General Topics

What Are The Most Common ENT Problems In Children? | ENT Specialist

Common ENT problems in children

Ear, nose, and throat (ENT) problems are extremely common in kids. Part of that is because many parts of the ENT region in children have not developed enough and, therefore, are apt to not function properly. Another issue that often leads to ENT problems in children is allergies. It’s important to know the most common ENT troubles children face and be able to distinguish if allergies are playing a part in the problem.

Ear Infections: Most every child at some point is faced with an ear infection. In fact, ear infections in children are as common as a cold. Most ear infections are otitis media, or middle ear infection. Upper respiratory tract infections can make their way up the Eustachian tube and infect the middle ear to cause pain, fever, and even some hearing loss. In this instance, oral antibiotic medications typically help. In some cases, however, allergies can be to blame. If the child is under the age of two, most likely allergies aren’t to blame for any ear infection. But in older children, allergies can lead to fluid behind the eardrum and painful ear pressure.

Sore throat: Two common throat problems in children are tonsillitis and pharyngitis. The difference between the two is that pharyngitis specifically affects the throat while tonsillitis affects the tonsils. Both conditions can lead to infections and inflammation in the throat, and anti-inflammatory medications can often treat them. However, sore throats are simply caused by allergies. Allergies can cause too much mucus to form, leading to a postnasal drip (a runny nose down the back of the throat).

Sinusitis: Sinusitis is usually caused by an infection of the maxillary sinus in children. Typical symptoms are frequent runny nose, nasal obstruction, and cough, and antibiotics are usually given to treat sinusitis. But if symptoms persist, the underlying problem could be allergies. Chronic sinusitis can also be caused by an allergy that needs to be determined. It is a common ENT problem in children.

Rhinitis: Allergic rhinitis is commonly known as hay fever and is a common ENT problem in children. Allergic rhinitis can be seasonal or year-round and usually causes nasal congestion, runny nose, trouble sleeping, fatigue, and skin rashes. The chronic problem can be caused by several allergens, both indoors and outdoors, along with certain foods.

Ignoring the symptoms of ENT problems can lead to not only unnecessary pain and discomfort but also possible lifelong illness. If your child is experiencing any of these problems, make an appointment with a member ENT specialist to get a diagnosis and find out if allergies.

When to contact a specialist?

Pediatric Ear, Nose, and Throat (ENT) disorders remain one of the top reasons children go to the doctor, according to the American Academy of Otolaryngology. Most paediatricians are prepared to handle an ear infection or runny nose, but how do you know when your child needs to see a specialist?

Snoring is not normal

Many parents think snoring is cute and fun, but it is not normal. When a child snores obstinately, it is not a cause for instant concern, but it deserves further evaluation by a paediatrician or ENT specialist.

Certain conditions, such as sleep apnea, can lead to a variety of health problems, including malformed facial bones, behaviour problems, and even bedwetting. Be sure to tell your child’s paediatrician if she snores frequently. The doctor can decide if your child should be referred to a pediatric otolaryngologist.

A recurring cold does not always turn into a sinus infection

Children can have a runny nose and cough every three to four weeks.

It’s completely normal for children, particularly those in daycare, to have a recurring cold. Cold is viral and cannot be treated with antibiotics. The decision to prescribe antibiotics should be made carefully by your primary care physician.

If your child’s cold symptoms last longer than seven days, especially if the symptoms get worse, it’s probably time to call the doctor.

Consider using ear tubes for recurring ear infections

The ear tubes improve air pressure and your child’s hearing. In many cases, ear pipes are a great solution for ear infections.

Under certain circumstances, placing tubes in the ears will help prevent upcoming ear infections and the need for additional rounds of antibiotics.

The decision to use ear tubes is made with the input of the child’s parents, paediatrician, and pediatric otolaryngologist.

If your child has had more than three ear infections in six months, you should ask your child’s paediatrician if ear tubes are appropriate.

Ear, nose, and throat physicians treat additional than ear infections and tonsillitis

Ear infections, a runny nose, and tonsillitis are indeed common reasons that parents bring their children to a pediatric otolaryngologist. However, pediatric otolaryngology specialists also treat everything from head and neck cancer to hearing loss or impairment, facial fractures, swallowing disorders, balance disorders, and more.


What is Ultrasonography | Orthopaedics

Overview of ultrasonography or ultrasound

Ultrasonography or ultrasound is a medical test that uses high-frequency sound waves to take live pictures from inside your body. This is also known as an ultrasound.

