Paediatric ENT service

The paediatric ear, nose and throat (ENT) service provides comprehensive diagnostic, therapeutic, and surgical care for children and young people aged 0-18 years with conditions affecting the ear, nose, throat, head and neck region at the Lister Hospital.

All the ENT surgeons in the department treat children. The paediatric lead is Ms Marie Lyons, a fellowship trained ENT surgeon with a special interest in paediatric ENT surgery.

Service aims

• Provide timely, safe, and effective ENT care for paediatric patients
• Deliver family-centred care in age-appropriate environments
• Reduce unnecessary hospital admissions through effective outpatient management
• Ensure seamless transition to adult services where appropriate
• Maintain high clinical standards and patient safety
• Support training and professional development

Conditions we treat

Ear conditions:

• Acute and chronic otitis media
• Otitis externa
• Hearing loss (conductive and sensorineural)
• Tympanic membrane perforation
• Cholesteatoma
• Congenital ear anomalies
• Ear trauma

Nose and sinus conditions:

• Rhinosinusitis (acute and chronic)
• Allergic rhinitis
• Nasal obstruction
• Epistaxis
• Nasal trauma and fractures
• Congenital nasal anomalies

Throat and neck conditions:

• Tonsillitis and adenoiditis
• Sleep-disordered breathing/obstructive sleep apnoea
• Voice disorders and hoarseness
• Swallowing difficulties
• Neck lumps and lymphadenopathy
• Thyroglossal duct cysts
• Branchial anomalies

Head and neck conditions:

• Salivary gland disorders
• Facial nerve disorders
• Congenital head and neck anomalies
• Head and neck trauma

Age groups

• Neonates (0-28 days)- these patients are assessed by the ENT team- if surgical intervention is needed this is done at our local tertiary centre which is Addenbrookes in Cambridge
• Infants (1 month – 2 years) Selected operative cases are undertaken at the Lister from the age of 6 months
• Pre-school children (2-5 years)
• School-age children (5-12 years)
• Adolescents (12-18 years)

Paediatric ENT service components

Outpatient services:

• New patient consultations
• Follow-up appointments
• Pre-operative assessments undertaken by our CNS team who have been trained in pre assessment and consenting)
• Post-operative reviews
• Joint clinics with other specialties (audiology, speech therapy, paediatrics)

Day case surgery:

• Myringotomy and grommet insertion
• Tonsillectomy (selected cases)
• Adenoidectomy
• Minor procedures under local anaesthetic

Inpatient surgery:

• Complex tonsillectomy cases
• Major head and neck procedures
• Cases requiring overnight observation

Emergency services:

• 24/7 ENT emergency cover
• Acute clinics (accessed via on call team)
• Urgent outpatient appointments
• Emergency theatre access

Referral pathways

Primary care referrals:

• GP referrals via Choose and Book/e-Referral Service
• Urgent referrals via telephone consultation
• 2-week wait referrals (rare in paediatric ENT)

Secondary care referrals:

• Emergency Department
• Paediatric wards
• Other hospital specialties
• Regional tertiary centres (complex cases)

Self-referrals:

• Not accepted except for established patients with agreed care plans

Other information

Theatre Access

• Dedicated paediatric theatre sessions (1.5 sessions per week)
• Emergency theatre access 24/7
• Appropriate paediatric anaesthetic support

Professional Development

• Consultant continuing professional development programme
• Specialty training posts aligned with curriculum requirements
• Nursing staff competency programmes
• Allied health professional development opportunities

Research and Audit

• Participation in national audits
• Local audit programme
• Research opportunities for appropriate cases
• Quality improvement initiatives

Governance arrangements

Clinical governance

• Monthly departmental clinical governance meetings
• Incident reporting and investigation procedures
• Regular mortality and morbidity reviews
• Multi-disciplinary team working

Service management

• Service manager responsible for operational management
• Clinical director providing clinical leadership
• Integration with wider paediatric services
• Links with regional paediatric ENT networks