As pediatricians we examine many ears in a day’s work. I can’t say i like it very much even after 11 years in pediatrics. Newborns are easier to examine, however, you can’t see very much. Infants sometimes beat me up. Toddlers, well, they are toddlers. Enough said. They put all kinds of things in there, but then they don’t want us to shine a light in there for 3 seconds. Younger children are usually fine with an ear check and don’t put objects in there which makes me happy ( I am starting a collection of “things I have removed from ears and noses”). Teenagers usually stay still for the ear exam, but are always self- conscious about ear wax (necessary for a healthy ear!).
So, here I am, checking ears, cleaning out wax and ruining the perfectly good friendship I had with your toddler…until the next visit:)
A few things about ears…
First and foremost, please do not use q-tips to clean your ears. They are self- cleaning structures! Wax is indeed a normal process to protect your ear canal. We promise not to judge you if you come in for a check up and we see wax in your ear. We know that you “usually” bathe, even if you are a stubborn teenager. I write that with love:) Similarly, please do not put urine in your ear. Your own urine or anyone else’s urine. Clean your outer ear with a washcloth and your finger. Really. Keep life simple.
Let’s talk about ear infections.
As an osteopathic physician, I am trained in musculoskeletal techniques which can help along side traditional medicine to heal and use your body’s natural defenses. For example, there is an ear drainage technique which can sometimes be used to aid in the drainage of the eustachian tube. What is the eustachian tube? Let’s take a journey into your ear. Think of your ear as a tunnel. You enter your ear and you are in the auditory canal (where the protective wax is). This is where swimmer’s ear or “otitis externa” occurs (the canal gets swollen, red and oozes yellow/white fluid, ear is painful to the touch.) You would need an ear drop to treat an infection here. Next you travel down the tunnel and you hit the ear drum or “tympanic membrane”. This is what we view to see if you have an inner ear infection “otitis media”, fluid behind the ear drum “effusion” or a hole in it “perforation”. This is also where the tubes go when a kiddo gets ear tubes (they get ear drops as well because if there is a hole there, the drops get directly to the infection). This is what we are afraid of when your toddler punctures it with a pencil, legos, rocks, beads, popcorn, play doh or screws in there (all things I have seen in ears!) Ugh! Behind this ear drum is where the inner ear infection happens. The typical ear infection. It houses the smallest bone in your body! It leads to another canal called the eustachian tube - think of it as a slide. This canal is at a more steep angle in an adult which is why it is uncommon for adults to have ear infections. The fluid there can drain more easily. In a child, the fluid can linger there and is more likely to lead to an infection. Some kids have issues with the eustachian tube where it does not drain the fluid efficiently. This does not always lead to an ear infection. This explains why we do not prescribe antibiotics for every ear with fluid behind the eardrum. But if it does, it is important that we give it immediate attention because ear infections can lead to more serious infections. This slide or eustachian tube can be mobilized by an osteopathic technique called the “Auricular Drainage Technique”. I usually teach my parents to do this if we are holding off on antibiotics (48 h of watchful waiting) or even alongside a course of antibiotics. It is a safe, easy technique and the only caveat is if you have a toddler. They likely will not sit still for it unless you put on Barney. Sorry.
It is important to note though, that there are times when we must treat with antibiotics right away without any 2 day watching period. This is usually when you have a moderate to severe infection, lots of pain, high fever, irritability or a chronic history of ear infections.
Let’s not ignore the earlobes. The common issues I see here involve skin problems. Infections from ear piercing/poor hygiene or eczema. If your kid gets her/his ears pierced be very mindful of keeping it clean. Use alcohol frequently and wash the area with soap during baths.
By the way, we have now started to offer ear piercing in our offices! Call us to make an appointment so that your child can be in a familiar, clean environment and we can share in the memory!
So what else can I say about ears? Take good care of them! You need them for listening to the giggles and voices of our beautiful littles and bigs.
Dr. S“The Ear is The Avenue to the Heart”, Voltaire