Ask the Expert: Ear, Nose and Throat Issues That Can Affect School-Aged Children

Posted by Jodi McCaffrey on Sep 8, 2022 7:00:00 AM
5 minute read

September can be an exciting time for many families as kids head back to class and parents return to a more traditional work schedule. But, unfortunately, back to school often means back to the pediatrician.

“The cold and flu season typically starts in September, when children who have been home all summer start interacting again and sharing germs,” explained Wasyl Szeremeta, M.D., a pediatric otolaryngologist with Pediatrix® ENT of Houston. We sat down with Dr. Szeremeta to learn what parents need to know about seasonal illnesses of the ear, nose and throat.

Q: What is an otolaryngologist?

A: An otolaryngologist is an ear, nose and throat (ENT) specialist. We’re the surgical specialty that specializes in how we interact with our world through some of our senses. For example, being able to hear properly and sleep well helps children be productive at school and even enjoy the experience. ENT specialists diagnose and treat everything from hearing issues and obstructive sleep apnea to croup and speech and swallowing disorders.

Q: What are the differences in symptoms for a cold, the flu, sinus infection and COVID?

A: In younger kids, it’s hard to distinguish between these illnesses because they all share similar symptoms. However, viral sinus infections produce fever, pus and yellow or green mucus. With COVID-19, your child may only experience mild symptoms or may have no symptoms at all. Worrisome signs of a COVID-19 infection are shortness of breath and low oxygen saturation.

Q: What should I do if my child has symptoms of a viral sinus infection?

A: I recommend seeing if symptoms improve for the next week to 10 days. If your child still has a fever and pus draining from the nose after 10 days, he or she may have a bacterial infection, not a virus. In that case, call your health care provider to see if he or she recommends a course of antibiotics to fight the infection.

Q: What are the symptoms of an ear infection?

A: Ear infections typically affect children from 10 months of age to about age 6. This is because most infants benefit from immunity passed on from mom for about 10 months, and then protection begins to wane. However, around age 6, the eustachian tubes in the ears move into their adult positions, which allows the middle ear to drain properly.

Symptoms of an ear infection include fever, irritability and changes in hearing ability. Younger children may have difficulty sleeping or balance issues as well. Despite common belief, tugging on the ears without other symptoms, such as fever or irritability, is not a true sign of infection.

Q: Will my child need ear tubes if he has frequent infections?

A: Placement of ear tubes is the second-most common surgery in children. While most kids will outgrow the risk of ear infections by age 6, tubes can help the ears drain properly. If your child develops ear infections frequently, he or she should see an ENT specialist. In general, surgery may be necessary if your child has experienced three infections in six months or six infections in a year.

Q: What should I do if I suspect that my child has hearing issues?

A: Kids get hearing screens as part of their annual school physicals, but these screenings may not be accurate. Fluid in the ears, not getting enough sleep, seasonal allergies and nasal congestion can all impact the ability to hear properly.

Signs of hearing loss in school-aged children include missing the beginning of sentences, being easily distracted or looking bored. Teachers usually notice a change in a child’s behavior first.

If you think your child has a hearing issue, ask that he or she be moved to the front of the classroom and have his or her hearing formally checked by an audiologist in conjunction with a complete ENT exam. Your child’s pediatrician can refer you to an ENT specialist for more formalized hearing testing in a soundproof booth.

Q: How do I know if my child has strep throat? How do I know it’s not just a typical cold?

A: Typically, strep throat causes a fever and may cause a burning sensation in the throat. The tonsils may be bright red with white pus pockets. Your child’s doctor will need to perform a throat swab or blood test to determine if it’s strep throat. If the test comes back positive for strep, your pediatrician or ENT specialist will prescribe antibiotics. If the sore throat is caused by something else, drinking clear fluids and hot tea and taking Tylenol or Motrin can help.

Q: Will my child need to have her tonsils removed if she develops throat infections frequently?

A: Tonsillectomies are the third-most common surgery for children in the United States. While this was very popular in the 1950s, the criteria for surgery have been refined since then. Your child’s doctor may recommend a tonsillectomy if they are causing an obstruction or if your child has seven sore throats in a year. The symptoms of an obstruction include snoring, sleep apnea, mouth breathing, bedwetting, difficulty paying attention and poor school performance. Removing the tonsils and adenoids cures the condition in 90% of cases. I recommend talking with your child’s provider to weigh the benefits of surgery against the risks. If your child is missing a lot of school due to illness, surgery may be the best course of action.

Last thoughts …

Yes, COVID-19 is still out there, but so are several other viruses and flus, and kids get them all. Remind your child to wash his or her hands often and wear a mask or stay home from school if they aren’t feeling well.

Topics: Pediatric, COVID-19