CHILDRENS PROBLEMS: THE EARS

CARE OF THE EARS

The ears do not require a lot of care and concern because, generally, they are adequately protected. It is important to keep the ears warm and covered as they have little protection from the cold or excessive sun and, as the blood vessels to the ear are very small, damage may take time to repair. Sunburn and gangrene are not uncommon in extremes of weather and the use of protective covering such as sun-blocks and ear muffs should always be considered.

The ear canal is lined by small hairs called cilia, which meticulously flick outwards dirt and debris that enter the canal. Different people will create different amounts of secretion, which, if in excess, can block the canal and is known as ear wax .

Cleaning of the ear should be done daily using mild soap and water, cleaning only the external or pinna part of the ear. The use of ear-buds (small balls of cotton on the end of sticks) may cause more harm than good. The insertion of anything into the ear can push dirt, wax and infection deeper into the ear and is unlikely to be of any great benefit because the cilia will do the job.

The need for the protection of the ears from loud noises is becoming more apparent as younger people are experiencing auditory loss (deafness) at an alarmingly increasing rate. This has been associated with the advent of loud popular music but more so with the widespread use of personal stereos. Loud noises cause vigorous vibrations that, in turn, cause small abrasions around the ear ossicles, which slowly but surely scar and reduce the mobility of these middle ear bones. Conductive deafness is the outcome, which may not be repairable .

EAR PROBLEMS

Problems with the ear can occur at any age but they are most frequently associated with children. The reason for this is probably twofold. Firstly, the middle ear (the most common area to cause problems) is much smaller and therefore easier to affect and, secondly, children are more prone to mucus production and coughs and colds, which can block the narrow Eustachian tube (the channel between the middle ear and the throat).

Anatomically and medically speaking there are three parts to the ear:

The pinna and outer canal make up the outer ear.

The middle ear, including the stapes, incus and malleus (which are the ear bones or ossicles).

The inner ear comprising the cochlea, which contains the fluid through which sound waves are transmitted to the auditory nerves.

Problems must therefore be divided into which part of the ear is affected and treated accordingly.

ACHES AND PAINS Outer ear

Pains in this part of the ear are usually caused by the cold, trauma, infections or foreign bodies. Eczema of the external ear may often lead to infection and treatment of this dry skin is necessary. Common sense is the initial treatment, including warming of the pinna, removal of foreign objects and application of soothing balms.

Apply common sense, especially with regard to the removal of foreign objects .

Topical application of Arnica or Calendula creams may be curative.

An inflamed external ear associated with cold wind may be successfully treated with Aconite 6, one dose every 2hr.

Review the remedies Petroleum and Graphites if there is eczema associated with the external ear discomfort.

Middle ear

Aches and pains in the middle ear are usually associated with infection or trauma caused by loud noises.

It is well accepted throughout the orthodox medical world that approximately 50 per cent of ear infections are caused by viruses. The pain is the same but the use of antibiotics (ineffective against viruses) should be limited to infections that are caused by bacteria. The persistent use of antibiotics in ear infections leads to resistant strains and recurrent infections. I recommend that antibiotics are used only when a problem is very severe and preferably after the GP has taken a swab of any discharge and sent it to a laboratory for confirmation of the presence of bacteria. The use of an antibiotic may weaken the individual’s immune system and prolong the problem .

RECOMMENDATI

Earache that is severe or persistent should be assessed by a GP. If the GP recommends an antibiotic, ask if it is possible to take a swab (it may not be feasible if there is not discharge) and ask the GP’s opinion on whether he/she is convinced that it is not viral.

One or two drops of mullein oil can be instantly relieving and potentially curative. This can be repeated every 3 or 4hr if required.

If there is discharge associated with the pain, whilst awaiting the laboratory report on the swab that should have been taken by your doctor or practitioner, consider reviewing the following homeopathic remedies: Pulsatilla, Hepar sulphuris calcarium, Chamomila, Silica and Belladonna.

If there is discharge, keep the outside of the ear as clean as possible but do not attempt to clear the ear canal.

