All About Ears
Why do children have more middle ear infections? The adult Eustachian tube inclines about 45 degrees while the child’s Eustachian tube inclines only about 10 degrees. Consequently, the adult gains the benefit of gravity which acts to increase resistance to fluid entering the middle ear.
For more information regarding the illness affecting your child’s ears, review our Kids ENT health links listed below.
A Quick Glossary for Good Ear Health
A Quick Glossary for Good Ear Health Your child has an earache. After your first visit to a physician you may hear some of the following terms related to the diagnosis and treatment of this common childhood disorder.
Acute otitis media – the medical term for the common ear infection. Otitis refers to an ear inflammation, and media means middle. Acute otitis media is an infection of the middle ear, which is located behind the eardrum. This diagnosis includes fluid effusion trapped in the middle ear.
Adenoidectomy – removal of the adenoids, also called pharyngeal tonsils. Some believe their removal helps prevent ear infections.
Amoxicillin – a semi-synthetic penicillin antibiotic often used as the first-line medical treatment for acute otitis media or otitis media with effusion. A higher dosage may be recommended for a second treatment.
Analgesia – immediate pain relief. For an earache, it may be provided by acetaminophen, ibuprofen, and auralgan.
Antibiotic – a soluble substance derived from a mold or bacterium that inhibits the growth of other bacterial micro-organisms.
Antibiotic resistance – a condition where micro-organisms continue to multiply although exposed to antibiotic agents, often because the bacteria has become immune to the medication. Overuse or inappropriate use of antibiotics leads to antibiotic resistance.
Audiometer – an electronic device used in measuring hearing for pure tones of frequencies, generally varying from 125–8000 Hz, and speech (recorded in terms of decibels).
Azithromyacin – an antibiotic prescribed for acute otitis media due to Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Also known by its brand name, Zithromax®.
Bacteria – organisms responsible for about 70 percent of otitis media cases. The most common bacterial offenders are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.
Chronic otitis media – when infection of the middle ear persists, leading to possible ongoing damage to the middle ear and eardrum.
Decibel – one tenth of a bel, the unit of measure expressing the relative intensity of a sound. The results of a hearing test are often expressed in decibels.
Effusion – a collection of fluid generally containing a bacterial culture.
First-line agent – The first treatment of antibiotics prescribed for an ear infection, often amoxicillin.
Myringotomy – an incision made into the ear drum.
Otitis media without effusion – an inflammation of the eardrum without fluid in the middle ear.
Otitis media with effusion – the presence of fluid in the middle ear without signs or symptoms of ear infection. It is sometimes called serous otitis media. This condition does not usually require antibiotic treatment.
Otitis media with perforation – a spontaneous rupture or tear in the eardrum as a result of infection. The hole in the ear drum usually repairs itself within several weeks.
OtoLAM™ – a myringotomy performed with computer-driven laser technology (rather than manual incision with a conventional scalpel).
Pneumatic otoscopy – a test administered for the middle ear consisting of an inspection of the ear with a device capable of varying air pressure against the eardrum. If the tympanic membrane moves during the test, normal middle ear function is indicated. A lack of movement indicates either increased impedance, as with fluid in the middle ear, or perforation of the tympanic membrane.
Recurrent otitis media – when the patient incurs three infections in three months, four in six months, or six in 12 months. This is often an indicator that a tympanostomy with tubes might be recommended.
Second line treatment – antibiotics prescribed when the first line of treatment fails to resolve symptoms after 48 hours.
Trimethoprim Sulfamethoxazole – an alternative first line treatment for children allergic to amoxicillin.
Tympanostomy tubes – small tubes inserted in the eardrum to allow drainage of infection.
Do not hesitate to seek clarification from your physician if he or she uses a term that you do not fully understand.
Children and Facial Trauma
What is facial trauma?
The term facial trauma means any injury to the face or upper jaw bone. Facial traumas include injuries to the skin covering, underlying skeleton, neck, nasal (sinuses), orbital socket, or oral lining, as well as the teeth and dental structures. Sometimes these types of injuries are called maxillofacial injury. Facial trauma is often recognized by lacerations (breaks in the skin); bruising around the eyes, widening of the distance between the eyes (which may indicate injury to the bones between the eye sockets); movement of the upper jaw when the head is stabilized (which may indicate a fracture in this area); and abnormal sensations on the cheek.
In the U.S., about three million people are treated in emergency departments for facial trauma injuries each year. Of the pediatric patients, five percent have suffered facial fractures. In children less than three years old, the primary cause of these fractures is falls. In children more than five years old the primary cause for facial trauma is motor vehicle accidents.
Our fast paced world of ultra sports and increasing violence puts children at risk for facial injury. But, children’s facial injuries require special attention. A child’s future growth plays a big role in treatment for facial trauma. So, one of the most important issues as a care giver is to follow a physician’s treatment plan as closely as you can until your child is fully recovered.
Why is facial trauma different in children than adults?
Facial trauma can range between minor injury to disfigurement that lasts a lifetime. The face is critical in communicating with others, so it is important to get the best treatment possible. Pediatric facial trauma differs from adult injury because the face is not fully formed and future growth will be a factor in how the child heals and recovers. Certain types of trauma may cause a delay in the growth or further complicate recovery. Difficult cases require physicians with great skill to make a repair that will grow with your child.
Types of facial trauma
New technology, such as CT scans, have improved physicians ability to evaluate and manage facial trauma. In some cases, immediate surgery is needed to realign fractures before they heal incorrectly. Other injuries will have better outcomes if repairs are done after cuts and swelling have improved. A new study has shown that even when injury does not require surgery, it is important to a child’s health and welfare to continue to follow up with a physicians care.
Soft tissue injuries
Injuries such as cuts (lacerations) may occur on the soft tissue of the face. In combination with suturing the wound, the provider should take care to inspect and treat any injures to the facial nerves, glands, or ducts.
When a fracture of the bones in the face occurs, the treatment process is similar to that of a fracture in other parts of the body. Factors that affect how the fracture should be dealt with are the location of the fracture, the severity of the fracture, and the age and general health of the patient. It is important during treatment of facial fractures to be careful that the patient’s facial appearance is minimally affected.
Injuries to the teeth and surrounding dental structures style
Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Because of the specific needs of the dental structures, certain actions and precautions should be taken if a child has received an injury to his or her teeth or surrounding dental structures.
- If a tooth is “knocked out”, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible.
- Never attempt to “wipe the tooth off” since remnants of the ligament which hold the tooth in the jaw are attached and are vital to the success of replanting the tooth.
Copyright American Academy of Otolaryngology/Head & Neck Surgery 2006