1. all about ears health
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I
t’s no secret that kids know how
to turn the volume up on life.
With ultrasonic squeals and
sometimes thunderous tantrums, their ears
have a lot to contend with. And that’s before
you consider the staggering statistic that
practically all children will develop an
ear infection in their early years.
“Nearly 100 per cent of kids will
have an episode,” reveals ear, nose and
throat specialist Associate Professor
Shyan Vijayasekaran, from the Princess
Margaret Hospital University of Western
Australia. “By the age of one, between 20 to
60 per cent of kids have had an ear infection,”
he says. By the age of three, this figure rises
to a startling 60 to 100 per cent. And some
children, including those living in smoking
households and those with allergic noses,
are particularly susceptible to ear issues.
With the stats sky high, it’s important
we listen to the problem. ›
ERIN SMITH explores the world
of common ear troubles in children
Listen
up!

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BE A RESISTANCE
FIGHTER
Antibiotics are one of our most
important weapons against bacterial
infections and, says Erin Jardine from
NPS Medicinewise, they’ve saved
millions of children’s lives. But using
antibiotics when they’re not needed, or
not taking them exactly as directed, can
help the bugs they are designed to fight
develop resistance. This means some
bacterial infections may become harder
to treat. While ear infections can be
painful and cause distress, they usually
get better in a few days without any
treatment because the body’s immune
system takes care of the infection.
Talk to your doctor about whether
antibiotics are truly needed for your
child’s situation, and for more details
see www.nps.org.au/earinfection.
THE COMMON CULPRITS
Kiddies’ ear troubles are so common
that they top the charts as one of the main
reasons parents take their children to the
doctor.There are two main conditions to
look out for in your littlie…
Glue Ear
(Scientific term: otitis media with
effusion) ‘Glue ear’ is a major complaint
for littlies and affects 10 to 30 per cent of
kids aged two to seven years. It involves a
sticky build-up of fluid that remains behind
the eardrum and is the most common
cause of hearing impairment for children
in western nations.
What are the symptoms?
Babies may be less responsive to sounds,
while older children may experience dulled
or selective hearing, such as having difficulty
hearing with loud background noise or
when the person speaking to them is behind
them. Your child may become distracted,
aggressive, unbalanced and have difficulties
with speech development.
Why does it happen? Glue ear
can follow a middle ear infection or arise
on its own. It occurs when a problematic
Eustachian tube alters the pressure in the
middle ear, allowing fluid to remain behind
the eardrum. “This causes a degree of
hearing loss and occasionally a thinning
of the eardrum,” Dr Baxter says.
What are the treatments?
Your doctor may need to treat an underlying
nasal condition or may simply suggest a
period of ‘watchful waiting’ along with some
over-the-counter pain relief for discomfort.
Glue ear often resolves with time, although
it can take some months.
Middle Ear
Infection
(Scientific term: acute otitis media)
The most common complaint for children’s
ears, it’s often once, twice, three times an ear
infection with this one! By three years of
age, up to half of all children have grizzled
their way through at least three episodes.
For unknown reasons, middle ear infections
are more common in boys than girls.
What are the symptoms?
Look out for earache, pulling of ears,
fever, irritability, increased waking at night
and poor sleep patterns.
Why does it happen? The infection
is usually a combination of virus and bacteria.
HEALTHY HEARING
We’re constantly amazed by the blueprints of
our littlie’s bodies and their intricate ears are
no exception. Inside those cute floppy shells
of skin, a tiny network of bones, muscles and
tubes allow healthy heads to tune into the
stimulating world around them.
The work is done by three major parts of
the ear: the outer ear, the middle ear and the
inner ear.The outer ear is the part you can
see and includes the ear canal.The middle
ear is the small space behind the eardrum,
which contains air and bones.These
transmit sound vibrations to the inner part.
“In healthy conditions, the middle ear
drains by a part called the Eustachian
tube into the back of the nose, where
there’s some tissue called the adenoid,”
Associate Professor Vijayasekaran
explains.The adenoids are like strong
sponges that trap harmful bacteria and
help keep things healthy.
This impressive mini mechanism boasts
a self-cleaning ear canal, which starts at
the ear opening and travels to the eardrum.
“Skin and wax grow from inside towards
the external opening where they’re shed,”
explains Dr Malcolm Baxter, head of the
Ear Nose and Throat Clinic at Southern
Health in Melbourne.This means there’s
no need to use cotton buds or other foreign
objects to keep your youngster’s ears healthy.
“Such objects poked into the ear will
inevitably push wax further in and
scratch the very delicate skin of the
canal,” Dr Baxter warns.
If your child has wax issues, use olive
oil or commercially available ear drops
for wax removal, Associate Professor
Vijayasekaran suggests. Otherwise simply
allow nature to take its course and gently
remove any wax or debris that you can easily
see on the outside parts of your child’s ear.
WHEN GERMS ATTACK
Your child’s smart little hearing circuit
can struggle when she picks up a virus
or other bug, and a build-up of germs
can easily develop into an ear infection.
The reason rests with basic biology:
a child’s Eustachian tube – that vital
drainage tube, which manages the balance
of air and fluids in the middle ear – has
not yet fully developed.This makes it
harder to drain. “The Eustachian tube is
shorter and more horizontal in infants,”
Dr Baxter says. “Malfunction of the
Eustachian tube is the underlying
cause of all middle ear infections.”
If the Eustachian tube is blocked by a
virus, germs in the middle ear cannot drain
away.The usually sterile, delicate area may
become inflamed.
What should I do? See your doctor.
There are different ways of treating the issue,
Associate Professor Vijayasekaran says, but
initially something simple such as children’s
paracetamol will help. Your doctor may
consider prescribing antibiotics, but there’s
been a movement against their unnecessary
use in recent years, Dr Baxter adds.The
good news is 80 per cent of cases clear
up naturally in a couple of days.
Surgical Steps
Sometimes ear conditions such as glue
ear linger, or recurrent ear infections occur,
and if mucus in the middle ear does not
disappear naturally in three months, or
your child experiences continued hearing
loss or speech problems, your doctor may
refer her to an ear, nose and throat surgeon.
A simple surgical procedure where tiny
silicon ‘tympanostomy tubes’, better known
as grommets, can be inserted into the ear
and may help resolve the problem.
“Grommets are small tubes that are
inserted into the eardrum after the surgeon
makes a small cut and sucks out the fluid,”
explains Dr Baxter. “Their purpose is to
ventilate the middle ear – to allow air in
to equalise the pressure and bypass the
blocked Eustachian tube.”
While this procedure may sound
invasive, don’t be alarmed. Grommet
placement is a common daytime operation,
performed under a five- to 10-minute
general anaesthetic. Kids experience very
little discomfort and recover quickly after
the operation. “If you’re just putting
grommets in, recovery takes about
24 hours or less,” Associate Professor
Vijayasekaran assures. Grommets will
gradually fall out naturally after six to
12 months, as the eardrum grows.