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Ear, Nose & Throat: Pediatric Otolaryngology - Head and Neck Surgery

We provide care for children with disorders of the ears, nose and throat.
Our Program
The Division of Pediatric Otolaryngology provides care for children with disorders of the ears, nose and throat. These disorders can be congenital or acquired. The otolaryngologists care for a vast area of disorders, including:
  • ear infections
  • hearing loss
  • airway obstruction
  • obstructive sleep apnea
  • tonsillitis 
  • nosebleeds
  • sinus infection
  • voice disorders
  • salivary gland diseases
  • thyroid lumps
  • abnormally-shaped ears
  • congenital cysts
  • sinuses and fistulae of the head and neck
  • foreign bodies
  • tumors of the ear, nose, sinuses, neck, salivary glands, thyroid, larynx, trachea, and skull base.
Surgery ranges from relatively minor, such as myringotomy and tympanostomy tube insertion, adenoidectomy and tonsillectomy, to complex major procedures of the head and neck, such as cochlear implantation, mastoidectomy, bronchoscopy using balloons and lasers, open laryngeal reconstruction, neck or thyroid tumor removals, and endoscopic skull base surgery.

Every year, many thousands of children are assessed and treated through the Pediatric Otolaryngology (Ear, Nose and Throat) Clinic, including children referred from across British Columbia, the Yukon, and beyond. In addition, the team members participate in a number of multi-disciplinary clinics with other colleagues from across the campus, for example, cleft lip and palate, craniofacial, vascular anomalies, home ventilation and tracheostomy, complex aerodigestive disorders, esophageal atresia, thyroid, cochlear implantation, and bone conduction implantation.

You can find more information and resources in the Family Resource Library and about choking prevention and safe feeding through the Safe Start Program.

Your Visit 

What to Bring
It is important to your child to make this visit as informative as possible, so the adult(s) who come with her/him should have the best knowledge of the history. Please bring the following to each clinic visit:
  • BC CareCard/Services Card
  • List of medications your child takes
  • Medical or personal records, such as x-rays or lab tests. If you are unsure about what to bring, please call the clinic office.
  • If you have a number of questions, most parents find it handy to make a list to bring with them
For more information on planning your visit, please see here: http://www.bcchildrens.ca/our-services/your-visit/planning-your-visit

If You Need to Cancel

If you need to cancel your appointment, please contact us as soon as possible (at least 48 hours ahead of time, if you can) so that your appointment time can be used by another patient.

If Your Child has an Infection

If your child has been in contact with any infectious diseases (such as chicken pox or measles) during the three weeks before your appointment, please let us know immediately. We may need to reschedule your appointment.

If You Need an Interpreter

If an interpreter would be helpful for you, please phone us as soon as possible and we will arrange for this.



Our Team

Our dedicated and highly experienced team of healthcare professionals work diligently to create a safe, compassionate and healing environment for you and your child. 

Administrative Staff

Aisa Danganan, MOA to Dr Chadha & Dr. Felton


Nancy Davies, MOA to Dr. Ludemann & Dr. Moxham

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Philana Do, MOA to Dr. Kozak & Dr. Rahmanian

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Michelle Poulsen, MOA to Dr. Ludemann & Dr. Moxham

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Nursing Staff

Valerie Yeung RN, Pediatric Otolaryngology Clinical Nurse


Cheryl Atkins-Labelle RN, Sedation nurse 



Other Team Members

Clinical Fellows, Otolaryngology Residents, and medical students



Physicians

Dr. Neil K Chadha, MBChB(Hons), MPHe, BSc(Hons), FRCS, (Department Head)

Chadha headshot.pngDr. Neil Chadha joined the Division of Pediatric Otolaryngology-Head and Neck Surgery (Ear Nose and Throat Surgery) at BC Children’s Hospital in July 2010.  He has been Division Head since September 2018. Dr. Chadha is also the Director of Pediatric Otolaryngology Research at BC Children’s Hospital and an Associate Clinical Professor at the University of British Columbia. Dr Chadha completed his Medical and Otolaryngology training in the United Kingdom and his Pediatric Otolaryngology Fellowship at The Hospital for Sick Children in Toronto. 

His practice is exclusively pediatric, with special interests in airway surgery including airway reconstruction, voice disorders, congenital head and neck lesions, thyroid surgery, salivary gland surgery, and endoscopic sinus surgery. 

