Healthcare can be confusing and especially so if you are trying to decide how to handle taking care of a sick child or yourself. Do you go to the doctor or wait it out at home?
We sat down with Dr. Michael Kubala, an ENT in Plano and a Dad of two young boys to get some guidance for our readers.
I know you put in ear tubes and take out tonsils in children, but what else do you do?
I see patients of all ages with a wide variety of both medical and surgical issues related to the ears, nose, sinuses, mouth, throat, and neck.
- ear infections
- ruptured ear drums
- hearing loss
- sinus infections
- difficulty breathing
- snoring/sleep apnea
- disorders of the salivary glands
- difficulty swallowing
- thyroid disorders and cancer
- parathyroid disorders
- skin cancers
- mouth/throat cancers.
This is one of the things I love most about my job. I can see patients of all ages with a diversity of interesting conditions.
My child has been getting a lot of ear infections recently. When should we consider getting ear tubes placed?
Although there is no consensus statement about an exact number of ear infections, most ENT’s follow the recommendation of at least 3 ear infections in 6 months or 4 ear infections in 12 months, treated with antibiotics. Ear tubes are also recommended for children that have fluid behind the eardrum for more than 3 months, since this can affect hearing and speech development.
Can my child go swimming or fly on an airplane with ear tubes?
Yes, to both of these. It is the current recommendations from the American Academy of Otolaryngology to not encourage the use of earplugs, headbands, or avoidance of water in children with ear tubes. I recommend earplugs for children with ear tubes only if they plan on submerging underwater more than three feet or if they specifically have pain with water exposure. In reference to flying, children with ear tubes do not experience the popping normally felt on take-off and landing, as the tubes provide a constant equalization of air pressure during this time. Most children with ear tubes do very well with flying.
What is the purpose of my tonsils and adenoids?
The tonsils and adenoids are part of the immune system’s defense against bacteria in the nose and throat. They collect bacteria and debris and present them to the immune system in order for the body to recognize injections and produce antibodies. The function is most active during childhood and declines with age. Several studies have looked at the immune functions of children following tonsillectomy and adenoidectomy. These studies show no compromise of the immune system or increase in the risk of developing immunomodulated diseases.
My child seems to make a lot of earwax. What is the best way to clean earwax at home?
Earwax (cerumen) is a normal part of the human body and has many useful roles. It has antibacterial and antifungal properties to protect from ear infections. It is a moisturizer to prevent drying and cracking of the ear canal skin. Cerumen also helps keep the ear canal free of dead skin and debris. Cerumen naturally moves from the inside of the ear canal to the opening of the ear canal and can be removed with a moist washcloth or tissue, easily done after a bath or shower. Some people may be prone to cerumen buildup caused by a narrow ear canal, overproduction of cerumen, skin conditions, or excess hair in the canal. A couple of drops from home remedies such as extra virgin olive oil or mineral oil can help loosen cerumen. Hydrogen peroxide or carbamide peroxide can also be used if there is not a hole in the eardrum. The most important thing to remember is to never stick an object into the ear canal to dig the cerumen out. This can push the cerumen further down the ear canal, causing an impaction or damage to the eardrum or ear bones.
How do I know if my child’s constant runny nose is a sign of allergies or something else?
This is a difficult diagnosis to make in children because the symptoms are very similar for allergies, adenoid hypertrophy, recurrent viral infections, and chronic sinusitis. These symptoms include nasal congestion, runny nose, postnasal drip, and cough. Allergies are commonly treated with over the counter antihistamines, nasal saline sprays, or nasal steroid sprays.
If the symptoms persist with continued treatment, further investigation should be done with a nasal endoscopy (scope of the nose), x-ray, or CT scan to rule out enlarged adenoids or a chronic sinusitis.
I have ringing in my ears. Is this common?
Tinnitus, or the perception of sound in the absence of an external source, is a common symptom experienced by many Americans. According to a research study published in 2010 from the Massachusetts Eye and Ear Infirmary, approximately 50 million adults in the United States report having any tinnitus, and 16 million adults reported having frequent tinnitus in the past year.
Frequent tinnitus is more common in older adults, non-Hispanic whites, former smokers, people with high blood pressure, hearing impairment, loud noise exposure, and generalized anxiety disorders. It is a good idea to have this checked by an ENT since tinnitus has many different causes, but for the majority of people, it is a benign condition.
I’m suffering from dizziness, but I don’t think I have any problems with my hearing.
Why am I scheduled to have a hearing test?
Many conditions that cause dizziness or vertigo can also affect hearing, even if it is not overtly noticeable. This is because the vestibular nerve, which receives input from the vestibular (balance) organs, is intimately associated with the cochlear nerve, which is the nerve responsible for hearing.
Therefore, any condition affecting one of these nerves can affect the other nerve at the same time. A hearing test can detect a dysfunction with the cochlear nerve and help the physician find the cause of the dizziness.
I have heard that nasal sprays are addictive. Is this true?
The condition people are referring to is called rhinitis medicamentosa. This happens only with one type of nasal spray called topical decongestants, which include oxymetazolone (Afrin, Sinex) and phenylephrine (4Way, Neo-Synephein). Patients initially use these sprays to help with nasal congestion, but after a prolonged period of use, a vicious cycle begins.
Once the medication wears off, the nasal lining will actually become more swollen and congested than before, which is then temporarily relieved by the same medication. This will lead to a perceived dependency on the medication to be able to breath through the nose. The best way to prevent this is to limit the use of topical decongestants to less than 3 days. No other nasal spray has been shown to cause this problem.
What are the best ways to prevent ear infections over the summer?
Acute otitis externa, also known as swimmer’s ear or an outer ear infection, is a common infection of the ear canal often caused by excess moisture during the summertime after a trip to the pool, lake, or beach.
Symptoms of this infection include ear pain, itchiness, drainage from the ear, a clogged feeling in the ear, decreased hearing, redness or swelling around the ear, and swollen lymph nodes around the neck.
You can take a few simple precautions to avoid this painful infection and a trip to the doctor:
· Avoid inserting anything into the ear canal – Items like fingers, cotton swabs, bobby pins, or other foreign objects can cause scratches or cuts of the ear canal skin leading to infection.
· Allow the ear to use its natural self-cleaning and self-drying function – Ear wax is a natural protective barrier to bacterial invasion.
· Avoid swimming in polluted or unknown bodies of water – Bacteria in the watercoupled with excess water in the ear is the perfect combination for bacteria to grow.
· Plug them up – Wear disposable earplugs for swimming in untreated (lake and ocean) water.
· Dry them out – When done swimming use a towel to dry the ears. You can also use a small ear dryer if you are prone to excessive water buildup. Use of acetic acid (vinegar) or alcohol drops can also help dry the ear.
Luckily, swimmer’s ear is a treatable condition, which typically clears up with a 7-10 day course of eardrop antibiotics.
If you think your kiddo may be suffering from an ear infection, contact Dr. Kubala to schedule an evaluation.
Dr. Kubala is on the medical staff of Texas Health Center for Diagnostics and Surgery in Plano. If you would like to schedule an appointment with him please call 972-543-1250.
You can also find out more about his practice here
Disclaimer: any medical advice given here is being offered by Dr Kubala, who is a licensed Medical Professional. Plano Moms takes no responsibility for the advice being given here.