Most children are served well by their primary physicians. But there are times when more focused experience and training are needed. Ear, nose, and throat (ENT) specialists treat conditions or disorders affecting these related areas of the body. Here’s when to consider heading to a specialist.
Ear infections are so common that five out of six children will experience at least one before their third birthday.
Ear infections occur most often between 3 months and three years. Also called otitis media, ear infections are common until age eight. Eighty percent of ear infections clear up with no intervention within a week. Some, however, require treatment with antibiotics or over-the-counter pain medications.
American Academy of Pediatrics (AAP) recommends that children with recurrent ear infections see an ENT. How frequent is recurrent? AAP defines it as more than three ear infections in six months or four in one year (with one episode in the preceding six months).
Ear infections sometimes come “with effusion,” which means fluid in the ears. Even after the ear infection clears, fluid can remain. If it lasts for more than three months, it’s time to see an ENT. If you notice your child is having language delays, hearing loss, or learning issues in addition to ear infections, make an appointment sooner.
Sinus and nasal conditions
A sinus infection or sinusitis often develops after a cold. It also can be caused by viral, bacterial, or fungal infections, allergic reactions, or environmental factors. Symptoms can include facial pain, ear pain, blocked drainage, and nasal congestion.
Not every case of sinusitis requires a visit to an ENT. But if your child’s symptoms last for more than a month, it’s a good idea to see an ENT.
If your child has chronic rhinitis (a runny or blocked nose), you should bring them to see an ENT. Symptoms occur from the constant inflammation of the inner lining of the nose. When those linings become inflamed, it causes nasal congestion. Mucus production increases, causing a runny nose and post-nasal drip.
Nosebleeds are a common nose issue that can require a visit to the ENT. If a child is struck in the nose and the nosebleed subsides quickly, there should be no cause for concern. Dry air, particularly in the winter indoors, can also cause nosebleeds. If nosebleeds are recurring, heavy, or aren’t resolved by the use of a humidifier, it’s good to see an ENT to rule out other causes.
Strep throat is another common childhood ailment. Strep throat is an infection of the throat and the tonsils caused by group A streptococcus bacteria. Group A strep is found in the nose and throat and can spread by coughing and sneezing. Usually, strep throat is mild. Symptoms can include throat pain, headache, belly pain, and a fever. Red, swollen tonsils (tonsillitis) with white patches can also be present. A throat culture is required to diagnose strep throat.
Strep throat alone is not a reason to see an ENT. However, if your child has frequent cases of strep throat (seven in 12 months) or has recurrent tonsillitis (six instances in a year), they should see an ENT.
When a child has a cold, it’s common for them to snore. But if an otherwise healthy child snores three or more nights a week, it might be good to see an ENT. Snoring can be caused by enlarged tonsils or adenoids or a deviated septum, all of which should be treated by an ENT.
A more worrisome cause of snoring is sleep-disordered breathing. A sign beyond frequent snoring is when a child gasps or has difficulty breathing while sleeping. This could be a sign of obstructive sleep apnea (OSA), which causes periods of decreased airflow and pauses in breathing. OSA is rare, only occurring in 1 to 4 percent of children.
To recap, if your child might require an appointment with an ENT if they have:
- Recurrent ear infections (more than three ear infections in six months or four in one year)
- Fluid in the ear that remains (more than three months)
- Language delays, hearing loss, or learning issues on top of ear infections
- A sinus infection or sinusitis with symptoms for more than a month or more than three sinus infections in a year
- Chronic rhinitis (a runny or blocked nose)
- Nosebleeds that are recurring, heavy, or aren’t resolved by humidifiers
- Snoring three nights per week or more when they’re otherwise healthy
- Recurrent strep throat (seven in 12 months)
- Recurrent tonsillitis (six instances in one year)