Surgery is a big part of our comprehensive otolaryngology care for kids. Our board-certified otolaryngologists are surgeons who specialize in evaluating and treating many types of pediatric disorders of the ears, nose and throat (which is why we're called ENT doctors). We also take care of head and neck masses, airway/breathing problems, voice issues, hearing loss and communication problems.
A few of our most common ENT procedures are:
- insertion of ear tubes (also called a "bilateral myringotomy with tubes," or "BMT") — to reduce the number and severity of ear infections, and restore temporary hearing loss due to fluid accumulation behind the eardrum
- tonsillectomy — to remove tissues in the back of the mouth that can get repeated infections or, when enlarged, can block the airway and cause snoring
- tonsillectomy and adenoidectomy (or "T&A") — to remove both the tonsils and adenoids (a patch of tissue that sits at the very back of the nose)
When your child has any procedure, we know it’s important for you to know and trust that your child’s surgeon will fix the symptoms, improve your child’s quality of life, and support their growth and development. And we know you look to us to perform the surgery with minimal risk for complications.
Why Measuring Results Matters
To provide pediatric care that's among the safest for all children, we measure our results and compare them to national rates for similar procedures by other surgeons. Why? So we can:
- help you make decisions about your child’s care
- be clear about our results
- review our own resuls and constantly strive to improve so we can deliver better, safer care
We’re proud to report that, as an entire system of ENT specialists, we're doing very well compared to national benchmarks (averages) and have low rates of complications for common ENT procedures in kids.
Helping Kids Stay Out of the Emergency Department (ED)
Preventing ED Trips After Common ENT Surgeries
Whenever kids have surgery, we want to make sure they don't have any complications that would send them to the hospital or emergency department (ED). Sometimes children might end up in the ED or be admitted with new infections, respiratory problems, gastrointestinal illnesses, etc. But it’s important to avoid, as much as possible, potentially preventable hospital and ED visits because of problems such as incomplete treatment or hospital-acquired infections (when a patient gets an infection during surgery or a hospital stay).
To prevent infections after surgery, we give antibiotics, perform skin prep, test for possible resistant bacterial infections, and limit traffic in the operating room. Communication with families and close follow-ups also are key to keeping kids out of the hospital and ED. That's why we:
- schedule all follow-up appointments and tests after surgery as needed
- provide clear educational materials and discharge instructions to families, including correct medications and doses
- give families access to a Nemours physician for postdischarge questions (after a hospitalization or surgery) through our CareConnect online doctor visits (available in the Delaware Valley)
- encourage online communication through your child’s electronic health record — MyNemours for families
Emergency Department Visits After Ear Tube Insertion or Removal of Tonsils and Adenoids
National average (benchmark)
Data source: Patient data for all T&A and BMT 2016 and 2017 patients in Orlando (Nemours Children's Hospital) and the Delaware Valley (Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del.; Nemours duPont Pediatrics, Deptford in Deptford, N.J.; and Nemours duPont Pediatrics, Bryn Mawr in Bryn Mawr, Pa.). Rates are per 100 procedures.
Benchmark: Shay S1, Shapiro NL, Bhattacharyya N. Revisit Rates and Diagnoses Following Pediatric Tonsillectomy in a Large Multistate Population. Laryngoscope. 2015 Feb;125(2):457-61. doi: 10.1002/lary.24783. Epub 2014 Jun 17.
Helping Kids Recover Faster After Tonsil Surgery
Reducing Bleeding After Tonsillectomies
During a tonsillectomy, the ENT surgeon removes enlarged tonsils (tissue on the sides of throat) and sometimes also the adenoids (glands in the back of the nasal cavity). Families are often concerned about two things after a tonsillectomy: bleeding and recovery. Bleeding after surgery usually happens after 5–7 days, when the scab separates from where the surgery was performed in the back of the throat. Preventing and minimizing bleeding after surgery (referred to as “postoperative bleeds”) means less chance of a return trip to the operating room, and a smoother recovery overall.
The national average for post-tonsillectomy bleeding is 5.4 percent. This means in surgery centers and hospitals in the United States, about five patients out of every 100 have postoperative bleeds. At Nemours, our ENT surgeons do much better than the national average because we’re precise with the procedures we perform, and we offer high-quality care after surgery.
Patients With Bleeding After Tonsillectomy, Nemours Children’s Health System (All Locations), 2016
Total tonsillectomies (combined)
Percentage with postoperative (after surgery) bleeding
National average (benchmark)
Data source: Patient data averaged from 2016 billing records for Nemours Delaware Valley and Orlando ENT locations, including Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.); Nemours duPont Pediatrics, Deptford (Deptford, N.J.); Nemours duPont Pediatrics, Bryn Mawr (Bryn Mawr, Pa.); Nemours Children’s Hospital (Orlando); Nemours Children’s Specialty Care, Jacksonville (Jacksonville, Fla.); and Nemours Children’s Specialty Care, Pensacola (Pensacola, Fla.).
Benchmark: J. R. Bellis1, M. Pirmohamed4, A. J. Nunn3, Y. K. Loke5, S. De2, S. Golder6 and J. J. Kirkham7. Dexamethasone and haemorrhage risk in paediatric tonsillectomy: a systematic review and meta-analysis. British Journal of Anaesthesia 113 (1): 23–42 (2014) doi:10.1093/bja/aeu152. Pinder DK, Hilton MP. Dissection versus diathermy for tonsillectomy. Cochrane Database Syst Rev. 2001;(4):CD002211.
Our Differentiators: What Sets Us Apart
Why Choose Nemours Otolaryngology (ENT)
Nemours has one of the largest pediatric ENT programs in the country, with nearly 65,000 outpatient visits each year. You can trust Nemours to provide top-level care by experienced, highly skilled ear, nose and throat specialists and teams. Here are just some of the reasons families choose us for their child’s care:
- “Best Doctors in America®”. We're proud to have some of our board-certified otolaryngologists selected year after year.
- The latest surgical techniques. This means less pain, less bleeding, and a faster return to normal diet and activity.
- Comprehensive care. With specialists in ENT, audiology and hearing, balance and vestibular disorders, airway disorders and more, we’re working together for all your child’s needs.
- Family-centered, convenient approach to care. Because our doctors, audiologists and speech therapists are all under one roof, your child can often have multiple appointments scheduled in one day. You can also see our experts at specialty care satellite locations, when and where you need us.