Pediatric ENT

Colds, a runny nose, and ear infections all may be part of childhood. However, if these become frequent or simply do not go away, there usually is a treatable cause. Having a comprehensive evaluation by a Pediatric ENT with the correct knowledge and experience can end this illness cycle and allow your child to return to good health.

Dr. Hester has worked as a Pediatric ENT for over 20 years, helping parents to identify the actual cause of their childʼs symptoms and then finding lasting solutions. Once the cause is identified, a thorough review of all treatment options is presented and discussed, with plenty of time for all questions to be answered.

If you would like an appointment, please call our office conveniently located in East Palo Alto at (650) 268-5133

Common Pediatric Issues

  • Sleep Disorders: Except when associated with the occasional cold or seasonal allergy, snoring is most commonly a sign that a child has an obstructive sleep disorder such as sleep apnea. Children with such a sleep disorder may rarely describe being tired or fatigued, but rather can have behavioral issues, bed wetting, difficulty with academic studies, and poor attention span-including being diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). In fact, as many as 30-40% of all children diagnosed with ADD or ADHD have sleep apnea. In this age group, poor interrupted sleep is not simply something a child will “grow out of” and should be evaluated.
  • Tonsils and Adenoids: Tonsil infections (tonsillitis) commonly present with fairly obvious symptoms of a significant sore throat. Although the occasional infection can certainly be just part of childhood, recurrent infections are not normal, and actually uncommonly improve as the child gets older. Treatment, including removal of the tonsils, may be indicated to stop this cycle of illness, missed school, and repeated antibiotics. Adenoid infections are not as obvious and are commonly misdiagnosed as allergies or just a “runny nose” since the adenoids sit in the back of the nasal cavity. Pain and fever are not common and the only symptom may be congestion. However, if this condition becomes chronic, it can lead to mouth breathing and even changes in the way the jaws develop and play a role in the need for orthodontia. Even in the absence of infection, tonsils and adenoids can cause symptoms when their size leads to obstruction. It is important for the physician examining the patient to understand that it is the size of the childʼs airway that is important rather the absolute size of the tonsils or adenoids. In other words, how much of the breathing and swallowing “tubes” are these structures obstructing, not just whether the doctor feels that they are large compared to other patients.
  • Nasal obstruction: Difficulty breathing through oneʼs nose may be seasonal when related to allergies. However, such difficulty that does not resolve with simple treatments is usually a sign of something more. The wall that separates the right and left nasal air passages may be crooked-this is known as a deviated septum. This could be caused by even mild trauma when the child was younger-even during birth- and worsen with time. Other structures inside the nose known as turbinates can become permanently enlarged after being exposed to chronic inflammation and/or infection. These problems need to be identified by a thorough examination to prevent possible unnecessary use of medications which cannot improve these conditions.
  • Sinusitis: Although sinus infections may present with the typical signs of discoloured drainage, headache, and fatigue, more subtle symptoms such as nasal congestion or even a chronic cough can be the only sign of a lingering infection.
  • Ear Infections: Ear infections do occur more commonly in children due to the anatomy of their eustachian tube. This is a muscular tube that runs from the back of the nose to behind the ear drum and keeps the pressure in the system normal. In the child, the tubeʼs shape and position does not allow it to work as well as in an adult. This can lead to fluid build up and infections that can result in hearing loss. If this becomes a chronic issue, it may not improve even with numerous antibiotics-which carry their own risks. At that point, the placement of a small tube in the eardrum can in most cases immediately restore normal hearing and end the need for recurrent antibiotics.
  • Hoarseness: Persistent hoarseness in a young child is most commonly due to misuse of the voice leading to small callouses on the vocal cords. This issue typically resolves with speech therapy, but an evaluation to rule out other causes is important. This may include an examination using a small scope that can easily and definitively see the cords.
  • Nosebleeds (epistaxis): It is estimated that 30-40% of all children will have nosebleeds. The most common cause is the childʼs own fingers! However, this problem can become more than just a nuisance if it continues. A thorough examination can identify the source of bleeding and a simple office based procedure (cauterization) can effectively put an end to this issue.
  • Tongue tie (ankyloglossia): In some children the tissue that attaches the front part of the tongue to the area behind the teeth is excessive and does not allow the tongue to move normally. This may affect feeding in the infant and speech as the child grows. A simple, quick, safe procedure can release this attachment and allow normal function. Dr. Hester has extensive experience in these and other ear, nose, and throat disorders that can affect your child. A simple consultation can identify and treat such issues and allow a return to a healthy childhood.

Dr. Hester, your trusted Pediatric ENT doctor, has extensive experience in these and other ear, nose, and throat disorders that can affect your child. A simple consultation can identify and treat such issues and allow a return to a healthy childhood.