Earache without discharge requires reviewing the following homeopathic remedies: Allium cepa, Gelsemium, Belladonna, Magnesia phosphorica.

With or without discharge, opening of the Eustachian tube is beneficial because it allows drainage of any catarrh in the middle ear. This is best achieved by inhalations of Olbas or lavender oil (one drop in a bowl of steaming water) or inhaling the steam from a ginger tea (chop half-inch of ginger root in hot water).

Inner ear

Pain emanating from the inner ear is difficult to assess and an infection of this part of the ear requires specialist attention.

RECOMMENDATIONS

Follow the advice of an ear, nose and throat specialist.

Gain the advice of a homeopath based on these symptoms.

BLEEDING FROM THE EARS

Bleeding from the ear is potentially a serious matter that requires a medical opinion to illuminate the cause. A small visible scratch with a little blood loss is not relevant and can be treated with commonsense but any bleeding that comes from within the canal or deeper and is not caused by an external cut must be seen by a physician.

RECOMMENDATION

All bleeding from the ear must be dealt with by a physician (unless from a visible, accessible cut).

EAR WAX

See Care of the ears.

Certain children have a predisposition to wax build-up and regular review by parents, gently pulling the ear lobe down and forward will allow visual access. If in doubt, please ask your GP to have a look.

RECOMMENDATIONS

Reduce mucus-forming foods such as dairy produce, refined foods and especially white sugar.

Do not attempt to clear out the ear by inserting any objects.

Proprietary ear wax-softening solutions available from chemists are safe and more effective than naturopathic compounds. Warm olive oil may be used, however, with some effect.

Persisting wax may need to be ‘washed out’, which should by done only be experienced medical practitioners, especially in children. Before this you may have success with proprietary drops and supporting the child’s head in a comfortably hot bath with the ears below the water line. • Please do not use ear wax candles at any age, and especially not in children.

FOREIGN BODY IN THE EAR

It is not uncommon for small children, in particular, to lodge small objects in the ear canal. If these are not easily removed, do not attempt to do so without medical attention.

RECOMMENDATIONS

An easily visible and removable object can be dealt with by fingers or blunt tweezers. If there is any resistance, either from the child or the object, take the child to hospital.

One or two drops of castor oil, olive oil or even vegetable oil on the way to the hospital may alleviate the problem sooner. ‘GLUE’ EAR

Glue ear is not strictly a medical term although it has entered the vocabulary. It is characterized by a thick mucus/catarrh that coagulates within the middle ear and is then unable to travel down the Eustachian tube. This thick syrup prevents the ear bones or ossicles from vibrating in response to sound waves and therefore leads to conductive deafness. The problem is compounded in youngsters who may not hear their teachers, parents or peers and therefore it can lead to poor academic standards, disobedience and poor sociability. A child may be incorrectly labelled retarded in extreme cases.

The thickened catarrh can also act as a medium for the growth of bacteria and fungi, thereby predisposing the child to recurrent infections. Glue ear is most frequently associated with: • Poor hydration (allowing the catarrh to become thick and tenacious).

Excess mucus production (associated with mucus-forming foods such as white sugar).

Poor immune system response (encouraging the production of mucus as a defence process).

Food intolerance/allergy (particularly dairy products).

One of the most important causes is passive smoking. A child living in a home where a parent smokes is 50 per cent more likely to have glue ear. Parents, please note that even if you do not smoke in the presence of your child it may still be a problem because the cigarette toxins settle on carpets, curtains and furniture they are then inhaled when the child moves around the room.

RECOMMENDATIONS

The diagnosis of glue ear needs to be established by a practitioner looking at the external eardrum and seeing a level of fluid in the ear. Try the following alternatives before using decongestant or operative options.

Consult a complementary medical specialist to ensure that the child has a sound and effective immune system.

Remove mucus-forming foods such as dairy products, refined foods and especially white sugar. Food intolerance/allergy testing by bioresonance or blood analysis is recommended.

