Lecture 13 ENT Paediatrics Flashcards
Otology disease history
• Ear symptoms o Pain o Discharge o Loss of function – hearing loss, dizziness, tinnitus • Speech development, school performance • Behavioural problems • Maternal perinatal infections • Delivery issues (prematurity, anoxia) • Neonatal infections, drugs, jaundice • Growth, immunisations, passive smoking, breast vs bottle feeding
Otology Examination
Auriscope
Subjective assessment
Objective assessment
Risk factors of Otitis media with effusion/glue ear
Day care, smoking, cleft palate, down syndrome
Symptoms of Otitis media with effusion/glue ear
◦ Hearing loss ◦ Speech delay ◦ Behavioural problems ◦ Academic decline ◦ Imbalance
Signs of the symptoms of Otitis media with effusion/glue ear
Dull T
Fluid level- cone of light not visible
Bubbles
Aetiology of Otitis media with effusion/glue ear
Eustachian tube defect
Adenoidal hypertrophy
Treatment of Otitis Media
◦ Auto-inflation- pressure auto-inflation of eustachian tube and move contents inside middle ear
◦ Grommet- 6 months-ear helps aerate the ear
◦ BAHA- bone anchored hearing aid
◦ Cochlear implant- congenital hearing loss
A child presents with painful discharge from ear what could they have
Otitis externa (inflammation of outer ear)
Treatment of otitis externa
◦ Aural microsuction- if child is systemically unwell
◦ Topical antibiotics
◦ Water precautions
What condition is when the fluid inside the middle ear becomes infected
Acute otitis media
What organisms are responsible for acute otitis media
Haemophilus influenza, strep pneumonia, Moraxella catarrhalis
How is acute otitis media treated
Antibiotics- co-amoxiclav (orak)
Grommet and adenoidectomy if recurrent
What investigation is used for chronic otitis media, Cholesetatoma
CT scan
What is the treatment for Cholesteatoma
Mastoidectomy
What are common symptoms of rhinology diseases
- Blocked nose
- Runny nose
- Sneezing
- Reduced sense of smell
- Facial pain
If a child presents with large adenoids what should you also check for
Sleep apnoea
What foreign body in the nose is an emergecy
Batteries- can perforate septum
What disease is sinusitis and polyps closely associated with
Cystic fibrosis
When does acute sinusitis become chronic
If it persists longer than 12 weeks
What does choanal atresia present with
Cyanosis
Where does epistaxis occur and why
Little’s (Kisselbach’s) area- anastomosis of all the arteries that supply the nose
What is the management of epistaxis
First aid- pinch soft part of nose Antibiotic ointments NASEPTIN BACTROBAN Cautery Silver Nitrate under LA Diathermy under GA Nasal packing- contains a balloon to act as a pressure dressing
Symptoms of diseases involved in laryngology
- Sore throat
- Airway issues
- Hoarseness
- Dysphagia
What would you look at during laryngology examination
- Tonsils
- Uvula
- Throat
- Neck
- Ears and Nose
What is the cause of Tonsillitis
• Bacterial (b haem Strep B) or viral (EBV) (majority and self-limiting)
What are the complications of tonsillitis
Glomerulonephritis
Peritonsillar abscess- infection moves beyond the tonsil and swelling of the soft palate
Anatomy and physiology of tile with airway issues
- Large tongue
- Large tonsils
- Large/Floppy epiglottis
- Short neck
- Sub glottis narrowest
Differential diagnosis for neck lumps
- Thyroglossal Duct Cyst
- Branchial Cyst
- Cystic Hygroma
- Cervical Lymphadenopathy
