Ask the Expert: Pediatric Ear, Nose and Throat



Dr. John Little, Dr. Michael Belmont, & Dr. Mark Ray | Children’s Ear, Nose & Throat Specialists

No other practice in East Tennessee offers the quality and comprehensive care that the surgeons at Children’s Ear, Nose & Throat Specialists provides. 

Led by Dr. John Little, Dr. Michael Belmont, and Dr. Mark Ray, this practice recognizes that effectively treating a child or adolescent requires an unmatched attention to detail and a deep understanding of the emotional needs of a child and their family during challenging times. They strive daily to minimize the effects of a child’s illness and create an environment optimal for healing, growth and development.

Each physician has completed full fellowship training, beyond the typical ENT residency that they and most other ENT doctors have done. Their additional fellowship training is specifically focused on pediatric and adolescent ENT medical and surgical care (birth to 21 years): Dr. Little—Johns Hopkins University Children’s; Dr. Belmont—Pittsburgh Children’s; Dr. Ray—Arkansas Children’s.

What is the most common pediatric ENT procedure, and when should a parent consider it?

Ear tubes are the most common ENT procedure in the US. They are inserted for recurrent ear infections and/or for fluid in the ears with associated hearing loss. If a child has had 3 ear infections in 6 months or 4 or more episodes in a year, consideration for tubes is appropriate. It is a 5 to 10 minute procedure that is well tolerated and can be life-changing for the child and parent alike.

Are there any other common ones parents need to be aware of? Tonsillectomies (and Adenoidectomies) are the third most common surgical procedure in the US. It is performed for (1) upper airway obstruction and Sleep Disordered Breathing, childhood snoring with restless sleep and irregular breathing, and (2) Recurrent Strep throat, if there are 4-6 episodes or more in a year. We are discovering the far-ranging ramifications of poor sleep and chronic mouth breathing, from school problems and behavior issues to facial growth and dental issues. Good sleep at night results in better behavior and better performance during the day.

What are some complicated pediatric ENT procedures?

All of our pediatric ENT’s at our practice perform both routine and more complicated sinus surgery, ear surgery, airway surgery, and head and neck surgery, including congenital cysts and masses. In addition, Dr. Ray is the director of the Cleft and Vascular Anomalies Clinic at Children’s Hospital, which treats cleft lips and palates and the problems associated with those abnormalities.  Dr. Little is the director of the Pediatric Cochlear Implant Program at Children’s Hospital, and he and Dr. Belmont see the most challenging patients with Ear problems and Hearing Impairment from all over East Tennessee and the surrounding areas.

Do ENT specialists work directly with Pediatricians and/or Family physicians?

Because we only see pediatric patients, we know and work closely with all of the pediatricians and family physicians in our region that see children. They are a great group of practitioners and we enjoy and appreciate those relationships. Children are not just little adults and have unique characteristics that must be considered to result in healthy and happy children and teenagers.

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