Children often have a significant level of Ear, Nose, Throat and Upper Respiratory problems. Because of their inability to vocalise , often the symptoms are neglected till they flare up into a severe infections. While these are treated at the time, failure to address the underlying conditions may, leads to persistent or frequent recurences of the problems.

“My child is having a flu all the time”; “My child needs to visit the doctor every other week” may be common comments made by parents in the play-group and kindergarten age. Hearing difficulty may be undiagnosed leading to learning impairment in this age group. Asthma cases are also higher when the recurring allergies and infections are not controlled.

Blocked Nose and Mouth Breathing

These are relatively common symptom. Often, the cause may be obvious such as the common cold or flu. However if this happens regularly or remains persistent beyond two weeks, an ENT evaluation may be necessary. Long-term mouth breathing in a child can lead to delayed mid face development which is permanent.

Possible Causes:

  • Allergy
  • Sinusitis
  • Swollen Turbinates
  • Enlarged Adenoids or Tonsils

Runny Nose

The most common cause for a runny nose is the common cold or flu. This typically increase in severity over 2 to 3 days often associated with a cough or fever. It runs its course and recovery is expected within a week.

If symptoms persist beyond a week, sinusitis will need to be excluded especially if the discharge is thick and discoloured.

If the discharge is clear and there are morning symptoms of sneezing and congested nose, the most likely cause is allergy. Allergy can be triggered by the environment or diet. There is an increase risk of asthma if the allergy is not well controlled. With proper diagnosis and treatment, cure is possible for allergy.

Chronic Cough

Chronic cough may be caused by allergy or sinusitis resulting from a post nasal drip. Chest infection and asthma are the other causes. A persistent cough is not normal and needs to be evaluated by a doctor. In the event where all the routine tests were not helpful allergy workup in particular food allergy may review reveal the cause.


This is the infection of the sinuses. The predisposing cause is a common cold, which has affected the sinuses. Often one would require antibiotics. Failure to eradicate sinusitis will lead to a chronic condition in which surgery may be necessary. Individual with allergies will tend to have more persistent symptoms. Again accurate diagnosis is the key.


Pharyngitis and Tonsillitis are common causes. Usually this starts as a viral infection in which antibiotics is not necessary. If the sorethroat worsens, and phlegm develops, a course of antibiotics is helpful. Tonsillitis is often associated with high fever in a child. If this is happening regularly, then a visit to the ENT doctor would be helpful. The best time to bring your child to the ENT doctor is when your child is having the acute infection, as this would allow a more accurate assessment. Tonsillectomy and adenoidectomy, which is the removal of the tonsils and adenoids, can now be accomplished as a day procedure with quick recovery.


Adult snores but some children snores like adults. Regularly loud snoring and noisy breathing should be assessed to exclude blocked nose, allergies, enlarge adenoids and tonsils. Sleep Apnoea can occur in which the child can become lethargic, with lack of energy and disinterest in his environment. Correction of the underlying condition will reverse this and return the child to his normal self. If the cause is enlarged adenoids and tonsils, their removal will solve the problem.

Ear Ache

This is caused by either an external or middle ear infection and is also a frequent cause of hearing loss. The symptoms are varied depending on the age. In infants and toddlers look for ear pulling, scratching at the ear, hearing problems, crying, irritability, fever, vomiting and ear drainage. In the older children and adults, earache, pressure sensation, hearing loss, dizziness, ear drainage and fever may present. Treatment will involve ear cleaning, eardrops, antibiotics and occasionally drainage of the fluid in the middle ear. If left untreated, the infection may cause serious problems if spread to the surrounding areas.

Hearing Loss

A child that has delay or inaccurate speech needs to have their hearing assessed. Similarly for the child that does not respond to the environment, parents, teachers or misinterpret commands will need to a hearing check. Diminished hearing affects learning ability, which is critrical in our highly competitive environment. The cause is usually in the outer or middle ear. In rare situation, the hearing loss is a result of a nerve condition.

As one can see, many of the child’s problems are inter-related. By just tackling the symptoms without searching out and managing the underlying cause, the problem will recur and persist. The take home message is if your child is having recurring symptoms in the same areas, do consult your physician for an evaluation. Most of the problems can solved if there accurate assessment and treatment.

Book an appointment with HealthSense Specialist Dr. YT Pang to look at your ENT problems and get cured.