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Children may develop airway obstruction at any age. If your child has been told they may have an obstructed airway, it could mean any of a number of specific things. Generally speaking, airway obstruction is a physical structural problem of the space where air should pass for breathing, between the nostril and the lungs. Therefore many different structures can be responsible for airway obstruction. Nasal obstruction due to a deviated septum, nasal valve collapse, or growths within the cavity can cause blockage. Structures like tonsils and adenoids can also cause blockage, a little further down. There can even be blockage at the voicebox, also called the “larynx”. This could be due to swelling, narrow cartilage, or a growth of some kind. Airway obstruction can usually be identified during the initial evaluation with a pediatric ear, nose and throat (pediatric ENT) doctor. Occasionally special testing must be completed to fully understand the location and severity of the obstruction.
Allergies are when the body’s immune system detects something in the environment as harmful and then overreacts to it. The substances that cause allergic reactions are called “allergens”. When someone has allergies, their immune system makes a very specific antibody. These antibodies respond to allergens. The symptoms that result are an allergic reaction. Common symptoms include itching, watery eyes, sneezing, runny nose, and skin redness. Sometimes pollen, dust, or other environmental exposures cause these reactions in children. It can be very confusing at times. Help from a pediatric ear, nose, and throat (pediatric ENT) specialist can help find causes and treatments that work for your child.
Ankyloglossia (tongue tie) is a congenital condition, meaning it occurs during development in the womb. In severe cases, the tip of the tongue is prevented from moving because a band of tissue abnormally connects it to the floor of the mouth. Some children then have trouble breast- or bottle- feeding and may develop complications because of this difficulty feeding, including poor weight gain and dehydration. In some cases, temporary supplementation is necessary. If identified and assessed to be the fundamental cause of the failure to adequately feed, a straightforward and low risk procedure can be helpful. The band of tissue can be carefully lysed (cut) in the office, using a small amount of numbing medicine for pain, and a fine sharp scissors. When appropriately selected, there is usually a very quick turn toward normal function – some mothers report an almost immediate improvement in latch and feeding efficiency. However, this topic is controversial and not all babies meet criteria. The best option is to make an appointment to discuss the possible need for ankyloglossia release with a pediatric ear, nose and throat (pediatric ENT) specialist to discuss your concerns and permit an evaluation of the child.
Cleft lip (CL) and Cleft Palate (CP) are congenital conditions that occur during development of the child in the womb. They result in the failure of the midface, palate, and lip to correctly align and grow together. They can occur together or separate, and are further categorized by the extent of the cleft, amount of surrounding tissue that is present, and degree of impairment of function. Very frequently the ears, nose, and throat and substantially affected, and may present an ongoing source of challenge for these delicate children. Families seeking correction of these conditions are best served by involving multiple doctors and specialists, surgeons and therapists, in a “team approach” with overlapping assessmments and treatment options, the ability to stage and consolidate care as needed, and provide longitudinal coordination of care. Universally, patients with cleft lip and palate require the careful management of a pediatric ear, nose, and throat (pediatric ENT) specialist. Dr. Harris collaborates with many local doctors and specialised therapists to deliver expert team-based care of children with congenital cleft lip and palate.
Children with Congenital High Airway ObStruction (CHAOS) are affected by severe, life threatening, and often complex airway problems arising from a number of factors. Frequently, these children are born with one (or sometimes many) conditions which make their very start in life complicated for their doctors and scary for the family. The importance of a collaborative and team-oriented approach is critical. Patients may experience a need for immediate airway correction or need a secondary airway at birth. These children may have a lifetime of medical and surgical needs arising from the interventions taken early in life, and for this reason many children with congenital high airway obstruction see a pediatric ear, nose and throat (pediatric ENT) doctor.
While abnormal lumps, bumps, and growths in the heads and necks of children may cause alarm, the appearance of a swelling or lump in the neck of a child is not uncommon. Many children have easily palpable lymph nodes (a site of normal inflammation in response to local infection) in the neck, which will swell during an active illness. However, these “knots” should remain less than an inch wide, be slightly tender without a soft center, have normal skin color over the top, and decrease in size after illness. Occasionally these lumps are a remnant of human development in the womb, and little clumps of tissue get trapped where they should not, resulting in a cyst (fluid filled) or lump. Occasionally a lesion known as a lymphatic malformation (or cystic hygroma) develops, trapping pockets of fluid throughout the head and neck. There mare many ways to evaluate lesions in this area, such as special kinds of ultrasounds, x-rays, and CT/MRI scans. Generally, these congenital masses should be removed when safe to do so, to prevent future problems such as abscess or cosmetic deformity.
