Patient's Query
Hello doctor,
My 5-year-old son has been complaining of severe ear pain (just the right ear). He occasionally says that he hears a sound in the same ear.
When he was abroad he had a nonstop cold, phlegm, and chest congestion. But when he travels to his native, he is absolutely fine. He also suffers from a blocked nose and struggles to breathe through his nose. He breathes through this mouth most of the time.
The doctors abroad suggested surgery to remove his adenoids. However, when he is here, he is absolutely fine and the doctors are against surgery. Could you please suggest what is the solution?
Thank you.
Hi,
Welcome to icliniq.com.
Have you taken an adenoid x-ray? Do you think there could be some allergen in his place abroad, which could be causing allergy and nose block in your son? Does he take food properly? Is there any dust inside the house abroad? Any chance of pollens or house dust mites? Does he have any sneezing or running nose? Does he show any rashes over his body?
Does he have ear pain only in the right ear, and when he stays abroad? Does your son have an ear problem here? Do you feel he has hearing loss in that ear? Have you covered his normal ear and checked the hearing from his affected ear? Can you share the relevant X-ray and blood tests?
We are worried if the adenoids are causing earblocks, this can lead to compromised development as your son will have some hearing loss. Removal of adenoids will take care of this problem. You may have to get some ear tests done. Meanwhile, the allergy may aggregate the problem when he is abroad, and here it may not be aggravated.
I hope that you get your answer.
Please let me know if you need any help.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
Yes, I have taken an adenoid x-ray about a year ago. I have attached the x-ray.
Possibly, there could be some allergen in the abroad, which could be causing allergy and nose block in my son. He is a picky eater. But he definitely eats well. There will not be any dust inside the house, as far as I know.
Yes, he has sneezing and, a running nose, and he does not show any rashes over his body. He has pain only in his right ear, and he does not complain of it when in his native.
We tested his hearing by closing one of his ears, and he hears normally. We do not see any difference. But he does not favor loud noises. He hates them. Loud, such as vacuum cleaners, crackers, and speakers makes him feel irritated.
The doctors abroad would not refer to these reports. All we were told was that the adenoids would decrease when he was seven years old, and not to worry. But when he is abroad, almost every day he has a cough, and cold and every month down with fever at least for a couple of days. What could be done?
Thank you.
Hello,
Welcome back to cliniq.com.
I have seen the attached reports. (attachment removed to protect patient identity).
Your son has extremely big adenoids. Fluid in the right ear and hearing loss as well. This is a clear indication for surgery. He needs adenoidectomy (a surgical procedure that removes the adenoid glands), myringotomy (a procedure to create a hole in the ear drum to allow fluid that is trapped in the middle ear to drain out), with or without grommet insertion (a minor surgical procedure that involves placing small ventilation tubes into the eardrum to treat conditions like glue ear and recurrent otitis media).
I think you have not consulted the right doctors for this.
If you want to know how I am sure of this, in the x-ray, there is absolutely no space behind the nose for air to pass. There is a complete block in the nasopharynx area. Most possibly it is grade 4 adenoids. The adenoids have blocked the eustachian tube opening inside the nose (not just in the right but in the left also). A blocked tube causes reduced ventilation and drainage of that particular ear, causing fluid accumulation, reduced pressure, and pain. This is what is bothering your son from that ear.
The fluid is indicated by the B-type curve in the right ear shown by your report of tympanometry (impedance audiogram) and the PTA (pure tone audiogram) shows 30 dB hearing loss (attachments removed to protect patient identity). In the PTA the 30 dB hearing loss is shown in the left ear. In the left ear, the curve is C which also shows impaired ventilation of the middle ear most probably due to adenoids. If you wait till adenoids to resolve on their own say by another three to five years, your child will have had a serious compromise with his hearing, and there will be adenoid facies and reduced mental development.
We have seen conservative approaches fail in many cases, and the kids end up dull and with reduced school performance. They are inattentive because they are unable to hear well due to this problem. Your son already has a 30 dB hearing loss in one ear and fluid in the other.
I hope it is clear to you. Adenoids may or may not regress normally by three or four years. Sometimes, we find adenoids in kids of 15 years also. But your son already is having damages due to it. His ear problem is serious.
Please let me know if you need any help.
Thank you.
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Answered byDr. Shyam Kalyan N
Medically reviewed byDr. Vinodhini J.
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