Children's ENT

Children often face a unique set of ear, nose, and throat (ENT) issues that can affect their breathing, hearing, and overall well-being. At ENT Surrey, we are highly experienced in treating paediatric patients, offering compassionate, child-friendly care for a wide range of conditions. We provide comprehensive evaluations and treatments designed to ensure your child’s health, comfort, and quality of life. We can see children in the purpose-built facilities at Paediatric Diagnostics.

We specialise in diagnosing and treating various ENT conditions commonly seen in children, including:

Ear Infections (Otitis Media)

Ear infections are one of the most common paediatric ENT issues, causing pain, fever, and sometimes hearing loss. Recurrent ear infections can affect a child’s hearing and speech development. Our team offers medical management, and when necessary, surgical solutions such as grommet surgery to reduce the frequency of infections and preserve hearing. More information can be found on our dedicated Children’s ENT web pages.

Tonsillitis and Adenoid Problems

Enlarged tonsils and adenoids can lead to chronic throat infections, difficulty breathing, snoring, and sleep apnoea in children. If frequent infections or airway obstruction occur, we may recommend an intracapsular tonsillectomy or adenoidectomy to improve breathing and reduce infections. More information can be found on our dedicated Children’s ENT web pages.

Hearing Loss

Hearing loss can significantly impact a child’s development, affecting their speech, language, and academic performance. Our team offers hearing assessments for children of all ages, and medical and surgical solutions for common hearing problems such as glue ear or more complex problems such as chronic infection or cholesteatoma.

Allergic Rhinitis

Allergic rhinitis is common in children, causing symptoms such as sneezing, runny nose, itchy eyes, and congestion. Our team work with families to manage allergies through medications, lifestyle changes, and allergy testing to provide relief and improve your child’s quality of life. More information can be found on our dedicated Children’s ENT web pages.

Tongue-Tie (Ankyloglossia)

Some children are born with a condition called tongue-tie, where a tight band of tissue under the tongue restricts movement. This can cause difficulty breastfeeding, eating, or speaking. A tongue tie assessment and division can be offered in our clinic at Paediatric Diagnostics. More information can be found on our dedicated Children’s ENT web pages

Wax impaction

Wax blocking the ear canal can be a source of discomfort and can affect a child’s hearing. At ENT Surrey we can provide wax microsuction at any of our clinics. This video from our partners at Paediatric Diagnostics helps explain what to expect.

At ENT Surrey, we understand that children require a gentle and caring approach to treatment. We work closely with families to ensure that parents are informed and comfortable with every step of their child’s care. Our clinics are equipped with child-friendly facilities and state-of-the-art diagnostic tools to make your child’s experience as stress-free as possible. We believe in a multidisciplinary approach to paediatric care and we therefore collaborate with paediatricians, audiologists, speech therapists, and other healthcare providers to create a comprehensive treatment plan that addresses all aspects of your child’s health.

Intracapsular Tonsillectomy

What is the difference between intracapsular and extracapsular tonsillectomy?

The tonsil capsule is a thin fibrous partition between the tonsil and the underlying muscles of the throat. An extracapsular tonsillectomy involves complete removal of the tonsils and results in exposure of the muscle bed and the blood vessels that lie within the muscle. An intracapsular tonsillectomy involves removal of tonsil tissue up to, but not through the capsule. In the UK, most surgeons performing intracapsular surgery will aim to remove all of the visible tonsil tissue (more than 95%). There are different ways to perform an intracapsular tonsillectomy, but one of the most popular techniques is to use Coblation®. Coblation® uses a special plasma derived from saline which breaks down tissue at reasonably low temperatures, resulting in less pain and discomfort than some other techniques.

This video depicts the principal differences between intracapsular and extracapsular surgery: What are the advantages of an intracapsular tonsillectomy?

Intracapsular tonsillectomy has been pioneered for use in children and is mainly used for large tonsils causing obstruction (obstructive sleep apnoea). There is also now increasing evidence for it to also be offered to children suffering with recurrent tonsillitis. Intracapsular surgery has the advantage of reduced risks of bleeding as well as a much speedier recovery. One of the major downsides of conventional extracapsular surgery is the risk of bleeding after the operation (most commonly between after 3 to 7 days) with rates quoted between 2 and 5%. With intracapsular techniques the risk of bleeding is thought to be as low as 0.2%. Most children who have an intracapsular operation can return to school or nursery within a week whereas those that undergo extracapsular procedures will need 14 days off school.

Are there any disadvantages of an intracapsular tonsillectomy?

There is a small risk of tonsil regrowth over time using the intracapsular technique and an even smaller risk of this tissue causing similar problems in the future. In practice, this is reasonably rare. In the largest study of intracapsular surgery, 1,000 children were followed up after the procedure for more than a year and the chance of revision surgery was found to be about 2%. This occurred more frequently in children who were very small (less than 15kgs in weight) at the time of their surgery. The possibility of revision surgery is more than offset by the reduction in complications, including life-threatening bleeding, when compared with conventional extracapsular procedures. In our experience, revision surgery is very unusual in children above the age of 3.

