Medication ENT + Surgery Flashcards
Penicillin V
Tonsillitis
10 days
Amoxicillin
Sinusitis
Otitis media
Flucloxacillin
Staph infection including cellulitis
Often used in chronic cellulitis without polyp
Use macrolide if allergic
Gentamicin ear drop
Otitis externa as pseudomonas common
Use with caution if perforated due to risk of otototicty
Ciprofloxacin (quinolone)
Unlicsned but used as no risk of toxicity
Otitis extern
Otitis media with perforated TM
Anti-fungal
Fungal otitis externa
Topical nasal steroid
Allergic rhinitis
Chronic sinusitis
Usually take 2-3 weeks to work
Oral steroid
Significant nasal polyp
In conjunction with Ax for acute sinusitis
Bells palsy
Sudden onset acute sensorineural loss
Anti-histamine
Rhinitis
If take systemic get anti-cholinergic SE
Prochlorperaizne
Dopamine antagonist for N+V
Don’t take for more than 2 weeks
Betahistine
Improve blood flow and reduce pressure
Not sure of evidence
Intratympaic dexamethasone or gentamicin
Reduces vestibular nerve function
Dex preferred to gent due to risk of ototoxicity
Indications for grommet
Otitis media with effusion >3 months
Recurrent acute otitis media
What is a grommet
Ventilation tube to help ventilate the middle ear
GA or LA
Peri-op care
Keep dry 2 weeks
Audiogram 6-12 weeks
Usually self extrude in 12 months and TM heals
Complications
Infection
Tympanosclerosis (scarring)
TMperforation
When is a myringoplasty / tympanoplasty recommended
Fix a perforated TM
What is an ossiculoplasty
Reconstruction of ossicles
When is a mastoidectomy indicated
CHolestoma
Cochlear implant
Complications
Bleeding Infection Hearing loss - audiogram at 6-12 weeks Disturbance of taste Facial weakness CSF leak
What are indications for tonsillectomy
Recurrent tonsillitis
QUinsy
OSA
Suspected malignancy
What are CI / cautions for tonsillectomy and adenoidectomy
Coagulopathy
Acute infection
Cleft palate
Complications
Primary haemorrhage within 24 hours Secondary haemorrhage - day 4-7 Infection Dental injury Taste disturbance 2 weeks of work
Indications for adenoidectomy
Nasal obstruction +_ OSA
Recurrent otitis media
What are indications for sinus surgery
Acute or chronic sinusitis not relieved by medical Nasal polyp Orbital complications Drainage of mucocele Endonasal tumour Access to skull base
What are complications
Bleeding Infection Injury to nasolacrimal duct Orbital injury - rarely diplopia and blind CSF leak Anosmia
Indications for parotidectomy
Neoplasm
What are complications
Bleeding
Haematoma
Facial weakness
Require drain for 48 hours after to avoid wound haematoma
Indications for thyroidectomy
Malignancy
COmpression Sx
What are risks
Bleeding Need for surgical drain post op Infection Damage to external laryngeal nerve - Unilateral = hoarse - Bilateral = obstructed airway HYpocalcaemia due to parathyroid injury Thyroid storm if hyperthyroid
When is neck dissection indicated
Metastatic carcinoma
What are complications
Bleeding Haematoma Infetion Nerve damage Facial lympoedema
What is a tracheostomy
A surgically created opening in front of trachea
Can be elective or emergency
Indications
Airway obstruction
Weaning from ventilation as reduces dead space
Complications
Bleeding Dislodged tube Blocked tube Infection Subcutaneous emphysema Pneumothorax or pneumomediastinum
What is needed post op
Humidifcation and regular suction
Care of inner tube to avoid blockage
Stoma wound care
Remove tube as soon as possible
