Children with ear issues may present with symptoms of pain, smelly discharge or a swelling in or around the ear. On the other hand, children with hearing loss may not know that they are unable to hear. It is important to consult ENT to rule out any underlying congenital causes or if nasal or throat conditions are associated.
Otoscopy, microscopic examination under magnification and microscopic ear clearance are common procedures for ear conditions. Reassure your child that the procedure will not hurt and is quick. Age appropriate hearing test and nasal examination with nasal endoscopy are performed when necessary.
Ear Conditions
Ear Procedures
Book an Appointment
At Adult and Child ENT Specialists, We are committed on providing Effective, Personalised & Holistic Care for all patients.
Ear Conditions
Wax Impaction
Our ears are self-cleansing. Do not stick cotton buds or try to dig your child’s ears as it increases the risk of wax impaction, ear infection and trauma to the ear canal and ear drum. If your child complaints of ear blockage, discomfort or itch without any upper respiratory tract symptoms or ear discharge, it is likely that your child has impacted wax. Purchase over the counter wax softening eardrops. Apply 4-6 drops daily into the affected ear. This will soften, loosen the wax and it will come out on its own after a few days. Microscopic ear clearance is required otherwise.
Foreign body ear
Your toddler may have accidentally inserted a foreign body into the ear out of curiosity. Do not attempt to remove it yourself. Prime your child to sit still, and that Dr Soon will be using special ear instruments under microscopy to aid in foreign body removal. Removal under sedation is maybe required.
Hearing loss
Hearing loss in children can be congenital or acquired; conductive, sensorineural or mixed. Severity can be categorized to mild, moderate, severe or profound. Hearing loss can result in unclear speech or delay in language and speech development. Dr Soon will discuss with you the various treatment options depending on the diagnosis.
Otitis externa (Swimmer’s ear)
Otitis externa is an infection of the outer ear canal. It is common in children active in water sports. Water/moisture is trapped in the ear canal, encouraging the growth of fungus or bacteria. Symptoms include ear discharge and ear pain. Treatment by Dr Soon frequently involves microscopic ear clearance and a course of topical ear drops. Your child may require oral antibiotics if the ear canal or ear is swollen or red. Remind your child not to stick anything into the ear and it is generally recommended to stop swimming classes till the infection improves.
Middle ear infection (Acute otitis media, Otitis media with effusion)
Acute otitis media occurs due to an infection (virus or bacteria) of the middle ear space. It presents with a sudden onset of ear pain in young children, associated with poor sleep, decreased appetite, fever, usually accompanying an upper respiratory tract infection. Treatment is with high dose oral antibiotics and painkillers. Myringotomy and insertion of grommet tubes maybe indicated for severe cases or in children with recurrent acute otitis media.
Otitis media with effusion is a condition whereby fluid has collected in the middle ear space. Causes include nasal allergies, enlarged adenoids, reflux, colds, bottle feeding while lying down, cleft palate. Your child may be able to tell you that their ears feel blocked or decreased hearing. In addition, you may have noticed them to speak louder, asking you to repeat what you have said, not responding when you call their name and an increased TV volume. Hearing test maybe performed to evaluate the degree of conductive hearing loss. This condition commonly resolves by itself after several weeks. Valsalva and oto-vent nasal balloon maybe helpful. Antibiotics, antihistamines, myringotomy with grommet tube insertion, adenoidectomy may be indicated in some cases.
Ear drum perforation
Ear drum perforation in children can occur acutely due to trauma, or as a result from otitis media. The ear maybe dry or discharging. There is a chance that the ear drum will heal itself over a few weeks. Antibiotic ear drops will be started if there is an ongoing infection and hearing test done to evaluate the degree of conductive hearing loss. Tympanoplasty maybe indicated if the ear drum does not heal.
Swellings around the ear (preauricular sinus cyst, sebaceous cyst)
You may have noticed a skin tag, sinus opening or swelling around your child’s ear. Consult an ENT specialist if there are symptoms of infection (pain, discharge, redness) or if you suspect that your child is not hearing well. Do not squeeze or puncture the swelling.
Ear Procedures
Microscopic ear clearance, removal of foreign body ear
This procedure is done in the clinic whereby your child will be required to sit still. Fine ear instruments and ear suction will be used to clear out wax, discharge, fungal debri or remove any foreign body in the ear canal under microscopy. Reassure your child that the procedure is comfortable and will be quick. It is useful to apply ear wax softeners a few days prior if this procedure is required to clear impacted ear wax.
In emergent cases (eg. severe ear infection or an impacted ear foreign body), this procedure has to be performed under anesthesia.
Myringotomy, grommet tube insertion
This procedure is conducted in the operation theatre whereby your child is asleep and a slit-like incision is made on the ear drum to allow fluid trapped in the middle ear to drain out. A ventilatory tube (grommet) is thereafter inserted into the hole to help maintain drainage. This tube commonly extrudes after a few months.
Incision and drainage of abscess
This procedure is performed when pus has accumulated (abscess formation) and needs to be drained to prevent complications. Common indications in children include infected preauricular sinus cyst and infected sebaceous cyst.
Your child will be asleep (general anesthesia) for this procedure. A stab incision is made over the collection and pus released. The pus is sent for culture and cyst wall taken for histology. The abscess cavity is thereafter cleansed and left open with dressing. Healing is by secondary intention.
Excision biopsy
This procedure is performed under general anesthesia for complete removal of the ear lump. Common indications include preauricular sinus cyst, sebaceous cyst, lymph nodes. Absorbable sutures will be used and there will be no need for suture removal. Histology results will be discussed with you thereafter.
