ENT

Question 1

Duration of effusion after AOM

Answer 1

90% cleared after 3 months

Question 2

Indications of myringotomy and tubes

Answer 2

• recurrent AOM with middle ear effusion
• bilateral OME (>3 mos) with CHL
• unilat/bilat OME (>3 mos) with other problems: vestibular,behaviouralproblems, discomfort, school performance
• at-risk children
• other uncommon indication
• complications of AOM (i.e. mastoiditis)
• lack of response to medical therapy l chronic retraction of TM

Question 3

Extra cranial complications of AOM

Answer 3

• TM Perforation
• mastoiditis
• post-auricular abscess
• labyrinthitis
• labyrinthine fistula
• facial nerve paresis/paralysis -Bezold’s Abscess
• cholesteatoma

Question 4

Intracranial complications of AOM

Answer 4

l meningitis
l brain Abscess
l subdural empyema
l epidural abscess
usually temporal lobe
l sino-venous thrombosis
l Gradenigo’s Syndrome (Petrositis) l otic Hydrocephalus
l CSF Leak

Question 5

Branchial Oto Renal Syndrome Inheritance

Answer 5

Autosomal dominant

Question 6

Risk factors for hearing loss

Answer 6

l affected family member
l bilirubin
l congenital intrauterine infection (i.e.rubella, CMV) l defects of the ear, nose and throat
l small at birth (birthweight <1500 g)

Question 7

Incidence of sensorineural hearing loss

Answer 7

2-4/1000

Question 8

OAE (otoacoustic emissions)

Answer 8

• tests outer hair cell function
• for babies with no risk factors
• requires clear middle ear
• no information about degree of hearing loss

Question 9

Audiogram

Answer 9

frequency specific behavioural response

Question 10

Absolute indications of adenotonsillectomy

Answer 10

l OSA (AHI>5/hr) and large tonsils
l Cor pulmonale
l suspectedmalignancy l hemorrhagic tonsillitis l severe dysphagia

Question 11

Relative indications of adenotonsillectomy

Answer 11

l tonsillar hypertrophy
l recurrent tonsillitis
l complications of tonsillitis l tonsilloliths and halitosis

Question 12

Differential for inspiratory stridor

Answer 12

laryngomalacia vallecular cyst saccular cyst foreign b

Question 13

Differential for expiratory stridor

Answer 13

tracheomalacia* foreign body tracheoesophageal fistula* complete tracheal rings*

Question 14

Stridor red flags

Answer 14

SPECS-R

• severity
• progression
• eating and feeding
• cyanosis
• sleep
• radiology

Question 15

When to refer laryngomalacia

Answer 15

• severe obstruction/desaturation
• failure to thrive
• too many calories spent breathing l effort dependent aspiration
• diagnosis in question

Question 16

Neck Masses in Children

COIN

Answer 16

1. Congenital: midline vs. lateral
2. Other
   3Infectious/Inflammatory: acute vs. chronic
3. Neoplasms
   benign vs. malignant