No single topic elicits more questions and discussion in the pediatric ENT office than a discussion of ear wax. Ear wax is a healthy and normal product produced by healthy cells in the ear canal. Generally speaking it has many helpful qualities and components, helping to discourage bacterial growth and carrying dust and dirt out of the canal over time. When excess ear wax (called “cerumen”) is visible at the openig to the ear, it should be gently washed with a mild soap and warm water, and the ear should be patted dry. No attempt at “q-tipping” or “digging” out the ear canal should be made at home. It is difficult to see the sensitive ear canal skin without proper tools and hence, during home attempts at probing, the canal the skin can be damaged, resulting in infection. The canal has an odd angle in a young child and the skin is very tender to the touch, and usually the child will find it extremely uncomfortable after a very short time, even if they are normally well-behaved and easy going. Finally, most cerumen can be quickly and painlessly removed if it is obscuring the ability to see the eardrum and diagnose other problems in the office, requiring only a compliant child and few minutes under the microscope. If you have concerns about ear wax and your child, please do not hesitate to contact Starfish Pediatric ENT of Charleston and schedule an evaluation today.
The ears of children are comprised of 3 sections: the outer ear, the middle ear, and the inner ear. The outer ear includes the outer “pinna” for capturing and reflecting sound into the ear canal, and the external ear canal, which directs sound to the eardrum. The middle ear is made up of the eardrum, several small bones which vibrate in response to sound, and the air around the bones. Finally the inner ear, a special sensory organ encased in bone, which converts mechanical sound waves into electrical signal to send to the brain, allowing us to hear the world around us. Then the air on one side of the eardrum is at a different pressure than the other, healing can be compromised. The body has a small channel from the back of the nasal cavity (high up behind that “punching bag” in the middle of the throat known as the uvula) known as the Eustachian Tube, which is only about 1 mm wide and opens and closes with swallowing and chewing. However, during upper respiratory illnesses, and occasionally for other reasons, this tube will malfunction and the middle ear will fill with fluid or abnormal air pressure. When this happens, healing is usually affected, pain may develop, and significant complications may arise. Sometimes this problem resolves as the underlying illness resolves, but for some patients the problem becomes more chronic and a surgical option may help. At Starfish Pediatric ENT of Charleston, Dr. Harris is an expert at diagnosing, treating, and surgically managing Eustachian tube dysfunction. If your child is affected by this condition or you are concerned that they might be, please do not hesitate to call. Frequently patients with these problems can be seen within 24 hours so an accurate
All children drool at some point, for a variety of normal development reasons. Children may develop excessive drooling, also known as “sialorrhea”, as part of a medical problem affecting the nose, mouth, or throat. Swallowing problems frequently result in drooling issues, especially if severe. One sad fact that has been discovered is that many children with special needs develop difficult to manage sialorrhea, and this has been shown to affect their bonding to their caregivers and others. For this reason, drooling that causes leakage beyond the lip throughout the day and night, leads to skin break down, or leads to airway complications, should be evaluated and treated. Many options exist for patients to address these concerns, from medication to surgical, and here at Starfish Pediatric ENT we are committed to working with you and your child to find solutions to improve the quality of life of your child.
Bad breath (Halitosis) is an embarrassing and difficult problem for many children. A combination of factors related to developing anatomy in the mouth, the teeth, and the throat, as well as diet and hygiene, may each play a role. If your child experiences halatosis along with frequent throat infections, discolorations of the mouth or tongue, abnormal breathing, sore throat or burning throat pain or swallowing, there may be other factors at play besides simple oral health and hygiene. If you are concerned that your child has developed halitosis due to a problem in the head or neck, please call the schedule an appointment today with Dr. George Harris at Starfish Pediatric ENT.
Lumps and masses in the head and necks of children can be startling, unnerving, and worrisome for the parents of children. The appearance of a mass in the neck of a child can be caused by remnants of development, infection, or abnormal cell growth. Many structures in the head and neck can develop regions of abnormal growth, and while these grows usually do not cause long term harm, many cause worry, must be thoroughly investigated and monitored, and ultimately may need to be surgically removed if present. The step-by-step process to determine the best treatment is specific to each individual and there is no “one-size-fit-all”. If you have concerns that your child suffers from a tumor of the head and neck, please call to schedule an appointment with Dr. George Harris at Starfish Pediatric ENT.
