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When Does a Child Need a Tonsillectomy? London & Essex ENT

  Tonsillectomy Decision-Making: Why It Is About Much More Than Tonsil Size For many parents across East London and Essex, sitting in a consulting room looking at a child's enlarged tonsils triggers a singular question: “Are these big enough that they need to be cut out?” It is a completely natural assumption that a surgical recommendation is based purely on how crowded the back of the throat looks during a physical examination. However, in modern pediatric otolaryngology, the physical size of the tonsils is only one small piece of the puzzle . The clinical decision to recommend a tonsillectomy depends on a dynamic combination of factors: the frequency of infections, the impact on sleep quality, safety-netting parameters, and the overall extent to which the child's daily growth and learning are being affected. This guide breaks down the specialist framework used to determine when surgery is truly the right step forward for your child. The Decision-Making Framework: Five Critic...

Sudden sensorineural hearing loss




Why is it essential to identify Sudden hearing loss?
Treatment of sudden hearing loss due to inner ear infection is a medical emergency. Sudden hearing loss could be due to simple cause due to wax in the ear canal or inner ear infection. If the treatment of inner ear infection is delayed by more than 7days, it can lead to permanent hearing loss. 10-20 people every 100,000 per year can get sudden sensorineural hearing loss.  


How do I know that it is a sudden sensorineural hearing loss?
It is straightforward to test by humming test. If you suspect your hearing is down in one ear. Humming "aa" and "ee" can help.
If you hear, sound louder in the ear you feel deaf then the chances are you have conductive hearing loss due to wax or glue ear. If the sound is louder in the better ear, then chances are you have sensorineural hearing loss, and you need to see a doctor urgently.
Example, you had flu for a few days, and suddenly you feel that hearing is low in the right ear. Next thing you do is hum "aa" and "ee" for 10-15 seconds. If you hear hum louder in the left ear, then this is a medical emergency.


 What can be done if have sudden sensorineural hearing loss?
If you see your doctor, he will organise an urgent appointment with an Ear Nose Throat Surgeon and start you on steroid tablets. 


What happens when I see Ear Nose Throat Surgeon? 
ENT surgeon will take a detailed history and examine you covering possible causes for sudden sensorineural hearing loss. You will need a hearing test, some blood test and a special head scan (MRI Scan). He will start you on one week of steroid tablets if it has not been prescribed yet, and arrange for you to be seen again in one week to retest the hearing. 


What are my options if there is no change hearing after steroid tablets?
If there is no response to oral steroid tablets, then Ear surgeon will discuss with your option of injecting steroid medication directly into the middle ear. This is known as an intratympanic steroid injection. This can be done under local anaesthetic by just numbing the ear canal or full general anaesthetic.  On the day of the injection, you will need someone to drive you home after the procedure.  You will need two to three such doses. In most cases, puncture created by the needle to inject medication closes in two to three weeks. 

Such possible complications of this procedure are bleeding, infection, dizziness,  hole in the eardrum and no response to the injection. Tinnitus is generally due to hearing loss due to disease rather than procedure. Complications are very rare.

Studies show a different response rate to steroid injection. In general patients with high BMI, cholesterol, and blood glucose (metabolic syndrome) have a poor prognosis. Always check with the surgeon about results in his hands.

Is sensorineural hearing loss reversible?

 Evidence is early intervention within 72hours of symptoms have good prognosis and recovery.

What treatment options do I have if have no response to medical treatment and injections?
If someone has no response to treatment, then he or she may need support with tinnitus, hyperacusis (sensitive to sounds) and hearing loss. Tinnitus and hyperacusis are managed by masking, tinnitus retraining and cognitive behaviour therapy. For hearing rehabilitation options are cross hearing aid and bone anchored hearing aid.  


Mr Gaurav Kumar

Consultant Ear Nose Throat Surgeon

To make an appointment 

Book Online

Call 07494914140

email info@entsurgeonclinic.co.uk

Disclaimer: For general information only, always seek medical advice from your treating consultant



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