Cache Valley ENT


Pediatric Services

The physicians at Cache Valley Ear, Nose, and Throat, treat the spectrum of common pediatric head and neck disorders. These include tonsil and adenoid problems, chronic ear disease, congenital abnormalities of the ear, hearing loss, hoarseness, language disorders, otitis media and otitis externa (Swimmer's Ear) as well as other disorders such as neck lumps and masses. We also specialize in Pediatric Allergy and Asthma.  Each physician has spent years training in children’s hospitals to prepare to care for young patients with head and neck disorders. 

Tonsils and Tonsillitis

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The tonsils are located in the back of the throat. The tonsils are similar to lymph nodes in their structure and function.  The tonsils can become enlarged, obstructive, and chronically infected.  When this happens removal of diseased or enlarged tonsils can significantly improve an affected individuals health.   Removal of the tonsils has not led to an increase in infections or a loss of immune (disease fighting) function. This is because there are hundreds of other lymph nodes in the head and neck that perform the same function.

Tonsillitis is an infection of the tonsils. This infection usually involves the back of the throat as well (pharyngitis). Tonsillitis is uncommon in children less than one year of age. Tonsillitis is seen most frequently in children three to fifteen years of age.  At times, tonsillar infections can persist into adulthood. 

Both viruses and bacteria can cause tonsillitis. One cause of tonsillitis is the bacteria Streptococcus, otherwise known as "strep throat". Other bacteria can also cause tonsillitis,

Tonsillitis usually results in a sore throat and difficulty swallowing. The throat visibly looks inflamed (red). In younger children, refusal to eat may be noted. Fever, headache, earache, and enlarged and tender glands in the neck may also be experienced. Tonsillitis can be viral or bacterial.

Viral tonsillitis is primarily treated with bed rest, Tylenol for fever and pain relief, and lots of fluids. Antibiotics do not help treat this type of infection and this process will often run its course in 7-10 days. Streptococcal tonsillitis does require the use of antibiotics to help get rid of the infection quickly and prevent complications. Complications can include an infection in the bloodstream, heart problems, rash, and others.

Tonsillitis can become difficult to treat (chronic tonsillitis) or infections may recur frequently. This can result in fatigue, poor weight gain, poor school attendance and other problems.  Frequent sore throats and abdominal pain are common symptoms of chronic tonsillitis. 

The tonsils can become so enlarged (tonsillar hypertrophy) that your child may have difficulty breathing (especially at night) or difficulty swallowing. Enlarged tonsils can disrupt normal sleep and cause obstructive sleep apnea.  In children this can result in irritability, poor concentration, and behavior problems.  If your child snores heavily you should call your physician and be evaluated for this possibility.

Adenoids and Adenoiditis
The adenoid is a clump of tissue located at the back of the nose above the tonsils. In order to see them, your physician can look through your mouth and view the back of your nose using a mirror, or may choose to look with a flexible camera in the nose.  At times, the adenoid is visible through the nose. 

pediatric services - kidsAdenoid tissue is lymphatic tissue similar to tonsils and lymph nodes.  Adenoid can become chronically infected and cause sinus infections with congestion and chronic nasal discharge.  Adenoid infection and enlargement is also clearly associated with ear infections and can be a cause of chronic or recurring ear problems.  Nasal obstruction can result in crooked teeth and orthodontic problems. 

Adenoiditis is often treated with antibiotics taken by mouth. If antibiotics fail to get rid of the infection, the adenoid tissue may have to be removed.

In most children, the adenoid enlarges normally during early childhood, when infections of the nose and throat are most common. They usually shrink as the child gets older and disappear during puberty. In some children the adenoid is large and blocks the passage behind the nose. This can result in snoring, breathing through the mouth, and/or a hyponasal sound to the speech Additionally this can result in otitis media (middle ear infections) because of blockage of the eustachian tube (the tube that connects the ear to the throat).

Ear Infections & Otitis Externa and Otitis Media
Otitis refers to an infection of the ear. There are two types: Otitis externa (outer ear infection) and otitis media (middle ear infection).

Otitis Externa is an infection in the outer ear canal. Another name for this infection is "swimmer's ear", as this infection can be associated with exposure to water.  Some cases of otitis externa are not associated with swimming.  The symptoms include redness and swelling of the skin in the ear canal, significant pain of the ear canal and drainage. Treatment for this infection includes antibiotic or antifungal eardrops and possibly oral (by mouth) antibiotics. Preventive treatments can include rinsing the ears with water and white vinegar.

Otitis Media is also known as a middle ear infection (an infection in the space behind the ear drum). Otitis media is one of the most common pediatric infections. More than 90% of all children will have at least one infection by age 2.  Recurrent acute otitis media refers to repeated ear infections.  Chronic otitis media occurs when an infection persists for several weeks, or fluid behind the ear drum does not clear.   Ventilation tubes or ear tubes can be very helpful in the treatment of recurring and persistent otitis media. 

Ear infections can be caused by bacteria or viruses.  Risk factors for otitis media include day care, allergies, family history, and adenoid problems. 

Ear infections can be very painful. Commonly associated symptoms include pulling on the ears, increased irritability or behavioral changes, awakening at night, fever, decreased appetite, not wanting to lie flat or a loss of balance. You should contact your physician if your child is experiencing ear pain or if you suspect an infection. Some children have little or no discomfort, and ear infections in these children may be picked up only upon a physician visit or as part of an examination for another complaint.

Hearing Loss can affect young and old children alike.  We evaluate and treat the full spectrum of pediatric disorders ranging from newborn infants with failed hearing screening tests to adolescents with earwax problems.  Hearing loss is often treatable with ventilation tubes and other interventions. 

Chronic Ear Problems include issues such as persistent ear drainage and infection.  Other conditions can include perforations of the tympanic membrane (hole in the eardrum) or malformation of the hearing bones with associated hearing loss. 

Language Disorders are common in the pediatric population.  Some examples of language disorders include hoarseness due to vocal nodules, hyponasal speech, and speech delay due to hearing loss or ear infections. 

Neck Masses occur in children and can represent anything from benign lymph nodes to more serious problems.  Children are unique in this regard and present to the clinic with many possible causes for neck lumps or masses.  Only a careful history and physical exam by a trained head and neck surgeon combined with imaging studies such as ultrasound, can determine the likely diagnosis of pediatric neck masses or lumps. 

Allergic Disorders affect the pediatric population in unique and various ways.  Infants and toddlers commonly suffer from food allergies.  Food allergy symptoms include nasal congestion, nasal drainage, ear infections, abdominal pain and others.   Older children often suffer from inhalent allergies such as pollen or dust, although food allergies are possible in these age groups as well.  These allergic substances cause congestion of nasal membranes, and conjunctival (eye) membranes.   Chronic runny and stuffy nose problems are often caused by allergic reactions.   Treatment includes medications and allergy testing for exact diagnosis and treatment planning. 

Asthma is a common problem affecting children of all ages.  Asthma occurs in children when the small air passages in the lungs become hypersensitive to environmental substances, such as pollen, or dust.  Cold air or other mild irritants can also trigger asthma. Medications  play a key role in the management of pediatric asthma.  Allergy testing and treatment can also be very helpful in the care of pediatric patients with asthma.