Pediatric ENT: What a Children’s Ear, Nose and Throat Doctor Treats and When to See One
Quick answer: A pediatric ENT, also called a pediatric otolaryngologist, is a surgeon who diagnoses and treats ear, nose, throat, head and neck problems in children. The most common reasons kids see one are repeated ear infections or fluid behind the eardrum, hearing loss, enlarged tonsils or adenoids, snoring or sleep apnea, chronic sinus or nasal problems, and noisy breathing or voice problems. Pediatric ENTs complete medical school, a surgical internship and 3 to 4 years of otolaryngology–head and neck surgery residency, often followed by a pediatric fellowship. Ask your pediatrician about a referral if your child has frequent ear infections, ear fluid lasting 3 months or more with hearing concerns, frequent strep or tonsil infections, loud snoring with pauses in breathing, or a lump in the neck that doesn’t go away.
What is a pediatric ENT?
A pediatric ENT (ear, nose and throat doctor) is a pediatric otolaryngologist: a surgeon who specializes in disorders of the ears, nose, throat, airway, head and neck in babies, children and teens. They treat problems with medicine and, when needed, surgery, and they work closely with pediatricians, audiologists, speech therapists, allergists and sleep specialists.
Ear, nose and throat problems are among the most common reasons children see a doctor. Ear tube placement is the most common outpatient surgery in U.S. children, with about 667,000 children under 15 getting tubes each year, and tonsillectomy is one of the most common surgeries in the country. For a deeper list of conditions, see common issues treated by pediatric ENTs.
What does a pediatric ENT treat?
| Area | Common conditions |
|---|---|
| Ears | Repeated ear infections (otitis media), fluid behind the eardrum, swimmer’s ear, hearing loss (including follow-up after a failed newborn hearing screen), ear differences present at birth, cochlear implants |
| Nose and sinuses | Chronic sinusitis, stuffy nose that won’t clear, enlarged adenoids, deviated septum, nasal polyps, frequent nosebleeds, objects stuck in the nose |
| Throat and mouth | Repeated tonsillitis and strep throat, enlarged tonsils, tongue-tie, swallowing problems |
| Sleep and breathing | Snoring and obstructive sleep apnea, noisy breathing (stridor), airway narrowing |
| Voice | Hoarseness, vocal cord nodules or paralysis |
| Head and neck | Neck lumps and swollen lymph nodes, thyroid and salivary gland masses, hemangiomas, facial nerve problems |
When should my child see a pediatric ENT?
Most children see a pediatric ENT after a referral from their pediatrician. Common reasons include:
- Frequent ear infections, such as 3 or more in 6 months or 4 or more in a year
- Fluid behind the eardrum lasting 3 months or longer, especially with hearing, speech, balance or school concerns
- Hearing concerns, a failed hearing screen, or speech that seems delayed
- Frequent sore throats or strep: about 7 or more in a year, 5 a year for 2 years, or 3 a year for 3 years
- Loud, regular snoring, gasping or pauses in breathing during sleep, or daytime sleepiness and behavior problems
- A stuffy nose or mouth breathing that doesn’t go away, frequent nosebleeds, or chronic sinus symptoms
- Noisy breathing in a baby, a hoarse voice lasting weeks, or trouble swallowing
- A lump in the neck that grows or doesn’t go away
Get emergency care for trouble breathing, drooling with inability to swallow, a swallowed button battery or magnet, heavy bleeding after tonsil surgery, or a child who seems very sick. Read what to do for a swallowed button battery, and see our red-flag guide for parents.
Does my child need ear tubes?
Ear tubes (tympanostomy tubes) are tiny tubes placed in the eardrum to let air in and fluid drain out. The 2022 clinical practice guideline from the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) says:
| Situation | Guideline recommendation |
|---|---|
| Repeated ear infections with fluid in one or both ears at the ENT visit | Tubes should be offered |
| Repeated ear infections but no fluid at the ENT visit | Tubes should not be placed |
| Fluid in both ears for 3 months or longer with hearing difficulty | Tubes should be offered |
| Fluid for 3 months or longer with balance, school, behavior or ear-discomfort problems | Tubes may be considered |
| A single episode of fluid lasting less than 3 months | Tubes should not be placed; watch and recheck |
A hearing test is recommended when fluid lasts 3 months or longer or before surgery. Children at higher risk, such as those with speech, developmental or hearing problems, may be considered for tubes sooner. Learn more about treatment options for recurrent ear infections and how to tell an ear infection from a cold.
Does my child need their tonsils out?
The AAO-HNSF guideline on tonsillectomy recommends:
- Watchful waiting for repeated throat infections if a child has had fewer than 7 in the past year, 5 a year for 2 years, or 3 a year for 3 years.
- Tonsillectomy may be considered at or above those numbers, when each infection was documented with fever over 101°F (38.3°C), swollen neck glands, pus on the tonsils or a positive strep test.
- Tonsillectomy is recommended for obstructive sleep apnea confirmed by an overnight sleep study. A sleep study before surgery is advised for children under 2 and those with obesity, Down syndrome, craniofacial, neuromuscular or sickle cell conditions, or when the need for surgery is unclear.
- After surgery, ibuprofen and/or acetaminophen are recommended for pain, and codeine should not be used.
If your child snores loudly, read could snoring be a sign of sleep apnea?
