Kids ENT Health Archives - ENT Health

Vaping Is Not a Safe Alternative to Smoking

John Trumbo — Sun, 18 Oct 2020 15:38:16 +0000

Vaping Is Not a Safe Alternative to Smoking

Vaping, the use of electronic cigarettes (e-cigarettes) or other Electronic Nicotine Delivery Systems (ENDS), has increased in recent years compared to the use of traditional cigarettes. Like traditional cigarettes, vaping has multiple harmful effects, including special concerns for young people. Despite recent regulations by the FDA, loopholes still exist that allow the sale of flavored ENDS devices to youth.

ENDS are battery-fueled devices that heat and vaporize liquid chemicals for inhalation. They are not combustion activated like regular cigarettes, but explosions and burn injuries have occurred from the lithium batteries that power the ENDS heating element. The enclosure around the battery, improper charging in the USB port, and expanding gas within the case are believed to be the most common triggers for explosions that can result in severe injuries including substantial facial burns, fractures, and/or loss of vision.

A September 2020 Centers for Disease Control and Prevention (CDC) study reported, “During September 2014–May 2020, e-cigarette sales increased by 122.2%. Sales of prefilled cartridges increased during September 2014–August 2019; since then, sales of disposable products have increased. Prefilled mint cartridge e-cigarette sales increased from September 2014 to August 2019, then decreased, as menthol sales increased during August 2019–May 2020.”

What Are the Health Risks of E-cigarettes and Vaping?

Poisoning has occurred in children from ingesting the highly concentrated nicotine found in the ENDS chamber and refill containers. These products are often marketed with colorful, attractive packaging and flavors (e.g., fruit, candy, and mint), which can be tempting to children. Nicotine poisoning in young people can result in coma, seizures, heart attack, cancer, and death.

The “e-liquids” in ENDS, even in absence of nicotine, have been shown to harm middle ear function, and e-cigarette use increases the risk of asthma attacks in youth. Furthermore, the recent (2020) use of e-cigarettes is associated with a five-fold higher risk of COVID-19 infection in a survey of adolescents and young adults, possibly due to respiratory poisoning and frequent hand-to-face touching in users.

Use of e-cigarettes in pregnancy can have multiple harmful effects on the fetus, and the harm may occur before the mother knows she is pregnant. Smoking of all types increases the risk of congenital heart defects. Nicotine exposure in utero can increase the risk of childhood and adult high blood pressure, impair the development of normal brain circuits, and is associated with pre-term births and still births.

Nicotine in e-cigarettes may affect the maturing brains of adolescents, leading to emotional disorders and increasing impulsive reactions. Nicotine is an addictive drug and may lead to addiction to other “hard” drugs.

Additional Resources

https://e-cigarettes.surgeongeneral.gov/knowtherisks.html

https://e-cigarettes.surgeongeneral.gov/documents/SGR_ECig_ParentTipSheet_508.pdf

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm

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Secondhand Smoke and Children

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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Secondhand Smoke and Children

John Trumbo — Fri, 06 Sep 2019 18:20:01 +0000

Secondhand Smoke and Children

Secondhand smoke is a combination of the smoke from a burning cigarette and the smoke exhaled by a smoker. It contaminates the air and is collected in clothing, hair, curtains, and furniture. Many people find secondhand smoke unpleasant, annoying, and irritating to the eyes and nose. More importantly, it represents a dangerous health hazard. According to the Centers for Disease Control and Prevention (CDC), tobacco smoke contains a deadly mix of more than 7,000 chemicals, hundreds of which are toxic, and about 70 can cause cancer.

Who Is at Risk of Secondhand Smoke?

Although secondhand smoke is dangerous to everyone, fetuses, infants, and children are at most risk because it can damage developing organs, such as the lungs and brain. About four out of 10 U.S. children ages three to 11 (40.6 percent) are exposed to secondhand smoke. The percentage of U.S. children and teens living with at least one smoker is about three times the percentage of nonsmoking adults who live with a smoker.¹

Furthermore, it’s estimated that secondhand smoke caused nearly 34,000 heart disease deaths each year between 2005 and 2009 among adult nonsmokers in the U.S., and secondhand smoke exposure caused more than 7,300 lung cancer deaths each year among adult nonsmokers in the U.S. during the same time period.²

What Are the Effects of Secondhand Smoke on Children?

Maternal, fetal, and placental blood flow change when pregnant women smoke, although the long-term health effects of these changes are not known. Some studies suggest that smoking during pregnancy causes birth defects such as cleft lip or palate.³ Smoking mothers produce less milk, and their babies have a lower birth weight. Maternal smoking is also associated with neonatal death from Sudden Infant Death Syndrome, the major cause of death in infants between one-month and one-year-old.^4-5

Exposure to secondhand smoke decreases lung efficiency and impairs lung function in children of all ages. It increases both the frequency and severity of childhood asthma, and aggravate sinusitis, rhinitis, cystic fibrosis, and chronic respiratory problems such as cough and post-nasal drip. It also increases colds and sore throats. In children under two, secondhand smoke exposure increases the likelihood of bronchitis and pneumonia. Children of parents who smoke half a pack a day or more are at nearly double the risk of hospitalization for a respiratory illness.

