ENT - paediatric otology Flashcards
what surgery comprises otology
External, Middle & Inner Ear Surgery
Lateral Skull Base Surgery
what are common symptoms in otology
hearing loss - onset, rate of progression
otalgia - earache
otorrhoea - discharge
tinnitis
vertigo - hallucination of movement
what are important questions to ask during history
birth history
- pre term
- traumatic
- neonatal jaundice +/- phototherapy
breast vs bottle feeding
passive smoking
speech development
what groups are at risk for sensorineural hearing loss
family history of hearing loss
meningitis
perinatal sepsis (ToRCH)
- toxoplasmosis
- rubella
- CMV
- herpes
what examinations should be carried out
otoscopy
nose exam
throat exam
what are objective tests that can be used
otoacoustic emmisions (OAE) auditory brainstem response (ABR) tympanometry
what tests can be used for different age groups
6-18months - distraction tests
12 months-3 years - visually reinforced audiometry
3-5 years - play audiometry
4years + - pure tone audiometry
what is otitis media with effusion (OME)
thick or sticky fluid behind the eardrum in the middle ear - occurs without an ear infection
what groups are at risk of OME
day care older siblings parental smoking cleft palate downs syndrome
what are the symptoms of OME
hearing loss speech delay behavioural problems academic decline imbalance
what are the signs of OME
dull Tympanic Membrane
fluid level
bubbles
what are the three causes of OME
eustachian tube dysfucntion - anatomy of skull mase
- muscular immaturity
adenoidal hypertrophy
resolving Acute Otitis Media
what is the treatment of OME
autoinflation
valsalva
hearing aids
surgery
- grommet insertion
+/- adenoidectomy (better long term effect for recurrent OME)
what are the symptoms of acute otitis media
short history pain +++ fevre systemic upset sleep disturbance ear discharge
what three bacteria are most likely to cause AOM
haemophilus influenzae
strep pneumoniae
moraxella catarrhalis
what are the signs of AOM
often vague
- unwell screaming child
- rubbing their ears
- high fever
what is the diagnostic procedure for AOM
otoscopy 90%
what is the management for AOM
analgesia
antibiotics (5-7 days)
- 1st line = amoxycillin/co-amoxicalv
- 2nd line = erythromycin/clarithromycin
recurrent AOM
- long course low dose antibiotics
- 4-6 weeks
what are extra cranial complications of AOM
acute mastoiditis / mastoid abscess facial nerve palsy ossicular / cochlear damage labyrinthitis chronic perforation (com)
what is acute mastoiditis
an infection that extends to the air cells of the skull behind the ear
what are intracranial complications of AOM
febrile convulsion
brain abscess
meningitis
sub/ extradural empyema
what is the treatment for recurrent/complicated AOM
grommet insertion
+/- adenoidectomy
what are the different types of hearing loss
congenital vs. acquired
static vs. progressive
unilateral vs. bilateral
conventional vs. surgical aiding
what are different types of treatment for hearing loss
bone anchored hearing aid
cochlear implant