He has a Masters Degree in Public Health and Epidemiology and to date has published over 80 research articles and 5 book chapters. In his spare time, Dr. Chadha loves playing and coaching soccer, running half marathons and is a terrible and uncommitted guitar player.


Dr. Mark Felton, MBchB, Msc, MD, FCRS

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Dr. Felton is a consultant Pediatric Otolaryngologist at BC Children’s Hospital and Clinical Assistant Professor for the University of British Columbia. 

Originally from the UK, he studied at the University of Leeds in England, graduating with an Honours degree in Anatomy before completing his medical degree. Dr. Felton carried out his specialist ENT training at the University of Manchester. Following this, he undertook a subspecialist pediatric ENT fellowship in Vancouver at BC Children’s Hospital in 2015/2016. After this he spent over 3 years at the Evelina London Children’s Hospital, UK, as a consultant otolaryngologist with a subspecialist interest in children’s ear disorders. He rejoined the Division of Pediatric Otolaryngology at BC Children’s Hospital as a consultant in 2019. 

Dr Felton is active in medical teaching, having completed a Masters degree in Medical Education. He regularly enjoys teaching trainees, students and allied specialists. He is also active in research, having a postgraduate research degree, with numerous international presentations and peer reviewed publications. His research focuses on ear disorders and outcomes from implantable hearing aids. 


Dr. Fred Kozak, MD, FRCSC

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Dr. Jeffrey Ludemann, MD, FRCSC

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Dr. Jeffrey Ludemann joined the Division of Pediatric Otolaryngology-Head and Neck Surgery at BC Children’s Hospital in 1999. He is a Clinical Professor of Otolaryngology at UBC; and the Quality of Care Lead for the Division of Otolaryngology at BC Children’s Hospital.

Dr. Ludemann is the principle founder of https://dontchoke.ubc.ca (in 8 languages) - and the Be Smart, Don't Choke Facebook page (evidence-based injury prevention education).  Dr. Ludemann was the Founder and former Chair of the Canadian Society of Otolaryngology Pediatric Study Group. He conceptualized development of the Storz Vancouver Forceps, which have been used since 2006, by Pediatric Otolaryngologists around the world, for safer removal of small foreign bodies.

His hobbies include Kung Fu, playing guitar, hiking, farming, skiing and snowshoeing. He also enjoys biking, especially to fundraise money via the Vancouver Rotary Club, for hearing loss research.  Dr. Ludemann is married, with 3 amazing children - and Scout, their Huskador puppy.


Dr. Paul Moxham, MD, FRCSC

PMoxham.jpegDr. Paul Moxham is a Pediatric Otolaryngologist at BC Children’s Hospital in Vancouver, Canada. He completed medical school at the University of Alberta in Edmonton in 1992, followed by an internship at Charles Camsell Hospital (1993), a residency in Otolaryngology-Head & Neck Surgery at the University of British Columbia 1998), and finally a fellowship in Pediatric Otolaryngology at the Royal Children’s Hospital in Melbourne, Australia, with the University of Melbourne (1999). 

In his downtime, Dr. Moxham enjoys running, particularly trail running for the last 10 years. When his oldest daughter is home from school, they run together in Pacific Spirit Park 4-5 days a week. He also enjoys cycling with his wife and younger daughter several days a week as well. During the winter, Dr. Moxham loves downhill skiing, trying new hills or his old favorites in BC and Alberta. Dr. Moxham was born in London, Ontario, and has lived all across Canada (Toronto, Calgary, Edmonton, Vancouver) as well as Melbourne, Australia. He has called Vancouver home for 26 of the last 27 years. 


Dr. Ronak Rahmanian, MD, FRCSC

RR headhsot.jpgDr. Ronak Rahmanian completed her undergraduate education in Microbiology and immunology at the University of British Columbia, during which time she worked at the British Columbia Center for Disease Control as well as the Protiva Biotherapeutic Company performing basic science research. 

She then earned her medical degree and completed her residency at the University of British Columbia. She pursued a fellowship in Otology & Neurotology at the St. Paul’s Hospital Rotary Hearing Clinic & Vancouver Hospital Neurotology Services. She completed a second fellowship in Pediatric Otolaryngology at Rady Children’s Hospital and worked as an Assistant Clinical Professor at the University of California San Diego (UCSD) – Rady Children’s Hospital as a full-time pediatric otolaryngologist prior to joining the pediatric otolaryngology team at BC Children’s Hospital. 

