Q: My child has gotten a lot of ear infections recently, so we were referred to a pediatric ENT. What should I expect at the first appointment?

A: A pediatric ENT is an ear, nose, and throat specialist who can help determine the best ways to treat and prevent your child's ear infection bouts. When you first visit the ENT, he or she will examine your child and look at any x-rays, lab tests, or CT scans you may have had done. You'll also be asked about your child's medical history, including when each of his ear infections occurred, how long they took to clear up, what medications were used to treat them, and any meds your son is currently taking, as well as any other health problems (be sure to have all that information with you).

Since styles of practice differ from physician to physician, it's hard to know exactly what your particular ENT will do, but it will most likely be one of the following:

• If the ENT determines that the pus building up in your son's ears (which causes the infections) is compromising his hearing by at least 40 decibels, he may decide to put tympanostomy tubes in his ears. These tubes (which are placed surgically in an outpatient procedure) help properly drain pus out of the ears, keeping the area behind the eardrum clear and preventing future infections. This is one of the most common childhood surgeries, but there are often times when the need for tubes is not clear-cut. If you're concerned, be sure to ask the doctor exactly why he feels the tubes are necessary, and whether you could wait to have them placed.

• If your child's hearing and speech are not being dramatically affected by his recurrent ear infections, the doctor may decide to simply observe him (while treating the ear infections with antibiotics) for a few more months to see if the infections persist and if hearing worsens before proceeding with tube surgery. In this case, you may want to ask about the side effects of regularly using antibiotics, which include diarrhea, yeast infections and diaper rash, and antibiotic resistance.

• Lastly (and this is the least likely scenario) the ENT may decide to drain the pus that's pooled in your child's ear. However, many doctors prefer not to do this, since draining the ear is just as invasive as tube surgery, and won't prevent future infections.

Copyright 2009

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