Exposure to secondhand smoke increases both the number of ear infections a child will experience, and the duration of the illness. Inhaled smoke irritates the eustachian tube, which connects the back of the nose with the middle ear. This causes swelling and obstruction which interferes with pressure equalization in the middle ear, leading to pain, fluid and infection. Ear infections and middle ear fluid are the most common cause of children’s hearing loss. When they do not respond to medical treatment, the surgical insertion of tubes into the ears is often required. Upon insertion of tubes, secondhand smoke increases the risk of persistent drainage from the tubes.⁶ Secondhand smoke also puts teenagers at a higher risk for low-frequency sensorineural hearing loss that is directly related to level of exposure.⁷

Finally, children of mothers who smoked during pregnancy are more likely to suffer behavioral problems such as hyperactivity than children of non-smoking mothers. Modest impairment in school performance and intellectual achievement has also been demonstrated.

How Can I Limit or Eliminate My Child’s Exposure to Secondhand Smoke?

Here are some steps you can take to help protect your child or children from the harmful effects of secondhand smoke:

If you smoke, stop now. Consult your physician for help, if needed. There are many new pharmaceutical products available to help you quit, in addition to support groups and online resources.
If you have household members who smoke, help them stop. If it is not possible to stop their smoking, do not allow them to smoke in your home or near your children.
Do not smoke or allow smoking in your car.
Be certain that your children’s schools and daycare facilities are smoke-free.

References

¹ https://www.cdc.gov/tobacco/basic_information/secondhand_smoke/children-home/index.htm
² U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014
³ Burg ML, Chai Y, Yao CA, Magee W 3rd, Figueiredo JC. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate. Front Physiol. 2016, 7:67.
⁴ U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General: Secondhand Smoke: What It Means To You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006
⁵ U.S. Department of Health and Human Services. A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010
⁶ Bizzell JG, Cox MD, Want AR, Richter GT, Nolder AR. The impact of tobacco exposure on development of otorrhea after myringotomy tube placement. Int J Pediatr Otorhinolaryngol. 2017, 92: 67-69.
⁷ Lalwani AK, Liu YH, Weitzman M. Secondhand smoke and sensorineural hearing loss in adolescents. Arch Otolaryngol Head Neck Surg. 2011, 137: 655-662.

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The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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Facial Sports Injuries

John Trumbo — Fri, 06 Sep 2019 17:22:18 +0000

Facial Sports Injuries

Participating in sports is a great way to stay healthy and active, but facial sports injuries are all too common, whether you’re playing softball, basketball, football, soccer, bicycling, or nearly any kind of physical activity. Even the use of popular standing electric scooters has led to increased emergency room visits for injuries such as fractures, head trauma, cuts, contusions, and sprains. UCLA researchers recently studied patients in the ER “with injuries associated with electric scooter use during a one-year period, with 10.8 percent of patients younger than 18 years and only 4.4 percent of riders documented to be wearing a helmet.”¹

The best way to treat facial sports injuries is to prevent them. Here are some guidelines to help you ensure a safer athletic experience:

Wear protective equipment such as helmets, padding, face masks, head and mouth guards, ear protectors, and/or goggles depending on the activity
Cover non-removeable goal posts and other structures with thick, protective padding
Carefully check equipment to make sure it’s functioning properly
Have adequate adult supervision for all children’s competitive sports
Prepare athletes with warm-up exercises before engaging in intense team activity
Be sure the playing area is large enough and free from dangerous obstructions or obstacles, particularly for sports involving motorized vehicles

What Are the Most Common Types of Sports Injuries?

Even the most careful person can get hurt. Here are some common types of injuries:

Facial fracture—Getting hit in the upper face, by a ball or bat, for examples, can fracture the delicate bones around the sinuses, eye sockets, bridge of the nose, or cheek bones. A direct blow to the eye is very dangerous and may cause a fracture, as well as blurred or double vision. It’s important to pay attention to swelling because it may be masking a more serious injury. Applying ice packs and keeping the head elevated may reduce early swelling.

When your jaw or lower face is injured, it may change the way your mouth and teeth come together. To restore a normal bite, surgeries often can be performed from inside the mouth to prevent visible scarring of the face; and broken jaws can often be repaired without being wired shut for a long period. Your primary care physician or ENT (ear, nose, and throat) specialist, or otolaryngologist, can explain the latest treatment techniques and your unique treatment options.

Soft tissue injuries—Bleeding underneath the skin causes bruising. Applying pressure, elevating the bruised area above the heart, and using an ice pack for the first 24 to 48 hours minimizes discoloration and swelling. After two days, a heat pack or hot water bottle may also help. Most of the swelling and bruising should disappear in one to two weeks.

External bleeding from cuts and scrapes can be stopped by immediately applying pressure with gauze or a clean cloth. When the bleeding is uncontrollable, you should go to the emergency room.

Scrapes should be washed with soap and water to remove any foreign material that could cause infection. Abrasions can often be treated at home by cleaning the area with three-percent hydrogen peroxide, and covering it with an antibiotic ointment or cream until the skin is healed. Cuts or lacerations, unless very small, should be examined by a physician as stitches may be necessary.

