Did you know that ear infections are the No. 1 reason parents bring their children to the doctor? Other ear, nose and throat concerns also are common complaints among the pediatric population.
February is Kids’ ENT Health Month, and Lake Regional Ear, Nose and Throat is providing education on some common ENT disorders and illnesses.
“At Lake Regional Ear, Nose and Throat, we see a lot of pediatric patients for recurrent ear infections and tonsillitis,” said Keith Bonacquisti, M.D., Lake Regional’s board-certified otolaryngologist. “Although these conditions might start without causing much harm, they can lead to more severe health problems, if not properly treated.”
Recurrent Ear Infections
Five out of six children have at least one ear infection by their third birthday. The eustachian tube, which equalizes pressure in the middle ear behind the eardrum, becomes congested and stops working. This leads to trapped fluid in the middle ear, which can result in hearing loss, discomfort or pain. It also can become infected and cause even more pain.
“Because ear infections can occur before a child can talk, it is important to look for potential signs of an ear infection,” Dr. Bonacquisti said. “If your child is pulling at their ears, is fussier than normal, has a fever, has difficulty sleeping or hearing, or is off balance — or if their speech development is delayed — they could be experiencing eustachian tube dysfunction or an ear infection. An ear infection typically begins after a child has a sore throat, cold or other upper respiratory infection.”
Children who have persistent fluid or recurrent ear infections may benefit from surgery to place a small tube in the eardrum. This is the most common surgery performed in the United States. The average age for ear tube surgery is 1 to 3 years old. Ear tubes resolve the hearing loss caused by middle ear fluid and reduce the risk of future ear infections.
Tonsillitis is an infection that leads to swelling and soreness of the tonsils. It can be caused by viruses or bacteria, including the bacteria that cause strep throat. According to the American Academy of Otolaryngology, tonsillitis most often occurs in children but rarely in those younger than two.
“Treatment for tonsillitis will depend on if it is caused by a virus or bacteria,” Dr. Bonacquisti said. “When tonsillitis is caused by bacteria, antibiotics are usually prescribed. Staying well-hydrated, resting and eating smooth foods are some ways to make children feel better at home.”
Children who have frequent tonsillitis may benefit from having their tonsils removed, a procedure known as a tonsillectomy. Tonsillectomy can reduce the frequency of severe throat infections — those that bring a fever of 101 or higher, swollen or tender neck glands, coating on the tonsils, or a positive test for strep throat. An ENT specialist will review your child’s health history to determine whether this surgery is right for them.
Most tonsillectomies and adenoidectomies –– 90 to 95 percent –– are performed to alleviate chronic mouth breathing and snoring. Mouth breathing and snoring lead to disrupted sleep and, when severe, may cause obstructive sleep apnea. Even more commonly, when a child chronically mouth breathes or snores for years, the muscle pull of having to keep their mouth open to breathe at night restricts the growth of the jaws. This can result in crowded and crooked teeth; inflammation and pain in the jaw joint, resulting in headaches or facial pain; a recessed chin/overbite; and, when severe, a restricted airway that increases the likelihood of developing obstructive sleep apnea even into adulthood. Obstructive sleep apnea may have adverse effects on the heart, blood pressure and blood sugar and increase the odds of developing dementia, among other medical problems.
“Every parent should periodically check to see if their children are breathing through their nose routinely while sleeping,” Dr. Bonacquisti said. “If they are chronically mouth breathing or snoring, they have an anatomical upper airway obstruction and should see an ENT.”
Dr. Bonacquisti uses Coblation for tonsil and adenoid surgery because it reduces recovery time, reduces pain, reduces the operative time required and enables an essentially bloodless procedure. Because it uses lower temperatures than other methods, Coblation results in less thermal injury to the underlying tissue.
Learn more about Dr. Bonacquisti’s pediatric and adult services at lakeregional.com/ent.