Pediatric Otolaryngology

Loud snoring at night is a sign of upper airway obstruction or breathing difficulty. Large tonsils and adenoids are the most common cause of upper airway obstruction in children. When children sleep, large tonsils and adenoids may make it difficult for them to move air easily.

In more severe forms, the airway obstruction leads to gasping, pauses in breathing, and even the inability to move air, called apnea. Breathing difficulties from large tonsils and adenoids can lead to significant problems with a child's sleep which may cause daytime tiredness, lack of energy, and behavior and attention difficulties. Large tonsils and adenoids may also cause other difficulties such as swallowing problems.

Because of the risk of complications from ear infections, antibiotics are frequently used for treatment. Vaccinations for certain ear infections are showing great promise and are just being introduced into use.

Some children and occasionally adults, have so many ear infections that an alternate route is needed for the air to get into the middle ear to prevent the fluid from developing that can lead to the ear infections. This is what a ventilation tube or "ear tube" does. Air can enter the middle ear through the ventilation tube. The tube usually stays in place for 12-18 months and then is gradually pushed out of the eardrum during healing. In most children, the 12-18 months is enough time to allow the natural ventilation tube (Eustachian tube) for the ear to function correctly. This is how children "outgrow" ear infections.

Ear tubes can help prevent ear infections in children and can eliminate the fluid that builds up behind the eardrum after an ear infection. This fluid can cause many problems for children because it can affect their hearing.

In young children the hearing loss from the ear fluid may cause speech and language delays. If your child has had 3 to 4 ear infections in a six month period, or 5 to 6 ear infections in a 12 month period, or has fluid that stays behind the eardrum for more than 3 months in a row; you may want to talk to your pediatrician or family doctor about seeing an ear, nose, and throat (ENT) specialist.

Both bacteria and viruses can cause ear infections. One of the main structures in the body which helps prevent ear infections is the Eustachian tube. The Eustachian tube connects the middle ear to the throat at the back of the nose. The Eustachian tube helps prevent ear infections by allowing air to ventilate the middle ear, draining fluid from the middle ear, and preventing bacteria from entering the middle ear from the back of the nose and throat.

Infants and children have Eustachian tubes that are smaller, shorter, and more horizontal than those in adults and they often work less well than those of older persons. This is one of the main reasons young children are prone to ear infections. When a child develops a cold, the nasal lining swells. This can also cause the opening of the Eustachian tube to close. Then, the air cannot get in the middle ear. The blood supply of the middle ear lining carries away the oxygen portion of the middle ear air causing a negative pressure. Tissue fluid from the middle ear lining is pulled into the middle ear space. This fluid has protein and sugar in it. In a bacterial ear infection, the same negative pressure in the middle ear can draw bacteria-filled mucus from the back of the nose up the Eustachian tube and into the middle ear.

The fluid in the middle ear allows the bacteria from the nose to grow in number. This attracts the body's white blood cells to fight the bacteria. This is an ear infection. The middle ear lining swells and there is pressure on the eardrum causing pain. In some cases the body's own immune system will fight off an ear infection, but antibiotics are often prescribed to prevent complications such a eardrum perforation, hearing loss, or spread of the infection.

Yes, any age child can have their hearing tested. Even newborns can have their hearing screened. If you have any question of your child's ability to hear, it is very important to get his or her hearing tested as soon as possible. This is important because a child's ability to understand speech is developing even in infancy. Loss of hearing can affect speech development. The loss of effective communication can have a life long impact.

Some children are born with a hearing loss and others develop it later on. Some types of hearing loss are inherited and others occur due to abnormal development of the hearing apparatus.

Ear infections and persistent fluid in the middle ear can cause a mild to moderate hearing loss. Any identified hearing loss in a child needs to be completely investigated. Some types of hearing loss can be corrected and others can be treated with hearing aids.

A pediatric otolaryngologist or pediatric ENT is an ear, nose, and throat surgeon who has received special training in ear, nose, and throat disorders in children. This training concentrates on diagnosing ENT disorders in children and developing skills to perform complex surgery in kids such as airway reconstruction and removal of congenital abnormalities of the head and neck.

In addition, pediatric ENT training provides additional training in more common problems in children, such as ear infections and tonsil disease. A pediatric ENT's practice is specifically structured for kids in that it has pediatric nurses and office staff who have a special interest and skills in caring for children.

The Medical College of Wisconsin is a private medical school with ENT physicians, otolaryngologists, who work at Children's Hospital of Wisconsin. There are also adult ENT physicians, otolaryngologists, who work at Froedtert Hospital. The pediatric ENT physicians associated with the Medical College are the largest group of ENT physicians in the state of Wisconsin with special training in the treatment of ear, nose, and throat disorders in children.

They perform the largest number of both complex and more routine pediatric ENT procedures of any other group in Wisconsin. This experience allows for special expertise in pediatric ENT disorders.

In addition, the pediatric ENT surgeons at the Medical College participate in research and national programs which give them special access to treatments which are not available through other sources. Specific examples include new antibiotics not available except though the physicians at the Medical College and a new treatment for lymphangioma provided through their research efforts.

No, you may still have ear infections after tubes, although many patients do not. Patients that have infections after tubes normally have fewer and the infections are less severe.

No, a tonsillectomy is performed typically for patients having a large number of throat infections or for those with symptoms of obstruction such as loud snoring, the stopping of breathing, and/or difficulty swallowing.

Yes, they are forms of lymphoid tissue or lymph nodes that produce some cells to fight infection. However, there are hundreds of lymph nodes in the same area of the body as the tonsils and adenoids that perform a similar function.

Removing the tonsils and adenoids does not make you more likely to get infections or have an effect on your body's ability to fight off infection. In fact, the tonsils and adenoids sometimes become chronically infected with bacteria and removing them, in this case, significantly reduces the chances of getting future infections.