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Pediatric ENT 2

Chronic Tonsillitis Chronic Ear Infections
Pediatric Nasal Obstruction Congenital Cysts and Tumors
Sleep Apnea Chronic Sinusitis

Chronic Ear Infections Treatment

iStock_000006573176MediumThe ear is made up of three different parts – the outer ear, middle ear and inner ear. Although infections can occur in any area, the middle ear is most susceptible. The middle ear is the area just behind the eardrum and connects to the nose through tiny passages called eustachian tubes. When fluid, often from a cold or other viral infection, builds up in the middle ear, it can become inflamed or irritated. Since children’s eustachian tubes are narrower than those of adults and therefore unable to clear the fluid as effectively, children are more likely to develop ear infections. Middle ear infections , also known as otitis media, are one of the most common childhood conditions. Three out of four children in the US will have at least one ear infection by the time they reach the age of 3, according to the National Institute on Deafness and Other Communication Disorders.

Certain risk factors place children at a higher risk for ear infections. Some of these factors include:

Age (between 6 and 18 months) Family history
Group child care Race
Feeding position

Ear infections can be hard to detect in young children due to a lack of communication. Symptoms of a middle ear infection typically include:

Earache Headache
Fever Dizziness
Ear discharge

Your child may tug or pull at their ears, be irritable, cry often or have trouble sleeping if they are suffering from an ear infection. These symptoms often present themselves after a cold. An ear infection can be diagnosed by using an otoscope, a small lighted tube used to view the eardrum, as well as performing a complete physical examination of the throat, sinuses, head, neck and lungs. A hearing test may also be performed for chronic or recurring ear infections. Your can help reduce your child’s risk of ear infections by keeping them away from other sick children and secondhand smoke, breastfeeding and maintaining proper hygiene to prevent infection.

Treatment for chronic ear infections include:

Pressure Equalization Tube Placement / Tympanostomy Tubes

Children who suffer from repeat ear infections or fluid in the ear may benefit from ear tubes. Tympanostomy tubes, commonly known as ear tubes, are plastic inserts that are surgically placed in the eardrum under general anesthesia. The insertion of ear tubes can help allow air to enter the middle ear, allow fluid out of the ear, prevent future buildup of fluid and restore hearing.

p-iStock_000008999494SmallEar tubes are usually considered when a child has fluid in both ears for more than 3 months or has repeated ear infections. The tubes drain the ears of fluid and allow ventilation into the middle ear. Ear tubes usually stay in place for 6-12 months, at which time they fall out on their own or are surgically removed. The tubes are usually effective in preventing ear infection and the buildup of pressure and fluid.


A mastoidectomy is the surgical removal of an infected portion of the mastoid bone (the prominent bone behind the ear) when medical treatment is not effective. Mastoidectomy is performed to remove infected air cells within the mastoid bone caused by mastoiditis, ear infections, or cholesteatoma (an inflammatory disease of the middle ear). The air cells are open spaces containing air that are located throughout the mastoid bone. They are connected to a cavity in the upper part of the bone which is connected to the middle ear. Infections in the middle ear can therefore spread through the mastoid bone, making surgery necessary if antibiotics do not work. A mastoidectomy may also be performed to repair paralyzed facial nerves.

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