remain in the middle ear after infections without causing pain, and this is easily missed. The child hears as though underwater — turning the television up, not responding when called, appearing inattentive at school, or showing delayed or unclear speech. Many cases resolve spontaneously over weeks to months, which is why a period of watchful waiting with hearing assessment is standard. Persistent fluid with hearing loss affecting speech or learning may need grommets (ventilation tubes).
Snoring and mouth breathing
Habitual snoring, restless sleep, an open mouth by day, morning tiredness and behavioural or concentration difficulty often trace to enlarged tonsils and adenoids. This is one of the most rewarding problems to treat.
Hearing and speech concerns
If a child is not meeting speech milestones, hearing must be tested — not assumed to be normal. Hearing assessment is possible at any age, including infancy, using age-appropriate methods. Early identification matters enormously for language development.
Preauricular sinus
A small pit in front of the ear, present from birth. It needs nothing at all unless it becomes infected — but once it has been infected, recurrence is common and complete surgical excision of the pit and its tract is usually advised.
Other frequent concerns
- Persistent runny nose, allergic rhinitis and repeated colds
- Foreign bodies in the ear or nose
- Neck swellings and lymph node enlargement
- Noisy breathing in infants (stridor)
- Recurrent tonsillitis and throat infections
- Nosebleeds
Why "wait and watch" is often the right answer
A good paediatric ENT practice recommends surgery less often than parents expect. Many childhood ENT problems are self-limiting: glue ear frequently clears without intervention, adenoids naturally shrink as children grow, and most sore throats need nothing beyond supportive care.
What justifies moving from observation to treatment is evidence of impact — measured hearing loss, disturbed sleep with signs of airway obstruction, effects on growth or school performance, or a frequency of infection that is genuinely disrupting the child's life. Making that judgement properly requires examination and, where relevant, objective testing rather than an impression.
Record your child's sleep symptoms before your visit
The Pediatric Sleep Questionnaire is a standardised parent-completed questionnaire about sleep-disordered breathing. Your answers stay on your own device.
Open the questionnaire →What to expect at a children's appointment
- Time to observe. A lot is learned simply by watching how a child breathes, speaks and behaves before any instrument is used.
- Gentle examination. Ears, nose and throat examined with the child sitting comfortably, often on a parent's lap. Nothing painful.
- Hearing testing where indicated, using methods appropriate to the child's age.
- A clear plan in plain language — what the problem is, whether it needs treatment now, what to watch for, and when to return.
Bringing a record of episodes — how many infections, when, what treatment was given, and any school or teacher observations — makes the assessment considerably more useful than trying to recall it in the room.
Difficulty breathing or noisy laboured breathing, drooling with inability to swallow, a swollen tender neck with high fever, sudden hearing loss, facial weakness, a foreign body in the airway, or any object such as a button battery inserted into the nose or ear — button batteries are a genuine emergency and cause tissue damage within hours.
കുട്ടികളുടെ ഇഎൻടി — ചുരുക്കത്തിൽ
കുട്ടികളിലെ ചെവി-മൂക്ക്-തൊണ്ട പ്രശ്നങ്ങൾ മുതിർന്നവരുടേതിൽ നിന്ന് വ്യത്യസ്തമാണ്; അവ കുട്ടിയുടെ കേൾവി, സംസാരം, പഠനം, വളർച്ച എന്നിവയെ ബാധിക്കാം.
ശ്രദ്ധിക്കേണ്ടവ: വിളിച്ചാൽ പ്രതികരിക്കാതിരിക്കുക, ടിവിയുടെ ശബ്ദം കൂട്ടുക, സംസാരം വൈകുക (ചെവിയിൽ വെള്ളം കെട്ടിനിൽക്കുന്നതിന്റെ ലക്ഷണമാകാം), എല്ലാ രാത്രിയും കൂർക്കംവലി, വായ തുറന്ന് ശ്വസിക്കൽ, ഇടയ്ക്കിടെ ചെവിവേദന.
പ്രധാനം: പല പ്രശ്നങ്ങളും തനിയെ ഭേദമാകും — എല്ലാത്തിനും ശസ്ത്രക്രിയ വേണ്ട. കേൾവി, ഉറക്കം, വളർച്ച എന്നിവയെ ബാധിക്കുമ്പോൾ മാത്രമാണ് സജീവ ചികിത്സ വേണ്ടത്.
അടിയന്തരം: ശ്വാസതടസ്സം, ഉമിനീർ ഇറക്കാൻ കഴിയാതെ വരിക, ഉയർന്ന പനിയോടെ കഴുത്ത് വീങ്ങുക, മൂക്കിലോ ചെവിയിലോ ബട്ടൺ ബാറ്ററി കയറുക — ഉടൻ ആശുപത്രിയിൽ എത്തിക്കുക.
Frequently asked questions
My child does not respond when called — could it be hearing?
Possibly. Fluid behind the eardrum (glue ear) causes hearing loss without pain and is easily mistaken for inattention. Signs include turning up the television, not responding when called from another room, unclear or delayed speech, and teachers reporting poor concentration. Hearing can be tested at any age and should be checked rather than assumed normal.
Does glue ear always need grommets?
No. A large proportion of glue ear resolves on its own within a few months, which is why a period of watchful waiting with hearing assessment is standard practice. Grommets are considered when fluid persists and is causing hearing loss that affects speech development, learning or behaviour.
When does a preauricular sinus need surgery?
A preauricular sinus — the small pit in front of the ear present from birth — needs no treatment unless it becomes infected. Once it has been infected, recurrence is common, and complete surgical excision of the pit and its entire tract is usually advised. It is a short day-care procedure through a small, well-hidden incision.
How many throat infections justify removing tonsils?
Frequency alone is not the only factor, but established criteria consider genuine, documented episodes with fever and difficulty swallowing that required medical treatment, counted over the preceding one to two years, along with the impact on school attendance and the child's wellbeing. Occasional sore throats do not warrant surgery.
Is it safe to give a child general anaesthesia for ENT surgery?
Modern paediatric anaesthesia is very safe when carried out by trained anaesthetists in an appropriate facility. Risks are discussed individually before any procedure, and the decision always weighs them against the harm of leaving the condition untreated — for example the effects of obstructed sleep on growth, behaviour and learning.
What should I do if my child puts something in the nose or ear?
Attend for assessment rather than attempting removal at home, which usually pushes the object deeper. A button battery in the nose or ear is a genuine emergency requiring immediate hospital attendance, because it can cause serious tissue damage within a few hours.
Related information
This page is general health information about pediatric ent care and is not a substitute for a personal medical consultation. Every patient is different; treatment decisions — including whether surgery is appropriate — should be made after an examination by a qualified ENT surgeon. If you have sudden severe symptoms such as difficulty breathing, heavy bleeding, sudden hearing loss or severe headache, seek emergency medical care immediately.