Common ENT Disorders

According to the American Academy of Otolayrngology’s Division of Head and Neck Surgery, ear, nose, and throat disorders are one of the main reasons children see a physician, and ear infections rank as the number one reason. February is Kids ENT Health Month, so this blog reviews a few of the more common ENT disorders that affect children.

Just about every child will experience an ear infection at some point. My child was no exception; he had his share. Acute otitis media is a painful ear infection that occurs when the middle ear, which lies between the eardrum and the inner ear, where the cochlea and vestibular system are located, becomes inflamed and infected.

With acute otitis media, your child’s Eustachian tube becomes swollen or blocked, and fluid gets trapped in the middle ear. That fluid can become infected and cause symptoms. Symptoms of otitis media include unusual irritability, difficulty sleeping or staying asleep, tugging at one or both ears, fever, fluid draining from the ear, loss of balance, difficulty hearing, and ear pain.

Treatment begins with home care, which includes applying warm, moist compresses over the ear and using over-the-counter eardrops and pain relievers to ease pain. If over-the-counter products don’t do the trick, your child’s doctor may prescribe stronger eardrops and pain relievers. If your child’s symptoms persist after that, the doctor may recommend antibiotics to treat the infection.

Enlarged tonsils and adenoids are also common in children. Tonsils and adenoids are collections of lymphoid tissue that help the body fight infection, but they can become enlarged if they become infected or irritated.

Enlarged tonsils and adenoids are actually normal in some children. But in other children, the enlargement is due to a bacterial or viral infection, allergies, exposure to irritants, or possibly even to gastroesophageal reflux disease.

Usually, there are no obvious symptoms when the tonsils and adenoids are enlarged. But the condition can cause difficulty breathing or swallowing, and can cause your child to sound like they have a stuffy nose when they talk. Enlarged tonsils and adenoids can also cause nosebleeds, bad breath, and cough.

In some cases, enlarged tonsils and adenoids can cause recurring ear or sinus infections, or sleep apnea, a sleep disorder in which the upper airway becomes blocked, causing the child’s breathing to stop and star during the night.

Treatment for enlarged tonsils and adenoids begins by treating the underlying cause, such as the allergies or infection. If this treatment fails to achieve results, your child’s doctor may suggest removing the tonsils and adenoids. Surgery may be recommended if your child has sleep apnea or extreme difficulty when talking and breathing, or if they experience multiple throat infections.

Another common ENT issue in children is sinusitis. The sinuses are air-filled cavities in the skull behind the face that are lined with mucus membranes. Sinusitis is an infection of the sinuses near the nose.

Sinus infections often develop after a cold or upper respiratory infection. These infections cause inflammation of the nasal passages that can block the opening of the sinuses into the nose. Allergies can also cause sinusitis due to the swelling of the nasal tissue and increased mucus production.

Treatment for sinusitis may include a course of antibiotics, acetaminophen for pain, a decongestant and/or mucus thinner, and a nasal spray to reduce inflammation. Your child’s doctor may recommend that you run a cool humidifier in your child’s room to keep the air moist.
In extreme cases, surgery on the sinuses may be needed.

Allergic rhinitis, also known as hay fever, is another ENT problem that is common in children. Allergic rhinitis, which is a reaction that happens in the eyes, nose and throat, can be seasonal or year-round. The most common causes of allergic rhinitis in children include pollen from trees, grass or weeds; dust mites; mold; cockroach waste; and animal dander. These substances are called allergens because they trigger an allergic reaction.

Symptoms of allergic rhinitis include sneezing, nasal congestion, nasal discharge, fatigue, and skin rashes. Treatment generally involves giving your child antihistamines, decongestants, and nasal sprays. If your child also has asthma, their doctor will treat those symptoms as well.

Consider allergy shots if your child has severe allergic rhinitis. The shots are a type of immunotherapy that helps your child’s body get used to the allergens so that they do not react when exposed to them.