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    Common ENT Problems in Kids

    Dr. David Wahle Deaconess Clinic ENT physician   01/10/2022

    Issues with ear, nose and throat health seem to be a part of childhood. I’ve been a practicing otolaryngologist/head and neck surgeon for more than 20 years here in Evansville. In that time I’ve treated thousands of children who have had problems with their ears, nose and throat that required surgery.

    Two of the most common issues I treat are chronic ear infections and tonsil and adenoid disease.

    Ear Infections
    Ear infections are the single most common reason for children to see their pediatrician or family medicine physicians.Ear infections are most commonly treated with antibiotics. As a surgeon, I see children for ear infections if appropriate medical management does not improve their ear infections.

    When a child is referred to me, one of the most important first steps is the assessment of their risk factors to help me determine if tubes are appropriate.(Note: Tubes that I refer to are temporary drainage tubes that reduce the severity and number of ear infections. They’re surgically placed by an ENT surgeon in an outpatient procedure.)

    These are the four major considerations I have:

    • Daycare – is the child in daycare regularly? If so, he/she is exposed to far more upper respiratory viruses.
    • Second hand smoke exposure – It is well known that second hand smoke significantly contributes to respiratory issues.  And ear infections are a respiratory illness.
    • Family history – Is a less-significant risk factor, but still can identify a child who is more likely to have ongoing ear issues.
    • Early-onset first ear infection – This is a statistical point to identify, as any ear infections before 6 months of age is a risk factor for needing tube placement. The more risk factors that are in place, the more likely it is that a child will be a candidate for tubes. Over time, the child’s natural ear drainage systems—the Eustachian tubes—hopefully will mature and the problem will resolve itself with age.

    Tonsil and Adenoid Disease
    Tonsils and adenoids are tissues that live in the throat and the back of the nose. They do not serve any purpose after birth, but removing them surgically is only needed when they cause problems. The two most common reasons for removal of tonsils and adenoids are recurrent bacterial infections and obstructive enlargement causing difficulty swallowing, obstructive sleep apnea syndrome (problems with breathing while sleeping), and orthognathic changes—changes in jaw and dental alignment.

    Removal of these tissues is also an outpatient procedure (most of the time), and in children, the recovery is less difficult than in adults. I typically keep the kids out of school for 7-10 days, depending on their individual recovery. There is significant post-op pain that needs to be managed with safe, narcotic medication at small doses.

     Also, a misconception is that kids should only eat ice cream and cool, smooth foods when recovering from tonsillectomy/adenoidectomy. In fact, I encourage eating solid, normal, regular food when recovering. It helps prevent scab formation which speeds recovery, and reduces the likelihood of bleeding—which is the primary risk of this operation.

    Other Helpful ENT Information for Kids
    I want to share some helpful links that can help improve your knowledge about your child’s ear/nose/throat health. Next month (February) is Kids ENT Month. The American Academy of Otolaryngology & Head and Neck Surgery (of which I am a member) has a dedicated web page for the month, where you can learn more about:

    • Better ear health
    • Children’s hearing health
    • Hearing loss and ear infections
    • Ear infections and the roles of vaccines
    • Middle ear infection
    • Swimmer’s ear
    • Ear tubes
    • A helpful and extensive glossary of ENT terms

    HPV Vaccination
    Also, HPV vaccination is a topic that is really important to me and my colleagues.  Children—beginning around ages 9-12, need to receive a 2-part series of vaccination for HPV.  HPV (human papilloma virus) is being increasingly linked to head, neck and throat cancers in both men and women.

    For more information about this important vaccine, and how it’s related to head and neck cancer prevention, please read this blog written by my colleague Dr. Jacklyn Oakley, family medicine physician at Deaconess Clinic.

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