Children are not simply small adults. ENT problems can affect hearing, speech, sleep, breathing, eating, school performance and general wellbeing.

Mr Jain has completed a one-year Paediatric ENT Fellowship at Evelina London Children’s Hospital, St Thomas’ Hospital, developing specialist experience in the comprehensive management of ENT conditions in children. He is also trained to perform newer and less invasive techniques for Coblation tonsilotomy which has a much quicker recovery rate with lesser risk of bleeding. Give your child the benefit of highest level of expertise with Paediatric ENT Fellowship experience. Always ask your specialist whether they have Paediatric ENT Fellowship experience.

His paediatric ENT practice includes both common childhood ENT conditions and surgical treatment where required.

• Tonsillitis and recurrent tonsillitis
• Enlarged tonsils
• Snoring and sleep-disordered breathing
• Obstructive sleep apnoea
• Adenoid enlargement
• Glue ear and hearing problems
• Grommet insertion
• Tonsillectomy
• Adenoidectomy
• Coblation tonsillotomy
• Pinnaplasty
• Turbinate reduction
• Tongue-tie excision
• Thyroglossal cyst excision

Treatment is recommended only when appropriate following a detailed assessment. For example, many children with glue ear improve without surgery, while grommets may be considered when persistent hearing loss is affecting a child’s everyday life, communication or development.

Tonsil Surgery for Children and Adults

A tonsillectomy is an operation to remove the tonsils. It may be considered for appropriately selected patients with recurrent tonsillitis, significant tonsil-related obstruction, sleep-disordered breathing or obstructive sleep apnoea.

The decision to operate depends on the patient’s symptoms, frequency and severity of episodes, effect on daily life and the overall clinical assessment.

For recurrent tonsillitis, established clinical criteria are commonly used when considering surgery, although the appropriate threshold can vary according to the clinical circumstances.

 

Coblation tonsillotomy

Coblation tonsillotomy is a technique that reduces the size of the tonsils rather than completely removing them.

It can be particularly useful in selected children with enlarged tonsils causing snoring, sleep-disordered breathing or obstructive sleep apnoea.

The technique uses controlled radiofrequency energy to remove tonsil tissue at relatively low temperatures. Current NHS paediatric information describes Coblation tonsillotomy as an option for selected younger children with sleep-related breathing problems, with the potential advantages of reduced postoperative pain and bleeding compared with some conventional approaches. Because some tonsil tissue remains, there is a possibility of recurrent tonsil problems and further surgery.

The most appropriate operation depends on the child’s symptoms, age, tonsil size, medical history and the underlying reason for surgery.

Adenoid Removal in Children

The adenoids are a collection of lymphoid tissue located behind the nose.
Enlarged adenoids can contribute to:

• Persistent nasal blockage
• Mouth breathing
• Snoring
• Sleep-disordered breathing
• Obstructive sleep apnoea
• Glue ear and hearing difficulties

An adenoidectomy removes the enlarged adenoid tissue.

In selected children having grommets for glue ear, adenoidectomy may also be considered depending on the child’s individual circumstances.

Grommets for Glue Ear and Children’s Hearing Problems

Glue ear, also called otitis media with effusion, occurs when fluid collects behind the eardrum. It can cause temporary hearing loss and may affect communication, behaviour and learning when persistent.

Most cases improve naturally and do not require surgery. Where hearing loss persists and is causing significant problems, treatment options may include observation, hearing support or grommet insertion.

A grommet is a tiny ventilation tube inserted into the eardrum. It allows air into the middle ear and helps prevent fluid from remaining behind the eardrum.
Grommets usually remain in place for several months and commonly fall out naturally as the eardrum recovers.

A detailed ENT and hearing assessment is important before deciding whether grommet surgery is appropriate.

Tongue-Tie Surgery

A tongue-tie, or ankyloglossia, occurs when the tissue connecting the underside of the tongue to the floor of the mouth restricts tongue movement.

The significance of tongue-tie varies between individuals. Some people have no symptoms, while others may experience functional difficulties.

An ENT assessment can determine whether restricted tongue movement is clinically significant and whether treatment is appropriate.

Where surgery is indicated, tongue-tie excision or division releases the restricting tissue.
Mr Jain undertakes Tongue tie clinics every Saturday (Spire London East hospital), Monday morning (At Nuffield Holly and Brentwood hospitals) and Wednesday afternoon (At Nuffield Brentwood hospital). This has been setup as there is a Paediatric nurse to help.

Prominent Ear Surgery

Pinnaplasty, also called prominent ear correction or otoplasty, is surgery to alter the shape and position of the ears.

It may be considered for children or adults who are concerned about prominent ears.

The operation is usually performed through an incision behind the ear, allowing the cartilage to be reshaped and the ear positioned closer to the head.

The aim is a natural-looking result while maintaining an appropriate ear shape and position.

Treatment for Nasal Blockage

The inferior turbinates are structures inside the nose that help warm and humidify inhaled air.
When the turbinates become persistently enlarged, they can contribute to nasal obstruction, difficulty breathing through the nose and mouth breathing.

If medical treatment does not adequately control symptoms, turbinate reduction surgery may be considered.

The procedure aims to reduce excessive turbinate bulk while preserving their normal function.

Turbinate reduction may sometimes be performed alongside other nasal procedures, depending on the underlying cause of nasal obstruction.

Treatment of Thyroglossal Duct Cysts

A thyroglossal duct cyst is a congenital cyst that develops along the embryological pathway of the thyroid gland.

It commonly presents as a lump in the middle of the neck and may occasionally become infected.

Assessment usually involves clinical examination and appropriate imaging.

When surgical treatment is recommended, the cyst and associated thyroglossal duct tissue are removed using an operation designed to reduce the risk of recurrence.