Transcription:
A Guide to Common Summertime Ear, Nose and Throat Issues

Bill Klaproth (host): Summer is officially here. Kids are excited to jump into the pool and get into their various summertime activities. However, increased activity, often results in increased injury. From swimmer's ear to allergies, to head trauma, summertime, ear, nose, and throat safety should be taken seriously. So to ensure our kids have a great summer, let's talk with Dr. Anthony Sheyn. Division chief of ENT at LeBonheur Children's Hospital. He is here to talk with us about the most common ENT issues and injuries during the summer, as well as how parents can prevent these and have an eventful and safe summer with their children.

This is the PEDS Pod by LeBonheur Children's Hospital. I'm Bill Klaproth, Dr. Sheyn, thank you so much for your time. It's great to talk with you. And summer is always an exciting time. Everybody's geared up. Oh my God. Summer is here, but it is important to think about the safety of our kiddos. So let's start here. What are the most common summertime ENT issues that you see in the pediatric population?

Dr. Anthony Sheyn: Thank you, first of all, for having me on. like you said, we are heading into summer and most of our little kiddos are going to be running around outside and getting into all sorts of things. So the most common things that we see are, especially in this part of the country is we have a lot of, lakes and beaches, not too far away. So, kids come in with swimmer's ear or external ear infections. And that usually presents with pretty severe pain. lots of drainage from the ear. Pain is actually very, very difficult to control. And unfortunately these infections do not respond to your typical antibiotics that would be prescribed They have to be treated with ear drops that are a thousand times more powerful because they act directly where the infection is.

And every now and then you may have to combine that with an antibiotic by mouth or an antibiotic to the vein called intravenous antibiotic. Very rarely we, starts reading appropriately, do kids, have to be hospitalized for this, but it can happen. Usually, if kids come to my clinic, they've been treated appropriately by the pediatrician and I do have to clean the ears, by suctioning out All the debris putting in a little bit of medicine in there, myself, if I need to, and this can happen several times over a couple of months to get the infection under control. In terms of ears, that's the most common, issue.

One thing you can do to avoid this is drive eight year out after the kids get out of what we call dirty water. And that includes lakes and oceans, pools. And, bathtime, those are clean water, and you can dry them out by, using a hairdryer on a very low setting, held at a little bit of a distance to drive the water out. Take some of those ear drops that we prescribe, or even get some controlled swimmer's ear over the calendar and drive the liquid out and you can always use your earplugs as well. And the best of your plug for your dollar are actually called docks earplugs. They're pretty moldable to your child's ear ears and, quite a bit cheaper than the professionally made ear plugs, which cost close to 70 to $80 and have to be changed frequently becausethe canal changes. as the child grows.

And one other thing you can do to avoid ear infections, specifically external ear infections is to stop using Q-tips. That's not common knowledge that wasn't common knowledge to me until I started practicing, specifically my specialty. But if you look at the Q-tip box, it actually says, do not use inside the ear. And what you're doing is you're actually taking a lot of the wax out and wax is actually quite important. The wax protects against infections. It captures all the debris, all the bacteria andtakes it out. Too much wax is bad. Some wax is good and no wax is also bad. So the ear is actually a self-cleaning organ. If I were to take, some ink and put it on your eardrum, it would actually over a period of weeks to months would migrate, to the opening of your ear canal.

And you would actually be able to see it. So they're a little hair cells, but keep moving the debris, out of the ear canal. So you don't actually have to clean it. I have not cleaned the inside of my years in about, 17 years now. So, quite often when I have to take the wax out is because Q-tips are used, I have to take Q-tips out of the kids ear canals in the office. So they're great for cleaning your mouths. They're great for cleaning other remote control. They're great for cleaning the outside of your ear, but they are not great for cleaning the inside of your ear. No matter how good it feels.

