Ear Diseases in Children

Dr. Gokhan Guvener

Otorhinolaryngologist-Head and Neck Surgeon, Acupuncturist

Tel: 07521 195818

http://www.drgokhanguvener.com

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With the cooling of the weather in the winter months, the incidence of ear diseases in children increases. By grouping these diseases, we can list their diagnosis and treatment and the measures to be taken as follows:

Middle Ear Infections

The air-filled cavity located deep behind the eardrum is called the middle ear. Infections here are usually caused by bacteria and viruses that come from the nasal area through the Eustachian tube. Ears must be checked for prolonged weakness and discomfort during or immediately after an upper respiratory tract infection.

In children especially while lying down aggravated ear pain, feeling of pressure in the ear, hearing difficulties, fever, headache, nausea and appetite disorders in some cases are common findings in middle ear infections. If the infection has caused perforation of the eardrum as a result of intense pressure, inflammatory discharge from the ear may be seen.  In younger children, findings such as fever of unknown origin, disturbances in feeding and sleeping patterns, crying attacks, moving hands towards the ear and tugging should raise doubts.

The main reasons why middle ear infections are more common in children are upper respiratory tract infections, which are more common in this period, and the Eustachian tube is shorter and relatively more susceptible to the progression of microbes.

The main functions of these canals (Eustachian tubes), which connect both middle ear cavities to the nasal passage at the back of the nose, are to ensure the discharge of natural currents in the middle ear and balance air pressure. This function is also very important for healthy hearing. The eustachian tube can be blocked due to reasons such as upper respiratory tract infections, adenoid problems, allergies, and its functions may be impaired. This situation causes the germs in the nasal passage to progress to the middle ear, inflammatory fluid accumulation and infection occurrence.  Painkillers and antipyretics are used in the treatment to relieve the child. Use of antibiotics is required in most cases. The main purpose of using antibiotics is to prevent probable complications.

Feeding babies with a bottle in a lying position is also a facilitating factor.  Being in crowded nurseries and classrooms and passive smoking due to family smoking also increase the risk of otitis media. Infrequently recurring infections, underlying causes such as allergies, chronic infections of the tonsils and adenoid should be investigated.

One of the other common problems of the middle ear in childhood is also the disease called serous otitis. Here an abnormal fluid accumulation in the middle ear is also the point in question. However, since there is no microbial inflammation, signs of infection such as pain and fever are usually not seen. Since most of the time the only finding is hearing loss, it is not uncommon to be diagnosed late or even not diagnosed at all in young kids. Conditions such as allergies, chronic adenoid and tonsil infections, structural disorders in ear anatomy, passive smoking, being in crowded nurseries and classrooms are considered among the risk factors. According to some studies, a familial tendency for this disease is aforesaid. Close follow-up is important in treatment. As spontaneous recovery can sometimes be seen, treatment and environmental measures for an underlying cause such as allergy and chronic infection may also be beneficial. Surgical interventions such as insertion of an ear tube and removal of adenoid may be required in such cases of non-recovery fluid, the presence of a progressive hearing loss, and affected speech development, especially in young children. In this intervention, the eardrum is scratched, the fluid accumulated inside is removed, and a small tube is placed in the membrane to provide ventilation and prevent a recurrence.

Foreign objects in the ear

Foreign objects that young children put into their ears can turn into an important health problem. An intervention to remove the object can push it deeper. A careless approach risks damaging the external auditory canal and eardrum. When such a situation is noticed, it is best to apply to the nearest health institution. The foreign body is removed by the physician with special instruments made for this procedure, in some cases, anaesthesia may even be required to perform an intervention. It is important to keep small objects that can fit in the nose and ear holes out of the reach of children.

Earwax

The mixture that occurs with skin residues, sweat glands and sebaceous glands in the outer ear is called earwax. It is not actually a health problem, and it has nothing to do with cleanliness and hygiene as its name suggests. In some bodies, due to excessive production of wax or defects in the excretion, accumulation occurs in the external ear canal and even the ear canal can be completely blocked. Although this problem, which is seen in about 10% of children, is not very important, it is the most common cause of conductive hearing loss. Findings such as bringing his/her hand to his /her ear frequently, pulling on the ear, and hearing loss in complete obstruction are observed. It is not correct to insert cotton swabs and so on into the ear canal for cleaning purposes. Softening drops can be used, in case of complete clogging and hearing loss, the earwax can be removed by the doctor with a vacuum device or washing method.

External ear infections

This condition, including the condition called swimmer’s ear, usually develops depending upon the unclean pool and sea waters. Disruption of the protective integrity of the outer ear skin due to various allergic skin diseases is also among the reasons. Oedema and swelling develop because of infection in the external auditory canal skin, whose natural protective layer has been lost. Sometimes this swelling can progress to the auricle. In the treatment, it is important to take down the swelling with drops and to clean the external ear canal from the inflammatory discharge with the help of an aspirator. Antibiotics can also be used in severe infections.