Pediatric ENT Disorders – Ear, nose and throat conditions can affect children differently than adults. As such, different treatment methods may be needed. The physicians of CornerStone Ear, Nose & Throat have decades of experience in evaluating and treating pediatric conditions.
Because all our doctors have children of their own, they also have a unique understanding of how to provide ENT care for pediatric patients, as well as of the particular concerns of parents as they try to make the correct medical decisions for their children.
The sinuses do not fully develop until we are in our later teen years. As a result, sinusitis can be challenging to identify in children because symptoms of sinusitis may be confused with allergies or viral infections such as colds. Symptoms of a sinus infection in a child may include:
- A cold lasting longer than 10-14 days
- Thick yellow-green mucus
- Bad breath
- Post-nasal drip that leads to sore throat, cough, nausea or vomiting
- Swelling/puffiness around the eyes
- Sinus pressure/headache
- Irritability or fatigue
- Cough while sleeping
Pediatric sinus infections are typically treated with antibiotics and nasal decongestant sprays. After treatment, symptoms should begin to improve within a few days. However, should symptoms linger for 12 weeks or more, it could indicate chronic sinusitis. If recurring bouts of sinusitis persist, it is important to schedule a consultation with an ENT physician to determine if further medical or surgical treatment is necessary.
For children who have ongoing sinus problems, sources of inflammation should first be identified and treated. It may be necessary to determine if allergies are a factor. Testing of seasonal allergens, such as tree, grass and weed pollen, and year-round airborne allergens including dust mites, mold and animal dander can reveal if immunotherapy (allergy treatment) would be beneficial. CornerStone Ear, Nose & Throat offers allergy drops (sublingual immunotherapy) as an attractive alternative to weekly allergy shots (which our practice also offers) given weekly at the doctor’s office. These drops, which are taken daily at home, under the tongue, can be a great option for allergy treatment for children and busy parents. Just like allergy shots, they build up the patient’s immunity to the things they are allergic to, much the way a vaccine does against a virus. These allergy treatments have also been shown to be helpful in treating patients with ADHD.
Pediatric Ear Infections
Inside the ear, there is a channel called the eustachian tube that connects the back of the nose to the middle ear. One of the main functions of this channel is to help drain excess fluid from the ear. It also helps maintain a normal air pressure in the middle ear so that the eardrum can move freely. In children, the eustachian tube is not yet fully developed. It is smaller, shorter and more horizontal than that of adults. These factors often inhibit the ears’ ability to drain effectively, allowing fluid to build up in the middle ear and resulting in an ear infection or “fluid in the ears,” both of which are called “otitis media.”
Patients who have frequent otitis media may benefit from bilateral myringotomy and tube placement. This very simple and low-risk procedure creates a temporary but constant pressure release for the middle ear. Learn more about this process by reading Should my child have tubes placed? You might also be interested in the different types of ear infections, related symptoms and available treatment options.
Pediatric Reflux Disorders
Children may struggle to describe their symptoms related to reflux disorders as accurately as adults, and this often prevents their condition from being successfully diagnosed. Parents who suspect that their child may be suffering from a reflux disorder should schedule an appointment with an ENT physician for testing immediately in order to avoid long-term damage. The most common types of reflux disorders in children include:
Gastroesophageal reflux disorder (GERD) – The most common symptom of GERD is heartburn, which is a sensation that may be difficult for a child to describe. Instead, children are likely to complain of discomfort or pain in their stomach. Additional symptoms can include:
- Poor appetite/weight loss
- Difficulty swallowing
- Sore throat
- Cough/throat clearing
- Sinus infections
- Ear infections
Laryngopharyngeal reflux (LPR) is another reflux disorder that causes swelling in the soft tissues in the back of the throat. The result is a sensation of phlegm that cannot be cleared. In pediatric patients, common symptoms of LPR include:
- Wet cough (croup)
- Bitter taste in the back of the throat
- Sleep-disordered breathing/sleep apnea
- Noisy breathing
To learn more about reflux disorders and treatment options offered at CornerStone Ear, Nose & Throat, click here: http://www.cornerstoneent.com/conditions-treated/throat-mouth-disorders/.
