Children face many of the same health problems that adults do; however, symptoms may show themselves differently and treatment methods that work well in adults may not be appropriate for children. This page identifies common pediatric ear, nose, throat, head, and neck ailments, and what you should ask your child's doctor about diagnosis and treatment.
Child's Hearing Loss
At birth, one in 1,000 children have significant permanent hearing loss. When mild hearing loss is included, six in 1,000 children are affected. By age 18, 17 in 1,000 people have some degree of permanent hearing loss.
- Speech and language delay
- Not babbling, or babbling has stopped
- By 12 months, does not understand simple phrases such as “wave bye-bye” or “clap hands"
- Not turning head in direction of sound
- Difficulties in school
What causes pediatric hearing loss?
What are the treatment options for pediatric hearing loss?
The symptoms of allergic rhinitis, a physiological response to specific allergens such as pet dander or ragweed, are fairly simple. They include a runny nose, watery eyes, and some periodic sneezing. Administration of the proper over-the-counter antihistamines may alleviate the symptoms, and seasonal allergic rhinitis may resolve after a short period.
However, if your child suffers from year round allergic rhinitis, an examination by a ENT specialist will assist in preventing other ear, nose, and throat problems from occurring. You can learn more about potential ear, nose, and throat problems related to allergies below.
One of children's most common medical problems is otitis media, or middle ear infection. These infections are especially common in early childhood. They are even more common when children suffer from allergic rhinitis (hay fever). Allergic inflammation can cause swelling in the nose and around the opening of the Eustachian tube (ear canal). This swelling has the potential to interfere with drainage of the middle ear. When bacteria laden discharge clogs the tube, infection is more likely.
Hay fever allergens may lead to the formation of too much mucus which can make the nose run or drip down the back of the throat, leading to "post-nasal drip." It can cause a cough, a sore throat, and a husky voice. Air conditioning, winter heating, and dehydration can aggravate the condition.
Chronic nasal obstruction is a frequent symptom of seasonal allergic rhinitis and perennial allergic rhinitis. This allergic condition may have a debilitating effect on the nasal turbinates: the small, shelf-like, bony structures covered by mucous membranes. The turbinates protrude into the nasal airway and help to warm, humidify, and cleanse air before it reaches the lungs. When exposed to allergens, the mucosa can become inflamed. The blood vessels inside the membrane swell and expand, causing the turbinates to become enlarged and obstruct the flow of air through the nose. This inflammation, or rhinitis, can cause chronic nasal obstruction that affects individuals during the day and night. Enlarged turbinates and nasal congestion can also contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea.
Allergic rhinitis can cause enough inflammation to obstruct the openings to the sinuses. Consequently, a bacterial sinus infection occurs. The disease is similar for children and adults. Children may or may not complain of pain; however, in acute sinusitis, they will often have pain, a fever, and nasal discharge. In chronic sinusitis, pain and fever are not evident. Most will have a purulent, runny nose and nasal congestion to the point where they must mouth breathe. The infected sinus drains around the Eustachian tube, and therefore many children will also have a middle ear infection.
Child's Sleep Apnea and Sleep Disordered Breathing
What causes pediatric sleep disordered breathing?
- Snoring — The most obvious symptom of SDB is loud snoring that is present on most nights. The snoring can be interrupted by a complete blockage of breathing, with gasping noises associated with waking up from sleep.
- Irritability — A child with SDB may become irritable, sleepy during the day, or have difficulty concentrating in school. He or she may also display busy or hyperactive behavior.
- Bedwetting — SDB can cause increased urine production at night, which may lead to bedwetting.
- Learning Difficulties — Children with SDB may become moody and disruptive, or not pay attention, both at home and at school.
- Slow Growth — Children with SDB may not produce enough growth hormone, resulting in abnormally slow growth and development.
- Cardiovascular Difficulties — OSA can be associated with an increased risk of high blood pressure, or other heart and lung problems.
- Obesity — SDB may cause the body to have increased resistance to insulin, and daytime fatigue can lead to decreased physical activity. These factors can contribute to obesity.
How is sleep apnea diagnosed?
Child's Head and Neck Cancer
Tumors or growths in the head and neck region can be divided into those that are benign (not cancerous) and those that are malignant (i.e., cancer). Fortunately, most growths in the head and neck region in children are benign. These benign growths can be related to infection, inflammation, fluid collections, swellings, or neoplasms (tumors) that are non life-threatening. On the other hand, malignant growths may be life-threatening and cause other problems. Even malignant growths in the head and neck are usually treatable.
It is very common for children to have enlarged tonsils and adenoids. These are almost always from an infection or inflammation. It is very rare that children develop cancer, lymphoma, or sarcoma of these areas. When the tonsils, adenoids, or other areas of the mouth or throat remain enlarged or are enlarged on only one side, it is important to have an evaluation by an ENT specialist.
The lymph nodes of the neck region may become enlarged during childhood. Most of the time, this is related to inflammation or infection. However, if the lymph nodes remain enlarged for a period of time without going away, it is important to visit an ENT to evaluate the problem.
Other benign growths in the face and neck include cysts. These often require removal due to their continued growth and potential for infection.
Sinus and Nose Growths
Although most children have nose bleeds, occasional allergies, and sinus infections, sometimes tumors of the nose and sinus present with similar symptoms. It is generally recommended that a child with continuous sinus problems or nose bleeds be evaluated by an otolaryngologist to be sure it is not a tumor or other treatable condition.
Salivary Gland Tumors
There are three paired sets of salivary glands in the head and neck region. These include the ones in front of the ears (parotid), below the jaw (submandibular), and underneath the tongue (sublingual). Additionally, there are numerous very small salivary glands throughout the mouth and throat. Although tumors can arise in these areas, they are rare. Thus, any child with a growth in these areas should be seen by an otolaryngologist.
The thyroid gland is found in the front of the lower part of the neck just above the chest area but below the Adam's apple. Although tumors can arise in this area, they are rare. Any child with a growth in this area should be seen by an ENT specialist.
- A lump in the neck
- Persistent swollen lymph nodes
- A tight or full feeling in the neck
- Trouble with breathing or swallowing
- —This form of thyroid cancer occurs in cells that produce thyroid hormones containing iodine. This is the most common form of thyroid cancer in children and it grows very slowly. This form can spread to the lymph nodes via lymphatics in the neck and occasionally spreads to more distant sites.
- Follicular—This type of thyroid cancer also develops in cells that produce thyroid hormones containing iodine. The disease afflicts a slightly older age group and is less common in children. This type of thyroid cancer is more likely to spread to the neck via blood vessels, causing the cancer to spread to other parts of the body.
- Medullary—This rare form of thyroid cancer develops in cells that produce calcitonin, a hormone that does not contain iodine. This cancer tends to spread to other parts of the body and constitutes about five to ten percent of all thyroid malignancies.