ENT Flashcards
Criteria to diagnose otitis media
Acute onset of symptoms → otalgia or ear tugging
Presence of a middle ear effusion →
- bulging tympanic membrane
- otorrhoea
- decreased mobility on pneumatic otoscopy
Inflammation of the tympanic membrane → erythema
Does Otitis Media require antibiotics?
No
List 4 instances where OM requires antibiotics
- Symptoms > 4 days or not improving
- Systemically unwell but not requiring admission
- Immunocompromise or high risk of complications
- < 2 years with bilateral OM
- Perforation and/or discharge in the canal
Abx of choice for acute otitis media
5-7 day course of amoxicillin is first-line
Complications of OM
- mastoiditis
- meningitis
- brain abscess
- facial nerve paralysis
Samter’s triad?
asthma, aspirin sensitivity and nasal polyposis
Where does Epistaxis most commonly originate?
Little’s area in the anterior nasal septum is the site of Kiesselbach’s plexus, supplied by 4 arteries.
Finding of a Dix-Hallpike manoeuvre
Rotatory nystagmus
Malignant Otitis Externa:
- organism
- population
Pseudomonas aeruginosa
Affects diabetes (90%) or immunocompromised
Investigation for sinusitis
In most cases, investigations are not necessary. In patients with persistent symptoms despite treatment, investigations include:
- Nasal endoscopy
- CT scan
Nasal Spray Technique
- Tilting the head slightly forward
- Using the left hand to spray into the right nostril, and vice versa (this directs the spray slightly away from the septum)
- NOT sniffing hard during the spray
- Very gently inhaling through the nose after the spray
“do you taste the spray at the back of your throat after using it?” Tasting the spray means it has gone past the nasal mucosa and will not be as effective.
Bacteria causing otitis Media
Streptococcus pneumonaie, Haemophilus influenzae and Moraxella catarrhalis
What is chronic suppurative otitis media
CSOM is defined as perforation of the tympanic membrane with otorrhoea for > 6 weeks
When should a tonsillectomy be considered
- sore throats due to tonsillitis (i.e. not recurrent URTIs)
- five or more episodes of sore throat per year
- symptoms occurring for at least a year
- episodes of sore throat are disabling and prevent normal functioning
Established indications for a tonsillectomy
- recurrent febrile convulsions secondary to episodes of tonsillitis
- OSA, stridor or dysphagia secondary to enlarged tonsils
- peritonsillar abscess unresponsive to standard treatment
