Paediatric ENT in London

There are numerous ear, nose and throat conditions that can affect children and impact the quality of their lives. We know how worrying it can be when your child is sick and needs treatment. The Medical Chambers Kensington is home to Ms Romana Kuchai, an experienced paediatric ear, nose and throat surgeon, who trained at the renowned Great Ormond Street Hospital.

She also runs the Paediatric Clinic for general and complex paediatric ear, nose and throat conditions at St Mary's Hospital, London, part of Imperial College NHS Foundation Trust.  

Romana is excellent at reassuring children and their parents, and can help your child with a range of conditions. She's particularly experienced with childhood allergies

Here are some of the most common children's ear, nose and throat conditions:

• Glue ear
• Ear infections
• Nasal obstruction and mouth breathing
• Runny nose
• Allergic and non-allergic rhinitis
• Sore throat and tonsillitis
• Voice disorders
• Lumps and bumps in the neck

Some children's conditions may go away on their own and others may need routine treatment or require surgery. Our specialists will look after your child with individual care and attention and will make sure that you have all the information you need about treatment options. We’ll ensure that your child is kept as comfortable as possible during their appointment, and prescribe any treatment that is needed. 

During an ENT examination, our paediatricians can gently examine your child’s ears and tell whether they have an infection of the ear canal (otitis externa) with pain and discharge, or an infection of the middle ear (otitis media) with pain or reduced hearing as a result of glue ear. Having made the diagnosis, they can suggest the best treatment, which may be ear drops, painkillers, or regular monitoring as the condition clears up on its own.

Hearing loss in children may have a clear cause, such as glue ear or an infection, or it may be present from birth. In some cases, the cause may not be clear, so hearing tests may be needed.

Here are some signs that your child may be having hearing problems:

• Turning up the volume on the TV or stereo
• Not replying when you call
• Struggling to follow conversations or answering questions inappropriately

The middle ear normally contains air, but sometimes becomes filled with a thick glue-like secretion instead. This can cause earache, tinnitus (a ringing or buzzing noise), and reduced hearing.

Your child could have glue ear if they:

• are speaking more loudly or quietly than normal
• struggle to hear what you are saying
• keep asking you to repeat what they say
• want the TV or music turned up loudly
• are difficult to understand

If your child is having difficulty hearing because of glue ear, we offer a full hearing check with Audiologists Dr Alam Hussain and Ms Beaterice Vincent. This is especially important if your child’s ear problems are affecting their ability to listen at school. If necessary, a temporary hearing aid will help until glue ear problems improve.

Although the vast majority of glue ear problems resolve with monitoring and treatment, your child might be referred to one of our consultant paediatric ENT surgeons for further investigation. They will advise whether your child’s glue ear needs to be treated by inserting grommets (small tubes placed across the eardrum to relieve pressure and fluid build-up in the middle ear). This is a routine surgical procedure, so you should not worry if your child needs to have this done.

Ear infections are common in young children. Most go away on their own and will not need treatment, but sometimes they cause hearing loss, which can be worrying for parents. This is usually temporary, and your child's hearing will return to normal once the infection has cleared up.

Our ear, nose and throat specialists will discuss your child's symptoms with you and examine your child's ears in order to suggest the right treatments. Treatment for an infection may include painkillers such as paracetamol or antibiotics.

In some cases, the infection may spread to a space inside the middle ear called the mastoid cavity. If this becomes infected it may cause a discharge from the ear and may also affect your child's hearing. Occasionally, the infection can lead to a skin growth in the ear. If this happens, then a surgery (known as mastoid surgery or mastoidectomy) may be needed to remove the infection or skin growth. This is a routine surgery and your child will probably be able to return home the same day. Our ear, nose and throat specialists will be able to discuss this in detail in order to reassure you and make sure your child receives the best care.

In some cases, a child may be born with hearing loss. This may be caused by an inherited condition, or it may be as a result of problems during pregnancy or premature birth.