The technology is similar to that used by sonar and radar, which helps the military to detect planes and ships. It allows your doctor to see problems with organs, vessels, and tissues without the need for an incision.

Unlike other imaging methods, ultrasound does not use radiation. For this reason, it is a preferred method of observing the development of the fetus during pregnancy.

Why is the procedure done?

Most people associate ultrasounds with pregnancy. These scans can give the expectant mother the first sight of her unborn baby. However, there are many other uses for testing.

Your doctor may order an ultrasound if you have pain, swelling, or other symptoms that require an internal view of your organs.

Provides an ultrasound view:

  • Bladder
  • Brain (in babies)
  • Eyes
  • Gallbladder
  • Kidneys
  • Liver
  • Ovaries
  • Pancreas
  • Spleen
  • Thyroid
  • Testicles
  • Uterus
  • Blood vessels

Ultrasound can also help guide a surgeon’s movements during certain medical procedures, such as biopsies.

How to prepare for ultrasonography or ultrasound?

The steps you need to take to prepare for ultrasonography depending on the area or organ being examined.

Your doctor may tell you to fast for eight to 12 hours before the ultrasound, especially if your abdomen is being examined. Undigested food can block sound waves, making it difficult for a technician to get a clear picture.

For the gallbladder, liver, pancreas, or spleen exam, you may be instructed to eat a fat-free meal the night before the test and then fast until the procedure. However, you can continue to drink water and take your prescribed medications. For other tests, you may be asked to drink lots of water and hold your urine so your bladder is full and clearly visible. Inform your doctor of any medications, over-the-counter medications, or herbal medications you may be taking before the test.

It is important to follow your doctor’s instructions and ask yourself any questions before the procedure. Ultrasound has minimal risks. Unlike X-rays or CT scans, ultrasounds do not use radiation.

How ultrasonography is performed?

Before the test, you put on a hospital gown. You can lie on a table that will expose a part of your body for the test. An ultrasound technician called a sonographer applies a special lubricating jelly to your skin. They can run an ultrasound transducer on your skin to avoid friction. The transducer has a similar appearance to the microphone. Jelly also helps transmit sound waves.

High-frequency sound waves send through your body. The waves resonate when they touch a dense object, such as an organ or bone. Those echoes are reflected in the computer. Sound waves are louder than the pitch the human ear can hear. They form a picture that the doctor can understand. Depending on the area being examined, you may need to relocate so that technicians have better access.

After the procedure, the gel will be wiped off your skin. The entire procedure usually takes less than 30 minutes, depending on the area examined. You will have the freedom to learn about your normal activities after the procedure is complete.

After the ultrasonography

After the test, your doctor will review the images and look for abnormalities. They will call you to discuss the results or to schedule the next appointment. If there are any abnormalities on the ultrasound, you may undergo other diagnostic procedures, such as a CT scan, MRI, or tissue biopsy, depending on the area examined. If your doctor can diagnose your condition based on your ultrasound, they can begin your treatment right away.

Variations of ultrasonography

  • Mode A: Graph‌ peaks (used for eye scan)
  • Mode B: As two-dimensional anatomical images (used during pregnancy to assess fetal development or to assess internal organs)
  • Mode M: waves are constantly displayed to show moving structures (used to assess fetal heart rate or heart valve defects)

Doppler ultrasonography

Doppler ultrasound uses a change in the frequency of sound waves when they are reflected off a moving object (called the Doppler effect). In medical images, the moving objects are red blood cells in the blood. Therefore, Doppler ultrasound can be used to assess.

  • Does blood flow through blood vessels?
  • How fast it flows
  • Flow in any direction

Doppler ultrasonography is used

  • To assess how well the heart is working (as part of echocardiography).
  • Identification of blocked blood vessels, especially in the veins of the legs, such as deep vein thrombosis, when the veins are blocked by blood clots.
  • To identify narrow arteries, especially the carotid arteries in the neck, that carry blood to the brain.

Spectral doppler ultrasonography

This procedure graphically displays blood flow information. It can be used to estimate how much is blocked in a blood vessel.

Duplex doppler ultrasonography

This approach combines spectral and B-mode ultrasound.

Color doppler ultrasonography

For this test, color superposes were applied to the gray-toned image of the bloodstream produced by Doppler ultrasound. The color indicates the direction of blood flow. Red can be used to indicate current on the transducer side and blue can be used to indicate current is away from the transducer. The brightness of the color indicates how fast the blood flows.

