1301 20th Street, Suite 300, Santa Monica, CA 90404

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Pediatric ENT 3

Chronic Tonsillitis Chronic Ear Infections
Pediatric Nasal Obstruction Congenital Cysts and Tumors
Sleep Apnea Chronic Sinusitis

Congenital Cysts and Tumors

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Branchial Cleft Cysts Thyroglossal Duct Cysts
Lymphangiomas Hemangiomas

Branchial Cleft Cysts Treatment

p-iStock_000012073096LargeA branchial cleft cyst, also known as a branchial cleft anomaly, is a birth defect that appears as a lump in the neck, after tissues in the neck and collarbone area failed to develop normally. It may form as a small lump or skin tag that can drain fluid on one or both sides of the neck within the branchial cleft area.

Treatment for a branchial cleft anomaly usually involves surgical removal to reduce the risk of infection and the development of an abscess. Surgery is performed under general anesthesia in our Los Angeles area office and involves an incision placed strategically in a natural skin crease to minimize scarring. Some cases can also be treated with antibiotics, or may not require any treatment at all.

Lymphangiomas Treatment

A lymphangioma, also known as a cystic hygroma, is a birth defect that develops as the baby grows in the womb and appears as a mass in the head or neck area. During fetal development, pieces of embryonic lymphatic tissue and other materials that carry fluid and white blood cells form together to create a soft mass under the skin. These masses continue to grow over time and may not be noticeable until the child is older. In some cases, they may be detected through ultrasound while the baby is still in the womb.

Whenever possible, lymphangiomas should be thoroughly removed with surgical excision to reduce the risk of complications and prevent recurrence of the mass. However, because of its sensitive location, lymphangiomas can sometimes invade other structures within the neck, making complete removal difficult. Other treatment options may include chemotherapy, radiation therapy or steroids.

Thyroglossal Duct Cysts Treatment

During fetal development, the thyroid gland develops at the bottom of the tongue and then moves down towards the neck to its normal position. In some cases, the thyroid may drag some of the pharyngeal lining with it as it moves, causing a cyst to develop at the base of the thyroid. These cysts tend to appear between the ages of two and ten years old, but may present at any time during adulthood as well. This condition often appears as a mass in the middle of the neck and may move with swallowing.

Treatment for a thyroglossal duct cyst usually involves surgery to remove the cyst and reduce the risk of complications. This procedure is performed under general anesthesia in our Santa Monica office, and most children are able to return home the same day. If an infection is present, the cyst may be treated with antibiotics


A hemangioma is a type of birthmark that appears on the skin as a bright red patch because of a grouping together of blood vessels underneath the skin. These marks may be present at birth or develop within the first few weeks of life and can appear nearly anywhere on the body, although they are most common on the face, scalp or neck.

While hemangiomas may fade significantly as the child grows, some remain visible and may be of cosmetic concern because of their prominent location or disfiguring appearance. Treatment for a hemangioma may include corticosteroid medications or laser surgery, both of which can stop the growth of or remove these birthmarks.

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Chronic Sinusitis

Sinusitis is a condition that refers to an inflammation of the lining within the paranasal sinuses. Sinusitis can be classified by location:

  • maxillary, which causes pain or pressure in the cheek area;
  • frontal, which causes pain or pressure above and behind the eyes;
  • ethmoid, which causes pain or pressure between or behind the eyes; and
  • sphenoid, which causes pain or pressure behind the eyes.

Sinusitis can also be classified by duration: acute lasts for four weeks or less, subacute lasts four to twelve weeks, chronic lasts more than twelve weeks, and recurrent consists of several acute attacks within a year.

Most acute cases of sinusitis are caused by an inflammation of the sinuses that eventually lead to a bacterial infection. With chronic sinusitis, the membranes of both the paranasal sinuses and the nose are thickened because they are constantly inflamed, possibly due to allergies, chronic bacterial infection or nasal polyps.

Minimally Invasive Endoscopic Sinus Surgery

p-iStock_000001944479SmallEndoscopic sinus surgery is a minimally invasive surgical procedure used to remove blockages in the sinuses for recurring sinus infections. During the procedure, a thin lighted tube with a camera on the end is inserted into the nose to let the doctor visually examine the area. Tiny surgical instruments are then inserted to remove the obstructive tissues. Endoscopic sinus surgery does not require any incisions, as the whole procedure is performed through the nostrils. Most procedures are performed on an outpatient basis in our Los Angeles-based office, and patients can go home the same day.

Most patients experience a major relief in symptoms such as facial pain and swelling, difficulty breathing and headaches. Aside from sinus conditions, endoscopic sinus surgery can also treat a deviated septum, polyps or tumors.

Balloon Sinuplasty

The painful symptoms associated with sinusitis can be overwhelming, causing debilitating headaches, facial pain, and nasal congestion. This condition affects millions of children each year, many of whom do not respond well to antibiotics. A new surgical option called balloon sinus surgery, or balloon sinuplasty, is now available for treatment of blocked sinuses.

Balloon sinuplasty is an endoscopic, catheter-based system for patients suffering from sinusitis. Approved by the FDA, this minimally invasive surgical technique uses a small, flexible sinus balloon catheter to open up blocked sinus passageways, restoring normal sinus drainage. When the sinus balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.

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