Bill Klaproth (host): Yeah, well, it does feel good. I gotta tell you sometimes ears get a little itchy and it's, put the Q-tip in there, but you're saying don't do that. Not a good idea. Okay. So swimmer's ear is one of the most common summertime, E N T issues. And you said generally it's pain and loss of drainage. So if a child is complaining of pain in their ear, that's a telltale symptom. How do we know if there's no drainage? Is that when you feel like water is caught in the ear?

Dr. Anthony Sheyn: It can feel like that, but that, typically goes away. But a very, classic sign is if you press on the outside of the ear, that little outpouching just, on the front of your ear canal, close with your cheek, it's called the traygus. If you press on that, and your ear starts hurting, that's a pretty classic sign that you have an external ear infection and most pediatricians or specialists can tell even without any drainage that there's swelling in your canal. As one of the few very clear cut diagnoses. There are other causes of ear pain allergies for one, which are also common, during, the summer.

We start developing allergies at around age two. That's when we start getting exposure to, indoor allergens. Cause we spent a lot of time at doors and by age five, even developed allergens to outdoor, stimuli. And if you're very congested, if you're sniffling a lot, then it can give you something called eustachian tube dysfunction, or a dysfunction of the inside of your ear. Behind the ear[inaudible], if you sniff a lot, it creates a vacuum and you have negative pressure. And that can cause again, pretty severe pain, but it's not related to an ear infection. And unfortunately it does not respond to antibiotics.

And what the actual treatment is to treat the allergic symptoms, to make your nose be able to breathe better. There is dependency to use Afrin, which works real quick and real effectively, but Afrin, unfortunately part of the cocaine family of medications. And that's why people become so dependent on it. Because if you use it for three to five days, you do, kind of put yourself at risk for having a condition called rhinitis medicamentosa, which is a fancy way of saying that unless you use Afrin, you're going to be congested. And that's a very, very hard thing to treat in children or in adults.

So it's Okay to use every now and then it's okay to use if you're using a protective medication such as a nasal steroid. but should not be used, but allergens, start with Trees, in the early to mid spring and then proceed to grasses. And now we're in the time of pollen. That is the most common cause of allergies during this time a year. And it's pretty easy to figure out what you're allergic to depending on which season, your allergies, and then if it's year round, we typically reccomend testing, by our allergy colleagues here.

And unfortunately, if you live in Memphis or the surrounding area, this is the second worst part of the country for developing allergies. And the worst part is actually Jackson, Mississippi. So we are right there. And a lot of the conditions that myself and my colleagues treat are related to allergies, and that includes sinus infections, ear infections, ear pain.

Bill Klaproth (host): Okay. How do you recommend parents treat these allergies at home?

Dr. Anthony Sheyn: The best way to do it is, there are over the counter medications, Zyrtec, or cetirizine is a good one, but you also need to not only have a systemic treatment, you need to have a topical treatment. So when I treat patients, I always combine a systemic medication with a topical medication, such as Flonase and nasal steroids, they work just in the nose. They help with watery eyes, itchy nose, nasal congestion. They do not necessarily help with a runny nose, but you can actually get anti-histamine networks in the nose as well. And some of these are available over the counter or some of these need to get a prescription for, but those are really effective medications.

And if you're pretty convinced that your child has allergies that are not responding to medications or, as actually developing sinus infections because of this, then it's time to be seen by either an ear, nose and throat physician, or an allergy physician to be evaluated. And we actually work really closely together, we're developing, kind of a team approach to where we will be located at one site, when we have one ENT physician, an allergist working together, evaluating our patients together.

Bill Klaproth (host): that's great advice, Dr. Sheyn. Thank you. All right. let's move on to injuries. Now. What ENT related injuries do you see the most during summer?

