In order to ensure that articulation therapy is successful, goals need to be targeted at the right level during every practice session. Throughout this blog, I will be discussing how you can work on target sounds at word level. Here are a few activities that are useful for targeting sounds at these levels. Sounds in […]
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Earwax is a vital substance. The skin glands in your ears produce it to repel water and to keep your ear canal free of unwelcome foreign matter. It traps dust, dirt, bacteria, and other outside matter that could otherwise cause major damage to your eardrum. As material gets caught in it, wax builds up just a little bit, and then dries out and washes away out of the ear.
Unfortunately, we all know that too much waxy buildup in the ears can also cause some really uncomfortable problems, especially for children. When your child is sick, the ceruminous glands in their ears will tend to produce wax faster than their body can shed it, causing the ears to be plugged up with waxy buildup.
Because your child’s Eustachian tubes are more horizontal than an adult’s is, they cannot drain fluids as efficiently. This, in conjunction with waxy buildup as a result of a cold or sinusitis, can lead to very painful ear infections. Clearing out excess earwax can help your child hear better and sometimes help him or her feel better too, but you have to be very careful.
You might be tempted to try to clean your child’s ears out with a Q-tip or cotton bud, but do not do this under any circumstances. In fact, do not stick any foreign objects in your child’s ear canals.
For one thing, your child’s eardrum is as thin as a tissue, and you could very easily push too far into the ear canal, put pressure on it, and cause it to burst. Second, rubbing around in your child’s ear canal with a Q-tip is likely to just pack the earwax farther into the canal, rather than extracting it. This method is not only dangerous, but it’s also very ineffective.
First of all, do make an appointment with your child’s ear, nose, and throat doctor. Waxy buildup may be indicative of other problems, or may be easily mistaken for outer ear infection – otitis externa. Treatment with prescription ear drops may be needed. In any case, do not try to self diagnose your child at home.
The ENT doctor will likely manage your child’s ears under the microscope. If there is tenacious wax down deep in the ear canal, the doctor may have to carefully remove it out manually. This process is uncomfortable and sometimes painful, depending on the degree of infection. So be prepared to hold your child’s hand and to give them a big hug when it is over.
If you can’t get to the ENT specialist, you can help your child with a little bit of relief in the meantime. First, if there is any wax built up around the outside of the ear, go ahead and wipe it away gently with a warm, damp washcloth. Next, you can see your local doctor, who will be able to contact an ear nose throat specialist as needed.
After the ears are cleared, your ENT specialist may suggest maintenance with olive oil ear drops. This is a traditional remedy for removing ear wax. Use an eyedropper to squeeze about 1-2 drops of olive oil into the ear. Make sure that your child lies still for at least 5 minutes. Repeat the process for the other ear. Managing waxy ears at home is safe if you do it this way, but it should not be used as a replacement for visiting the ENT doctor. If your child’s ears are overproducing wax and causing problems, it’s time to make an appointment to treat the problem, and to also ensure that there is no underlying infection.
If you have questions about ear wax buildup or otitis externa management contact your local doctor who will arrange for you see an ear nose and throat surgeon.
The post What to do about Waxy Buildup in Your Child’s Ears appeared first on ENT Clinic Sydney.
Epidermolysis bullosa is a blistering skin disease which is usually first noticed during early childhood. In epidermolysis bullosa, blisters form on the skin following minor skin trauma, such as bumping into objects, sitting on hard surfaces and walking. This is because the skin of sufferers of epidermolysis bullosa is highly fragile. It is a rare genetic condition, and there is a positive family history of the disease in many patients who are diagnosed with the disease.
There are three main types of epidermolysis bullosa which are classified according to the level of the skin which is affected. The deeper the level of the skin affected, the more severe the disorder.
The three subtypes are:
There are several subtypes of epidermolysis bullosa, which have varying degrees of severity:
Mild forms: The most common subtype is called the Weber-Cockane subtype, and this is the mildest form of the disease. Blisters are mainly found on the palms of the hands and the sole of the foot, and in most instances were caused by some form of trauma to the area. This subtype is sometimes also associated with hyperhidrosis, which is a condition which causes excessive sweating.
