Paediatric ENT

Specialist ENT care for children — from glue ear and tonsillitis to paediatric sleep apnoea.

Ear Conditions in Children

Glue Ear (Otitis Media with Effusion)

Glue ear is the most common cause of hearing loss in children in the UK. Fluid builds up behind the eardrum in the middle ear, reducing the eardrum's ability to vibrate and causing muffled hearing. It is extremely common — most children will have at least one episode before the age of 10.

The condition is often missed because children do not always complain of pain or tell parents their hearing has changed. Signs to watch for include turning the television up, frequently saying "what?", seeming to ignore instructions, behavioural changes, or falling behind at school. In younger children, glue ear can affect speech and language development if it persists undetected.

In many cases, glue ear resolves on its own within three months and can be managed with a watch-and-wait approach. Where it persists beyond three months and is causing significant hearing loss or affecting development, grommets (ventilation tubes) may be recommended.

Recurrent Acute Otitis Media (Ear Infections)

Recurrent ear infections are a significant cause of pain, sleep disturbance, and school absences in young children. When infections become frequent — typically more than four in six months or six in a year — grommets may be offered to ventilate the middle ear and reduce the frequency and severity of infections.

Hearing Loss in Children

Any concern about a child's hearing should be investigated promptly. Hearing loss in childhood — whether from glue ear, congenital causes, or other conditions — can significantly affect speech, language and learning if not identified and managed early. Professor Veer will arrange appropriate audiological assessment and investigation.

Nose and Adenoid Conditions

Enlarged Adenoids

Adenoids are lymphatic tissue at the back of the nasal passage. In young children they can become enlarged and cause significant problems:

  • Nasal obstruction — persistent blocked nose and mouth breathing
  • Snoring and sleep-disordered breathing — adenoids are one of the most common causes of snoring and sleep apnoea in children
  • Glue ear — enlarged adenoids can block the eustachian tubes, preventing the middle ear from draining properly
  • Recurrent ear infections — related to eustachian tube blockage
  • Recurrent sinusitis

Adenoidectomy (surgical removal of the adenoids) can be performed alone or combined with grommet insertion or tonsillectomy. It is a short, safe, day-case procedure performed under general anaesthetic.

Allergic Rhinitis in Children

Nasal allergy causing chronic nasal obstruction, sneezing and itching is common in children. It can significantly affect sleep, school performance and quality of life. Treatment includes allergen avoidance, nasal steroid sprays (which are safe for long-term use in the recommended doses), antihistamines, and where appropriate, allergen immunotherapy in older children.

Tonsil and Throat Conditions

Recurrent Tonsillitis

Frequent tonsil infections are a significant cause of school absences and misery for many children and their families. When tonsillitis is recurrent and severe — typically seven or more episodes in a year, five or more in two consecutive years, or three or more in three consecutive years — tonsillectomy may be recommended. See our dedicated Tonsils & Adenoids page for full information.

Paediatric Obstructive Sleep Apnoea

Enlarged tonsils and adenoids are the most common cause of obstructive sleep apnoea in children. Unlike adults, children with OSA may not be sleepy during the day — instead they may show hyperactivity, behavioural problems, poor concentration, or falling behind at school. Loud snoring with pauses in breathing during sleep, restless sleep, night sweats, and sleeping in unusual positions (such as with the neck hyperextended) are warning signs.

In most cases, tonsillectomy and adenoidectomy (TA) is curative for paediatric OSA — a very different situation from adult OSA where surgery alone rarely achieves complete resolution. Prompt treatment prevents ongoing effects on growth, behaviour and development. As an obstructive sleep apnoea specialist London, Professor Veer takes a thorough approach to paediatric sleep assessment, ensuring that children receive the right intervention at the right time.

Tonsil Stones (Tonsilloliths)

While more common in teenagers and adults, tonsil stones can occur at any age. They cause a persistent foul smell from the breath or throat. See our Tonsils & Adenoids page for treatment options.