Which patients would the procedure be most suitable for?

Intracapsular surgery is generally offered to children, as the benefits are very clear. Children presenting with very big tonsils and/or adenoids are ideal candidates for an intracapsular procedure. At ENT Surrey, we also have very good experience of intracapsular techniques in children with recurrent tonsillitis. Surgery needs to be more meticulous in these cases to avoid the possibility of on-going symptoms. In our most recent study, on-going or recurrent symptoms were exceptionally rare. We are also using this technique in adults, but at the moment there is a lack of widespread evidence to understand the long-term outcomes. Early suggestions are that this is a useful technique in adults, but the benefits of reduced bleeding and faster recovery may not be quite as obvious as in children. If you are considering a tonsillectomy as an adult, you should ask your surgeon of their personal experience of intracapsular surgery.

How widely available is the procedure in the UK?

Intracapsular tonsillectomy, particularly with Coblation®, is becoming much more widespread within the UK. Many of the major paediatric hospitals in the UK are already using this as their main surgical technique. As more and more evidence is released about the benefits of the procedure, it is likely that more surgeons will offer it.

The following videos show intracapsular surgery being carried out:

Please note that these videos show real surgery being performed and viewer discretion is therefore advised.

Adenoidectomy

The following videos show Coblation Adenoidectomy surgery being carried out:

Coblation Total Intracapsular Tonsillectomy (Case One)

Coblation Total Intracapsular Tonsillectomy (Case Two)

Hearing Problems

Hearing loss and related issues can significantly impact daily life, from communication difficulties to challenges in social and professional settings. At ENT Surrey we provide comprehensive hearing services via our partners at Gatwick Audiology and Audiology Planet for patients of all ages, using the latest technology and treatments to diagnose and address a wide range of hearing problems. Whether you're experiencing mild hearing difficulties or profound hearing loss, our team are here to help.

Our team can diagnose and treat a variety of hearing-related conditions, including:

Conductive Hearing Loss

Conductive hearing loss occurs when sound cannot efficiently travel through the outer or middle ear to the inner ear. Common causes include earwax buildup, ear infections, glue ear, damage to the eardrum or problems with the ear bone (ossicles) such as fixation or disarticulation. We can provide medical and surgical options to treat the cause of this type of hearing loss.

Sensorineural Hearing Loss

Sensorineural hearing loss results from damage to the inner ear (cochlea) or the auditory nerve, and is often related to aging, noise exposure, or genetic factors. Via our partners at Gatwick Audiology, we can offer hearing aids or environmental devices to help.

Tinnitus

Tinnitus, or a persistent ringing, buzzing, or clicking sound in the ears, can be distressing and affect your ability to concentrate or sleep. Our team offers various treatments for tinnitus, including sound therapy, hearing aids with tinnitus masking features, lifestyle counselling and neuromodulating treatments such as the Lenire ™ device to help you manage the condition.

Our Diagnostic Services

Our audiology services are provided in partnership with Gatwick Audiology and Audiology Planet. They use state-of-the-art diagnostic tools to thoroughly assess the nature and extent of hearing problems in adults and children. Testing can include pure-tone audiometry, speech audiometry, tympanometry with stapedial reflexes and otoacoustic emissions testing to determine the type and degree of hearing loss.

At ENT Surrey we are dedicated to helping patients regain their hearing and improve their quality of life. Our multidisciplinary team offers personalised care and cutting-edge treatments to address all types of hearing problems. Whether you’re seeking relief from hearing loss, tinnitus, or balance issues, we are here to provide the highest level of care.

Ear Wax Microsuction

Earwax buildup can cause discomfort, hearing loss, and even infections if left untreated. At ENT Surrey, we provide safe and effective wax microsuction, a quick, painless, and highly efficient method of removing excessive earwax. This procedure is performed by our ENT Consultant – Mr Khemani using specialised equipment, ensuring that your ears are cleaned thoroughly without the risks associated with traditional methods like ear syringing or at-home remedies.

What is Wax Microsuction?

Wax microsuction is a gentle, non-invasive procedure used to remove earwax (cerumen) from the ear canal. Unlike ear syringing, which uses water to flush out wax, microsuction uses a small, low-pressure suction device to carefully extract earwax under direct vision through a microscope or an endoscope. This allows for precise and safe removal, even in cases of stubborn or impacted wax.

Microsuction is the preferred method for earwax removal due to its many benefits:

Safe and Precise

Microsuction allows our ENT surgeon to have a clear, magnified view of the ear canal during the procedure, ensuring that the earwax is removed safely without damaging the ear canal or eardrum.

Painless and Comfortable

ost patients find the procedure to be painless and comfortable. There is no need for water or chemicals, reducing the risk of infection and irritation that may occur with other earwax removal methods.

Quick and Effective

Wax microsuction is a quick procedure, typically taking less than 10 minutes to complete. It's effective at removing even hardened or deep-set wax, providing immediate relief from symptoms such as hearing loss, discomfort, or ear fullness.

