Watchful waiting
Glue ear often clears by itself within about three months, and sore throats tend to become less frequent with age.
CHILDREN'S ENT · ISLAMABAD
Ear, nose & throat carefor children.
Dr M Riaz Khokhar sees children with tonsil and adenoid problems, snoring and mouth breathing, ear infections, glue ear and hearing concerns at PNS Hafeez Hospital Islamabad.
Evening clinic, Monday to Friday, 5–7 pm. Your appointment time will be confirmed by the clinic.
WHEN TO COME
Reasons to bring your child.
- Frequent sore throats or tonsillitis, with missed school days.
- Loud snoring, mouth breathing, restless sleep or pauses in breathing at night.
- Repeated ear infections or ear discharge.
- Concerns about hearing: not responding, turning the TV up, or speech that is slow to develop.
- A constantly blocked or runny nose.
- A lump in the neck that has not gone away after a few weeks.
Many childhood ENT problems improve as children grow. Assessment helps decide whether to wait, treat with medicines, or consider an operation.
YOUR VISIT
What happens at your child's appointment.
It helps to note how often infections have happened over the past year, and to bring any hearing tests and previous prescriptions.
1
Listening to you and your child
The history comes mostly from parents: symptoms, sleep, school, speech and how often infections occur.
2
A gentle examination
Ears, nose, throat and neck are examined, usually with your child sitting on your lap.
3
Hearing tests when needed
Age-appropriate hearing tests and a middle ear pressure test (tympanometry) may be arranged.
4
A clear plan
You will be told what was found and the options: watchful waiting, medicines, or surgery when it is clearly needed.
TREATMENT OPTIONS
Many children do not need an operation.
Medicines
Treatment for allergy, infection or nasal symptoms, used only when it is likely to help.
Surgery
Considered for frequent, well-documented tonsillitis, for enlarged tonsils or adenoids that disturb breathing during sleep, and for glue ear that persists and affects hearing.
CHILDREN'S OPERATIONS
Common operations and what to expect.
Tonsillectomy
Removal of the tonsils under general anaesthetic. A sore throat for one to two weeks afterwards is normal, and children usually stay off school for about two weeks.
Adenoidectomy
Removal of the adenoids from behind the nose, through the mouth, often together with tonsil or ear surgery. Recovery is usually quicker than after tonsillectomy.
Grommets (ventilation tubes)
A tiny tube is placed in the eardrum to let air into the middle ear and improve hearing. It is a short operation, and the tubes usually fall out by themselves after several months.
Risks
All operations carry a small risk of bleeding and infection, and anaesthetic risks. Bleeding after tonsillectomy can occur up to two weeks later and needs urgent attention. Dr Khokhar will explain the risks for your child before you decide.
When to seek urgent care
Take your child to the nearest emergency department if they have:
- Difficulty breathing, noisy breathing, or drooling with an inability to swallow.
- Any bleeding from the mouth or nose after a tonsil or adenoid operation.
- A swallowed or inhaled object, or a button battery in the nose or ear.
- A painful, red swelling behind the ear, with fever.
COMMON QUESTIONS
Questions parents often ask.
How many throat infections mean the tonsils should be removed?
There is no single number for every child. As a guide, surgery is discussed after around seven significant infections in one year, five a year for two years, or three a year for three years.
Will removing the tonsils weaken my child's immunity?
Studies have not shown a meaningful weakening of immunity after tonsillectomy. Other tissues in the throat continue to do the same job.
Is snoring in children normal?
Occasional snoring with a cold is common. Loud snoring on most nights, especially with pauses in breathing or restless sleep, should be assessed.
What is glue ear?
Fluid collects behind the eardrum and dulls hearing. It is very common in young children, is usually painless, and often clears without treatment.
What should I bring to my appointment?
Previous prescriptions, hearing test results, any discharge summaries, and a note of how many infections your child has had in the past year.
Reviewed by Dr M Riaz Khokhar, ENT Consultant · November 2026. This page gives general information and does not replace a consultation.
Ready to arrange your child's appointment?
Monday–Friday · 5–7 pm · PNS Hafeez Hospital Islamabad