We are in the middle of summer, children are swimming in the sea and in the pools, what problems could arise that will need your consideration? (ears, nose, mouth, larynx)

-At this time, the most frequent problems that concern and require an examination by the Pediatric ENT specialist are the ears, so we will talk about the most common condition called Otorrhea .

What is otorrhoea?;
– First of all, let me clarify that usually almost all children (like all of us) produce a pale yellow-brown liquid which is the normal “wax” and is easily cleaned.

Otorrhoea is therefore the outflow of liquid from the ear, the duct is full, runs out and in severe cases, stains the hair, the face and the pillow.
It has different shades, different texture (thick-fluid-thick) and smell (smelly-odorless).
It can be accompanied by pain or fever, but usually it is “silent” (without symptoms).

What could be the cause?

-Many and different (in the anatomical sense) as we will see later.

It can come from:

A. The external part of the ear: Otitis externa, Fungal infections, Dermatitis of external auditory canal.
These situations are characteristic of summer because they are favored by humidity (sea baths and especially baths in swimming pools).

The most common is the otitis externa with characteristic pain and otorrhoea (You can’t touch his ear – it hurts when you try to put his shirt on).

B. The Middle part of the ear:

I. Acute diseases

–Acute Otitis Media which ends in a rupture of the eardrum (a normal outcome of the disease if the body does not have the defense to deal with it or if the antibiotic does not have time to act) it is usually preceded by ear pain and possibly fever.
Another condition to distinguish (because it has similar symptoms) is
-THE Vesicular Myringitis that is, it presents bubbles on the surface of the drum that cause particular pain.

It is characteristic in both cases that the child is relieved when he presents with otorrhoea. They are more common in winter.

II. Chronic Diseases

Chronic Otitis Media

-Known cracks (holes) of the eardrum (with or without underlying accompanying pathology).

– Pathological conditions (cholesteatoma), when they are in a flare-up.

–Ventilation Pipes (tubes). The well-known tubes that are placed by myringotomy due to a long stay of the liquid in the middle ear.
In a small percentage they may present otorrhoea.

C. Head injuries. After a head injury, otorrhea (usually clear) is indicative of a serious condition that needs careful treatment (in collaboration with a neurosurgeon).

When and how is otorrhea treated?

-Every otorrhoea must be checked -especially if it is silent, i.e. it does not have strong symptoms (pain, fever).
This is where the role of the pediatric otolaryngologist is important.

After carefully cleaning the ear (which is usually full of fluid), the doctor will be able to diagnose what the problem is. Maybe in some more serious cases he needs to ask for some tests (eg CT scan or magnetic resonance imaging). He will then administer the appropriate medication. Usually topical drops combined with thorough cleaning are sufficient. In more severe cases, oral (or intravenous) treatment may also be administered.

Is a culture necessary?

-Not always because the external auditory canal is colonized with several micro-organisms (normally). It could help in cases of acute otitis media or an exacerbation of chronic otitis media before medication, but special technique is needed when taking the liquid.

What do you recommend for precautions in children with central ventilation tubes (tubes)?

-modern studies indicate that we should not be so strict with water precautions. Generally, otorrhea in children with tubes is treated with topical antibiotic drops with or without cortisone.

When do we worry in cases of otorrhoea?

In principle, when there has been a previous head injury.
When combined with severe pain and fever.
And when ear drops have already been administered and the otorrhoea persists and the symptoms worsen.

What advice do you have for parents?

In any case that their child’s ear runs they should immediately seek the advice of the Pediatric ENT because this way they can prevent situations that could potentially develop into serious ones if they are not treated in time, even though most are mild and can be treated with ear drops.