Pediatric ENT vs. allergist vs. pediatrician: who treats what?
| Pediatrician | Pediatric ENT | Pediatric allergist | |
|---|---|---|---|
| Best for | First visit for ear pain, sore throat, colds and stuffy nose | Problems that keep coming back, don’t improve, or may need a procedure or surgery | Allergies, hay fever, asthma, food allergies |
| Typical treatments | Medicines, watchful waiting, referrals | Ear tubes, tonsil and adenoid removal, sinus and airway procedures, hearing care | Allergy testing, medicines, allergy shots |
| Surgery? | No | Yes | No |
A chronic stuffy nose may need both: an allergist to treat allergies and an ENT to check for enlarged adenoids or other blockages.
Why see a pediatric ENT instead of an adult ENT?
Many general ENTs treat children, but pediatric ENTs focus on kids. Children’s airways, ears and sinuses are smaller and still developing, and kids can’t always describe their symptoms or sit still for an exam. According to the American Academy of Pediatrics (AAP), pediatric ENTs use child-sized equipment, offices designed for children, and training that helps kids stay relaxed, and they offer the widest range of treatment options for children’s ENT problems.
What training does a pediatric ENT have?
According to the AAP, pediatric otolaryngologists complete:
- At least 4 years of medical school
- At least 1 year of surgical internship, often with another year of general surgery
- 3 to 4 years of residency in otolaryngology–head and neck surgery
- Often, additional fellowship training in pediatric otolaryngology at a large children’s hospital
ENT surgeons are board certified by the American Board of Otolaryngology–Head and Neck Surgery. Most pediatric ENTs practice at children’s hospitals, university medical centers and large community hospitals.
What happens at a pediatric ENT visit?
The ENT will ask about your child’s symptoms and history, then examine the ears, nose, throat and neck. Depending on the problem, they may use:
- Otoscopy to look inside the ears, and tympanometry to check for fluid behind the eardrum
- Hearing tests, often done by an audiologist on the same day
- Nasal endoscopy, a thin, lighted scope to look inside the nose, throat or voice box
- Imaging such as a CT scan, or an overnight sleep study for suspected sleep apnea
How to prepare
- Write down how many ear or throat infections your child has had, with dates and treatments
- Bring past hearing test results and a list of medicines
- Record a short video of snoring or noisy breathing on your phone
- Note any speech, hearing, sleep or school concerns
How to find a pediatric ENT
- Ask your pediatrician for a referral; many specialists and insurance plans require one
- Check the ENT or otolaryngology department at the nearest children’s hospital
- Search our pediatrician directory to find specialists near you
Frequently Asked Questions
What does a pediatric ENT do?
A pediatric ENT, or pediatric otolaryngologist, diagnoses and treats ear, nose, throat, head and neck problems in children, such as repeated ear infections, hearing loss, enlarged tonsils and adenoids, sleep apnea, sinus problems and noisy breathing. They treat with medicine and, when needed, surgery such as ear tubes or tonsillectomy.
How many ear infections before a child needs tubes?
Repeated ear infections are often defined as 3 or more in 6 months, or 4 or more in a year with at least one in the past 6 months. The 2022 AAO-HNSF guideline recommends offering tubes when a child with repeated infections also has fluid behind the eardrum at the ENT visit, and not placing tubes if there is no fluid.
When does a child need their tonsils removed?
Tonsillectomy may be considered for repeated throat infections when a child has had at least 7 documented infections in a year, 5 a year for 2 years, or 3 a year for 3 years. It is also recommended for obstructive sleep apnea confirmed by a sleep study. Fewer infections usually call for watchful waiting.
Should a child who snores see an ENT?
Occasional snoring with a cold is common. Talk to your pediatrician about seeing an ENT if your child snores loudly most nights, gasps or pauses in breathing during sleep, or has daytime sleepiness, bedwetting, poor school performance or behavior problems, which can be signs of obstructive sleep apnea.
What is the difference between a pediatric ENT and an allergist?
A pediatric allergist diagnoses and treats allergies with testing, medicines and allergy shots. A pediatric ENT treats structural and infection-related problems of the ears, nose and throat and can perform surgery, such as removing enlarged adenoids. Some children with a chronic stuffy nose see both.
Are ear tubes common and safe?
Yes. Ear tube placement is the most common outpatient surgery in U.S. children, with about 667,000 children under 15 getting tubes each year. It is a short procedure done under general anesthesia, and your ENT will explain the risks and benefits for your child.
What training does a pediatric ENT have?
Pediatric ENTs complete at least 4 years of medical school, at least 1 year of surgical internship, and 3 to 4 years of otolaryngology–head and neck surgery residency, often followed by fellowship training in pediatric otolaryngology. They are board certified by the American Board of Otolaryngology–Head and Neck Surgery.
Do I need a referral to see a pediatric ENT?
Often, yes. Many pediatric ENT clinics and insurance plans require a referral from your child’s pediatrician, who can also share records of past infections and hearing tests. Check with the clinic and your insurance plan.
Related guides
- Common Issues Treated by Pediatric ENTs
- Pediatric Otitis Media (Ear Infections)
- Tonsillectomy: An Overview
- Sleep Apnea in Children
- Sinusitis in Children
- Types of Pediatricians
Sources
- AAP (HealthyChildren.org): What is a Pediatric Otolaryngologist?
- AAO-HNS Bulletin: Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)
- American Family Physician: Tonsillectomy in Children, AAO-HNS Updates Guideline
- WebMD: What Is a Pediatric Otolaryngologist?
Last reviewed October 2026 against the sources above. This article is for general information and is not a substitute for advice from your child’s doctor.