Dr. Anthony Sheyn: Lots of nasal fractures. and that's actually the most common injury. Kids are riding bicycles and I cannot stress how important it is to wear a helmet whenever you're doing any kind of activity, either rollerblading, rollerskating, being on a bicycle, using a four Wheeler, or any kind of motorized activity. Golf carts are Okay. They're pretty enclosed. They don't move that fast. But any kind of activity, where you're moving around on some kind of vehicle, we strongly encourage using a helmet. And that could actually save your life, no matter what kind of injuries. So nasal fractures, nasal bone fractures are the most common, fortunately they're ones that are healed pretty well on their own with very little intervention on our part.

We would only if the nose looks different after the swelling goes away. If there is difficulty breathing after the injury, and then there's a fractures are followed by, fractures of the jaw. Those, also fortunately in children, the younger you are the less likely that they will require surgery because the bone is so elastic at that point that it is able to absorb the force of most traumas, but on occasion we do have to fix these fractures, and that includes putting a metal plate, that includes wiring the jaw shut. While those are pretty well tolerated, that's a pretty bad way to spend your summer.

And then followed by, mandible factors. You have, your fractures around the socket of the eye, which we also handle. And those can be a little more traumatic because you can't have potential injuries to the eye, and it could result in potential loss of vision. Fortunately, the repair is pretty, easy, relatively speaking, but, if you wear a helmet, a lot of this can be prevented.

Bill Klaproth (host): Yeah. So nasal fractures, jaw fractures, and the eye socket fractures are some of the most common ENT related injury. So what can parents do to keep their kids safe?

Dr. Anthony Sheyn: Again, wearing a helmet, keeping an eye on your kids. If you have older kids making sure, that they are trained to look both ways, to be aware of cars, not to wear their AirPods or any headphones, when they're riding around. And it only takes one person to cause an accident. So as long as you are watching what you're doing and keeping peripheral vision of what other people are doing, you should be able to stay safe.

Bill Klaproth (host): Yeah. Great advice on that. So, as we talk about summer is officially here and the increased activity often results in increased injury. Any final thoughts on keeping kids safe over the summer Doctor Sheyn?

Dr. Anthony Sheyn: It's very easy to have a good time and it's very easy for a good time to turn into a bad time. So if you have little ones, be aware of when they're in the water, do not be distracted when you're looking at them, drowning as silent, and it takes us a matter of seconds. You don't hear splashing, so that's number one is keep an eye on your little ones if they're in the pool or the lake or the ocean, don't, take your eyes off of them. And if you do, make sure somebody else is looking after them. In terms of trauma, again, wearing a helmet, wearing knee pads and elbow pads, a very, very important. That kind of protection keeps you safe and keeps you a little one safe and prevents a lot of, traumatic injuries, a scrape here and there is okay.

Broken bones, much more significant. If they want to go outside, but they have allergies, that's a pretty easy fix. A lot of this is available over the counter. If you'd like to be evaluated by a physician, the first step is to go to your pediatrician, and there'll be able to direct you, to the appropriate medications, but it also helps to switch allergy medicine every six months. So you don't get too used to it. And a lot of them are available over the counter once the patent expires, lots of companies start making generic ones. There is a whole bunch of them on the shelves at your local pharmacy. And don't use Q-tips.

Bill Klaproth (host): Yeah. And don't use Q-tips right absolutely. I like how you said that don't turn a good time into a bad time. So that kind of sums it up. Dr. Sheyn, thank you for all of these great tips and talking to us about this. We really appreciate it. And here's hoping to kids have a great and safe summer. Thank you, Dr. Sheyn.

Dr. Anthony Sheyn: Thank you for having me on.

Bill Klaproth (host): And once again, that's Dr. Anthony Sheyn,.And visit leboneur.org to learn more about LeBonheur Children's Hospital. And be sure to subscribe to the paeds pod on apple podcasts, Google podcasts, or wherever you listen to your podcasts. You can also check out leboneur.org/podcast. To view the full podcast library. And if you found this podcast helpful, please share it on your social channels. This is the PEDs Pod by LeBoneur Children's Hospital. Thanks for listening.