Tonsil Problems

In children, upper respiratory tract obstruction due to tonsillar enlargement and recurrent tonsillitis are the most common problems. Tonsil enlargement is usually seen together with adenoid enlargement. Treatment is generally surgical in these conditions.

How Long Does Tonsil Surgery Take?

Tonsil surgery is a simple operation that takes about half an hour and the patient can be discharged on the same day.

From What Age Is Tonsil Surgery Performed?

If it causes serious obstruction, it can be done as of 2 years of age.

Tonsil Surgery does not have any season.

ADENOID PROBLEMS

Adenoid enlargement manifests itself with symptoms such as snoring frequent sinusitis, chronic cough, open mouth sleeping, night sweating. In fact, every child has some adenoids, but if it grows excessively, it fills the post nasal area and causes airway obstruction. Treatment is usually surgery.

How Long Does Adenoid Surgery Take?

Adenoid surgery is a simple operation that takes about half an hour and the patient can be discharged on the same day.

From What Age Is Adenoid Surgery Performed?

If it causes serious obstruction, it can be done as of 2 years of age.

Adenoid Surgery does not have any season.

ACUTE OTİTİS MEDİA

It is a condition that manifests itself with ear pain, ear discharge, fever, which is usually seen in childhood. Oral antibiotics and antipyretic drugs are used in its treatment. Since it can lead to complications if left untreated, it should be considered important.

Ventilation Tube Insertion

Fluid collection in the middle ear may occur in approximately one-third of children after viral upper respiratory tract infections. This is the result of dysfunction of the Eustachian tube and functional obstruction. In most children, this accumulated fluid is discharged through the Eustachian tube within 15 days to 1 month as the middle ear function improves. In patients where fluid accumulation continues, changes begin to occur in the mucous membrane covering the middle ear and the membrane itself over time. The liquid changes its character and takes on a jelly-like consistency. This may lead to hearing loss. Children with hearing loss may manifest as tuning the volume up when watching tv or do not respond to their parents when they call them. If such a situation has arisen, it would be correct to suspect hearing loss and consult a physician.

In What Condition Ventilation Tube Inserted?

Ventilation tubes are used in treatment of middle ear pressure problems that cause fluid accumulation in the middle ear and collapse of the eardrum which are related with adenoid hypertrophy or nasal allergy. Tube insertion is also an option in treatment of recurrent bacterial otitis media. It is usually performed in children, but may be needed in adults.

How Does Tube Insertion Perform In Children?

Both local anesthesia and general anesthesia can be used for tube insertion. However, general anesthesia is often used in children. Working with a microscope, the external ear canal is entered and the eardrum is scratched. This process is called paracentesis. The fluid in the middle ear is drawn out from the scratched area in the eardrum. With special tools, the tube is inserted into the scratched area on the membrane. There is no visible change in patients apperarance.

Does the tube always stay in place?

No, the tube is expelled after a while. Rarely, the tube cannot be expelled and the doctor may need to pull it out. The shape of the inserted tube also affects the stay time. Tubes called T-tube and Paparella stay in place longer.

Does Tube Instertion is the Final Solution?

Tube insertion usually corrects the problem in the middle ear, but if the cause of the pressure problem in the middle ear continues after the tube is removed, the same disease may recur. Therefore, adenoids, allergies or other causes should also be treated appropriately. Sometimes there are patients who need to have a tube inserted several times and still cannot get a definitive solution.

What are the Drawbacks of Tube Insertion?

Tube insertion to the drum is usually a problem-free operation. However, sometimes problems may occur. In addition to the risk of anesthesia, there may be complications such as ear discharge, calcification in the eardrum and a permanent perforation. Ear discharge is indicative of infection and usually clears up easily with antibiotics.

Precautions After Tube Insertion

The most important issue that the patient will pay attention to is to prevent water from entering the ear. This can be harmful as it may cause infection and inflammation. Apart from this, the patient can continue his normal life. The patient who has tubes inserted should visit his doctor at regular intervals (3 months) to check the tubes.

KOLESTEATOM

It usually occurs after middle ear aeration problems experienced in childhood. The outer ear canal skin and eardrum collapse towards the middle ear, gaining a different character and becoming an inflammation-producing tissue. This tissue progresses by destructing the middle ear ossicles and the bone located in the mastoid region behind the ear. It can progress to the inner ear, causing hearing loss and vertigo problems. Apart from this, if it progresses to the adjacent brain tissue, it can lead to serious life-threatening complications such as meningitis and brain abscess.

The treatment consists of surgically removing this inflamed tissue completely and, in appropriate cases, restoring hearing by repairing the ossicles.

Sometimes this condition may occur congenitally, and in some cases, it may occur due to external ear infections and traumas.

COCHLEAR IMPLANTS

Cochlear implants enable hearing by placing electrodes directly in the inner ear in patients with severe hearing loss and who cannot benefit from hearing aids. It can be performed to patients with congenital hearing loss (Prelingual: who did not gain the ability to speak yet) until the age of 4, and to patients who have subsequently lost their hearing without age restriction. Thanks to this technology, it is possible for children who were born deaf and can learn to speak and have a life similar to normal hearing indviduals.

Whether a child is a suitable candidate for a cochlear implant is determined after tests and audiological evaluations by expert audiologists.

Evaluation of Hearing in Children

Evaluation of hearing and determination of hearing loss, if any, are of great importance, especially in infancy and childhood, for children to acquire language (speaking) and cognitive skills in the future.

Hearing is evaluated differently in infants and children.

Behavioral Observation Audiometry

It is generally used in infants (0-4 months). The baby’s hearing thresholds are determined by the audiologist by examining the baby’s behavioral responses (blinking, head turning, hand and foot movements, crying and sucking reflex) via sending pure tone stimuli, speech stimuli and various noises to the baby in the free field.

Visual Reinforcement Audiometry

It is generally performed in infants and children (5-24 months). Headphones are used in free field. The child is seated so that he can see both sides. There are light boxes and moving toys on the right and left. During the test, an audiologist should play with the child and keep the child’s attention. Then, hearing thresholds are determined by monitoring the child’s reaction to the sounds sent from visual stimulus device.

Game Audiometry

It is generally used in children (24 months and later). The test is administered in free field or with headphones. A headset is put on the child and blocks or toys are placed in front of him. The child is conditioned to listen to the lego whenever a sound is heard and to throw the lego into the box after hearing the sound. In this way, the hearing thresholds of the child are determined.

TYMPANOMETRY

Tympanometry is a test frequently used in children; that detects middle ear air-pressure and Eustachian tube problems. It also helps to determine presence of fluid in the middle ear or movement disorders in the ossicular system.

Acoustic Reflex Test

This test give us and objective information about the function of middle ear ossicles and of the auditory nerve and facial nerve. It is also used in the objective evaluation of hearing in children and infants.