Although she enjoys all aspects of clinical pediatric otolaryngology, she has a special interest in pediatric ear surgery and cochlear implants. Dr. Rahmanian was raised in Vancouver, Canada. During her spare time she enjoys the outdoors, playing tennis, skiing, learning to surf and spending time with her friends and family.


Patient Information

Preparing for Surgery

Preparing your child for surgery can help make things run more smoothly. Please see BCCH Procedures and Surgical Services for more information. You may also find this handout helpful which includes the general fasting guidelines: Anesthetic Care Unit.pdf

Learn more:
BC Children’s Hospital: Anesthetic Care Unit (Website) 

Procedures

An adenoidectomy is a surgery performed to remove the adenoids. Adenoids are pads of tissue located high in the throat at the back of your child’s nose. Adenoidectomy may be considered if it impacts your child’s breathing, or if there are repeated infections. 

For information on how to care for your child after the surgery, please see the following handout: 

Learn more:

 

 

A bone conduction hearing aid works by sending sound to the inner ear using sound vibrations through the bone. Bone conduction hearing aids may be considered for children with conductive hearing loss, or if a regular hearing aid does not work for your child. 

There are several types of bone conduction hearing aids. 

Learn more: 
  • BC Children’s Hospital: Hearing Problems (scroll to the ‘Hearing aids’ section, and open the ‘Bone conduction hearing aids’ button)
  • BC Family Hearing Resource Society: Support for BC families 
Sports, injuries, or falls can cause a nasal fracture, also called a broken nose. A closed nasal fracture reduction is a procedure that moves your child’s nose back to its original position. It’s important to do this procedure in a timely manner, waiting too long can cause the bones to set irregularly.

Learn more:
The cochlea is a part of the inner ear. It turns sound vibration into neural messages that stimulates the hearing nerve. The hearing nerve sends messages about the sound to the brain. 

A cochlear implant is a device that directly stimulates the hearing nerve. It uses electrodes to capture vibrations and send messages to the hearing nerve.

A cochlear implant may help if your child has severe to profound sensorineural hearing loss. These implants can also help when regular hearing aids do not. 

During a surgery, a doctor inserts the implant into the cochlea, and implants a receiver behind the ear.

For more information on how to care for your child after the surgery, please see the following handout: Cochlear Implant Handout.pdf

Learn more:

Ear tube surgery is also known as a myringotomy and tympanostomy tubes surgery. The doctor makes a small opening in the eardrum, then ear tubes are placed to let fluid drain out of the middle ear. An ear tube is like a tiny straw. It is usually 2-3 mm long and can only be seen in the ear with special equipment. The ENT doctor may suggest tubes if your child has had a number of ear infections, or if the build-up of fluid appears to impact their hearing.

 

For information on how to care for your child after the surgery, please see the following handout: 

Ear Tubes Handout.pdf


Learn more:

 

A Functional Endoscopic Sinus Surgery (FESS) is a surgery done to unblock the sinus openings into the nose. This may ease the pressure and pain from blocked sinuses. Surgery is sometimes considered after patients have tried other treatments. During the surgery, the ENT doctor will place a telescope with a special light system that allows them to zoom in and see the sinus openings.  


For information on how to care for your child after the surgery, please see the following handout:

FESS Handout.pdf


Learn more:

 
A laryngoscopy and bronchoscopy are examinations that use a scope to look at parts of the airway. During this procedure, the doctor examines your child’s mouth, throat, voice box (larynx), windpipe (trachea) and finally the passages that lead to each lung (bronchial tubes). Your child will be under anesthesia for this procedure. 

For information on how to care for your child after the procedure, please see the following handout: 

Learn more:

Otoplasty is a surgery performed to reshape the ears. It may be considered if the child is born with prominent ears. Your child will have a bandage around their head for 7-10 days.

 

For information on how to care for your child after the surgery, please see the following handout: Otoplasty Handout

 

Some babies are born with small skin tunnels that open in front of, or inside, the ear. These are called "preauricular sinuses". These tunnels result when tissues forming the ear do not fuse completely. No one knows why this happens or why it happens more often in girls than boys. No treatment is needed unless these tunnels become infected. If they do, the doctor may recommend surgery to remove them.

