Tonsils? Green mucus? Ear tubes? It’s all in a day’s work for Robert Sprecher, MD. He’s a Nemours pediatric otolaryngologist – or ENT – meaning he takes care of ears, noses, throats and more for St. Johns County kids. We asked Dr. Sprecher to cough up some answers to your most common ENT questions.
My son snores – it’s pretty loud. I know it can be a danger sign in adults, but he’s in middle school. Should I worry?
“Snoring is not necessarily bad – it means there is a partial obstruction of the airway. What you need to be concerned with is a complete obstruction or sleep apnea. Listen for a pause in your son’s snoring or breathing, and then his waking up with a gasp. If this is the case, he’s probably waking up throughout the night and not getting good quality sleep. He should see an ENT to find the cause of the obstruction.”
My infant daughter keeps getting ear infections. Our pediatrician has started talking about ear tubes — will that stop the infections?
“Yes – ear tubes will basically eliminate the infections. It’s very common with children to have fluid buildup behind the eardrum. When this fluid gets infected, that’s the ‘ear infection.’ We can treat the infection with antibiotics, but we don’t want to keep repeating antibiotics or using them long term. Ear tubes allow the fluid to drain out and not build up.”
When I was a kid I remember everybody getting their tonsils out. Now, not so much. What changed?
“Tonsils can be responsible for things like chronic sore throats and sleep apnea. In the past, if a child’s tonsils were large, there was a ‘knee-jerk’ reaction to take them out proactively, before the problems could occur. Today, we don’t want to subject a child to a procedure if it’s not necessary. That said, tonsillectomies are still one of the top childhood procedures. At Nemours, we do thousands annually.”
My toddler is clumsier and falls down more than the other kids his age at daycare. The owner said I might want to get his ears checked. Why? What could it be?
“Well, they’re called ‘toddlers’ for a reason – they’re still mastering walking and will fall. However, fluid buildup in the ears could affect balance. Ear infections are a sign of fluid buildup, but a child can have fluid buildup without getting ear infections. So, while it could be fluid, it may be your child is just a little clumsier at this stage and will develop out of it.”
My daughter’s ear tubes fell out. Is she done with that as a treatment option?
“We can use ear tubes as often as needed. But, generally only about one out of five children will need a second set of tubes. Tubes fall out because the child’s own Eustachian tubes and eardrums are growing, and should be able to drain fluid better naturally.”
My son only likes certain foods and coughs a lot when trying to chew something different. My husband says he’s just a “finicky eater” and will grow out of it. What should I do?
“If a child is choosing soft foods and has trouble swallowing other types of food, it is probably due to enlarged tonsils. If a child is coughing regularly when eating, it means food is going down the ‘wrong tube.’ You should bring the child in for an examination to see what is happening.”
I hear people use the term all the time, but what exactly is a “deviated septum?”
“The septum is the vertical piece of cartilage that separates the two sides of the nose. Everyone’s septum is deviated to some degree – they are never perfectly formed and tend to get more deviated as we get older. Having a badly deviated septum is rare in kids unless there has been some type of injury.”
My daughter keeps getting sore throats. It’s been happening on and off for a while. When should I see a specialist?
“You should have a sore throat swabbed and tested for strep. Multiple bouts of strep throat could be caused by the tonsils, and they may need to come out.”
My mom told me that if my son’s mucus is green, he has a sinus infection – is that true?
“No, the color of the mucus is not an indication of infection – it’s the length of time the condition has persisted. Most colds last seven to 10 days. If it’s not getting better after that, it could be a sinus infection. The problem is that many parents want antibiotics for their child after day three or four. The cold, a virus, will run its course, unaffected by the antibiotics. Over-prescribed antibiotics are a concern for the healthcare industry.”