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Is Your Child Ignoring You or Having Trouble at School?

August 27, 2013

These Can Be Signs of Hearing Loss and Other Ear, Nose, and Throat Problems

Does your child pay attention when you talk? Is he or she having trouble at school? Hearing loss and other ear, nose, and throat problems can show up in a number of ways that may not be obvious, including inattention, delayed speech, poor grades, and even hyperactivity.

"It's important to stay on top of these health issues," said Dr. Dale Amanda Tylor, a pediatric otolaryngologist with Washington Township Medical Foundation and a member of the medical staff at Washington Hospital. "Ear, nose, and throat problems are common in children, and they can have lasting effects on quality of life."

Chronic ear infections are one of the most common problems Dr. Tylor treats. According to the National Institutes of Health, three out of four children experience at least one ear infection before age 3.

When a child has frequent ear infections, especially when there is persistent fluid in the ear that is affecting their ability to hear, Dr. Tylor may place a tube inside the middle ear to prevent the accumulation of fluids and equalize the pressure inside the ear.

"Equalizing the pressure and ventilating the area with an ear tube reduces the need for oral antibiotics," she added. "With the fluid draining out, we can usually treat the infection with ear drops."

Dr. Tylor also performs a number of tonsillectomies and adenoidectomies. The tonsils and adenoids are part of the lymphatic system and are the first line of defense against germs that are breathed in through the mouth and nose.

The tonsils and adenoids can get infected, causing tonsillitis and adenoiditis. They can become inflamed and enlarged, making it difficult to breathe. If this happens too frequently or causes persistent breathing problems, it may be necessary to surgically remove them, she explained.

"Enlarged tonsils and adenoids can lead to sleep apnea, which occurs when breathing patterns disrupt sleep," Dr. Tylor added. "Lack of sleep in children looks different than you might think. When a child doesn't get a good night sleep, they can start bedwetting, become more cranky, and often can show signs of hyperactivity."

Another procedure she performs frequently is to correct tongue-tie in newborns. When babies can't stick out their tongues or lift their tongues properly, it makes breastfeeding difficult and sometimes impossible, causing many new mothers to turn to formula instead, according to Dr. Tylor. It can also cause speech problems in children later in life.

Technology Makes Diagnosis Easier

Advanced imaging technology has made it easier for otolaryngologists to get an accurate diagnosis of ear, nose, and throat disorders. Many of these ailments can be detected by inserting a tube with a camera on the tip through the nose and into the throat.

"Like many of the procedures we do, most of these diagnostic tests can be done in our clinic," Dr. Tylor added. "We can get a clear picture of the inside of the nose and throat, often avoiding the need to do a CT scan or even surgery to get a good view. The small fiber optics makes it possible for us to get our eyes on the problem area. Often we can show the results on a television screen in the clinic so parents can also see what's going on with their child."

This flexible scope is used to diagnose laryngomalacia, which creates a high-pitched squeaking noise when babies breathe. It can cause the airway to be partially blocked as well as feeding problems in some infants.

"It happens when the brain and nervous system are not fully developed," she explained. "Floppy tissue above the vocal cords falls into the airway when the child breathes in. It can be very distressing for parents, particularly because people often ask why their newborn is making a squeaking noise. Sometimes it can be observed with no treatment, but if it is moderate or severe, we can treat it with medication or rarely it might require surgery."

Hearing loss is another significant issue that Dr. Tylor regularly treats. There are several procedures she performs that can improve children's ability to hear, including cochlear implants.

"Hearing loss can have a serious impact on quality of life," she said. "We used to think as long as children could hear in one ear it was good enough. But now we know better. Kids miss a lot of sounds even if they only hear from one ear. In fact, children with hearing just in one ear have a 30 percent chance of failing a grade. It's hard to get instructions correctly when you can only hear part of what is being said. Often kids don't even know what they are missing."

Hearing aids and other types of amplification devices can help. There are also surgical procedures that can help children who are deaf in one ear hear stereo sound. For example, a titanium piece can be inserted into the skull bone next to the deaf ear. When sound occurs, it vibrates the skull bone so one ear is hearing from both sides, she explained.

Cochlear implants are for children with severe or profound hearing loss who aren't benefiting from hearing aids. The electronic device is surgically implanted and provides direct electrical stimulation to the auditory nerve in the inner ear.

"The procedure is most effective when done at an early age," Dr. Tylor said. "It allows children to develop language at an earlier age, which is critical. Kids who don't have any language skills by kindergarten have a very hard time catching up. That's why it's important for parents to make sure their newborns have their hearing tested and to be proactive about their child's hearing and speech development."

To learn about Washington Township Medical Foundation, visit www.mywtmf.com. For more about Washington Hospital, go to www.whhs.com.

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