Understanding the cause is important to finding the right treatments for your child. So, our ear, nose and throat specialists will discuss your child's symptoms and family history with you in detail. They may also carry out some routine hearing tests in order to assess your child's level of hearing loss and make treatment suggestions.

Your treatment choices will depend on the cause and may include hearing aids. These are very helpful for managing your child's hearing loss and they have improved enormously over the last few years. Some of the latest designs can only be seen by looking directly into the ear and are comfortable and safe for your child to wear and use. Our ear, nose and throat specialists can advise on the best types of hearing aids for your child.

If the cause of your child's hearing loss is not clear, then our ear, nose and throat specialists may suggest some routine hearing tests.

Tympanometry is a simple test to see if the ear is blocked. A very small tube is placed at the entrance of your child's ear and air is gently blown down it into the ear. This test will not hurt your child and is very helpful in diagnosing conditions such as glue ear.

Pure tone audiometry (PTA) is a non-invasive, painless test used to assess hearing in both ears. During this test, a machine called an audiometer produces sounds at various volumes and frequencies (pitches). Your child listens to the sounds through headphones and presses a button when they hear them.

A smaller nasal pathway in young children means they are more susceptible to blockages. Nasal obstruction or discomfort has many causes, including dried mucus, enlarged adenoids, swollen tissue in the sides of the nose, a deviated septum, or (especially in younger children) foreign bodies being inserted into the nostril!

It’s fairly typical for your child to experience a runny nose, but not all runny noses are due to common cold viruses. Visiting your paediatrician will allow them to investigate and understand their nasal symptoms before suggesting the most appropriate treatment.

Rhinitis is an inflammation of the nose. The swelling of its delicate passages causes congestion, a runny nose, and sometimes pressure pain if the sinuses are also inflamed. If your child has persistent symptoms, they may well have an allergic rhinitis, due to any number of common allergies:

• Pollen and/or spores
• Household pets
• Dust and/or dust mites
• Certain foods
• The presence of mould

These allergies can also cause a build-up of secretions in the middle ear (glue ear), which can affect your child’s hearing. An allergy test will determine the cause of the reaction.

Nosebleeds - Although they seem dramatic, a child’s nosebleed is often caused by something rather innocent. Rough and tumble play, a simple cold or sinus infection, and even a warm classroom can dehydrate and irritate the nose enough to make it bleed. And let’s not forget the chance that excessive picking or scratching of the nose may have exposed blood vessels and caused bleeding.

In the case of frequent nosebleeds, your paediatrician will advise whether there may be issues in relation to blood clotting or abnormal blood vessels and whether further testing or treatment is necessary.

A ‘sore throat’ is a common complaint with little ones and it can be difficult for a parent to judge how severe it might be. It is important to remember that antibiotic treatment is not always necessary. Often, a sore throat is caused by a virus and all that’s needed is some encouragement to drink fluids, and some attentive care. 

If you suspect something more serious, you can visit our private ENT clinic for children. One of our paediatricians will thoroughly examine your child's throat, before suggesting the best treatment. Depending on the degree to which the throat is inflamed or even infected, they might take a swab to check if your child has a bacterial infection (strep sore throat). This might need antibiotic treatment, and our paediatricians will advise on the use of painkillers or other treatments to bring down any fever.

• Rapid diagnostic testing for Strep A: A rapid test for strep means you and your doctor will know within minutes if your child needs antibiotics. This helps your doctor choose the best treatment quickly as there’s no need to wait for the results to come back from a lab, which makes a big difference.

If flu is suspected, our paediatricians also use rapid influenza screening (CRP rapid test and flu rapid test).

• Other throat problems: Ranging from a recurrent cough, enlarged adenoids (glands at the base of the nose), or the less frequent voice disorders or lumps and bumps in the neck, your paediatrician will advise referral to an ENT specialist. They can liaise with one of our consultant paediatric ENT surgeons, who will be able to advise whether more advanced treatment (such as removal of the tonsils or adenoids) is needed.