Severe forms: In the more severe subtypes of epidermolysis bullosa simplex (Koebner subtype and Dowling-Maera subtype), the blisters are more widespread and the onset of blistering is first noticed a short period of time after birth. Particularly in the Dowling-Maera subtype, the blisters may affect the mucous membrane lining the mouth. In the Koebner subtype, patches of the skin, particularly of the palms and soles, become thickened and the pigmentation of the skin appears darker.
There are 2 main subtypes of the condition:
Herlitz subtype: This is the most severe form of junctional epidermolysis bullosa. This subtype is often fatal and children affected by the condition generally do not survive beyond infancy, because they are very prone to infections which can enter the bloodstream. Additionally, there are also respiratory problems because the condition affects both the skin and internal organs. On the skin, there are obvious erosions surrounding the mouth, nose, eyes and anus. It also affects the lining of the gastrointestinal tract, from the mouth to the rectum, the lining of the respiratory system, the eyes and the lining of the genitourinary system.
Non-Herlitz subtypes: These subtypes cause deeper blisters and erosions than what are seen in epidermolysis bullosa simplex. The blisters are quite widespread across the body. The non-Herlitz forms may also affect the nails, the scalp and the teeth. There may be some involvement of internal organs, particularly of the gastrointestinal tract, with the non-Herlitz subtypes.
The blistering is severe and very prone to infection, as the wounds heal poorly. The long-term skin inflammation caused by dystrophic epidermolysis bullosa is problematic, as it can damage the DNA within the skin cells. This greatly increases the risk of developing squamous cell carcinoma. The life expectancy of sufferers of dystrophic epidermolysis bullosa is approximately 30 years; with death usually resulting from complications of the disorder itself or due to squamous cell carcinoma. The skin of children with this condition is very fragile, and for this reason, children with the disorder are sometimes called “Butterfly Children)
The signs and symptoms of the disease vary depending on the subtype.
Some possible signs and symptoms of the condition include:
There are multiple complications which are associated with epidermolysis bullosa. The potential complications vary with the subtype and the severity of the disorder. The most common complication of epidermolysis bullosa is infection. Having intact, unbroken skin is one of our most important defences against infection, because the skin has many defences that can stop bacteria and viruses from entering.
The blisters and erosions break the skin and it is very easy for bacteria and viruses to enter the skin and cause infection. Infections of the wound can then also spread to the bloodstream and result in sepsis; which is a very serious and potentially fatal complication if left untreated. The skin is also an important organ because it helps to prevent loss of fluid. Patients with epidermolysis bullosa are prone to dehydration, because the breaks in the skin allow fluid to escape easily. As mentioned above, chronic inflammation in the skin can induce DNA mutations in skin cells, which greatly increases the risk of developing squamous cell carcinoma. Particularly with subtypes affecting the deeper skin layers, contractures can form, which can lead to impaired joint function and deformity.
Complications can also arise from internal organ involvement. Due to involvement of the gastrointestinal tract, there are often difficulties with feeding and nutrition. If the lining of the mouth and oesophagus are affected, eating and swallowing is painful, and it is difficult for the sufferer to eat and drink sufficiently. Additionally, scarring of the oesophagus can result in narrowing, which also makes it difficult for food to pass down into the stomach. Due to reduced intake of food and drink, children can become malnourished, which can lead to problems with growth and development.
Good nutrition is important for skin healing, so this can lead to an added problem of slow wound healing. If intake of fibre is inadequate, this can contribute to constipation, which is often already an issue due to blistering and narrowing because of scarring. In some forms of the disease, the eyes can be affected, which can lead to visual problems and potentially blindness in severe circumstances.
Treatment of epidermolysis bullosa is aimed at treating symptoms and complications. There are no medications or treatments which can treat the underlying causes.
Some possible treatments for the disorder include:
The post Epidermolysis Bullosa appeared first on Dermatology Sydney.
What is PCOS? Do you find yourself putting on weight very quickly and are unable to loose weight quickly? Do you have irregular menstrual periods? These could be signs of PCOS. PCOS refers to polycystic ovary syndrome which is a complex hormonal condition. When diagnosing PCOS doctors use the Rotterdam criteria. A patient must fulfil […]
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In my last blog, I discussed one of the most common therapy hierarchies used when treating articulation disorders known as Van Riper’s model and how homework can be completed within the first stage of the hierarchy, which is working on sounds in isolation. Van Riper’s model is a framework used to structure speech therapy. AS […]
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