Ideal for Sensitive Ears

This method is particularly suitable for people with sensitive ears, including those with a history of ear infections, perforated eardrums, or those who have had ear surgery. It is also the preferred option for individuals who wear hearing aids, as it helps prevent wax buildup that can interfere with device performance.

Microsuction In children

At ENT Surrey, we aim to make the wax microsuction process as simple and stress-free as possible even in children. The following video can help prepare children for the procedure so both parent and child know what to expect.

Dizziness & Balance

Experiencing dizziness or balance problems can be unsettling and disruptive to your daily life. At ENT Surrey, our team specialises in diagnosing and treating disorders that affect an individual’s balance and equilibrium. Whether you're feeling lightheaded, experiencing vertigo, or having trouble with coordination, we are here to provide a thorough evaluation and personalised care.

Dizziness and balance problems can arise from a range of conditions, often related to the inner ear, which plays a key role in maintaining balance. Some of the most common causes we treat include:

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is a common cause of vertigo, characterized by brief episodes of dizziness when changing head positions. It occurs when tiny particles in the inner ear become dislodged, leading to balance disturbances. Our team can treat BPPV with simple, effective repositioning manoeuvres to alleviate symptoms.

Vestibular Neuritis & Labyrinthitis

Vestibular neuritis and Labyrinthitis are caused by inflammation in the inner ear, leading to sudden dizziness, vertigo, and balance issues. This condition is usually caused by a viral infection. We offer comprehensive management, including medications and physical therapy, to help restore your balance and reduce symptoms.

Meniere’s Disease

Meniere’s disease is a chronic inner ear condition that causes episodes of vertigo, hearing loss, tinnitus (ringing in the ear), and a feeling of fullness in the affected ear. Our specialists provide individualized care, including lifestyle changes, medications, and, in severe cases, surgical options to manage and reduce the frequency of attacks.

Balance Disorders in the Elderly

As we age, the risk of balance problems increases, leading to a higher chance of falls. Our team work with elderly patients to identify the causes of dizziness, often related to inner ear dysfunction, medications, or other health conditions, and provide effective treatments to improve safety and mobility.

Our Diagnostic Services

At ENT Surrey we are partnered with Audiology Planet who can use advanced diagnostic techniques to accurately identify the cause of your dizziness or balance issues. These include:

Videonystagmography (VNG)

VNG is a test that evaluates the function of your inner ear and eye movements, helping to determine if your balance problems are related to the vestibular system.

Rotational Chair Testing

This test assesses how your inner ear responds to changes in motion and helps diagnose certain balance disorders.

Posturography

Posturography evaluates how well you maintain balance in different conditions and helps identify issues related to your sensory, motor, and balance systems.

Treatment Options

Once we diagnose the cause of your dizziness or balance disorder, we tailor a treatment plan to meet your specific needs. Our treatments may include:

Vestibular Rehabilitation Therapy (VRT)

VRT is a specialised form of physical therapy designed to improve balance and reduce dizziness. By using exercises to retrain the brain to compensate for inner ear problems, we can help you regain stability and reduce your risk of falls.

Medications

Depending on the cause of your dizziness, we may prescribe medications to relieve symptoms such as nausea, vertigo, or inflammation. These may include anti-vertigo drugs, diuretics, or anti-inflammatory medications.

Canalith Repositioning Procedures (Epley Maneuver)

For patients with BPPV, we offer the Epley Maneuver, a simple, non-invasive procedure that helps move displaced calcium particles in the inner ear to their correct position, providing immediate relief from vertigo.

Surgical Options

In cases where conservative treatments are not effective, such as with severe Meniere's disease or chronic vestibular issues, surgical interventions may be necessary. We can perform procedures to alleviate symptoms and restore balance function.

Nose and Sinus Problems

The nose and sinuses play an essential role in breathing, filtering air, and maintaining overall health. When problems arise in this area, they can significantly affect a person’s quality of life, causing discomfort and difficulty in daily activities.

At ENT Surrey, we specialise in diagnosing and treating a range of nasal and sinus conditions, including:

Chronic Sinusitis

Chronic sinusitis occurs when the sinuses become inflamed and blocked for extended periods. Symptoms can include nasal congestion, facial pressure, headaches, and difficulty breathing. If left untreated, it can lead to recurrent infections or other complications.

Deviated Nasal Septum

A deviated septum is a condition in which the thin wall (nasal septum) between your nasal passages is displaced to one side. This can cause breathing difficulties, nasal obstruction, and chronic sinus infections. We can perform corrective surgery (nasal septoplasty) to improve airflow and alleviate symptoms.

Nasal Polyps

Nasal polyps are noncancerous growths that develop inside the nasal passages or sinuses, often due to chronic inflammation. These can lead to a blocked nose, reduced sense of smell, and recurring infections. We offer advanced treatments to remove polyps and prevent their recurrence.

Allergic Rhinitis

Allergic rhinitis occurs when your immune system reacts to allergens like pollen, dust, or pet dander, causing symptoms like sneezing, nasal congestion, and itching. Our team can help manage allergies through advice about allergen avoidance, medications or surgery. We can provide skin prick allergy testing in children via our partners at Paediatric Diagnostics