Tonsils & Adenoids
Tonsils are glands at the back of your throat that help protect against infections. But children with large tonsils may have problems breathing at night. The tonsils may also trap excess bacteria which can lead to frequent or very painful sore throats. In either of these cases, the child’s tonsils have become more harmful than protective and are often removed, along with the adenoid glands.
How Does Tonsillectomy work?
The surgery is done under general anesthesia, with your child asleep, comfortable and pain-free. The surgeon places a small tool into your child’s mouth to hold it open, then cuts and cauterizes the tonsils. The wounds heal naturally without stitches. After surgery, your child stays in the recovery room until he or she is awake and can breathe easily, cough, and swallow. Most children go home within a few hours after this surgery.
When to consider Tonsillectomy
- Your child has infections often (7 or more times in 1 year, or 5 or more times over 2 years).
- Your child misses a lot of school.
- Your child has trouble breathing and does not sleep well because the tonsils block the airway (sleep apnea).
- Your child has an abscess or a growth on the tonsils.
Ear Infections & Tubes
Ear infections are one of the most common infections in young children. It affects almost all children in the first two years of life, but some children are prone to multiple infections. While some ear infections may resolve after a short time, others may require the use of medication. Over time, these infections can even become less responsive to antibiotic medication, and in rare cases, can cause long-term damage that may result in hearing loss or neurologic problems and may contribute to speech or developmental delay.
Symptoms of Ear Infections
- pulling or rubbing the ears because of ear pain
- fussiness or irritability
- fluid leaking from the ear
- changes in appetite or sleeping patterns
- trouble hearing
Treating Ear Infections
Treatment of ear infections is typically achieved with antibiotics and over the counter pain medications for discomfort. While ear tube surgery is very commonplace, it is not the first choice of treatment for ear infections. Call your pediatrician if you suspect your child has an ear infection.
For children who suffer multiple ear infections, ear tubes may be recommended. This is a very common surgical procedure that only takes a few minutes. While recovery time varies, most children spend only a few hours in recovery before being allowed to go home.
How Ear Tubes Work
Ear Tubes are tiny tiny plastic or metal tubes that are placed in a small incision in the ear drum. These tubes help to eliminate a vaccum that is formed in the middle ear. Ear tubes allow air to circulate in the middle ear, effectively lowering the risk of infection. The tubes also act as a drain, allowing any pus from infections that do enter the ear to evacuate painlessly, and allowing parents and doctors to administer medication directly into the site of infection.
Because the incision is done in the ear, there is no visible scarring. Surgery is not generally needed to remove the tubes. In most cases, the tubes will fall out on their own, typically 6-18 months after the surgery.
Tongue-tie is the non-medical name for a relatively common physical condition called ankyloglossia, that limits the use of the tongue. The frenulum, a cord of tissue under the tongue, guides development of mouth structures pre-birth and continues to guide tooth development after birth. As we grow, it normally recedes and thins. In some children however, the frenulum is especially tight or fails to recede and may cause tongue mobility problems.
The tongue is one of the most important muscles for speech and swallowing. For this reason having tongue-tie can lead to eating or speech problems, which may be serious in some individuals.
A new baby with a too tight frenulum can have trouble sucking and may have poor weight gain. Such feeding problems should be discussed with your childs pediatrician who may refer you to an otolaryngologisthead and neck surgeon (ear, nose, and throat specialist) for additional treatment.
NOTE: Tongue tie can be an underlying cause of feeding problems that not only affects a childs weight gain, but leads many mothers to abandon breast feeding altogether.
For Toddlers and Older Children
While the tongue is remarkably able to compensate and many children have no speech impediments due to tongue-tie, others may. Around the age of three, speech problems, especially articulation of the sounds – l, r, t, d, n, th, sh, and z may be noticeable. Evaluation may be needed if more than half of a threeyearold childs speech is not understood outside of the family circle. Although, there is no obvious way to tell in infancy which children with ankyloglossia will have speech difficulties later, the following associated characteristics are common:
- V-shaped notch at the tip of the tongue
- Inability to stick out the tongue past the upper gums
- Inability to touch the roof of the mouth
- Difficulty moving the tongue from side to side
As a simple test, caregivers or parents might ask themselves if the child can lick an ice cream cone or lollipop without much difficulty. If the answer is no, they cannot, then it may be time to consult a physician.
Appearance can be affected by persistent dental problems such as a gap between the bottom two front teeth. Your childs physician can guide you in the diagnosis and treatment of tongue-tie. If he/she recommends surgery, an otolaryngologisthead and neck surgeon (ear, nose, and throat specialist), can perform a surgical procedure called a frenulectomy.
How Tongue Tie Surgery Works
Tongue-tie surgery is a simple procedure and there are normally no complications. For very young infants (less than six-weeks-old), it may be done in the office. General anesthesia may be recommended when frenulectomy is performed on older children. But in some cases, it can be done in the physicians office under local anesthesia. While frenulectomy is relatively simple, it can yield big results. Parents should consider that this surgery often yields more benefit than is obvious by restoring ease of speech and self-esteem.