Color doppler ultrasound can help assess stroke risk because it can help doctors diagnose and diagnose narrowing or blocked arteries in the neck and head. This approach is useful in evaluating people with transient ischemic attacks or risk factors for stroke and atherosclerosis. Color doppler ultrasound is also used to assess blood flow to internal organs and tumors.

General Topics

What Is Earwax In Children? | ENT Specialist

Earwax in children

Earwax In Children has some important jobs. It performs like a waterproof coating of the ear canal, protecting it and the eardrum from germs that can cause infections, traps dirt, dust, and other particles, preventing them from injuring or irritating the eardrum.

Why do ears make wax?

Wax is produced in the external ear canal, the area between the fleshy part of the ear on the outside of the head and the middle ear. The medical term for earwax is cerumen.

The wax has some important jobs.

  • Acts as a waterproof lining of the ear canal, protecting it and the eardrum from germs that can cause infections.
  • Traps dirt, dust, and other particles, preventing them from injuring or irritating the eardrum.

The wax makes its way through the outer ear canal to the opening of the ear. Then it either falls out or comes out during bathing. In most people, the outer ear canal makes earwax all the time, so the canal always has enough wax in it.

Is it necessary to remove earwax?

Earwax usually doesn’t need to be removed because it comes out on its own. Putting something in a child’s ears increases the risk of infection or damage to the ear canal or eardrum. Cotton swabs are useful for a variety of grooming needs, but should not be used to remove wax. In most cases, a regular bath is enough to keep it at healthy levels.

Although some people have more wax than others, in general, the ear produces as much wax as it needs. In rare cases, children’s ears produce too much wax. And sometimes the wax can build up and block the ear canal, especially when pushed with a finger, cotton swab, or another object. This is called “impaction.” If it affects your hearing or causes pain or discomfort, a doctor can remove it.

Parents, and children, should not attempt to remove earwax at home, even with remedies that promise to be safe and effective.

What can parents do?

If your child complains of ear discomfort and you see wax in the ear, it is okay to wipe the outside of the ear with a cloth. But don’t use a cotton swab, finger, or anything else to get into the ear. It could damage the delicate ear canal and eardrum, or pack the wax even more.

Symptoms of earwax build-up

It is thought that up to 10% of children have excessive earwax. Although having too much earwax may not cause any symptoms at all, in some cases, symptoms of excessive earwax might include:

  • Hearing loss ranging from 5 to 40 decibels (dB)
  • Ringing in the ears (tinnitus)
  • A sensation of fullness in the ear canal
  • Itchiness in the ear canal
  • Ear pain (otalgia)
  • Discharge or ear drainage (otorrhea)
  • The odour from the ear canal
  • Dizziness
  • Cough

Causes of earwax in children

  • Cotton swabs. Earwax build-up is usually due to the use of cotton swabs. They push the wax in and package it.
  • Fingers Some children (perhaps 5%) normally produce more wax than others. It will usually come out if you don’t push it back with your fingers.
  • Earplugs. Wearing earplugs of any kind can also push back the wax.

Treatment for earwax in children

How to do a routine ear cleaning

Your child’s outer ears can be cleaned regularly to remove dirt. The safest way to do this is to use a soft cloth.

Remember, “nothing smaller than your elbow” should be placed in your child’s ear. Items such as cotton swabs or hairpins should not be placed in the ear canal. Using these items in the ear canal will further build up the wax or damage the ear canal.

Peroxide cleaners and ear candles are not recommended for cleaning your child’s ears. Ear candles have no clear benefit and can be risky.

How to remove hardened wax

If you think your child has a build-up of hardened earwax, you can soften it with two to four drops of olive oil or mineral oil.

  • Heat some oil to skin temperature by holding it in a small bowl in your hands.
  • Use a dispenser to apply the oil to the affected ear.
  • Have your child lie down with the affected ear facing up and leave the oil in the ear for a few minutes.
  • When your child sits, the wax should come out.
  • If the wax does not come out, your doctor may be able to remove it with a special instrument called a curette or with a stream of warm water.

How ear wax made

The skin on the outside of the ear has special glands that make ear wax. Once the wax is made, it slowly passes through the external ear canal to the ear opening. Most people make a little earwax each time. The ear canal should continuously have some wax in it.

