Pediatric Otolaryngology

Pediatric otolaryngology is the study of ear, nose, and throat diseases within infants and children. Over the last three decades, Dr. Levine has acquired the additional skills necessary to appropriately care for younger patients with both common and rare disorders in the head and neck regions.

Ear Infections

Ear infections are usually bacterial or viral infections that affects the middle ear, the airy space behind the eardrum housing very small vibrating bones of the ear. Ear infections in children are more common than in adults.

Ear infections can often persist after sinusitis, resulting in long-term congestion which can interfere with hearing and balance. It can also be responsible for speech delay. so treatment frequently begins with simple pain management and monitoring the issue. Severe, long-term cases can cause permanent hearing loss and other complications.


  • Ear pain, especially when lying down
  • Difficulty sleeping
  • Frequent crying
  • Irritability
  • Difficulty hearing
  • Loss of balance
  • Fever
  • Drainage of fluid from the ear
  • Headache
  • Loss of appetite


For persisting infections or congestion, antibiotics are necessary in addition to antibiotics, antihistamines and sometimes steroids to reduce inflammation.  If your child experiences persistent fluid buildup, then surgery  to install ear ventilation tubes will be necessary to restore hearing and prevent infection. The hole will close behind the extruding tube.

I took my son to Dr. Levine a few years ago for an ear infection and took him back last year for Tonsillitis. Both times, Dr. Levine treated him so wonderfully. He is excellent with children!

Katherine C. – Saddle River, N.J. – 4/21/2016,

Nose and Sinus Problems

Your child’s sinuses will continue to develop until late in their teenage years. Pediatric sinus issues are often difficult to diagnose because they are frequently caused by other problems, such as viral illness and allergies. Many problems are a result of deviated septum. Straightening a recent traumatic deviated nose and septum may be necessary to minimize worsening of the nasal deformity and airway obstruction.


  • a “cold” lasting more than two weeks, sometimes accompanied by a fever
  • a runny nose with thick yellow/green mucous
  • sore throat, cough, bad breath, nausea and/or vomiting
  • headaches, usually in kids older than 6
  • tiredness, irritability, and general fatigue
  • inflammation around the eyes


For acute sinusitis, antibiotics are often very effective when treating these symptoms. Nasal saline or spray can also be prescribed to help stuffiness. Symptoms will often improve within the first few days of treatment. Please note, even if your child feels much better after a few days, it is important to complete the entire antibiotic therapy.

For chronic sinusitis (symptoms lasting for more than 12 weeks), a consultation is required. Surgical treatment is recommended if your child does not recover from antibiotics and other medical therapies. In surgery, Dr. Levine uses an endoscope to open and expand the drainage pathways of your child’s sinuses. This procedure results in a large decrease in the number and severity of sinus infections.

Depending on your case, Dr. Levine might also consider removing adenoid tissue from behind the nose. This tissue can often become infected and cause many of the same symptoms felt by sinusitis like runny nose, stuffy nose, bad breath, cough, headaches, and more.


What are tonsils? What are symptoms of Tonsilitis?

Tonsils are lymph nodes that fight infections and are located on either side of the back of the mouth. Sometimes tonsils become swollen due to chronic infections, which cause chronic sore throats. Sometimes the swollen tonsils do not respond well to antibiotics, and should then be removed. These problems are most common in children, but they can occur at any age.


  • Sore throat
  • Redness of the tonsils
  • Blisters or ulcers on the throat
  • Raspy or loss of voice
  • Headache
  • Low appetite
  • Ear pain
  • Difficulty swallowing
  • Bad breath
  • Nausea
  • Snoring
  • Sleep disturbance

Do you need your tonsils?

While you do not need your tonsils, they do play an important role within the immune system, as they prevent infectious mediums from penetrating the bronchial passages. Sometimes the tonsils can be overwhelmed from fighting infection, and the tonsils themselves become infected, in which case they should be removed.

Tonsillectomy with Coblation

Coblation is the most effective way to perform a tonsillectomy. It involves using radio waves that transform a salt solution into a stream of powerful ions. The ions don’t get hot and easily cut through tissues, resulting in less trauma to the surrounding area, minimal bleeding, and less pain.


Allergies are a very common cause of middle ear congestion and pediatric airway problems. Correction of allergies is critical since pediatric airways are narrower. Allergies contribute to 90% of asthma problems. Medications can include antihistamines, inhaled corticosteroids, and possibly long acting bronchodilators so that acute attacks are minimized.


  • Sneezing
  • Runny nose
  • Throat tickle, hoarseness, and coughing
  • Watery and/or itchy eyes
  • Itchy ears, nose, and throat
  • Wheezing, coughing, shortness of breath


Treatment begins with diagnostic testing, medications, and immunotherapy (allergy shots). These are important tools that can tame a hypersensitive immune system and prevent symptoms. The gold standard – intradermal skin testing – can be performed on children as young as 5 years old. There is no pain at all when a topical numbing cream is applied to the testing site prior to the testing.

Speech & Developmental Problems

Once the specific allergens are determined, allergy shots may be necessary. The length of the treatment varies per patient. Allergy shots dramatically reduce allergic reactions.