Paediatric Head and Neck Surgery

Paediatric head and neck surgery, largely the work of paediatric ENT surgeons, covers operations on children's tonsils, adenoids, ears, nose, airway and neck lumps. It includes some of the most common operations of childhood as well as rare airway reconstructions.

The decision to operate is often the key step. Many children outgrow enlarged tonsils, glue ear and recurrent infections, so surgery is advised only when guidelines are met, such as disturbed breathing during sleep or persistent hearing loss affecting speech.

Conditions this service looks after

• Enlarged tonsils and adenoids with snoring and obstructive sleep apnoea
• Recurrent tonsillitis
• Glue ear (otitis media with effusion) and recurrent ear infections
• Chronic ear disease, perforated eardrum and cholesteatoma
• Permanent hearing loss needing cochlear implantation
• Neck lumps: thyroglossal duct cysts, branchial cysts and enlarged lymph nodes
• Tongue-tie
• Noisy breathing in infants (laryngomalacia) and airway narrowing
• Prominent ears
• Nasal blockage and chronic sinus disease

Tests you may be offered

• Age-appropriate hearing tests and tympanometry: Measure hearing levels and middle ear pressure.
• Flexible nasendoscopy: A thin camera through the nose to view the adenoids and voice box, done awake in clinic.
• Sleep study or overnight oximetry: Confirms obstructive sleep apnoea when the history is unclear or the child has other health conditions.
• Neck ultrasound: First-line imaging for lumps; MRI for deeper or complex lesions.
• Airway endoscopy under anaesthesia: Examines the windpipe and voice box in children with noisy breathing.

Treatments available

• Adenotonsillectomy: Removal of tonsils and adenoids for sleep apnoea or frequent tonsillitis. Partial (intracapsular) tonsillectomy causes less pain and bleeding.
• Grommets (ventilation tubes): Tiny tubes in the eardrum for persistent glue ear with hearing loss.
• Tympanoplasty and mastoid surgery: Repair of the eardrum and removal of cholesteatoma.
• Cochlear implantation: For severe to profound deafness, followed by years of mapping and speech therapy.
• Excision of congenital neck cysts: Including the Sistrunk procedure for thyroglossal cysts.
• Airway surgery: Supraglottoplasty for severe laryngomalacia and reconstruction for subglottic stenosis in specialist centres.
• Otoplasty: Correction of prominent ears, usually from age 5 to 6.

When to ask for a specialist opinion

• Snoring with pauses, gasping, restless sleep or daytime tiredness and behaviour change
• Seven or more documented episodes of tonsillitis in a year
• Hearing concerns or speech delay lasting more than 3 months
• A neck lump persisting beyond 4 to 6 weeks, growing, or harder than 2 cm
• Noisy breathing with feeding difficulty or poor weight gain in a baby

Travelling to Türkiye for this care

Tonsil, adenoid and grommet surgery are short day-case procedures, but after tonsillectomy the risk of bleeding lasts up to 2 weeks, so the family must stay within easy reach of the hospital for 10 to 14 days and should not fly earlier. For that reason many families reasonably choose to have it done at home. Ear repairs and neck cyst removal fit a stay of 7 to 10 days. A cochlear implant should not be placed far from home unless the years of programming and speech therapy are firmly arranged locally. Breathing difficulty in a child is always an emergency for local services.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions