The doctors at Northeast Atlanta Ear Nose & Throat in Lawrenceville and Johns Creek/Suwanee believe in providing optimal treatment to our patients, including children.
That is why we choose to complete every pediatric surgery at the Children’s Healthcare of Atlanta. This hospital has been named as one of the top pediatric hospitals in the entire country. They truly serve as a role model for all other pediatric hospitals in the United States.
Specialized care and treatment are provided by the caring doctors and nurses at Children’s Healthcare of Atlanta. They realize and understand that specialized support and equipment are needed to properly care for children. We prefer Children’s Healthcare of Atlanta over all others because we know they are committed to keeping young patients safe, while openly communicating with all family members and caregivers involved.
Your child’s health will surely be in excellent, caring hands.
Common Childhood ENT Problems
At some point in time, children get sick— that is inevitable. However, when it comes to ENT problems, there are two pediatric ENT illnesses that are commonly diagnosed and treated: pediatric tonsillitis and pediatric sinusitis. We will explore both.
What is Pediatric Tonsillitis?
The pharyngeal tonsils are the glands at the back of the throat which you can visibly see when you open your mouth. If these glands become inflamed, then tonsillitis is usually diagnosed.
However, other areas in the back of the throat might also become inflamed if someone has tonsillitis. Other areas include the adenoids and the lingual tonsils (the tonsil tissue at the back of the tongue).
A patient can experience any of the variations of tonsillitis, including:
When seeing your ENT doctor, he or she will evaluate your child’s health history to identify which type of tonsillitis is present.
What Causes Pediatric Tonsillitis?
Oftentimes, when a child is diagnosed with tonsillitis, there may be several causes. A few of the most common reasons for pediatric tonsillitis include:
More specifically, tonsillitis can be caused by bacteria called streptococcus species. Furthermore, acute pharyngitis and acute tonsillitis are most commonly caused by:
Streptococcus pyogenes (GABHS)— causes most bacterial tonsillitis in children 5-15 years old (i.e. “strep throat”)
herpes simplex virus
Epstein-Barr virus (EBV)— There is a possibility of infectious mononucleosis due to EBV in an adolescent or younger child with acute tonsillitis (particularly when cervical, axillary, and/or groin nodes are tender)
the measles virus
As a matter of fact, bacteria causes approximately 15-30% of pharyngotonsillitis cases.
Just about all children within the United States experience tonsillitis at least one time throughout their childhood. However, the medical industry keeps improving its’ medications, diagnoses, and treatment options (medical and surgical treatments). That is precisely why major tonsillitis complications (like mortality) are rare.
At What Age Can Kids Get Diagnosed with Tonsillitis?
Tonsillitis can occur in children who are older than two years old. It is very rare for children who are younger than two to get tonsillitis.
The Streptococcus species bacteria oftentimes occurs in children of ages 5 through 15, while viral tonsillitis is more common in children younger than 5.
Peritonsillar abscess can be found in young adults, but can sometimes occur in children, as well.
What Symptoms are Associated with Tonsillitis?
Symptoms differ depending on which type of tonsillitis you have.
Symptoms of acute tonsillitis:
difficulty swallowing (called dysphagia)
tender cervical lymph nodes
painful swallowing (called odynophagia)
Furthermore, if a patient experiences airway obstruction (because of swollen tonsils), he or she may also experience sleep apnea (including snoring, mouth breathing, or nocturnal breathing pauses). If this is the case, malaise and lethargy are commonly experienced. These type of symptoms usually dissipate in 3-4 days (with some symptoms lasting up to 2 weeks despite therapy).
Symptoms of chronic tonsillitis:
persistent, tender cervical nodes
Symptoms of peritonsillar abscess:
severe throat pain
pain near the ear regions
unilateral bulging near the tonsils (above the tonsils and to the side of the tonsils)
difficulty opening the mouth (called trismus)
muffled voice quality (“hot potato” voice— as if speaking with a hot potato in his or her mouth) (this voice change is more severe in patients with peritonsillar abscess)
What to Expect During the Office Visit with an ENT Doctor
When your child comes in for an appointment, a general ear, nose, and throat examination will be conducted. In addition, the ENT doctor will review his or her health history, as well as conducting a physical examination.
If a child has tonsillitis, the ENT doctor might find the following during a physical exam:
symptoms of fever
enlarged and inflamed tonsils (commonly covered by pus)
signs of dehydration (found through examination of the skin and mucosa)
red, swollen tonsils with small ulcers on the surface (commonly found in patients who have herpes simplex virus—HSV— tonsillitis)
enlarged neck nodes
a fine, red rash over the body (may suggest scarlet fever)
the presence of palatal petechiae (tiny hemorrhagic spots the size of a pinpoint to a pinhead size on the soft palate) (typically found in patients with Group A beta-hemolytic Streptococcus pyogenes–GABHS)
tender cervical lymph nodes
a grey membrane which covers the inflamed tonsils from an EBV infection— the membrane can be removed without bleeding
Based on the symptoms, health history, and the underlying causes, the ENT physician will determine which treatment method is best.
Treatment Options for Pediatric Tonsillitis
Antibiotics are the typical treatment option to get rid of tonsillitis. It is also very important to replace fluids and to minimize the patient’s pain. In very severe cases of tonsillitis, hospitalization may be needed, particularly if airway obstruction is apparent.
If a child repeatedly gets diagnosed with tonsillitis (recurrent tonsillitis), then the ENT doctor might recommend surgically removing the tonsils.
For patients suffering from a peritonsillar abscess, he or she may need more urgent treatment to drain the abscess.
What is Pediatric Sinusitis?
The maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present at birth, even though they are very small. Your son or daughter’s sinuses do not fully develop until they are in their late teenage years.
Throughout the first several years of childhood, children are prone to infections of the ears, nose, and sinus. The infections are commonly caused by viral infections (the common cold).
However, the infections may be aggravated and symptoms exacerbated by allergies. If you notice that your child continues to remain sick beyond 10 days, a sinus infection may be the culprit.
Reducing the risk of sinus infections (sinusitis) is a common goal for caregivers and parents. You can reduce their risk by:
reducing their exposure to known environmental allergies
reducing their exposure to known environmental pollutants (tobacco smoke, etc)
reducing the amount of time, if any, he or she spends at daycare
treating stomach acid reflux disease right away, if present
It is important to remember that pediatric sinusitis is different than sinusitis in adults.
It is very important for your pediatric ENT doctor to thoroughly evaluate your child’s symptoms. Pediatric sinusitis is often difficult to diagnose in children because symptoms can be caused by other common problems, such as allergies or viral illness.
How to Determine if Your Child Has Sinusitis: What are the Symptoms?
If your child has a sinus infection, he or she may experience the following symptoms:
a cold which lasts longer than 10-14 days
a cold accompanied by a low-grade fever
thick, yellow-green nasal drainage
headache (usually occurs in children of ages 6 or older)
post-nasal drip (this can sometimes lead to or be exhibited by a sore throat, cough, nausea, bad breath, and/or vomiting)
fatigue or low energy
swelling near the eyes
If your child suffers from one or more symptoms of sinusitis for at least 12 weeks, then he or she might have chronic sinusitis (recurrent episodes of acute sinusitis).
If your child gets a sinus infection more than 4-6 times per year, this is an indication that you should seek help from a pediatric ENT doctor (an otolaryngologist).
When your child comes in for his or her appointment, our ENT doctors will examine the ears, nose, and throat. In addition, we will review his or her symptoms and health history. Oftentimes we need to use special instruments to look inside of the nose. At times we may need to order a CT Scan to determine how developed your child’s sinuses are, confirm the diagnosis, and/or determine where any nasal blockage is occurring.
Your ENT doctor can also evaluate certain factors that make your child more susceptible to pediatric sinusitis.
Such factors include:
immune system problems
Proper evaluation and testing lead to an accurate diagnosis so we can provide effective treatment.
Treatment Options for Pediatric Sinusitis
Treatment options for pediatric sinusitis differ. Treatment for acute sinusitis differs from treatment for chronic sinusitis. We’ll outline both.
Treatment for acute sinusitis:
antibiotic therapy (most children respond very well to this therapy)
nasal decongestant sprays or saline nasal sprays (provides short-term relief of nose stuffiness)
nasal saline (saltwater) drops or gentle sprays (helps thin out secretions and improves mucous membrane function)
For pediatric acute sinusitis, symptoms should improve within the first few days of starting treatment. Even if the symptoms fade away, it is very important to complete the entire antibiotic treatment, as prescribed by your ENT physician.
If for some reason your child’s allergies or other conditions make the sinus infection worse, he or she will decide a different course of treatment (i.e. different medications, etc).
It is important to note that over-the-counter antihistamines and decongestants are generally NOT effective in treating viral upper respiratory infections in children. The role of these two medications are not well defined in the treatment for pediatric sinusitis either. These two medications should NOT be given to children who are younger than 2 years old.
Treatment for chronic sinusitis:
medical treatment of the sinuses
surgical treatment of the sinuses
Is Surgery Necessary to Treat Sinusitis?
Surgery is needed for only a small percentage of children who are diagnosed with severe or chronic sinusitis (despite medical therapy). If medical therapy fails for some reason, surgical therapy is a safe and effective way to treat sinus disease in children.
If surgery is needed, the ENT doctor will use an endoscope to open the natural drainage pathway of the sinuses. He or she may also make the narrow passages wider. This process allows for culturing, which means that antibiotics can be directed to the specific areas. This procedure (of opening the sinuses and permitting air to circulate) results in a reduction in the frequency and the severity of sinus infections in kids.
There are times when an ENT doctor may recommend removing the adenoid tissue (located behind the nose). If the adenoid tissue becomes infected (called adenoiditis), it can cause many of the symptoms that are similar to sinusitis— bad breath, cough, headache, stuffy nose, runny nose, and post-nasal drip.
What Should You do if Your Child has Pediatric Tonsillitis or Pediatric Sinusitis?
If you notice that your child is suffering from the symptoms talked about in this article, seek help right away before symptoms get worse. Call either of our ENT offices in Johns Creek/Suwanee, GA or Lawrenceville, GA. We will schedule an appointment so your child can receive proper treatment and start feeling better in no time.