Decreased hearing leads to many problems for children, and for this reason Starfish Pediatric ENT is aggressive about identifying and treating hearing loss in children. While there are limits to the degree to which hearing can be corrected in some circumstances, no hearing loss is considered “normal” for children. Hearing loss impacts children’s development from birth throughout childhood, and is identifiable and treatable in many ways. Critical to success in correcting children’s hearing loss is the ability to continuously monitor hearing over longer periods of time to identify setbacks or regression as they occur and prior to significant interruption in normal development. Dr. George Harris with Starfish Pediatric ENT is here to support your child if hearing loss is identified. Call to schedule an appointment today if you are concerned your child has hearing loss.
A frequent source of concern in the young child is the development of hard-to-stop drainage from the nose. Mucus produced in the nose leaks out onto the skin and causes irritation and inflammation, and in some cases skin breakdown. Excess mucus can be caused by inflammation, infection, foreign material in the nose, or simply the inability for the mucus to drain naturally through the back of the throat. Occasionally, simple changes to the routine care of the nose can lead to significant improvements; other times, medication and even surgery may be involved in correcting excessive nasal drainage. Dr. George Harris is specially trained in the care of young children with nasal concerns, and applied the best diagnostic tools available to evaluate the problem, sometimes even using a specially sized ultrasmall pediatric flexible scope to evaluate the problem. Your child will be more comfortable during the evaluation because of this specialized equipment, and experience less discomfort than if a regular “general” scope was used. If you are concerned about your child’s nasal drainage, please do not hesitate to call Starfish Pediatric ENT to make an appointment.
The bones of the face, and the corresponding passageways in the head, allow for air to pass through the nose and into the throat, and eventually into the lungs. When there is an obstruction in the smooth flow of air through the nose, it leads to compensation in other areas (Usually without the child even being aware they have changed their breathing) and eventually disruption to quality of life. Mouth breathing, a common compensatory mechanism to nasal obstruction, may be the first sign that breathing is affected. A history of trauma or previous surgery can help your doctor understand what areas may be affected. Some obstruction is related to swelling of normal structures, due to inflammation or chronic infection. Other times, a physical obstruction due to previous fracture and slight changes in bone angulation are the culprit. If you are worried your child may suffer with nasal obstruction from any cause, please make an appointment today to have Starfish Pediatric ENT evaluate your child.
While “noisy breathing” can mean many things, Starfish Pediatric ENT believes no family should be left wondering if their child has a problem breathing. The term noisy breathing is used by caregivers wherever the child makes audible noises during regular breathing, and may be used as a substitute for increased work of breathing, trouble breathing, or uncomfortable breathing. Wheezing, whistling, snoring, snorting, and high-pitched stridor may all be thought of as “noisy breathing”. To the trained ear, however, the individual sounds can give clues as to the causes of the problem. Today, many families have the added tool of being able to record the child during an episode, for playback later with the doctor. These recordings can be very valuable and we encourage all families to make recordings whenever possible. If you believe your child is dealing with excessive noisy breathing, for any reason, please schedule an appointment today for evaluation.
Ear infections are extremely common in young children, and represent the most common cause of sick visits to doctors in children under 2 years of age. When the space behind the eardrum, called the “middle ear” becomes filled with infection and pus, and inflammation, there can be pain, decreased hearing, and discomfort. For certain types of infections, caused by bacteria, there is risk of infection spreading to the surrounding tissue and causing complications. Other causes do not lead to spread but can still be troublesome. Fortunately, treatment with medications is usually successful. However, in some cases treatment is ineffective or the infection returns before a full recovery, or there are reasons why treatment is complicated, such as allergies or GI issues, and other treatments must be considered. In these cases a surgery to place a small grommet (known as an “ear tube”) in the eardrum provides a means of removing infection, more easily identifying future infections, and more directly treating infections (the use of special ear drops). If you are worried your child may be having worrisome recurrent ear infections and would like to know more about treatment options available to you, please call Starfish Pediatric ENT of Charleston and schedule an appointment today.
Children can develop sinus infections from bacterial, viral, and even fungal infections. Sometimes, medications are used to treat the infections, while rinses and sprays are used to treat the tissue directly. In some cases, the tissue may become chronically or recurrenlty infected, and medication no longer provides much benefit. While rare, surgery on the sinuses for children may be necessary. New technologies, such as small balloon catheters which can expand the opening to a sinus without removing tissue, can be used to manage the underlying problem. If you believe your child suffers from sinus problems, please schedule an appointment today at Starfish Pediatric ENT of Charleston.
