As a Pediatric ENT Specialist in Dubai, Dr. Nanor Tchaghlasian provides specialist care for children with ear, nose and throat conditions. Common pediatric ENT problems include recurrent tonsillitis, enlarged adenoids, blocked nose, snoring, ear infections, middle ear fluid and hearing problems. Care is tailored to the individual needs of each child, from initial assessment and diagnosis through medical or surgical treatment when required.
Conditions We Treat
- Enlarged adenoids (Adenoid hypertrophy)
Enlarged tonsils- Recurrent tonsillitis and sore throat
- Snoring and sleep-disordered breathing
- Nasal blockage and mouth breathing
- Runny nose and allergic rhinitis
- Nosebleeds (epistaxis)
- Ear infections (acute and recurrent)
- Middle ear fluid (Otitis Media with Effusion)
- Hearing loss in children
- Ear pain
- Earwax problems
- Foreign bodies in the ear or nose
- Hoarseness and voice problems
Chronic cough- Neck lumps and enlarged lymph nodes
Common Conditions Treated by a Pediatric ENT Specialist in Dubai
1. Tonsillitis in Children
Tonsillitis is inflammation of the tonsils, usually caused by a viral or bacterial infection. It is common in children and may cause sore throat, painful swallowing, fever, swollen or red tonsils, enlarged lymph nodes in the neck, and sometimes white spots or patches on the tonsils.
Most episodes of tonsillitis are caused by viruses and improve with supportive treatment. Bacterial tonsillitis, including infection caused by Group A Streptococcus (strep throat), may require antibiotic treatment after appropriate clinical assessment and testing.
How Is Tonsillitis Diagnosed?
Tonsillitis is usually diagnosed by examining the throat and tonsils and assessing the child’s symptoms. When a bacterial infection such as strep throat is suspected, a rapid strep test or throat swab may be performed. In selected cases, additional laboratory tests may be recommended.
Treatment of Tonsillitis in Children
Treatment of tonsillitis depends on the cause and severity of the infection. Viral tonsillitis usually improves with supportive care, including adequate fluids, rest and appropriate pain or fever medication. Antibiotics may be prescribed when a bacterial infection, such as strep throat, is confirmed or strongly suspected. If antibiotics are prescribed, the full course should be completed as directed. Children who are unable to drink adequately because of severe pain or swallowing difficulty may require further medical assessment and, occasionally, intravenous fluids.
Home Care for Tonsillitis and Sore Throat in Children
Supportive care can help relieve symptoms while your child recovers:
- Encourage plenty of fluids to prevent dehydration.
- Allow adequate rest.
- Offer warm or cool drinks depending on the child’s preference.
- Older children who can gargle safely may use warm salt-water gargles.
- Age-appropriate throat lozenges may help older children; avoid them in young children because of choking risk.
- Use a humidifier if the air is dry.
- Avoid cigarette smoke and other airway irritants.
When Is Tonsillectomy Recommended in Children?
Tonsillectomy may be recommended for children with recurrent tonsillitis or when enlarged tonsils cause significant breathing, sleep, or swallowing problems. The decision is based on the frequency and severity of symptoms, examination findings, and the individual needs of the child.
2. Large Adenoids (Adenoid Hypertrophy)
Adenoids are lymphoid tissue located at the back of the nose, behind the nasal cavity. They are part of the immune system and help the body respond to infections, particularly during early childhood.
Adenoids normally become smaller as a child grows. However, in some children they become persistently enlarged or inflamed. Enlarged adenoids (adenoid hypertrophy) can cause a blocked nose, mouth breathing, snoring, disturbed sleep, and persistent nasal discharge.
Enlarged adenoids may also affect the Eustachian tubes and contribute to recurrent middle ear infections or persistent middle ear fluid (otitis media with effusion), which may affect hearing.
When Is Adenoidectomy Recommended?
Adenoidectomy (surgical removal of the adenoids) may be recommended when enlarged or persistently inflamed adenoids cause significant or recurrent problems.
Common reasons include:
- Persistent nasal blockage and mouth breathing due to enlarged adenoids
- Significant snoring or disturbed sleep related to enlarged adenoids
- Obstructive sleep apnea associated with enlarged adenoids
- Persistent or recurrent nasal symptoms related to chronic adenoid inflammation
- Recurrent middle ear infections or persistent middle ear fluid, particularly when enlarged adenoids contribute to Eustachian tube dysfunction
Adenoidectomy may be performed alone or together with tonsillectomy or insertion of ear ventilation tubes (grommets), depending on the child’s symptoms and clinical findings.
3. Middle Ear Fluid (Otitis Media with Effusion) in Children
Otitis media with effusion (OME), commonly called middle ear fluid or “glue ear,” occurs when fluid collects behind the eardrum without signs of an acute ear infection. It is very common in children and often develops during or after a cold or upper respiratory tract infection.
In many children, the fluid clears naturally within a few weeks or months. However, persistent middle ear fluid can affect hearing and may require further assessment and treatment.
Why Is Middle Ear Fluid Common in Children?
The middle ear is an air-filled space behind the eardrum. It is connected to the back of the nose by the Eustachian tube, which helps ventilate the middle ear and maintain normal pressure.
In children, the Eustachian tubes are smaller, more horizontal and less efficient than in adults. During a cold, upper respiratory infection or nasal inflammation, the Eustachian tubes may become swollen or blocked. This can prevent normal ventilation of the middle ear and lead to fluid collecting behind the eardrum. Enlarged adenoids can also contribute to Eustachian tube dysfunction and persistent middle ear fluid.
