Pediatric ENT Services in Savannah, GA
The surgical placement of ear tubes is the most common childhood surgery performed, with the average age range from one to three years old. This procedure can also be used with adults.
Chronic ear infections (acute otitis media) of the middle ear or the persistent presence of fluid in the middle ear (otitis media with effusion) can lead to other conditions such as:
- hearing loss
- balance problems
- behavioral or speech problems
To help alleviate these problems, an otolaryngologist (an ear, nose and throat surgeon) may recommend the insertion of ear tubes.
Less common conditions that can call for ear tubes include:
- anatomical malformations of the eardrum or Eustachian tube
- Down Syndrome
- cleft palate
- injuries to the middle ear resulting from air pressure reductions sometimes caused by altitude changes and scuba diving
A tympanostomy is an outpatient surgical procedure to place ear tubes (myringotomy tubes) through the eardrums. These small cylinders are fabricated from plastic, metal, or Teflon and are inserted though a small incision in the eardrum under general anesthesia to ventilate and provide pressure equalization to the middle ear. Where fluid is present it is suctioned out. Frequently a surgical microscope or laser will be used to perform the surgery.
Typically a procedure will last less than 15 minutes. Occasionally, the otolaryngologist may also recommend the removal of the adenoids that are located behind the nose at the same time ear tube surgery is being performed. This is often considered when it is necessary to repeat tube insertions. Research supports that the removal of the adenoids together with placement of the ear tubes can reduce the risk of recurrent ear infections and the need for repeat surgery.
Depending upon a child’s need, short term tubes or longer-term tubes can be used.
- Short-term tubes are smaller and can remain in place for six to twelve months.
- Long-term tubes are larger and remain in place for a longer duration.
While the tubes can fall out on their own, removal by an otolaryngologist during an office visit is sometimes necessary.
A tonsillectomy and an adenoidectomy are surgical procedures to remove tonsils and adenoids. Occasionally, tonsils can become inflamed or infected. Adenoids can also become inflamed or infected as well as becoming enlarged. If symptoms are severe enough or occur with great frequency, a tonsillectomy will be performed to remove the tonsils and an adenoidectomy will be done to remove the adenoids.
Treatment for Tonsillitis and Adenoiditis
Your physician can decide upon the best treatment based upon age, overall health, medical history, type of infection and a child’s tolerance for medication or therapies. Treatment also depends upon the severity of the infection and the frequency with which the child develops infections. While antibiotics can help, a physician may refer you to an Ear, Nose and Throat surgeon to have the tonsils and adenoids removed.
Conditions indicating a Tonsillectomy and Adenoidectomy include:
- Sleep apnea, or periods during sleep when someone stops breathing
- Difficulty swallowing
- Tumor in the throat or nasal passage
- Bleeding from tonsils
- Nasal passage blockages and uncomfortable breathing
- Severe sore throats in one year
- Five sore throats in each of two years
- Three sore throats in each of three years
- Sore throats with fever above 101º F, discharge on the tonsils, positive strep throat culture.
Additional and controversial symptoms indicating tonsil and adenoid removal include:
- Considerable snoring
- Frequent throat infections or abscesses
- Frequent ear infections
- Varying degrees of hearing loss
- Sinus infections
- Ongoing mouth breathing
- Frequent colds
- Bad breath
In all cases, a physician should be consulted for proper diagnosis and treatment.
Surgery and Recovery
Tonsillectomies and Adenoidectomies are generally performed on an outpatient basis and most patients can go home on the same day as the surgery. Since the surgery requires a general anesthesia, the patient will be anesthetized in the operating room where the surgeon will then remove the tonsils and adenoids through the mouth.
Recovery begins in the recovery room where the patient is closely monitored. Once he or she is doing well, they will be released to fully recover at home. Most physicians will prescribe pain medication, increased fluid intake and no rough activities for a specified length of time.
A tongue tie is a condition that restricts the tongue’s range of motion. Present at birth, a tongue tie can cause difficulty breastfeeding and can also affect the way a child speaks or swallows later on in life. Our physicians are qualified to diagnose and treat tongue ties. A simple surgical procedure, called a frenotomy, can be done right in our office. The procedure is quick and with minimal discomfort since there are few nerve endings or blood vessels in the lingual frenulum.
Foreign bodies in the ear, nose, and airway sometimes occur in children. A foreign body is considered any object in the ears, nose, or mouth that is not supposed to be there and requires medical attention. Our physicians can typically remove foreign bodies in the comfort of our office. We will also provide an exam and any follow up instructions as needed.
There are multiple reasons a child might need additional hearing tests. If a child failed a previous test, or requires further testing for a speech evaluation, a visit to an audiologist is typically recommended. Our audiologist, Karla McKenzie, can perform hearing tests for children of all ages.