"Dr Vik Veer is what a doctor should be — knowledgeable, capable, compassionate and humble. Our 5-year-old daughter suffered hearing loss after multiple ear infections. We came to Dr Vik Veer for a third opinion, having been told by two ENT doctors she needed grommets, an adenoidectomy and a tonsillectomy. As a direct result of following his advice, our daughter's hearing is almost back to normal and there is no need to put her under a general anaesthetic." Google Review, 5 stars — Jaspreet Rashid

When to Refer Your Child

  • Concerns about hearing or speech development at any age
  • Glue ear persisting beyond three months, or associated with significant hearing loss
  • Loud snoring, restless sleep, witnessed pauses in breathing, or night sweats
  • Recurrent tonsillitis meeting the frequency criteria above
  • Persistent nasal obstruction and chronic mouth breathing
  • Recurrent ear infections (more than four per year)
  • Chronic or recurrent sinusitis
  • Nosebleeds that are frequent, heavy, or prolonged
  • Any ear discharge
  • A child who consistently seems not to hear or respond normally
"Mr Veer treated my child with an adenotonsillectomy. She made a speedy recovery and has been full of life and energy since. In each interaction with her, and myself, Mr Veer made us feel at ease. He answered any questions we had with an implicit understanding of the potential anxiety parents may feel. My child enjoyed seeing Mr Veer — he is empathetic and has a great sense of humour." Google Review, 5 stars — J E

How to Book a Paediatric Consultation

Children can be referred by their GP for NHS assessment or by any clinician for private assessment. Parents can also contact Professor Veer's secretarial team directly to arrange a private consultation. Please contact us for availability and current waiting times.

Private: 150 Harley Street, Weymouth Street Hospital, Spire Bushey Hospital.

NHS: Queen's Hospital, Romford (via GP e-Referral).

Frequently Asked Questions

Yes. Obstructive sleep apnoea is more common in children than many parents realise. It occurs when the airway becomes repeatedly blocked during sleep, causing pauses in breathing. Enlarged tonsils and adenoids are the most common cause in children. Left untreated, paediatric sleep apnoea can affect growth, behaviour, school performance, and cardiovascular health.

Signs of sleep apnoea in children include loud snoring, witnessed pauses in breathing during sleep, restless sleep, night sweats, sleeping with the neck extended or in unusual positions, bedwetting, and night terrors. During the day, children may show hyperactivity, poor concentration, behavioural problems, or falling behind at school rather than the daytime sleepiness more typical of adults.

In children, the most common cause is enlarged tonsils and adenoids, and adenotonsillectomy is curative in the majority of cases. In adults, sleep apnoea is more commonly related to obesity, jaw anatomy, and multiple airway sites, and rarely resolves with a single surgical procedure. Children are also less likely to be sleepy during the day — they more often present with hyperactivity and behavioural changes rather than fatigue.

A child should be referred to a snoring specialist if they snore loudly on most nights, if parents witness pauses in breathing, if the child has restless sleep, persistent mouth breathing, recurrent ear infections or hearing problems, or if behavioural or developmental concerns may be related to poor sleep. An obstructive sleep apnoea specialist London will assess the upper airway thoroughly and arrange appropriate investigations.

Paediatric ENT conditions that benefit from specialist assessment include glue ear causing significant or persistent hearing loss, recurrent ear infections, enlarged adenoids causing nasal obstruction or sleep-disordered breathing, recurrent tonsillitis meeting surgical criteria, paediatric obstructive sleep apnoea, allergic rhinitis affecting sleep and school performance, and any concern about hearing or speech development.

An obstructive sleep apnoea specialist London will assess the child's upper airway including the nose, adenoids, tonsils and soft palate. A sleep study may be arranged to measure the severity of sleep-disordered breathing. In most children, adenotonsillectomy is the primary treatment and is highly effective. In more complex cases or where surgery is not appropriate, other options such as positional management or upper airway appliances may be considered.

Book a Consultation

Expert care at Harley Street, Weymouth Street Hospital or Spire Bushey.

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