 

For information on how to care for your child after the surgery, please see the following handout: Preauricular Sinus Removal Handout

 

Recurrent Respiratory Papillomatosis (RRP) is a rare disease in which benign (non-cancerous), wart-like tumours grow inside the larynx (voice box), vocal cords, and in a few cases, inside the windpipe. The first sign is a hoarse voice. New papillomas tend to keep growing, unless they are removed. Most people with this problem need to have the growths removed each time they grow larger; if left, they may block the airway and make it impossible to breathe. The surgeon removes the growths while the child is under an anesthetic.

 

For information on how to care for your child after the surgery, please see the following handout: RRP Handout

 

Learn more:

 

A Salivary Gland Duct Ligation is offered mostly for patients who have tried other therapies and have not been successful in decreasing the amount of drooling. This surgery involves tying-off of the 2 submandibular and the 2 parotid gland ducts through the mouth. If effective, this stops saliva getting from these 4 glands into the mouth, causing the glands to shrink which significantly decreases drooling. Other smaller salivary glands in the mouth will continue to produce saliva so your child's mouth will not become overly dry.

 

For information on how to care for your child after the surgery, please see the following handout: Salivary Duct Ligation Handout

 

The septum is the wall of bone and cartilage between the nostrils. If the septum is bent or causes a blockage, your child can have trouble breathing.

During a septoplasty (also called septal surgery), a doctor straightens your child's septum.

 

More resources:

 

Saliva comes from salivary duct glands. These glands can become inflamed when the glands are too narrow. They can also become inflamed when debris or stones block the gland openings.

 

A sialendoscopy is a procedure where a doctor examines the openings of your child's salivary glands, using a small camera. During the procedure, the doctor will also remove any stones or debris blocking the glands. 

 

Learn more:

 

When a baby develops inside the uterus, different parts of the body form and grow into place. The thyroid gland forms behind the tongue and then moves along a channel (called a duct) into its position over the trachea (windpipe). The duct disappears as part of the normal development. Sometimes, this duct, called the thyroglossal duct, remains. Surgery may be suggested because infections can occur, or if the cyst presses on throat passages making it hard to breathe or swallow.

 

For information on how to care for your child after the surgery, please see the following handout: Thyroglossal Duct Cyst Removal Handout

 

Learn more:

 

The thyroid is a butterfly-shaped organ at the front of the neck. It produces hormones that affect metabolism, body temperature, heart function, mood, and other body systems.

 

A thyroidectomy is surgery where a doctor removes your child's thyroid. Your child may need this surgery because of thyroid nodules, autoimmune disease, thyroid cancer, or another reason. 

 

Learn more:

 

A tongue tie is when the tissue that connects the bottom of the tongue to the floor of the mouth (frenulum) is too short and tight causing the movement of the tongue to be restricted. A tongue tie release surgery, also known as a frenotomy, is a procedure done to release the tissue that attaches the tongue to the floor of the mouth. This is most commonly done when it is affecting feeding or speech.

 

For information on how to care for your child after the surgery, please see the following handout: Tongue Tie Release Handout

 

Learn more:

 

The tonsils and adenoids are small masses of spongy tissue. The tonsils are in the back of the throat on both sides of the tongue. The adenoids are at the back of the nose where the passages of the nose and throat meet. The doctor may recommend a tonsillectomy with or without an adenoidectomy if they feel that your child is having a lot of infections, or they have large tonsils or adenoids that make breathing difficult.

 

For information on how to care for your child after the surgery, please see the following handout: Tonsillectomy Handout

 

Learn more:

 

The trachea, also called a windpipe, is part of the airway. It helps to move air into the lungs.

 

A tracheostomy is a surgery where a doctor puts a tube in your child's trachea. Your child may need this surgery to help with breathing, or another reason.

 

Learn more:

 

The mastoid bone is a part of the skull and lies behind the ear lobe. Sometimes, the cells of the mastoid bone, and/or the small bones (ossicles) inside the ear, are destroyed by chronic infection or a growth known as a cholesteatoma. When this happens, the affected mastoid cells may need to be removed which is known as a mastoidectomy.

 

For information on how to care for your child after the surgery, please see the following handout: Tympanoplasty and Mastoidectomy Handout


Learn more:

 
 


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