The purpose of ear wax

The wax serves an important purpose. It builds up naturally in the ear canal from a mixture of secretions from sebaceous glands, sweat glands, and skin cells. It then works to help keep the ear canal clean, transporting dirt, dust, and other small particles with the wax as it naturally exits the ear canal.

Have your kids ever got sand in their ears after a day at the beach or playing in a sandbox? As the wax builds up and flows out of your child’s ear, that sand is likely to be washed away. Wax can also help protect and lubricate the ear canal and can even help prevent external ear infections (otitis externa or swimmer’s ear).

There are two different types of earwax: wet and dry. Dry wax is flakier and is tan or grey in colour, while wet wax is darker brown and sticky.

The type of earwax you might have has been assigned to a single gene, with the dry versus wet earwax trait often depending on your ethnic group. Asians and Native Americans are more likely to have dry earwax, whereas wet earwax is more common among those of African and European descent.

Earwax in children risk factors

Children with narrow ear canals, including many kids with Down syndrome, are also at risk for having too much earwax.

Other risk factors for building up excessive earwax include wearing hearing aids and regularly using earbuds, or in-ear headphones, which are a popular way to listen to music with an iPod, iPhone, and other portable devices.

Prevention for earwax in children

Avoid the buildup of earwax in your child. Earwax is a natural body secretion and there is no way to prevent our body from secreting this substance. One of the ways to prevent impacted earwax is to avoid using cotton swabs in the ear canal.

The best way to clean the outer ear is to clean the outer opening with a damp cloth folded over the index finger, without entering the ear canal.

Since the rate of ear wax production varies from one individual to another, it is advisable to have your child’s ear checked at least once a month. If the wax starts to build up, you can start using any of the available home remedies to soften the wax.

Before using ear drops, make sure your child’s ear does not have an infection or a perforated eardrum. If your child develops an earache or ear discharge after using ear drops, stop using them immediately, and consult a doctor.

General Topics

What is Tonsillitis in Children | ENT Specialist

Overview of tonsillitis in children?

Tonsillitis most commonly affects children between preschool ages and mid-teens. Common signs and symptoms of tonsillitis include red and swollen tonsils. White or yellow lining or patches on the tonsils.

Symptoms of tonsillitis in children

Inflamed tonsils appear red and swollen, and may be covered with a yellow or whitish coating or spots. A child with tonsillitis may have:

  • Throat pain
  • Fever
  • Bad breath
  • Swollen glands (lymph nodes) in the neck
  • Difficulty swallowing
  • Stomach ache
  • Headache

Causes tonsillitis in children

Tonsillitis is frequently caused by a virus such as:

  • Adenovirus
  • The flu
  • Epstein-Barr virus (monkey)
  • Bacteria can also cause it, most commonly group A strep (strep throat). In rare cases, tonsillitis can be caused by more than just an infection.

Diagnosis of tonsillitis in children

The diagnosis is based on a physical examination of the throat. Your doctor may also take a throat culture by gently rubbing the back of your throat. The culture will be sent to a lab to identify the cause of your throat infection.

Your physician may also take a sample of your blood for a whole blood count. This test can show whether your infection is viral or bacterial, which can affect your treatment options.

Treatment for tonsillitis in children

Treatment usually depends on the cause of the infection. A doctor will examine the throat and may include a throat culture to determine if the cause is a bacterial infection. If the doctor determines that the cause is bacterial, such as strep throat, your child may be prescribed antibiotics. If the infection is viral, antibiotics will not exertion to clear the infection.

  • Stay hydrated
  • Gargling with salt water
  • Using throat lozenges
  • Use of acetaminophen to help relieve pain

Home care: Most children with tonsillitis can receive care at home after consulting a doctor (if necessary).

You can take care of your child in the following ways:

  • Make sure they get enough rest.
  • Give them pain relievers like acetaminophen or ibuprofen. See our fact sheet Pain Relief for Children.
  • Give them more fluids to drink. This will prevent your child from becoming dehydrated and help her throat feel less dry and painful. Ice cream sticks are a good option, as they provide more fluids, as well as soothing and numbing a sore throat.
  • There are no restrictions on what your child can eat or drink. However, they may prefer milder foods if they have a sore throat.
  • Your child should stay home until the fever is gone and they can swallow again. Usually, this will be three to four days.

If antibiotics are prescribed, give them to your child as directed, and be sure to complete the full course of antibiotics.

