Children’s Ear, Nose & Throat Health Tips

Monday, March 17, 2014

Bobak Ghaheri, MD

Winter can be a difficult time for children when it comes to their health. The most common infections that can cause problems include tonsillitis, ear infections and sinus infections.


Overview & Symptoms: The tonsils are lymphatic tissues in the back of the throat that are susceptible to infections by viruses and bacteria (both strep and non-strep).

Treatment: Recently, there has been some debate as to whether or not to even treat bacterial infections (viral infections don’t need treatment other than supportive care). Historically, we have treated strep throat with antibiotics to prevent potential health problems that can result when strep isn’t treated (like rheumatic fever). Because these other problems are so rare, some have advocated allowing tonsillitis to run its course without intervention.

Surgical Options: If tonsillar infections become repeated (or don’t clear with repeated antibiotics), some children benefit from tonsillectomy.

Ear Infections

Overview & Symptoms: Ear infections are another problem, typically in children under 4 years of age. Pain, fever, disrupted sleep and temporary hearing loss from fluid behind the ear drum can make children miserable. Many times, however, these infections go away without intervention.

Treatment: A popular method of treatment is to wait 48 hours from the onset of the symptoms, and if they are not improving after 48 hours, treatment can be rendered.

Surgical OptionsAgain, surgery can be helpful but should be thought of as a last resort if medical management is unsuccessful, especially if kids have had 3 separate infections within 6 months or 4 infections in 1 year.

Sinus Infections

Overview & Symptoms: Sinus infections in children are often difficult to diagnose. Many viral illnesses carry nasal congestion as a symptom. It is important to recognize that mere congestion is not to be confused with an infection that might benefit from antibiotic treatment.

Treatment: The easiest intervention to alleviating nasal congestion is to use a nasal saline spray or flush to remove the thick mucus in the nose. Even in babies, using a vacuum aspirator isn’t necessary, and some feel that the application of a vacuum actually contributes to more nasal congestion. If conservative management doesn’t help over the course of 7-10 days, then examination is warranted. If pus is seen, treatment can be rendered. Unfortunately, however, sinus infections tend to be more stubborn, and can demand longer courses of antibiotics to completely eradicate.

Surgical OptionsThankfully, children rarely have a need for sinus surgery. There is one clinical entity that can be confused with repeated sinusitis, and that is adenoid enlargement. The adenoids occupy the space behind the nasal passages, and if they are chronically enlarged, they may contribute to nasal congestion. Additionally, adenoid enlargement can trap mucus in the nose instead of allowing it pass into the throat as it should, so children can have longer episodes of nasal congestion if this is the case.


While obvious, appropriate hygiene can keep kids healthier throughout the winter. Frequent hand washing, covering up sneezes and coughs and maintaining appropriate nutrition can avoid many of the problems during the winter, and may keep entire families healthier once one child gets ill.