Department of Otolaryngology / Head and Neck Surgery

The Division of Pediatric Otolaryngology combines state of the art surgical therapies for ear, nose and throat disorders in children. Dr. Mitchell Austin in conjunction with medical pediatric subspecialists at The Children’s Medical Center provide complete diagnostic and treatment protocols for pediatric disorders involving recurrent ear infections, hypertrophied tonsils and adenoids, sleep apnea, tracheostomy, sinusitis, neck masses, foreign bodies and laryngotracheal reconstruction.

Visitors to this site are encouraged to contact the division for additional information and to visit the topics and related links listed below.

My child has ear infections and may need tubes.
Recurrent ear infections are more common now than in the past. An upper airway infection usually starts in the nose and may travel upward to the middle ear through the eustachian tube. These eustachian tubes act as protection from infection by allowing secretions to pass out from the ear. Some children ‘s eustachian tubes function poorly and ear infections are a result of this dysfunction. Antibiotics are prescribed only when clinicians can diagnose infection behind the eardrum. Recurring infections and frequent returns to the primary care physician occur in a small subset of children. After four to six episodes of acute otitis media, physicians and parents begin to discuss myringotomy and tube insertion to reduce the incidence of recurrent infections.

• Fact Sheet: Pediatric Sinusitis

My child has fluid behind the ear.
After an ear infection or during teething, allergy or other states fluid may build up in the middle ear space. This condition is called Otitis media with effusion. Fluid may interfere with hearing and children may/or may not appear to hear everything they encounter. Speech delay may occur. Hearing evaluations are available to children of all ages and are strongly recommended in any child suspected of not hearing or speaking at his or her age level.

• Stages of Language Development(ASHA)

Ear tube placement.
Tubes are placed during a short general anesthetic at the Children’s Medical Center. Recovery is quick and the child usually returns to his or her daily activities within one day. Tubes usually are pushed out of the eardrum by the process of skin growth over many months. Swimming is not recommended without earplugs and diving in deep water should be restricted. Outside bacteria, not commonly encountered in the sensitive middle ear may pass through the tube during water exposures.

• Myringotomy - Drainage of the middle ear cavity

My child snores and I’m worried about sleep apnea.
Snoring loudly is abnormal for anyone at any age. Despite it being annoying it may signal obstructive sleep apnea. Children with sleep apnea may snore, wake up irritable, do poorly in school, mouth breathe, constantly sound stuffy, gasp for air, breath hold more than 6 seconds, have restless sleep patterns, wet the bed, and have hyperactive behaviors. Simple parental observation may warrant further investigation. Primary care physicians are being educated to assist their parents and patients in the diagnosis of this disorder by obtaining a sleep study. A sleep study testing oxygenation, breathing patterns and heart rates of children suspected of having sleep apnea. Once a diagnosis of sleep apnea is made corrective treatments are available.

• Children and Sleep Disorders

Surgical treatment of sleep apnea in children.
The most common and effective treatment for obstructive sleep apnea in children is the removal of tonsils and adenoids. We offer Harmonic Scalpel Tonsillectomy as the choice of techniques for the removal of tonsils. Overnight observation and safety is a must with sleep apnea surgeries for children. Discharge is planned when

• Tonsilhelp.com       
• Respiratory Disorders: Obstructive Sleep Apnea

Pediatric Sinusitis.
Children’s upper respiratory system is under constant barrage from bacteria, viruses, and their environment. Children, on average have 6-7 upper respiratory infections per year.  Prolonged infections of the nasal cavity may pass into the sinuses causing sinusitis. Bacterial sinusitis is treated with decongestants, antibiotics and rest. Recurrent infections may cause frustration and concern with both the primary care physician and the parents. Allergy evaluation and environmental analysis are often the first and best routes to reduce infections. After a complete medical therapeutic approach has failed to reduce sinusitis then a surgical recommendation is approached. Adenoidectomy is the most common and recommended procedure for pediatric sinusitis. Endoscopic sinus surgery (ESS) is rarely indicated. ESS is a complex and detailed surgical examination and removal of tissue blocking the natural sinus openings. It should be performed on children as the last resort and is safest when performed by an Otolaryngologist experienced in pediatric sinus surgery.

• Fact Sheet: Pediatric Sinusitis

Tracheotomy
Some children have difficult respiratory problems. Tracheotomies are performed on children to improve their breathing. Not all tracheotomies are permanent but waiting for your child to grow and develop takes patience. We assist many children and families with our pediatric specialty groups’ support in the task of tracheotomy maintenance, bronchoscopy, and hopeful removal.

• Aaron's Tracheostomy Page

Childrens Medical Center