With the start of school year and weather getting colder, ear, nose and throat disorders in children are on a rise. Stating that a period in which children's physical development is rapid and the foundations of their academic success are laid is also important in terms of infections, Yeditepe University Koşuyolu Hospital Ear, Nose and Throat Diseases Specialist Op. Dr. Ziya Bozkurt pointed out that developmental delays and disorders that may occur in children can leave permanent traces in their future lives.

The first encounter with microbes is usually in kindergartens and school environments after leaving our homes, which are much more sterile. Yeditepe University Koşuyolu Hospital  Otolaryngology,Head and Neck Surgery Specialist Op. Dr. Ziya Bozkurt stated that children often have throat, ear and digestive system infections during school years due to this. Most common problems in schoolchildren are listed as adenoid and tonsil problems, ear problems, problems related to nose and sinuses and voice problems were encountered.

Bozkurt pointed out that this period is important for the physical and academic development of children, and stated that delays in treatment may lead to developmental delays and disorders that may leave permanent traces in the future life of the child.


“Children with chronic diseases get sick more often”

Stating that these infections are not seen at the same rate in every child, and both structural and environmental factors are important for this, Bozkurt gave the following information on the subject:

“For example, children who have problems during pregnancy, during or after childbirth, babies who do not receive enough breast milk, those who are allergic, children with chronic diseases get sick more often than their peers. On the other hand, it is known that environmental factors also play a role here. For example, eating habits, living in crowded places and kindergarten, school environment; as well as factors such as exercise and exposure to enough sunlight affect the immune system and make a difference among children.”


“Enlargement of adenoids and tonsils can also cause different problems”

Explaining that tonsils and adenoid tissues, which are part of the body's defense system, can grow whenever they encounter infections, they can sometimes cause an occlusive effect, and said:

“On the other hand, harmful factors such as bacteria and viruses can cause these tissues to inflame themselves. Thus, these two tissues cannot fulfill their protective functions and become a source of infection for the body by producing infections themselves.”

Reminding that the enlargement of the nasal flesh can also prevent the child's breathing and also create a basis for different health problems, Bozkurt continued, "This situation also causes problems by disrupting the discharge of the fluids formed in the ears and sinuses. In these children, hearing loss, snoring, mouth breathing, night coughs, nasal discharges occur. Breathing through the mouth may lead to orthodontic disorders, facial development disorders and speech disorders”.


“Does every child with adenoid problems need surgery?”

Bozkurt reminded that although every child has adenoids, especially at the age of 4-5, these tissues grow and become evident due to the infections encountered at the beginning of nursery and school, and said that they tend to shrink in older ages. Bozkurt told the following about when children need surgical intervention:

“If the adenoids cannot fulfill their protective functions and become infections themselves and cause continuous sinusitis or middle ear infections and related hearing loss, the size of the adenoids prevents breathing from the nose and causes serious problems such as continuous mouth breathing and snoring due to this, or being short of breath during sleep, which we call apnea. if it creates problems; or if there is deterioration in the jaw and tooth structure due to continuous oral breathing, then surgical treatment, that is, removal of the adenoid, should be planned”.


“If left untreated, it can cause structural problems”

Bozkurt stated that if not treated, the academic success of the child may be affected as well as cause some structural problems. “ Due to a lack of quality sleep at night for children who are suffering from snoring and sleep apneas due to their adenoid enlargements, such children may exhibit developmental problems and attention disorders, as well as social and academic problems due to a possible hearing loss.On the other hand, due to the constant oral breathing because of the enlargement of the adenoid tissue may lead to a shrunk lower jaw, and orthodontical disorders, problems in facial development and speech disorders.” Bozkurt explained.


“Surgery should be considered if there is no response from drug therapy for tonsils”

Emphasizing that in tonsil infections, which is another most common problem in school-age children, antibiotic treatment is started first, Bozkurt said that if there is no benefit from drug treatment, surgery is resorted to. Bozkurt drew attention to the importance of certain criteria in the decision-making process for surgery and continued his words as follows:

“While some of the criteria we mentioned are considered to be more precise criteria, such as apnea, breathlessness during sleep or permanent deterioration in the jaw and tooth structure; relative criteria are considered those such as frequently recurring tonsil infections, carrying Diphtheria (Crow's Palis) microbe and frequent otitis media or sinusitis attacks due to tonsillitis. This decision needs to be made individually, with each child carefully evaluated.”


Hearing Problems may be a Warning for Otitis Media in Children!

A problematic pregnancy or childbirth, adenoid enlargement, allergies, crowded environments, and regular upper respiratory system infections due to that, nutrition and smoking in the household are among the many factors that may lead to otitis in children. Pointing out that this issue, which is seen commonly among young children, may lead to permanent problems in ear, Bozkurt continued as follows:

“While the disease may present itself in acute form with pain and fever, there are serous cases of otitis that do not manifest itself with symptoms above, but with only hearing loss. In these cases, hearing issues are the dominant prolem, and cases of asking the parents to repeat what they said, turning the volume up on TV and not responding when called might be some of the exhibited behaviour. Left untreated, they may lead to academic and social problems, as well as permanent problems in ear. So, when the course is prolonged and there is a possibilit of a permanent issue, as well as acute infectinos are reoccuring, there are surgical options such as parasynthetic and ventilation tubes for in-ear channels. Specifically in case there are risks for otitis development and there are manifest symptoms such as the volume of TV or problems about hearing, the child should immediately be taken to a specialist”.


“The most important cause of hoarseness is nodules”

Pointing out that vocal cord nodules are among the causes of chronic hoarseness seen in school-age children, Bozkurt said, “The most common cause of vocal cord nodules is the child's habit of speaking loudly and often shouting. Diagnosis is made by seeing the nodules in the endoscope examination of the vocal cords. The most important point in the treatment of these children, who usually prefer a loud voice even when speaking, is to teach the child vocal hygiene. When necessary, it is treated by giving voice therapy”.




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