15 W. Dry Creek Circle                                                                                           6169 S. Balsam Way; Suite 290
         Littleton, CO  80120-4427                                                                                                                                   Littleton, Colorado  80123
     Phone: (303)  798-1309                                                                                                                                        Fax: (303) 798-2319
Ear, Nose & Throat Center
Specialists of the Ear, Nose and Throat   /  Head and Neck Surgery  /  Facial Plastic Surgery
Evaluation  of  Dizziness  &  Vestibular Disorders

For more information see us at our web site !      http://www.ENT Center.Net
   
Little Ears and Big Problems; Pediatric Ear Infections  

Your child's first year is full of exciting events - the first smile, first steps, first words. It might also be the year of your child's first ear infection. Half of all children in the United States have had otitis media, an infection in the middle ear, by their first birthday, and 90 percent have experienced it by the time they reach the age of 6. For some children, this type of infection is a recurrent problem. Children who develop their first ear infection before they are six months old are at a greater risk of having persistent infections than those who don't have an infection until they are at least one year old. You're probably wondering whether there's anything you can do to keep this from happening to your child. Probably not completely. What you can do to help your child is learn the possible causes of an ear infection and know how to respond to its symptoms.

Otitis media occurs when the eustachian tube, which connects the nasal cavity to the ear, becomes blocked. When that happens, fluid can't get through the eustachian tube, so it builds up, allowing bacteria to form and causing a pressure difference between the middle ear and outer ear. Children are particularly susceptible to these infections because their eustachian tube is short and not always at the right angle to drain properly, making it even more likely to become blocked. Kids are also prime candidates because they get a lot of colds, which can produce swelling around the eustachian tubes, leading to blockage. Enlarged adenoids can also cause blockage. The incidence of otitis media is greater in houses heated with wood and those inhabited by smokers, although no one is quite sure why.   

Although there is nothing you can do to guarantee that your child won't get otitis media, there are some things you can do to try to prevent it.    Protect against colds. Contrary to myth, it's not cold weather that causes ear infection, but the fact that cold weather keeps more people inside and in closer proximity. This makes the spread of cold viruses more likely, which in turn increases the incidence of ear infections.  Children who go to day care may be particularly susceptible to ear infections because there are more children with colds around, exposing them to more cold viruses than those who stay at home. To help reduce the spread of colds among children, heed this advice. Be sure your child's hands are washed frequently during the cold and flu season, particularly before each meal. Teach your child to cover his or her mouth when coughing and to use a tissue when sneezing. Make sure all family toothbrushes are separated in the bathroom. Designate a special place for your child's toothbrush so that  he or she can return it to its place.   

Keep eustachian tubes open. Parents can inadvertently add to the risk of ear infection by allowing an infant to fall asleep with a bottle in his or her mouth. The fluid may irritate the throat and cause swelling, which can block the eustachian tube, creating a breeding ground for infection.

Leave the ears alone. Otitis media occurs in the middle ear, not the outer ear, where wax is found. That means that all the poking in the world to get wax out of your child's ears is not going to prevent an infection. In fact, it's more likely to hurt your child and may lead to otitis externae - an infection of the outer ear. Wax in the ear usually isn't something to worry about. If you see wax or other fluid oozing from your child's ear, wipe it gently with a soft cloth, 

Be on the lookout for symptoms of ear infection if your child has a cold. When infants or young children pull or tug at their ears, it may be a sign of pain, especially if the child is irritable. If you suspect an infection, here's what you should do: Take your child's temperature to check for fever. Look into the ear to see if there is a discharge; this could be a sign of a ruptured eardrum. Check to see if your child has diarrhea. Call a physician if you think your child has an ear infection. It's best to call within 24 hours of the initial pain. Delay may only mean more pain and postponed treatment for your child. Undiagnosed and untreated infections can cause permanent ear damage.   

Confirmation of infection is a fairly straightforward process. A doctor will look inside your child's ear with a lighted instrument called an otoscope. If the eardrum is red and bulging, an infection is present. Your doctor will likely prescribe antibiotics to clear the infection. Be sure your child takes the entire prescription, even after the symptoms have gone. If your child has chronic infections, your doctor may prescribe continuous low-dose antibiotics for up to three months. The insertion of ventilation tubes by an otolaryngologist may also be recommended if your child has developed serous otitis media, or fluid in the middle ear. Ventilation tubes are tiny plastic tubes that are surgically inserted into the eardrum by an ear, nose and throat specialist. The tubes equalize the pressure between the middle ear and outer ear, reducing the formation of fluid in the middle ear.
  
To relieve pain and fever, you can give your child acetaminophen. Ask the doctor about dosage and frequency. You can also soothe pain by placing a hot-water bottle covered with a towel next to your child's ear. Topical anesthetic eardrops, available over the counter, can reduce pain, although these are not always recommended because they can make it difficult to diagnose a perforated eardrum and because they can be so effective at masking the pain that they may keep parents from seeking the proper treatment for a child. You should never use eardrops if there is drainage from the ear. If there is no drainage, it is probably OK to use over-the-counter eardrops to help your child sleep before the next day's doctor's appointment or after your child has been diagnosed and prescribed treatment has begun. Your child may have some temporary hearing loss because infections can interfere with the passage of sound waves through the eardrum. In most cases, your child's hearing will return to normal after the infection has cleared. If you notice that the hearing loss remains, then an evaluation is required by an ear, nose and throat specialist physician, who can check your child's hearing and recommend other treatments if necessary. You may want your child to take it easy and rest until the pain and fever have subsided, but once the fever is gone, your child should be able to resume normal activity.   

Your child's ear infections may try your patience, but their incidence will decrease with time. By your child's eighth year, the ear will have grown along with the body, self-correcting the anatomical problems that may have invited the infections in the first place. The key is to be aware of your child's symptoms so the problem can be diagnosed and dealt with before permanent scarring can occur in the ears. That way little ears will never have big problems !

An otolaryngologist is a specialist of the ear, nose and throat (ENT) concerned with the medical and surgical treatment of the ears, nose, throat and related structures of the head and neck.  The specialty encompasses ear disease evaluation and surgery as well as cosmetic facial reconstruction, surgery of benign and malignant tumors of the head and neck, management of patients with balance, endoscopic examination of air and food passages, and treatment of allergic, sinus, laryngeal, thyroid and esophageal disorders. To qualify for the American Board of Otolaryngology certification examination, a physician must complete five or more years of post.- M.D. specialty training. To be board certified by the American Board of Otolaryngology the otolaryngologist must pass a rigorous series of exams documenting excellence in knowledge and decision making in the field of otolaryngology.  Dr. Culberson was board certified by the American Board of Otolaryngology in 1990.