CHILDREN'S ENT HEALTH

Ear Infections

Otitis media, commonly known as an ear infection, occurs when fluid accumulates behind the ear drum and becomes infected. This area behind the ear drum is called the middle ear. Ear infections are the most common aliment affecting children; nearly 70% of children will experience at least one occurrence of otitis media before their third birthday. 

Why do Ear Infections Occur?

Most physicians feel that immature Eustachian tube function in children leads to frequent ear infections. The Eustachian tube is a slim tube that runs behind the ear drum to the back of the nose. In children the Eustachian tube is shorter than adults and in a more horizontal position, both factors predisposing children to ear infections. This shorter eustachian tube allows bacteria and viruses easier access to the ear. The horizontal position of the eustachian tube interferes with the normal draining process in the ear.  These factors all lead to eustachian tube blockage. As children grow, the eustachian tube begins angling down and enlarging, reaching adult development around age 6.

How Do I Know if My Child has Sinusitis?

It is difficult to diagnose pediatric sinusitis. Adolescent symptoms of sinusitis and the common cold are almost identical, making it difficult to diagnose. Testing can also be beneficial. A CT scan may look abnormal when a child simply has an upper viral infection. Cultures of the nose can be misleading since the bacterial from the front of the nose is usually different from lose infecting the sinuses. There isn't a reliable way to determine cause of nasal drainage merely my color, clear mucous is usually associated with allergy, it can occur with a bacterial or viral infection as well.  If the mucous remains stagnant the mucous can dry out creating a thicker colored mucous. This color can vary from white, yellow, or green regardless of the cause.

It is assumed that a child is suffering from acute sinusitis if the child has cold-like symptoms lasting longer than 10 days.  If these symptoms persist for months, it is assumed the child is suffering from chronic sinus issues. 

What Causes Hearing Loss in Infants?

Hearing loss can occur in two forms. Sensorineural or "nerve" deafness occurs due to the abnormalities of the inner ear (cochlea) or of the hearing (acoustic) nerve. Sensorineural hearing loss is the most common disability noted at birth. This form of hearing loss is permanent and sometimes progressive.

Early detection and treatment is essential when dealing with conductive hearing loss in infants. This may occur if the eardrum is unable to move is its normal pattern, which then limits transmission into the inner ear.  An example, ear infections result in fluid filling the space behind the eardrum which will then limit the ear drums ability to move. This type of hearing loss is generally reversible with treatment

Is it Hard to Test Infant Hearing?

Determining an infant's ability to hear is more difficult than it originally seems. Parents are usually sensitive to the way a child responds to their verbal stimulation and might become suspicious of a hearing problem. Developmental accomplishments have been established and used by physicians to determine levels of hearing and language development.

Until recently these behavioral assessments were the only way to test a baby's hearing. These methods picked up hearing loss late, missing important degrees of hearing loss, and were frequently inaccurate. Hearing loss was misdiagnosed and confused with other developmental problems. Hearing loss in one ear may be impossible to detect by behavioral methods.  All of these methods used to diagnose hearing loss were insufficient. Late treatment of hearing loss is detrimental to development of normal language and learning skills. 

How Can My Infant's Hearing Be Tested?

Previously, newborn hearing testing was restricted to 'high risk' infants whose family history or medical problems suggested a possibility of hearing loss. Today, accurate automated means of newborn and infant hearing assessments are used. These tests, administered by audiologist are:

  • ABR (Auditory Brainstem Response)  Auditory Brainstem Response measures brain wave activity in response to a click in the ear.
  • OAE (Otoacoustic Emissions) Otoacoustic Emissions records sounds generated by normal hearing ears. OAE are sounds generated within the cochlea of nearly all people with normal hearing by active bio-mechanical process within the outer hair cells. Since OAE's are usually present in normal ears, it can be compared to those that have an absence of the emission have signs of irregular cochlear function which may result in hearing loss.

Both tests are painless, fast methods of effectively testing an infant's hearing. 

Tonsillitis

Tonsillitis is an infection of the tonsils. This infection may be of bacterial or viral origin. In general, children younger than preschool develop viral tonsillitis, while children and adults are affected by bacterial infections. A throat culture may be helpful to diagnose bacterial tonsillitis.

Common symptoms of adolescent tonsillitis include

  • Sore throat
  • Fever
  • Pain or difficulty in swallowing
  • Swollen neck glands
  • Ear pain
  • Bad breath
  • Bright red tonsils (Occasionally white-yellow drainage on the tonsils)

What are Adenoids?

Adenoids are lymph tissues, very similar to tonsils, collected in the back of the nose. Adenoids are located close to the entrance of the breathing passages, leading physicians to believe their function is to sample or catch inhaled bacteria or viruses. During early childhood this process is an important part of their immune system to fight infection. With increasing age, this function diminishes. By three years of age, the adenoids are of minimal importance.

Common symptoms your child may experience with complications of the adenoids include

  • Difficulty breathing through the nose
  • Feeling of pinched nostrils
  • Noisy breathing
  • Snoring
  • Pauses in breathing during sleep

Adenoids decrease in size as children enter adolescence or young adulthood. Long-term research has shown no loss of the ability to fight infections in children who have had their adenoids removed. 

Protruding Ears in Adolescence

No other physical characteristic in children cried out for plastic surgical repair than protruding ears. Children do not have to go through adolescence being victim of name calling due to their protruding ears.  Otoplasty is the surgical repair or protruding ears and can be performed after the ears has reached full size, usually around age five or six.