Children may suffer from periods of decreased or even stopped breathing during sleep, sometimes called “sleep apnea”, for several reasons. It is important to understand what to look for, to understand the cause for each patient, before surgery can be undertaken. In some cases, a special study known as a “sleep study” may be necessary to understand the severity of the problem. For some children, with mild obstruction, medication may provide the relief they need. Others will demonstrate more significant disease and surgery may be recommended. However, it is critical to understand the role surgery plays in the management of pediatric sleep apnea, and to understand that “one size fits all” does not apply. If you are concerned that your child might have sleep apnea, please call today to schedule an appointment with Starfish Pediatric ENT of Charleston.
Chronic sore throat, affecting eating, drinking, speech, and voicing, can have many negative effects. Many children suffer for a long time before a diagnosis is made. Luckily, there are many ways to investigate and solve this problem. A thorough evaluation, including a careful history, examination, and specialized testing including an endoscopic view of the area are helpful. Some patients have a constant problem, while others have a more “intermittent” course. Management varys, from medications (or medication changes), changes in eating habits, and rarely, surgery. If you are concerned that your child is having chronic sore throats, please schedule an appointment today with Starfish Pediatric ENT.
The development of speech and language throughout childhood is perhaps the defining characteristic of human development. Problems with speech development, the mechanics of speech, and voice problems can be separately defined and evaluated. Structures from the lips to the voice box can be involved, and careful evaluation by a qualified pediatric ear, nose, and throat doctor will help determine the cause, or causes, of the problem. Sometimes, problems in one area may affect another, such as hearing and speech. If you are concerned that your child is having speech or voice problems, please give us a call. We would welcome the opportunity to assist you and your child.
Swallowing problems can develop anytime in childhood, affecting children from newborn age through adolescence. To evaluate difficulty swallowing, a careful history, an expert physical exam, specialized testing, and the input of specialized therapists may be necessary to find the cause and determine what treatments are best. Some children with a history of serious medical problems, prematurity, and congenital conditions are at an even higher risk of swallowing problems, and may require multiple approaches. If you would like us to evaluate your child and determine if they suffer from swallowing dysfunction, and what treatments would be best, please give us a call today at Starfish Pediatric ENT of Charleston.
The ear canal skin of a child can become infected, usually through minor trauma followed by exposure to contaminated water. Frequently, children suffer ear pain, drainage, and tenderness of the ear after swimming in one of the lowcountry’s many beautiful but very “alive” waterways. Prompt diagnosis, differentiating this infection from a “middle ear” infection, can alleviate the pain quickly and prevent complications, including development of a pus pocket, or “abscess”. We understand how important it is to get your child relief quickly, and we are here for you. If you would like us to evaluate your child, please call us today. Starfish Pediatric ENT of Charleston is here for you and your child.
When the small lumps known as “tonsils” in the walls of the throat become infected, a child will experience pain and difficulty swallowing. There may be additional symptoms, such as pain in the ear, pain with neck movement, swelling in the neck, or pain with opening the mouth. Some of these symptoms may seem mild, but when grouped together, we call it tonsillitis, and it can lead to complications involving the formation of “pus pockets”, sometimes called abscesses. Chronic tonsillitis is the low-grade but continuous inflammation of the tonsil tissue seen with certain kinds of infections. If the tonsils are regularly infected or if complications are occurring, medical management may no longer be an option. Surgery to remove tonsils, in the hands of an experienced fellowship-trained pediatric ear, nose, and throat doctor, provides the best occomes for children of any age. Younger children are at a particular higher risk of complication, so special measures to manage their condition may be used by Dr. Harris. If you are concerned that your child is experiencing tonsillitis and would like an evaluation, please call today and make an appointment with Starfish Pediatric ENT of Charleston.
The larynx, or “voice box”, of a child is the narrowest point in the airway, and any problems that increase obstruction can have far-reaching effects. Additionally, the vibration of the delicate vocal cords must be smooth and effortless, or the child will experience discomfort, problems with speech and language, or breathing problems. Children with hoarse, rough voices should be evaluated for problems in the vocal cords. An expert history of the problem, examination, and specialized testing may all be used to make a diagnosis. Special surgical instruments called laryngoscopes may be used to see the voicebox up close, and microscopic instruments can be used to remove abnormal growths on the vocal cords. This type of specialzed care is available from Starfish Pediatric ENT of Charleston, and we look forward to caring for your child should they need this service. Please call us today to set up an evaluation.
All images courtesy of Mandy Riley Photography
Monday: 8:30 – 5:00 pm
Tuesday: 8:30 – 5:00 pm
Wednesday: 8:30 – 5:00 pm
Thursday: 8:30 – 5:00 pm
Friday: 8:30 – 5:00 pm
Saturday: Closed
Sunday: Closed
