ENT + Ophthalmo Flashcards
Type of tympanogram for hearing loss
Type B
When should OME resolve?
90% resolve within 3 months
When should someone get ear tubes
- recurrent AOM with middle ear effusion
- 4x/6m or 6x/12m
- bilateral OME (>3 mos) with CHL
- unilat/bilat OME (>3 mos) with other problems (vestibular, behavioural problems, discomfort, school performance)
- at-risk children
- other uncommon indication
- complications of AOM (i.e. mastoiditis)
- lack of response to medical therapy
- chronic retraction of TM
Extracranial Complications of AOM?
- TM Perforation
- mastoiditis
- post-auricular abscess
- labyrinthitis
- labyrinthine fistula
- facial nerve paresis/paralysis
- Bezold’s Abscess
- cholesteatoma
What are char’s of a cholesteatoma:
older persistent/recurrent stinks like pseudomonas unilaterral responds to steroid drops but recurs
What are intracranial complications of AOM?
meningitis brain abscess subdural/epidural sino-venous thrombosis Gradenigo’s Syndrome (Petrositis) otic Hydrocephalus CSF Leak
How to tx epistaxis?
humidify lubrificate cauterize ant and post pack treat underlying coagulopathy
Red flags for periorbital cellulitis?
Proptosis Diplopia Altered Vision Severe Pain / HA Altered LOC
Complications of OSA?
Poor school performance Daytime somnolence Eneurusis ADHD FTT Cor pulmonale
Indications for T&A?
absolute: OSA (AHI>5/hr) and large tonsils Cor pulmonale suspected malignancy hemorrhagic tonsillitis severe dysphagia
relative: tonsillar hypertrophy recurrent tonsillitis 7 episodes in the previous year, or 5 episodes in each of the previous 2 yr, or 3 episodes in each of the previous 3 yr complications of tonsillitis tonsilloliths and halitosis
Peritonsillar abscess
- characteristics + age
- invest
- tx
unilateral tonsil bulge in palate
uvular deviation
trismus
older children/teenagers
invest
none
treatment
- antibiotics
- surgical drainage
Retropharyngeal abscess
- characteristics + age
- invest
- tx
midline bulge in retropharynx
posterior to palate
younger children
limited lateral ROM neck torticollis
invest:
lat xray - prevertebral bulge
CT to confirm
treatment
- antibiotics
- +/- drainage
What test to screen for hearing in infants?
If fail, next step?
otoacoustic emissions (OAE)
auditory brainstem response (ABR)
Midline Neck Mass Ddx?
Thyroglossal duct cyst Dermoid cyst Teratoma Cervical Cleft Foregut duplication cyst Ranula Vascular Malformation
Lateral Neck Mass Ddx?
Branchial cleft cyst Fibromatosis Colli Hemangioma Thymic cyst Vascular malformation Laryngocele
Most common midline nasal mass
Dermoid cyst
CHARGE?
Coloboma Heart defect Atresia chonae Retarded growth/development Genital / urinary anomalies Ear anomalies/deafness
Thrombosis of IJ?
Lemierre syndrome
from deep neck infections
Nerves of Eye movement?
CN3
SO4
LR6
Eyelid nerves
CN3»_space;> Sympathetic
Horner syndrome?
ptosis
miosis (small pupil)
anhydrosis
Cause of periorbital/preseptal cellulitis vs orbital cellulitis
Periorbital - scratch/bite
Orbital - sinusitis
Signs of Orbital cellulitis
Red eye Proptosis Pain/limited EOM RAPD possible UNWELL
Treatment for orbital cellulitis
IV abx
- cefuroxime, ceftriaxone/vanco
