Ellen Quinn, Rainbows’ Pediatric Audiologist shares the three abnormalities she sees most often in children’s ears.
As a pediatric audiologist, the three abnormalities I see most often in children’s ears are fluid behind the eardrum, wax occlusion and foreign objects. At some point in your child’s life, you will probably deal with at least one of the three, or even all three. So let me briefly touch on each topic and give you some information I think will be helpful.
Fluid behind the eardrum is by far the most common abnormality I see in children. Fluid behind the eardrum does not always mean an ear infection though. Sometimes thin, clear fluid builds up behind the eardrum and resolves itself over time, usually within a few weeks. In such cases, your child’s doctor may recommend a “wait and see” treatment plan, meaning give your child a few weeks then recheck the ears to see if there are signs of improvement. However, when the fluid behind the eardrum is yellow or purulent, your child’s pediatrician will say your child has an ear infection, also known as otitis media. An ear infection can occur in one or both ears. When a child has an ear infection in both ears, your child’s doctor may say he/she “has a double ear infection”. An ear infection is usually treated with an antibiotic along with a recommendation to recheck your child’s ears in a few weeks.
The second common abnormality is wax occlusion. Wax occlusion is different than just having a little bit of wax in the ear canal. Our bodies naturally produce ear wax as a protective mechanism in the ear canal. Ear wax helps to clean and protect the ears by trapping debris, dirt and germs, preventing them from moving further down the ear canal towards the eardrum. Our bodies are designed to both produce and get rid of wax naturally. Most bodies do a very good job, so I strongly discourage the use of Q-tips, particularly with infants and young children. Q-tips can overstimulate the glands that produce wax to produce more wax than necessary. Q-tips also tend to push wax further down the ear canal rather than removing the wax. Lastly, there is also the risk of rupturing the eardrum with the end of the Q-tip (I have seen this type of injury numerous times over the years). So, please do not use Q-tips in your child’s ears. If you have concerns about wax build up in your child’s ears, talk with your pediatrician or ENT doctor about using some sort of softening agent, such as a drop of mineral or olive oil, or hydrogen peroxide in your child’s ears one to two times a week to prevent earwax from building up and hardening in the ear canal. But talk with your child’s doctor first, before putting anything in your child’s ears.
The third abnormality is the one that causes the most panic for parents: a foreign object in your child’s ear. I define a foreign object as anything that does not belong in the ear canal and did not arrive on its own. For the most part, foreign objects need assistance to get in the ear canal. I have seen all kinds of foreign objects over the years, the most common being beads (small, round, brightly colored plastic beads). I will always remember the day I was doing a mass screening at an elementary school and roughly one third of the children in one particular PK class had a foreign object in at least one or both ears (colored plastic beads). The classroom teacher was baffled because she did not have any beads in her classroom. We eventually found out that all the children went to the same after school day care and had put the beads in each other’s ears earlier in the week! Fortunately, no damage was done, other than to parent’s wallets as each took their child to the pediatrician or ER to have the beads removed. If you receive a call or note about a foreign object in your child’s ear, do not try to remove it yourself, especially a bead. Beads are round and roll, usually making them difficult to remove. Take your child in for medical attention. You’ll be glad you left the removal to a professional! It is also good to remind little ones to not put anything in their ears, and don’t let anyone else put something in their ears.
So, the next time the audiologist, nurse or pediatrician says, “Joey has a double ear infection” or “Suzie’s ears are occluded with wax” or “Uh oh…. I see something that doesn’t belong in Katie’s ears” you will know what they mean and what to expect.
By Ellen Quinn, Pediatric Audiologist
