Consult Request Guidelines

Conditions We Treat

We care for a wide variety of head and neck conditions in children. 

AIRWAY PROBLEMS

  • Breathing problems related to the upper airway or trachea
  • Snoring and obstructive sleep apnea
    • If the patient is less than 2 years of age, has craniofacial differences or a syndrome such as Trisomy 21, please simultaneously refer to the OHSU pediatric sleep clinic or a local sleep clinic for a sleep study. 
  • Recurrent croup
  • Airway foreign bodies
  • Tracheostomy tube care

FEEDING DIFFICULTIES

  • Feeding difficulties that are possibly related to an anatomical reason such as: 
  • Consider referring the patient to see a feeding specialist at the Pediatric Speech and Language Pathology clinic (if not already being seen) concurrently with the Otolaryngology referral

NASAL AND SINUS ISSUES

  • Nasal obstruction 
  • Deviated septum 
    • If there are also cosmetic concerns, please refer to a Facial Plastic Surgeon or community Otolaryngologist who performs cosmetic nasal surgery. 
  • Choanal atresia
  • Pyriform aperture stenosis
  • Persisting nosebleeds
  • Chronic or recurring sinus problems 
  • Nasal masses including juvenile nasopharyngeal angiofibroma (JNA)
  • Nasal congestion not responsive to medical therapies or allergy treatment
  • Enlarged nasal turbinates
  • Nasal fractures (ideally referred and seen within 7 days after they occur)
  • Foreign bodies in the nose

MOUTH OR SALIVARY ISSUES

  • Recurrent tonsil infections, especially if due to strep throat
    • The criteria that would warrant surgical removal of the tonsils are: 7 episodes in 1 year; 5 episodes per year for 2 years; 3 episodes per year for 3 or more years; complication of strep throat; history of peritonsillar abscess; or antibiotic intolerance with recurrent throat infections. 
  • Strep infections that lead to PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)
  • PFAPA (periodic fevers, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome
  • Enlarged tonsils that are causing problems such as breathing problems while sleeping, significant speech problems, recurring infections, or trouble swallowing food. 
    • Enlarged tonsils that are not causing any symptoms or problems do not need to be seen by a specialist and they do not need to be removed. 
  • Asymmetric tonsils that are not equalizing in size over time
  • Mouth lesions such as ranulas and blocked salivary ducts
  • Recurrent inflammation of the parotid or submandibular (salivary) glands
  • Excessive salivation
  • Very large tongue causing breathing, speaking or eating issues

EAR ISSUES

  • Hearing loss including that detected at birth and not improving quickly
  • Recurring or chronic ear infections
  • Middle ear problems such as cholesteatoma
  • Eardrum perforations (holes) 
    • If traumatic, please refer after 3 months if still not healing. 
  • Foreign bodies of the ear
  • Eustachian tube dysfunction
  • Dizziness and vertigo
  • Treatment of chronic hearing loss 
  • Cochlear implant placement 
  • Surgery for placement of bone-anchored hearing aids such as OSIA and SENTIO
  • Preauricular (in front of the ear) pits or tags
  • External ear deformity, ranging from mild to microtia or anotia
    • If the patient is less than 6 months old and has a cupped or folded ear, we can see them urgently for consideration of ear taping. Please make this an urgent referral, given that the success rate is higher the younger the patient is. 
  • Wax impaction causing pain or hearing loss

HEAD AND NECK MASSES

VOICE AND SPEECH PROBLEMS

Resources for Providers

How to contact us

Pediatric Otolaryngology Clinic Contact Information

Phone: 503-494-5350

Fax: 503-346-6826

Doernbecher patient consult line for referring providers: 503 346-0644 or 888 346-0644.