Pediatric Sleep-Disordered Breathing
Sleep-disordered breathing can range from loud and frequent snoring to obstructive sleep apnea (OSA), a potentially serious condition for children. If left untreated, sleep-disordered breathing can result in irritability, trouble focusing at home and in school, abnormally slow growth, weight gain and cardiovascular problems.
Common symptoms of pediatric sleep-disordered breathing include:
- Abnormal breathing during sleep
- Daytime mouth breathing
- Difficulty awakening
- Excessive daytime sleepiness
- Frequent awakenings or restlessness
- Frequent nightmares
- Hyperactivity/strongehavior problems
- Poor or irregular sleep patterns
If a child has these symptoms, it is crucial to schedule an appointment with an ENT physician who can determine if the child is suffering from obstructive sleep apnea due to enlarged tonsils and adenoids or other reasons. Sleep-disordered breathing is known to make other conditions worse. In patients with ADHD, removal of enlarged tonsils and adenoids can significantly improve symptoms of ADHD.
Pediatric Tonsil And Adenoid Problems
Tonsil and adenoid problems can greatly impact the developmental and social health of pediatric patients. Tonsils and adenoids are like lymph nodes and are located in the back of the throat and in the upper throat, respectively. When the tonsils and adenoids become infected (tonsillitis) or enlarged, nasal obstruction, as well as breathing, swallowing and sleep disorders, can occur. While it is important to seek ENT care for these conditions, the good news is that these problems are highly treatable using medical or surgical methods.
Treatment Of Tonsil And Adenoid Problems
Antibiotics are the standard initial treatment for most types of tonsillitis or adenoid infection. However, for pediatric patients who suffer from recurrent tonsillitis or deal with sleep-disordered breathing due to enlarged tonsils and adenoids, removal of the tonsils and adenoids is usually the best treatment option.
Historically, electrical cautery has been the most common method for the removal of tonsils and adenoids. However, this process burns the tissue at very high temperatures, effectively creating third-degree burns that must heal.
At CornerStone Ear, Nose & Throat, we exclusively use a Coblation® device, as opposed to using an electrocautery device or cold steel knife, to cut away the tissue. The advantages to Coblation include:
- Much less risk of bleeding and pain for the patient
- Patients tolerate fluids and food more quickly
- Recovery is faster
- Less risk of complications
Pediatric Hearing Loss
Children born in North Carolina are routinely tested for hearing loss before they leave the hospital. But sometimes, hearing loss in children develops as the child ages, during the crucial early stages of growth. If you have concerns about your child’s ability to hear or his or her speech development, it is important to have a hearing test with a qualified doctor of audiology.
Below are important developmental milestones related to hearing that should occur with children:
Birth to 3 months
- Startles in response to loud sounds
- Seems to recognize your voice
- Quiets or smiles when spoken to
4 to 6 months
- Babbles with many different sounds
- Moves eyes in direction of sounds
- Notices toys that make sounds
- Vocalizes excitement and displeasure
7 months to 1 year
- Listens when spoken to
- Imitates different speech sounds
- Enjoys games like peek-a-boo
1 to 2 years
- Points to some body parts when asked
- Says more words every month
- Listens to simple stories, songs and rhymes
- Puts two words together (“more juice”)
2 to 3 years
- Understands differences in meaning (“on-in”)
- Has a word for almost everything
- Often asks for objects by naming them
3 to 4 years
- Hears when you call from another room
- Talks about activities at school or a friend’s home
- Speaks in way that people outside the family can usually understand
5 to 6 years
- Pays attention and can answer questions about a short story
- Uses the same grammar as the rest of the family
- Communicates easily with other children and adults