On this page:

• Ear infections
• Tonsil problems
• Sinusitis
• Speech delay
• Neck lumps

See also:

• Hearing Center, Hearing Aids

 

 Pediatric Problems: Ear infections

Ear infections are the most frequent medical problem experienced by children who visit a physician for an illness. In addition to the earache, children may experience a hearing loss, speech delay, imbalance, irritability when lying down, fever and ear drainage.

Ear infections usually start with a viral infection that causes blockage of the Eustachian tube. This causes fluid to build up in the middle ear. If the fluid does not drain quickly, then repeated infections, hearing loss and balance problems may develop.

Our assessment of this problem involves examining the ears with an otoscope or small magnifying light, and assessing the degree of infection and size of the adenoids and tonsils. Two other tests are an audiogram evaluating the hearing and a tympanogram to measure the amount of Eustachian tube obstruction.

Infections left untreated may result in chronic or permanent problems.

 

Pediatric Problems: Tonsil problems

Tonsils and adenoids are lumps of tissue similar to lymph nodes or "glands" that we have in our neck, groin, or armpits. They are a part of our immune system. All children will have some infections in their tonsils or adenoids in their lives. Two main problems that can occur with this tissue are swelling, which can make breathing and eating difficult, and repeated infections. If they swell permanently and cause sleep apnea, surgery is often indicated. 

Generally recognized criteria for tonsillectomy due to repeated strep infections consist of four infections a year for three years, five a year for two years, or seven in one year. If surgery is necessary, it can be done safely on an outpatient basis. Your child will miss about one week of school following surgery. Chronic infections in the adenoids can also cause recurrent ear infections, and recent studies have indicated that an adenoidectomy can be very helpful in those situations. Allergies or intolerances to antibiotics may influence the exact number of infections required prior to surgery. The decision for surgery involves many factors, including the evaluation of the throat, the ears, lymph nodes in the neck, a history of allergies to antibiotics, or a peritonsillar abscess, and possibly the results of other tests such as x-rays and throat swabs.

Pediatric Problems: Sinusitis

Sinusitis can often affect children. Symptoms usually consist of yellow-green nasal discharge, discoloration or swelling under the eyes, nighttime cough, and generalized malaise. Sinusitis is often associated with an infection in the adenoids. It may also be associated with ear infections and allergies. Although the treatment of sinusitis in children is complex, it is a treatable problem.

Pediatric Problems: Speech delay

Your Baby's Hearing Checklist

Birth to 3 months:

• Quiets or diminishes activity when approached by sound (hears parent’s voice).
• Is startled by loud sounds (startle = blink, body jerk, cessation of sucking, sudden cry, etc.)

3 to 6 months:

• Turns head to search for source of a voice. 
• Enjoys rattles, noise-making toys. 
• Anticipates feeding by familiar sounds (bottles rattling, spoon in dish, etc.).

6 to 10 months:

• Reacts to music by cooing. 
• Responds to own name.
• Looks to right person when words "Mommy" and "Daddy" are said. 
• Shows understanding of common words such as "no," "all-gone," "bye," "nighty-night".
• Babbles (sounds like "da", "ba", "ma").

10 to 15 months:

• Knows names of favorite toys and can point to them when asked. 
• Likes rhymes and jingles. 
• Imitates simple words and sounds.

15 to 20 months:

• Can follow simple directions ("Go get your shoes, jacket."). 
• Recognizes hair, nose, eyes and other parts of body when named. 
• Asks for wants by naming "blanket," "cookie," or "teddy bear". 
• Speaks 10 to 20 words

20 to 24 months:

• Begins combining words such as "more juice," "Mommy home?" or "go bye-bye car". 
• Refers to self by name.
• Enjoys being read to. 
• Shows interest in sounds of radio, television and stereo.

24 to 3 yrs. of age:

At 24 months, speaks about 270 words with a very fast rate of increase in vocabulary each day. 
Wants to communicate to express needs and interests and tell experiences. 
Is frustrated if adults do not understand. 
By age three, vocabulary equals some 1000 words, about 80% of which should be intelligible even to strangers. It is not unusual for some sounds to be mispronounced (such as "th,"r", or "l")

Pediatric Problems: Neck lumps

There are many causes of neck lumps in children. Some may be quite normal and are due to swelling of lymph nodes or "glands" in response to an infection in the throat or sinuses. Swollen tender lymph nodes under the corner of the jaw will often occur with a strep throat. A swelling in the midline of the neck, especially above the voice box (Adam’s apple), can indicate the presence of a cyst which may be a developmental abnormality requiring surgery to remove.

Tumors are rare in children but can occur, and any suspicious neck lump needs to be assessed. An enlarging very tender neck lump may indicate an abscess needing urgent medical attention. If your child has neck lumps, you should seek the advice of either your primary care physician or one of our doctors to evaluate the problem.