When your child’s ear infection means it’s time to see an ENT

Technically it’s fall, but it’s also a lot of other “seasons”: The holiday season, football season, and Season 2 of ‘Modern Family,’ which is everything I dreamed it would be and more.

Signs it might be time to see a specialist

ENT deal with more than ear infections. If your child has any of
the following symptoms, you should ask your child’s pediatrician
about a referral to a specialist:

  • Repeated nose bleeds
  • Trouble breathing out of one or both sides of the nose
  • Frequent sinus infections
  • A running nose, or the sensation of drainage down your
    throat.
  • Snoring
  • Difficulty swallowing
  • Sudden or progressive hearing loss
  • Feeling of draining in the ear
  • Dizziness

Oh, and cold and flu season.

One day your child is fine, the next there’s the slightest hint of a runny nose, and by day three, it’s an up-all-night-ear-infection-turned-sinus-snotfest. Your pediatrician prescribes antibiotics, but three weeks later, it’s back again.

And that, experts say, is when it may be time to bring in the big guns.Otolaryngologists (often called ear, nose and throat doctors, or ENTS) take over when colds become chronic, difficult to manage or threaten to turn more serious.

To help clear up what exactly an otolaryngologist does and when you need to see one, I spoke with Dr. Joseph Donzelli of Midwest ENT Consultants, a practice with offices in Geneva, Naperville, Plainfield and Winfield.

First, why do kids get so many ear infections?

Basically, kids have small and funny-shaped heads, and it leaves them more susceptible to infection.The ear drainage system runs from the ear to the back of the nose. “In kids, it’s shorter and more horizontal, so it’s easier for bacteria to get stuck and cause an infection,” Donzelli says. “As kids grow, the canal lengthens and becomes more vertical, so infections are less common.”

Among kids, there are some conditions that make them more susceptible. Children with Down syndrome, and those with certain facial abnormalities like cleft palates tend to get more ear infections.

Can most ear infections be handled by a pediatrician? When is it time to see an ENT?

Most ear infections will be seen first by a child’s pediatrician, and then once it hits a magic number, the doctor will refer them to an ENT, Donzelli says. “That number is different for every doctor, but generally heading into the winter months, three ear infections in the past year would be concerning, and coming out of the winter months, five or more ear infections in the past year,” he says.

When should annual ear infections start tapering off?

Usually between the ages of 3 and 5, most kids start outgrowing the problem. But Donzelli says that’s also the age that seasonal allergies start to set in, which can keep some of the symptoms around and generally confuse the situation. “But generally, if we have a child older than 5 who’s still getting chronic ear infections, we’ll start talking about treatment options,” he says.

The most common treatment option are tubes in the ear, which doctors use toget rid of chronic fluid and cut down on recurring ear infections. But there are also things like antihistamines or nasal sprays that you can discuss with your doctor.

When is an ear infection something more serious?

Most earaches are just run-of-the-mill ear infections. But symptoms that go outside the ear itself could be indicators of two rare but potentially deadly infections. Mastoiditis is an ear infection that moves to the mastoid bone of the skull. The telltale sign is red, swollen and tender skin behind the ear. It’s treatable, but should be taken seriously.

Bacterial meningitis is an infection in the brain that can be caused by a severe ear infection that goes untreated. Bacterial meningitis moves quickly, often starting with a stiff neck, and is a true emergency requiring an immediate trip to the ER.

“If you start seeing swelling behind the ear, or really any symptoms that seem outside the geographic area of the ear itself, that’s not something to be messed around with,” Donzelli says.

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