Airway problems may present very early in life, particularly with congenital disorders affecting the laryngotracheal complex.

Complications of sinusitis in children are unusual but serious. Appropriate diagnosis involves knowledge of sinus and orbital anatomy. Radiographic imaging should be directed at the sinus source of infection as well as the area of suspected extension of infection (orbit, intracranial, or both). Multidisciplinary evaluation is critical, and broad spectrum antibiotics combined with timely surgical drainage is necessary for cure without sequelae.

Children are frequently affected with upper respiratory infections, of which some develop into rhinosinusitis. Depending on the time course of the symptoms, rhinosinusitis can be classified as either acute or chronic. Proper diagnosis of rhinosinusitis in children is critical, as there are many other disease conditions with overlapping symptomatology but require different treatments. Treatment strategies can follow an escalation of care, from the least invasive options such as nasal saline rinses, allergy management and antibiotics, to surgical options such as adenoidectomy, balloon sinupla

Children with hearing loss can be at great risk of developmental delays. Types of hearing loss include conductive hearing loss, sensorineural hearing loss, or mixed hearing loss.  Regardless of type, early diagnosis and therapeutic intervention is critical to give ample opportunity to prohibit these delays from developing.  Hearing loss may be present at birth (congenital) or later in childhood (delayed onset), and may be genetic (syndromic vs nonsyndromic), infectious, ototoxic, traumatic or idiopathic in origin.

Vascular lesions of the head and neck in pediatric patients can look very similar upon presentation. Accurate diagnosis is critical, as the etiology, histology, and clinical course of these lesions can vary considerably.  Proper recognition of the type of lesion, can lead the clinician to offer appropriate medical and surgical options, and avoid unnecessary therapeutic interventions which may not be efficacious and may even be harmful. Complications of treatment must be identified, as well as complications in untreated vascular lesions.

Pediatric patients may commonly present with cervical masses, and it is important to distinguish their etiology. Neck masses may encompass congenital lesions, infectious etiologies, as well as neoplastic causes. Accurate diagnosis of congenital neck masses can often be accomplished with a thorough history and physical examination, augmented by selective imaging. Standard treatment usually involves antibiotics for acute infections, and surgical excision as the definitive treatment.

Adenotonsillar disease is one of the most common reasons children seek otolaryngologic care. This accumulation of lymphoid tissue around the entrance to the upper aerodigestive tract may be affected by enlargement due to cellular hyperplasia, recurrent or chronic infections, or neoplasm. Treatment options range from medical options in an effort to treat infections or shrink enlarged lymphoid tissue, or surgery to remove the offending tissue.

The role of genetics in the evaluation and management of otolaryngologic problems is increasing. From cancer treatment to pediatric hearing loss, the otolaryngologist is expected to understand inheritance patterns, genetic testing and the impact of genetics on patient care. Genetic disorders are the basis of the syndromes that significantly affect the head and neck. Furthermore, a keen understanding of common craniofacial syndromes is necessary as many of these syndromes are a routine part of our practice.

Postoperative vital sign monitoring routines for pediatric otolaryngology – head and neck surgery patients differ with respect to adult vital sign monitoring and involve special considerations, particularly with respect to airway procedures and tracheotomy. Different techniques for anesthesia have special advantages for different pediatric needs, particularly with respect to the postanesthetic care. Antibiotic dosing schedules are weight based. Certain antibiotics are to be avoided in children due to their side effects.

Stridor is the result of disturbed or turbulent airflow in the airway. A rapid and thorough approach to determining the cause of stridor is critical to patient management. The initial objective of managing a patient with stridor is to assess the degree of respiratory distress and establish a secure airway if necessary. Once the etiology of the stridor is made, appropriate management requires an understanding of the natural history of the abnormality and implementation of appropriate treatment.