If the child is catarrhal, use the homeopathic remedy Allium sativa. For chronic catarrh associated with ringing or noises in the ear, consider Causticum, Chenopodium or Calcarea Carbonica. All these homeopathic remedies can be used at potency 6, three doses a day for two weeks, in association with the necessary restrictions discussed in the previous recommendation.

Ensure that adequate water is being drunk. Aim at one pint of water per foot of height per day. Juice and other fluids are not the same as water.

The use of Olbas or lavender oil inhalations as a decongestant may open the Eustachian tube, and in conjunction with good rehydration making the catarrh less viscous, may allow the ‘glue’ to drain.

If treatment is not effective, then the placing of small plastic tubes (grommets) through the eardrum under anaesthetic is a surgical option. See Operations and surgery if this is required. Prior to this, a GP may recommend decongestants but I have not seen these work well.

Do not allow the child anywhere near an environment where smoking has occurred.

See Otitis media and Catarrh.

Can the doctor see fluid behind the eardrum?

Does the doctor have strong grounds for believing that the infection is bacterial?

General practitioners are becoming less swift to prescribe an antibiotic for what may be a viral infection, but this does often occur unnecessarily . A red eardrum with no fluid behind it is not likely to burst nor have any permanent damage done and naturopathic treatments could be employed for 24 hours before an antibiotic is used. An eardrum that has burst and allowed the fluid to discharge is not a permanently damaging event in most cases. The infection will be able to leave the body and usually the eardrum heals perfectly.

RECOMMENDATIONS

If you suspect an ear infection (the infant is pulling at the ear), visit your GP.

If the GP recommends antibiotics, ask the reasons why a bacterial infection is suspected.

If the GP is ambivalent regarding whether the infection is bacterial or viral ask the GP if waiting 24hr may be dangerous.

If the GP is not insistent, then apply two drops of mullein oil or warm olive oil, four times a day to both ears.

Homeopathic remedies are often very effective. The most commonly prescribed are Aconite, Belladonna, Pulsatilla and Silica. Refer to a homeopathic manual to select the best treatment.

INFECTIONS OF THE EAR Middle ear (Otitis media)

Diagnosis of a middle-ear infection can only be made with the use of an otoscope in the hands of an experienced professional. If the doctor diagnoses an ear infection, ask the following questions.

If the problem has not resolved over 24 hours, consult a naturopathic practitioner; and if 24 hours later the problem persists, then consider using antibiotics.

Outer ear

Occasionally the outer ear may become irritated, red or scaly.

RECOMMENDATIONS

Two drops of mullein oil four times a day.

Bring any persistence to the attention of a naturopathic physician.

Keep the outer part of the ear clean.

Give the child the herbal remedy Echinacea at a dose recommended for children on the packaging or obtain advice from a local pharmacist or naturopathic practitioner.

Select a homeopathic remedy dependent upon the symptoms from your preferred homeopathic manual. In the meantime, give Pulsatilla 6, two pills every 2hr.

Avoid antibiotics. General practitioners are still too quick to prescribe for what may be a viral infection. Many reports in top medical journals suggest that antibiotics should only be used after a definitive diagnosis of a bacterial infection has been made.

RUPTURE (PERFORATION) OF THE EARDRUM

Rupture of the eardrum, also known as perforation, is associated most commonly with middle-ear infection or trauma. Middle-ear infection causes pressure outwards, which is markedly painful until the eardrum bursts and the pain is relieved. Discharge and small amounts of blood are the characteristic symptoms. Trauma, usually from loud blasts or a slap with an open hand, causes the eardrum to burst inwards, which is characterized by a very severe and sharp pain followed by a dull ache.

Hearing may or may not be affected, depending on the cause, size of the tear and associated damage to the ear ossicles.

RECOMMENDATIONS

Any suggestion of the above symptoms should be taken for review to your doctor.

Small tears or perforations will generally repair without problem but larger tears may require the expertise of surgical repair.

In the case of rupture caused by infection, antibiotics may need to be used because homeopathic or naturopathic therapies may work too slowly and the infection may worsen the rupture or destroy the eardrum. It may be easier for a complementary practitioner to deal with the side effects of the antibiotics than to repair a potentially serious eardrum injury.

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