Earache + Speech/Hearing Flashcards
if a child came in with ear ache what questions would you ask first?
How long have you had the symptoms for- acute or chronic condition
Have you had these symptoms before- showing recurrent or chronic conditon
How do you know if the child actually has an earache?
He points to the ears and says it hurst
He holds his hands over his ears
He is tugginh on his ears
His ears are red
What else do you need to know if the child presents with fever
other symptoms like irritability crying lethargy
What other question would you ask related to the ears?
Discharge: when, what, how much, how long, smelly
Hearing: think a little about how you would assess that in a 2 year old
Any previous problems
How can blocked nose lead to a ear infection
Blocked nose due to large adenoids might predispose to ear infections
How can a childs past medical history suggest an ear infection
COndition that might affect the immunity like downs syndrome and cystuc fubroiss
how can a childs social history suggest ear infection
Passive smoking, attendance at nursery?
If a child came in with ear ache how would you go ablut examinig the patient?
CHeck pulse and temp
Look at ears with aurosope
nose throat and general examination too
Name the very common ear infection
Acute otitis media
What is Acute otitis media?
An acute inflammation of the middle ear
Initially inflammation of the ear drum and middle ear mucosa
Fluid also in the middle ear
Why is Acute otitis media very common in young children?
Because children have shorter, wider and immature eustachian tubes. These are the tubes that connect the middle ear to the nasopharyx.
Young children have adenoidal tissue that is located between the Eustachian tubes. This is prone to infection and enlargement .
The immune system is immature
Acute otitis media is more common in…..
Autumn and winter
children who attend nursery
children who are bottle fed
children who are exosed to passive smoking
Patho of Acute otitis media
Viral URTI
inflammation and hyperemia of the middle ear mucosa
Mucoid exudate
Mucopurulent exudate
Perforation of tympanic membrane
Wht is a common cause of Acute otitis media
viral infections
Bacteria commonly responsible for Acute otitis media include
S pneumoniae, H influenzae, M. catarrhalis
Acute otitis media treatement
Analgesia alone for 24 to 48 hours
Abx and analgesia if the symptoms persist or are severe
Oral: amoxicillin, cefaclor, azithromycin according to local policy
Topical drops (Ciprofloxacin) if the drum has perforated and there is persistent discharge
Acute otitis media complications
Otutus Media with effusion
Recurrent Acute Otitis Media
Persistnet perforation/Chronic Otitis MEdia
Acute Mastoiditis
Intracranial infection
What are other causes of earache in a child
Wax (particularly when it swells with water)
Barotrauma (during descent on flight)
Referred pain
Otitis Externa (very uncommon in children)
Foreign Body
Trauma
What are some maternal infections that give rise to childhood hearing inpairment?
toxoplasmosis, rubella ( uncommon), cytomegalovirus, herpes infection, Epstein barr infection
What is a bionic ear?
Cochlear implant
It stimulates and transposes environmenal sounds into electrical stimulus which is then transmitted along the auditiory nerve
Can cochlear implants allow childrent to develop normal speech?
Yes with support, rehabilitation and intensive treatment
Some milestones in normal child development
4-6 wks?
starts to smile
Some milestones in normal child development
4-12 wks?
lifts head
Some milestones in normal child development
4-6 months?
babbles and makes noise
Some milestones in normal child development
6-8 months?
Sits up
Some milestones in normal child development
10-18 months
walks
Some milestones in normal child development
18 months to 2 years
Use two or more words together
TRUE OR FALSE
Patients with down syndrome are suseptible to hearing loss
TRUE
