ENT Paediatrics Flashcards
What is the assessment of hearing for 6-18 months?
Distraction test
What is the hearing test for patients who are 1 - 3 years old?
Visual reinforced audiometry
What is the hearing test for children aged 3-5 years old?
Play audiometry
What is the test for patients who are 4 years or older?
Pure tone audiometry?
What are the objective tests for the auditory systems?
- Otoacoustic Emissions
- Auditory Brain stem responses
- Tympanometry
What are risk factors for otitis media?
Day care, smoking, cleft palate, down syndrome
What is treatment of otitis media?
- Most improve by themselves
- Treat with hearing aids or grommets and adenoidectomy
What are the complications associated with paediatric otitis media (with effusion)?
- HEARING LOSS
- SPEECH DELAY
- BEHAVIOURAL PROBLEMS
- ACADEMIC DECLINE
- (IMBALANCE)
Signs include:
Dull tympanic membrane
Fluid level
Bubbles
What are the aetiologies of otiis media with effusion?
•EUSTACHIAN TUBE DYSFUNCTION
- ANATOMY OF SKULL BASE
- MUSCULAR IMMATURITY
•ADENOIDAL HYPERTROPHY
Who is a bone anchored hearing aid given to?
Children with conductive hearing loss
What is treatment for child with painful/discharging ear?
- Aural microsuction
- Topical antibiotics
- Water precautions
(clean ear, antibiotics, take care from water)
What are the causative organisms for otitis media?
•Haemophilus influenza, strep pneumonia, Moraxella catarrhalis
What is the treatment for otitis media?
- Treat with antibiotics (e.g. co-amoxiclav)
- Grommets + adenoidectomy if recurrent
How long does it take for the eardrum to repair?
3 months
What are the complications of acute otits media?
Mastoiditis, brain abscess
When would you suspect cholesteatoma in children?
Chronic dischargine ear
Hearing loss despite grommets
Requires mastoidectomy
What is rhinitis?
inflammation of the mucous membrane of the nose, caused by a virus infection (e.g. the common cold) or by an allergic reaction (e.g. hay fever).
What is treatment for rhinitis?
Nasal douching
Antihistamines
Nasal steroids
What can result from large adenoids?
Sleep apnoea
What do the symptoms of sinusitis and polyps overlap with?
With rhinitis and large adenoids
Associated with cycstic fibrosis
What is a complication of sinusitis?
Periorbital cellulitis
What is choanal atresia?
Choanal atresia is a congenital disorderwhere the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue (membranous) due to failed recanalization of the nasal fossae during fetal development
What is the treatment for choanal atresia?
However, the only definitive treatment is surgery to correct the defect by perforating the atresia to create a nasopharyngeal airway. If the blockage is caused by bone, this is drilled through and stent inserted.
What is management of epistaxis?
Apropriate first aid
Antibiotic ointments:
NASEPTIN
BACTROBAN
Cautery:
Chemical by silver nitrate under local anaesthetic
Diathermy (using high frequency electrical currents) - General anaesthetic
Nasal Packing
What are the causative organisms for tonsillitis?
•Bacterial (b haem Strep B) or viral (EBV)
What is the treatment for tonsilitis?
Antibiotics
What are the complications associated with tonsilitis?
Glomerulonephritis
Peritonsillar abscess (quinsy)
What aspects of anatomy and physiology can cause airway issues in children?
- Large tongue
- Large tonsils
- Large epiglottis
- Short neck
- Sub glottis narrowest
What is common in the history for patients that present with airway issues?
Recent illness
Feeding problems
Stridor
History of foreign body
What is the treatment for epiglottitis?
IV antibiotics
Nebulisation
Steroids
What is meant by laryngomalacia?
Is the most common cause of chronic stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction.
What are the common neck lumps in children?
- THYROGLOSSAL DUCT CYST
- BRANCHIAL CYST
- CYSTIC HYGROMA
- CERVICAL LYPMHADENOPATHY - can be as a result of chronic tonsillitis
What is a cystic hygroma?
Legion is more commonly referred to as a lymphatic malformation. Lymphatic malformation (LM). LMs usually affects the head and neck (~75%), with a predilection for the left side. Within the neck, the posterior triangle tends to be most frequently affected.
Lymphatic malformations are as a result of the following:
Failure of lymphatics to connect to the venous system
Abnormal budding of lymphatic tissue
Sequestered lymphatic rests that retain their embryonic growth potential
