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Ear, Nose and Throat (Otolaryngology)

 Conditions We Treat

Conditions and Services

Special expertise is available for otolaryngology conditions of the ear, nose and throat, such as:

  • ear disease and hearing loss

  • nasal and sinus disease

  • head and neck malformations or tumors (congenital and acquired)

  • swallowing and voice abnormalities

  • pediatric airway problems

Conditions

Allergic rhinitis is the most common form of childhood allergy. It can occur seasonally, usually as a reaction to pollen, or year round due to dust mites, mold, pet dander and other irritants. Treatment may include antihistamines, nasal sprays and/or allergy shots. 

NOTE: A severe allergic reaction is also called anaphylaxis. If your child's throat closes, if the tongue swells or hives break out, call 911 immediately – this is a medical emergency.

Speech sound disorders include problems with articulation – how words are pronounced – and phonological processes, which are patterns of sounds made when your child pronounces certain consonants or vowels. These errors are quite common in young children who are learning to talk. Causes of some speech sound errors include genetic syndromes, hearing loss and neurological disorders (e.g., stroke, brain injury and cerebral palsy).

A child with this disorder doesn’t hear sounds clearly no matter how loud or soft they are. For example, speech will sound like static. Auditory neuropathy/dysynchrony arises from problems in the hearing nerve or its connections; the degree of hearing loss can range from mild to severe. Treatment options are hearing aids, cochlear implants and other technologies.

Labored or difficult breathing, also known as dyspnea, can be caused by lung, heart or nervous system problems. Asthma and respiratory infections such as croup, bronchitis and pneumonia cause the most breathing difficulties in children. Treatment can include antibiotics for pneumonia, allergy shots and efforts to reduce anxiety.

Cholesteatoma is a type of skin cyst located in the middle ear that can cause permanent moderate conductive hearing loss. While infants can be born with a cholesteatoma, it is more common to occur as a result of a chronic ear infection. Surgery is generally needed to remove the cyst. A second surgery may be necessary to confirm complete removal has occurred and sometimes to insert a prosthesis to improve or restore hearing. 

Cleft lip is a birth defect in which the tissues that form the upper lip don’t join together completely during fetal development, resulting in an opening or split in the lip.

The severity of cleft lip can vary widely. In some cases, the cleft may also cause a split or separation in the upper gums and jaw bone. Cleft lip may occur together with cleft palate, an opening in the roof of the mouth (the palate) caused when the tissues don’t grow together properly. Cleft lip is one of the most common and treatable birth defects with surgery taking place after birth.

Conductive hearing loss occurs when the outer ear canal and the tiny bones (ossicles) of the inner ear are damaged, reducing sound levels or the ability to hear faint sounds. This type of hearing loss can often be corrected medically or surgically.

Otitis media, also known as an ear infection, is one of the most common childhood infections. It can occur in one ear or both ears at the same time. Otitis media is not contagious and there is not one specific cause. Treatment can include surgery to insert ear tubes that ultimately result in fewer and less severe ear infections and better hearing.

Cerumen is the medical term for earwax. It is secreted by glands in the ear canal to keep your ear moist and protects from infection. Wax can build up and block the ear canal, which increases the risk of infection and hearing loss. It can be removed using several methods such as irrigation, suction and direct removal.

Hypertrophy means enlargement of the tissues of the tonsils and the adenoids, which are both located in the throat and have a role in helping the body fight infection. Enlarged tonsils or adenoids may signal infection. However, in some children, the adenoids and tonsils may be naturally enlarged and present no problem. Treatment usually begins with antibiotics; surgery may be recommended if infections continue to occur. 

The eustachian tubes connects the upper part of the throat to the middle ear. They control the pressure behind the eardrum and middle ear space and help keep the middle ear free of fluid. The eustachian tubes are normally closed, but open on occasion with swallowing or yawning. Eustachian tube dysfunction occurs when a tube experiences chronic blockage. Surgery to place small tubes inside a child’s ears may be necessary.

Swallowing disorders, also called dysphagia, mean that infants and children have difficulties during the eating process. Feeding disorders are problems gathering food and getting ready to suck, chew or swallow. These disorders are often related to other medical conditions; children with developmental disorders experience them at a higher percentage than children who are developing appropriately. Treatment may include medicine (e.g., for gastroesophageal reflux), direct feeding therapy, nutritional changes and/or behavior management techniques.

Small amounts of fluid are normally produced in the middle ear and usually drains out of the ear through the eustachian tube. A middle ear effusion occurs when fluid builds up in the space behind the eardrum, usually due to an infection (otitis media). Middle ear effusion tends to go away by itself but if it lasts longer than 2 or 3 months, surgery may be need to insert tubes in the ears.

