Mommy, my ears hurt

August 11, 2016 by David Tremblay-Deschênes
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School-age children (5 to 12 years old) experience severe ear problems that differ from those in children under age 5. During this back-to-school season, we take a look at some of these diseases.

Cerumen buildup

This frequent and benign problem is due to the accumulation of cerumen (earwax) in the external ear canal. Generally, it doesn’t lead to any pain. Cerumen is a natural substance that keeps the canal clean, protects the ear from infections, and keeps foreign bodies (like insects) out.

Earwax buildup is frequently caused by the use of cotton swabs and the narrowness of the external ear canal in young children. To prevent this problem, avoid using cotton swabs and use a washcloth to clean only the pinna (external ear).

External otitis

External otitis is an inflammation of the external ear canal. There can be pain when moving the pinna, discharge, reddening of the ear, or problems hearing when there is a complete obstruction. External otitis can be secondary to a bacteria or a fungus. Certain factors predispose school-age children to this problematic, such as moist environments, inserting objects into the ear canal, recent intervention in the ear (extraction of earwax buildup), and eczema in the canal.

Generally, external otitis can be treated with a local antibiotic, pain medication, and regular hygiene with moist compresses. Consultation with a health professional is recommended to identify the cause. To avoid external otitis, prevent cerumen buildup, keep the ears dry, and avoid the use of cotton swabs, ask an audioprosthetist for custom swim plugs and clean your hearing aids. If eczema is the culprit, a topical corticosteroid can be prescribed.

Acute otitis media

About 80% of children under 3 years old will have an episode of acute otitis media (AOM) and 45% will have at least three. AOM is less frequent as children get older. Generally, this type of otitis is a complication from an upper respiratory infection (e.g., a cold).

If there is any pain, discharge, fever, or decrease in hearing, consult an ENT specialist, a specialized nurse practitioner or your family doctor, who will evaluate the child’s condition and the necessity of treatment (using analgesics, nasal cleansing with saltwater four times a day as needed, pneumococcal immunization, etc.). If fluid accumulation persists even with treatment, it could be appropriate to consult an ENT specialist in order to consider the placement of transtympanic tubes.

Careful with small objects!

Insertion of small objects inside the external ear canal can cause considerable injuries, such as an eardrum perforation. If your child has voluntarily or involuntarily inserted something into his/her ear, it is recommended to have someone look at it.

In any case, if your child experiences pain, fever, or discharge, suddenly can’t hear as well, or if you have questions about earwax buildup, consult a hearing health professional.

References:
LE SAUX, N., ROBINSON, J.L., “Management of acute otitis media in children 6 months of age and older.” 2016. Canadian Paediatric Society. Online. http://www.cps.ca/en/documents/position/acute-otitis-media. Consulted May 1, 2016.
TURGEON, J., HERVOUET-ZEIBER, C., OVETCHKINE, P., BERNARD-BONNIN, A.-C., and GAUTHIER, M. Dictionnaire de pédiatrie Weber, 3rd edition, 2015. Chenelière éducation, Montreal: Presse de Montréal, 1366 pages, ISBN 978-2-7650-4746-9.
Centre hospitalier universitaire Sainte-Justine, “Infection des voies respiratoires supérieures : Information destinée au parent.” 2010. Online. https://www.chusj.org/getmedia/64254569-a5af-4f31-a695-692add89cfed/depliant_F-851_infection-voies-respiratoires-superieures_FR.pdf.aspx?ext=.pdf. Consulted May 1, 2016.

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