Children's Clinic

Disorders of the ear, nose and throat accounts for a sixth of surgery carried out in children. Almost all the conditions affecting the ear, nose and throat of adults can affect children, and more!

The ABC of paediatric ENT - Airway, Breathing, Communication

'Ts & As', or removal of the adenoids and tonsils, have come under fire for years for doctors and politicians alike. However, from large research studies, we are increasingly aware of which symptoms in children are due to enlargement of the adenoids and tonsils, the long-term consequences of leaving those symptoms untreated and therefore which children would benefit from the operation. These symptoms include recurrent acute tonsillitis, snoring associated with breath-holding and sleep disturbance, halitosis and difficulty swallowing. Mr Kuo uses Arthrocare Smith and Nephew’s Coblation system for tonsillectomy which makes the operation less painful and reduces the complications associated with the operation as well as shortening the convalescence time before return to school.

Noisy breathing in children can also arise from disorders of the larynx (voice-box) and trachea (wind-pipe). They tend to give a different quality of noise from that arising from enlarged tonsils and adenoids. The diagnosis may require endoscopy but can also be apparent from the history and the nature of the noisy breathing.

Hearing is the most important of senses and especially so during education and the acquisition of language. Impairment of hearing during childhood can be due to inherited nerve deafness but much more commonly due to acquired conductive deafness due to fluid in the middle ear (“glue ear”). The ears can also misbehave, giving rise to earache, recurrent ear infections, ear discharge, ringing and dizziness.

Mr Kuo is one of the first surgeons in the UK to adopt an endoscopic approach to ear surgery wherever this is suitable in children. This approach not allows precise removal of any disease in the ear but its minimally invasive nature reduces post-operative pain, removes the need for an uncomfortable head-bandage and often allows chidren to be discharged on the day of surgery.

Tongue-tie (ankyloglossia) is quite a common condition. The effect of a tongue-tie depends on the shape and size of the tongue-tie, the extent with which it stops the tip of the tongue moving normally and the age at which it becomes apparent. Tongue-tie can affect breast-feeding (both for the mother and the baby), eating, dribbling and clarity of speech.