How Can Middle Ear Fluid Affect My Child?
Middle ear fluid may cause a temporary reduction in hearing. A child may seem to hear less clearly, ask for repetition, turn up the television volume, or have difficulty hearing in noisy environments. Some children may also experience ear fullness, discomfort or occasional ear pain.
If the fluid persists and hearing is affected for a prolonged period, it may interfere with speech and language development, particularly in younger children. It may also affect attention, listening and performance at nursery or school.
For this reason, persistent middle ear fluid should be assessed with an ear examination and, when appropriate, tympanometry and an age-appropriate hearing test.
How Is Middle Ear Fluid Diagnosed in Children?
Middle ear fluid is diagnosed by examining the ear and eardrum with an otoscope. The eardrum may appear dull or retracted, and fluid or an air-fluid level may be visible behind it.
Tympanometry can be used to assess the movement of the eardrum and middle ear function. A flat (Type B) tympanogram commonly supports the presence of middle ear fluid.
An age-appropriate hearing test may also be recommended to determine whether the fluid is affecting the child’s hearing.
Should I Worry If My Child Has Middle Ear Fluid?
In many children, middle ear fluid resolves naturally within a few weeks or months. However, persistent fluid may affect hearing and should be monitored.
Further assessment is particularly important if the fluid persists for several months, causes significant hearing loss, or if there are concerns about the child’s speech, language, learning, or development.
The need for treatment depends on the duration of the fluid, hearing test results, symptoms, and the individual needs of the child.
What Can Parents Do at Home for Middle Ear Fluid?
There is no home treatment that can directly remove middle ear fluid. In many children, the fluid resolves naturally with time.
Parents can help by avoiding cigarette smoke and other airway irritants. Children should also be assessed if they develop recurrent ear infections, persistent ear discomfort, hearing difficulties, or concerns about speech and language development.
Regular follow-up may be recommended to monitor the middle ear fluid and the child’s hearing.
Can My Child Travel by Airplane With Middle Ear Fluid?
Most children with middle ear fluid can travel safely by airplane. However, changes in cabin pressure, particularly during descent, may sometimes cause ear pressure, discomfort or pain.
Encouraging your child to swallow or drink during take-off and landing may help equalize middle ear pressure. Older children may also be encouraged to yawn or swallow frequently.
If your child has significant ear pain, an acute ear infection, or has recently had ear surgery, it is advisable to consult an ENT specialist before flying.
Treatments and Procedures by a Pediatric ENT Specialist in Dubai
Tonsillectomy in Children
Tonsillectomy is a surgical procedure to remove the tonsils. It may be recommended for selected children with recurrent tonsillitis or significantly enlarged tonsils causing breathing, sleep, or swallowing problems.
The procedure is performed under general anesthesia. The surgical technique and need for an overnight hospital stay depend on the child’s age, medical condition, symptoms, and individual clinical circumstances.
Adenoidectomy and Adenotonsillectomy in Children
Adenoidectomy is a surgical procedure to remove the adenoids. It may be performed alone or together with tonsillectomy (adenotonsillectomy), depending on the child’s symptoms and clinical findings.
Adenoidectomy may be recommended for children with persistent nasal obstruction, mouth breathing, significant snoring or sleep-disordered breathing related to enlarged adenoids. It may also be considered in selected children with recurrent ear infections or persistent middle ear fluid.
The procedure is performed under general anesthesia, and the adenoids are removed through the mouth without an external incision.
Tympanostomy (Grommet) Insertion in Children
Tympanostomy, commonly called grommet insertion, is a procedure in which a tiny ventilation tube is placed through the eardrum. The tube helps ventilate the middle ear, reduce persistent fluid build-up, improve hearing when affected by middle ear fluid, and may help reduce recurrent middle ear infections.
The procedure usually takes about 10–20 minutes and, in children, is commonly performed under general anesthesia.
When Is Grommet Insertion Recommended?
Grommet insertion may be considered for children with persistent middle ear fluid (otitis media with effusion), particularly when it is associated with hearing loss or concerns about speech, language, learning, or development.
It may also be recommended in selected children with recurrent acute middle ear infections. The decision depends on the child’s symptoms, examination findings, hearing assessment, tympanometry results, and duration of the problem.
Recovery After Grommet Insertion
Most children recover quickly and can return to their usual activities shortly after the procedure.
A small amount of ear discharge may occasionally occur after surgery. Ear drops may be prescribed when clinically indicated.
Benefits of Grommet Insertion
Grommets ventilate the middle ear and allow persistent fluid to resolve. When hearing loss is caused by middle ear fluid, hearing usually improves after the fluid is cleared. They may also help reduce recurrent middle ear infections in appropriately selected children.
How Long Do Grommets Stay in the Ear?
Most grommets remain in place for several months and eventually fall out naturally as the eardrum heals. Some children may develop middle ear fluid again after the grommet falls out and may require further assessment or, occasionally, another set of grommets.
Are There Any Risks?
Grommet insertion is generally a safe and commonly performed procedure. Possible complications include ear discharge or infection, blockage of the tube, scarring of the eardrum, early extrusion or prolonged retention of the grommet, and, less commonly, a persistent perforation of the eardrum after the tube falls out.
Swimming, Bathing and Air Travel
Normal bathing and surface swimming are generally possible after grommet insertion. Routine earplugs are not necessary for every child, although they may be recommended in certain situations, such as when swimming in untreated water, diving, or if water entering the ear causes discomfort or discharge.
Air travel is generally safe with functioning grommets because the tubes help equalize middle ear pressure.