You should see your general physician again if your child has tonsillitis and:

  • Shortness of breath with increased snoring when sleeping
  • Difficulty swallowing and demonstrations signs of dehydration
  • Difficulty opening your mouth
  • You are worried for any reason

Block the airways: Swollen tonsils are easier to see and form a reddish oval mass. Now and then they are big enough to touch in the middle. The severity and frequency of tonsillitis should be taken into account when considering a tonsillectomy. Hugely enlarged tonsils and adenoids can block the airways and cause sleep apnea and shortness of breath during the day.

Fortunately, the size of the tonsils and adenoids generally begins to shrink after age 9 and shrinks rapidly during adolescence. Also, the incidence of tonsillitis peaks between ages 4 and 7 and then begins to decline. Tonsillitis becomes relatively rare after the age of 15. Getting your child through these critical years with antibiotics and conservative treatment can eliminate the need for a tonsillectomy.

As part of the immune system, the tonsils and adenoids are part of the general lymphatic system and help fight infection by filtering bacteria and viruses from the air and food. Some parents are concerned that their child will get sick more often after the tonsils and adenoids are removed, but this is not true. The human body offers a lot of protection. For example, about 250 infection-fighting lymph nodes are located between the clavicle and the cheekbone.

The frequency of tonsillectomies combined with adenoidectomies has been increasing slowly over the past 40 years. Though, the reasons for performing the surgeries have been changing.

Surgery criteria: There are few absolute conditions for tonsillectomy other than an obstruction severe enough to cause a lack of oxygen in the body and cardiopulmonary changes. The following may indicate the need for a tonsillectomy:

  • The child has a severe sore throat seven times in a year, or five in each of two years, or three in each of three years.
  • The child has a throat infection severe enough to cause an abscess or an area of ​​pus and swelling behind the tonsils.
  • The child has a case of tonsillitis that does not get better with antibiotics.
  • Your child’s swollen tonsils and adenoids make normal breathing difficult.

As with all elective surgeries, the risks of surgery, including the risks of general anesthesia, bleeding, nausea, and postoperative vomiting, as well as the child’s absence from school and the parent’s absence from work, must be weighed against the benefits. Any decision concerning tonsillectomy must be made in collaboration with the family, surgeon, and pediatrician. Tonsillectomies are usually same-day surgeries, but doctors may suggest an overnight stay for very young patients. Your child will miss about a week of school and then resume her normal routine.

It doesn’t take long, 20 to 30 minutes, for an ear, nose, and throat (ENT) specialist like me to remove your child’s tonsils.

Risk factors of tonsillitis in children

Risk factors for tonsillitis include:

Early age: Tonsillitis occurs most often in children, but rarely in children under 2 years of age. Tonsillitis caused by bacteria is most shared in children ages 5 to 15, while viral tonsillitis is more common in newer children.

Frequent exposure to germs: School-age children are in close contact with their peers and are often exposed to viruses or bacteria that can cause tonsillitis.

Complications of tonsillitis in children

Inflammation or swelling of the tonsils from recurrent or ongoing (chronic) tonsillitis can cause complications such as:

  • Labored breathing
  • Interrupted breathing during sleep (obstructive sleep apnea)
  • Infection that spreads bottomless into the surrounding tissue (tonsillar cellulitis)
  • Infection that consequences in a collection of pus behind a tonsil (per tonsillar abscess)
  • Streptococcal infection

If tonsillitis caused by group A strep or another strain of strep bacteria is not treated, or if treatment with antibiotics is incomplete, your child is at increased risk for rare conditions such as:

Rheumatic fever, a provocative disorder that affects the heart, joints, and other tissues.

Post-streptococcal glomerulonephritis, an inflammatory disorder of the kidneys that causes inadequate removal of waste and excess fluids from the blood.

Prevention of tonsillitis in children

The germs that cause viral and bacterial tonsillitis are contagious. So, the best prevention is to repetition good hygiene. Teach your child to:

  • Wash your hands thoroughly and often, especially after using the bathroom and before eating
  • Avoid sharing food, glasses, water bottles, or utensils
  • Replace Your Toothbrush After Tonsillitis Is Diagnosed

To assistance your kid prevents the spread of a bacterial or viral infection to others:

  • Keep your child home when sick
  • Ask your doctor when it is okay for your child to return to school
  • Teach your child to cough or sneeze into a tissue or, when necessary, into their elbow
  • Impart your child to wash their hands after sneezing or coughing