Ear, Nose, and Throat (Otolaryngology) - Referral Guidelines

The Division of Otolaryngology at Children’s National is one the largest and most prestigious pediatric otolaryngology programs in the country. Each year, we treat more than 17,000 children within the Division of Otolaryngology. The experienced team includes eight board-certified, fellowship-trained surgeons, as well as anesthesiologists with specialized training in pediatrics. Our program also includes nurses trained in otolaryngology-specific care, physician assistants, and fellows and residents in training.

The Division of Otolaryngology provides a full range of diagnostic, medical, and surgical services for ear, nose, and throat conditions. Patients may be referred for evaluation, diagnosis and/or definitive treatment of these conditions. The types of problems seen by the division include chronic ear infections, hearing loss, sinusitis, tonsillitis, airway problems, cysts, and tumors of the head and neck.


Adapted from the American Academy of Pediatrics “Guidelines for Referral to Pediatric Surgical Specialists” Vol. 110 No. 1 July 2002, pp. 187-191:

A pediatric otolaryngologist has completed a 4- to 5-year residency in otolaryngology/head and neck surgery and is certified by the American Board of Otolaryngologic Surgery. In addition, he or she has completed 1 or 2 years of fellowship training in pediatric otolaryngology. For purposes of developing these guidelines, the following age group definitions are used: infant (0–1 year), child (2–12 years), and adolescent (13–18 years)

  • Infants, children, and adolescents with congenital malformations of head and neck structures, including the ear, nasal passages, oral cavity, and laryngotracheal airway.
  • Infants and children with sensory impairments, including conductive or sensorineural hearing loss, vertiginous disorders, unilateral and bilateral true vocal fold paralysis, facial nerve paralysis, and oromotor dysfunction as evidenced by speech, swallowing or drooling problems.
  • Infants and children with acquired otolaryngologic disorders involving the ear (e.g., cholesteatoma), the pharynx (e.g., obstructive adenotonsillar hypertrophy), the laryngotracheal airway (e.g., postintubation laryngotracheal stenosis), the aerodigestive tract (e.g., foreign body aspirations), and the facial skeleton (e.g., maxillofacial trauma).
  • Infants, children and adolescents with neoplasms or vascular malformations of the head and neck structures, including the laryngotracheal airway.
  • Infants and children with medical conditions that increase operative risk (e.g., congenital heart disease) who must undergo a common otolaryngologic procedure (e.g., adenotonsillectomy).
  • Infants and children requiring operative airway endoscopy for the evaluation of stridor.

The following patients are preferably managed by a pediatric otolaryngologist:

  • Infants and children with complicated infections that may require surgery involving the ear (e.g., otitis media with effusion and hearing change), the nose and paranasal sinuses (e.g., chronic rhinosinusitis), the pharynx (e.g., recurrent adenotonsillitis), the airway (e.g., epiglottitis), and the neck (e.g., retropharyngeal abscess).

Download a pdf of these guidelines.

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