Hearing loss can affect a child's ability to develop speech, language and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential. The three types of hearing loss are 1) congenital (present at birth), 2) conductive hearing loss (occurs because of a mechanical problem in the outer or middle ear) and 3) sensorineural hearing loss (due to a problem with the cochlea; it often cannot be reversed.) Depending on the diagnosis, treatment may include a hearing aid, removing impacted earwax or foreign object from the ear, cochlear implant, and/or surgery. 

Hoarseness is a condition in which the pitch or quality of the voice may sound weak, breathy, raspy or husky. The most common cause of hoarseness in children is related to colds or flu that inflame the vocal cords, which causes them to swell. Many other health conditions can cause hoarseness. Treatment may include observation, speech and voice therapy, medicine, and/or surgery if a growth on the vocal folds or if they are paralyzed.

Children with language disorders have trouble with vocabulary and word meaning, sentence structure and using language correctly. Receptive language disorders occur when a child has problems understanding spoken and written words and gestures. Expressive language disorders are when a child has problems speaking and writing. A speech-language pathologist helps parents learn how to work with children at home in everyday activities.

A child with a language-based learning disability usually has trouble with both the spoken and the written word. Causes include a difference in brain structure that is present at birth, not a person’s intelligence. Children with dyslexia have a specific learning problem that primarily affects reading and spelling but also may have other language learning problems. Certain strategies can help children offset these challenges. 

Mixed hearing loss, or single-sided deafness, results when one ear has no or very little hearing and the other ear hears normally. The child will typically behave as if hearing normally and will develop speech and language appropriately. However, the imbalance of hearing makes it hard to listen when background noise is present, making classroom learning difficult. Treatment may include hearing aids or a wireless FM system that transmits sound to the child via a receiver. 

Nosebleeds in children are common and are rarely life threatening. They occur due to numerous causes including allergies, sinusitis, and a foreign object in the nose or other nasal blockage. If your child experiences severe bleeding or frequently has nosebleeds, see your pediatrician.

With, tonsillitis, the tonsils located on both sides of the throat are infected by bacteria or viruses, which causes them to swell. At-home care may be all that is necessary to make your child more comfortable. Removing the tonsils (tonsillectomy) is a possible surgical option.

The eardrum is a thin tissue separating the middle ear from the inner ear that protects the middle ear from bacteria, water and foreign objects. A ruptured eardrum happens when a tear occurs, possibly from an infection or injury to the middle ear. Most ruptured eardrums heal within a couple of months with treatments such as medications, antibiotics or surgery if the rupture is severe. 

Sensorineural hearing loss is usually a result of a problem with the cochlea (inner ear). Most of the time, sensorineural hearing loss cannot be medically or surgically corrected. This is the most common type of permanent hearing loss. Children with sensorineural hearing loss will typically need ongoing support, depending on the severity of the hearing loss. Typical support includes tutoring in certain subjects or using American Sign Language, if unable to develop adequate spoken language.

When the sinuses, which are normally filled with air, become blocked and filled with fluid, then germs can grow and cause a sinusitis infection. Risk factors include a compromised immune system, allergies and cystic fibrosis. Patients with chronic sinusitis may be referred to an otolaryngologist to be evaluated for possible surgery.

Sleep apnea is a chronic condition that disrupts sleep by causing a child to have paused or shallow breathing. It is most commonly due to enlarged tonsils and adenoids that block the airway. Sleep apnea is a leading cause of excessive daytime sleepiness. Possible treatments include possible removal of the adenoids and the tonsils or use of continuous airway pressure mask (CPAP). 

Children learn to talk and learn language in their first three years. By then, a child should be able to speak and be understood. Causes of speech delay include not being able to hear, a delay in neurological processes and certain disorders. Your child's doctor may refer you to a speech pathologist who will evaluate and treat the child. 

Difficulty in swallowing, called dysphagia, affects infants and children. Causes include developmental disorders, neurological disorders, prematurity and structural abnormalities. Living with swallowing difficulties can be challenging. Types of treatment depend on what causes the problem; these include medication for acid reflux, therapy to make the muscles of the mouth stronger, improving sucking and drinking ability, and tube feeding.

The vestibular system refers to the parts of the inner ear and brain that process sensory information for controlling balance and eye movements. Dizziness, vertigo and trouble with balance are the most recognizable symptoms of vestibular disorders in children, but hearing and vision can also be affected. Treatment can include a combination of vestibular rehabilitation therapy, physical and occupational therapies, exercise, dietary adjustments and medication.

A vocal disorder affects the quality of the voice, resulting conditions such as hoarseness, breathiness, harshness or weakness. Voice disorders are often the result of straining the vocal cords, but can also be caused by injury, disease and other factors. After evaluation by the doctor, treatment may be medical, surgical and/or behavioral.

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