Bandages may be needed to protect the area while it heals. Residual scarring after six to 12 months can be discussed with a facial plastic surgeon.

Nasal injuries—The nose is one of the most injured areas on the face. Applying a cold compress and keeping the head higher than the rest of the body can help provide early treatment. Nosebleeds are common and usually short-lived. Often, they can be controlled by squeezing the nose with constant pressure for five to 10 minutes.

You should seek medical attention if you or the injured person has difficulty breathing, an obvious deformity of the nose, persistent bleeding, or deep cuts.

What Should I Do during an Injury?

Call 911 for medical assistance if you suspect the injury may be serious
Do not move the victim or remove any helmets or protective gear
Do not give food, drink, or medication until a medical professional has determined the extent of the injury
Be very careful around body fluids, and protect your hands with plastic bags in an emergency
Apply pressure to bleeding wounds with a clean cloth or pad
If the eye or eyelid is affected, or a loose bone can be seen or felt, do not apply pressure but gently cover the wound with a clean cloth
Apply ice or a cold pack to areas that have suffered a blow (such as a bump on the head) to help control swelling and pain

Reference

¹ Trivedi TK, Liu C, Antonio ALM, et al. Injuries Associated With Standing Electric Scooter Use. JAMA Netw Open. 2019;2(1):e187381. doi:10.1001/jamanetworkopen.2018.7381

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The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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Treatment for Pediatric Allergies

John Trumbo — Thu, 07 Feb 2019 19:12:58 +0000

Treatment for Pediatric Allergies

Inhalant and contact allergies in children—those that can be inhaled or touched—are often caused by excessive immune system responses to everyday things in the environment. Outdoors, things like pollen, plants, molds, and insect bites can cause a serious reaction. Indoors, things like mold, dust mites, or exposure to animal hair, skin, or saliva can also cause allergic issues. Some children can also be allergic to certain foods and medications when ingested.

Since the normal process of breathing allows the lining of the nose, throat, voice box, and lungs to come into direct contact with airborne particles of potentially allergic substances, these are often the most affected areas in the body. Particles in the air can cause sneezing, itchy eyes with circles under the eyes, itchy ears with blockage, swelling of the face and airway, drainage from the nose into the throat, tickling in the throat, and coughing. Eyes can become dry or runny and red, and the nose can be congested or runny with a decreased sense of smell.

The most important way to identify potential allergies is to watch your child’s reaction to foods and different environmental settings. Food allergies can cause stomach aches, vomiting, and diarrhea, and may indicate a serious reaction to something your child ate or drank. Paying special attention to foods like peanuts, milk, eggs, wheat, and shellfish can help narrow down what your child might be allergic to.

What Should I Do if My Child Has Allergies?

The most concerning allergic reaction is called “anaphylaxis,” when the air passages swell and close. This reaction can be life-threatening, and can happen quickly, or it might happen hours after exposure. Anaphylaxis is usually treated with an injection of adrenalin from an Epi-Pen, and parents often take their child to the emergency room for treatment and close monitoring.

Although less serious than an anaphylactic reaction, chronic airway obstruction and drainage can lead to infections, poor sleep, and fatigue at home, in school, or during physical activities. Allergic symptoms such as a stuffy nose and sneezing can also resemble a common cold or sinus infection. Kids with allergies may be more prone to getting multiple ear infections or nose and throat infections. However, controlling allergies can often lead to less infections and illness and overall improvement.

Discussing your child’s symptoms—when they occur and how severe they have been—with your primary care physician or ENT (ear, nose, and throat) specialist, or otolaryngologist, is the most important way to determine what may be making your child sick. Common tests help determine exactly what your child is allergic to, and how to help them. Skin or blood tests can be performed in the office with minimal discomfort that can identify specific things that your child should stay away from.

Your doctor can instruct you in basic preventive measures to follow at home and might start your child with a nasal spray, eyedrops, or an antihistamine pill to relieve their symptoms. Most antihistamines for children do not cause drowsiness. For more severe allergic reactions, allergy shots (sometimes called subcutaneous immunotherapy) or drops placed under the tongue (sometimes called sublingual immunotherapy) might be helpful for long-term control.

Because certain allergies can be hereditary and run in the family, be sure to let your doctor know if other family members have allergies, asthma, sinus infections, or reactions to certain foods. That can help identify what might be happening with your child.

What Other Steps Can I Take to Protect My Child from Allergies?

Even though there is no cure for allergies, patients can be gradually desensitized to many substances and their symptoms can be managed. The best first step is to avoid allergic triggers and let everyone—family members, teachers, parents of your child’s friends—know that your child has a certain reaction.

At the grocery store or a restaurant, be aware that even though a specific food may not be in a dish, there is a possibility that the allergic substance can be nearby or in materials used to cook certain dishes, which can also cause a problem. Make your server aware of food allergies prior to ordering.

Finally, you may wish to consider special air filters, linens, pest control methods, hot water in the washing machine, and changing the way your child interacts with family pets can also help decrease their allergic symptoms and discomfort.

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The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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