Paediatric ENT Flashcards
What are the possible otological symptoms?
Hearing loss Discharging ear Ear ache Tinnitus Vertigo
What are the forms of paediatric hearing loss?
Congenital vs acquired
Uni vs bilateral
Conductive vs sensorineural
What symptoms may be present in a child with hearing loss?
Pain
Discharge
Dizziness
Tinnitus
What history must be taken for a child with hearing loss?
Symptoms
Speech development, school performance
Behavioural problems
Maternal perinatal infections, drugs, jaundice
Growth, immunisations, passive smoking, breast vs bottle feeding
What subjective tests can be done to test for hearing loss in 6-12 months?
Distraction test
What subjective tests can be done for hearing loss in 12 months- 3 years?
Visual reinforced audiometry
What subjective tests can be done for hearing loss in 3-5 year olds?
Play audiometry
What subjective tests can be done for hearing loss in 4+ year olds?
Pure tone audiometry
What objective tests can be done for hearing loss in children?
Otoaucostic admissions
Audiometry brain stem response
Tympanometry
What is the most common cause of hearing loss in children?
Otitis media with effusion
What are the risk factors for otitis media with effusion?
Day care
Smoking
Cleft palate
Down syndrome
How is otitis media with effusion treated?
Hearing aids
Grommets
Adenoidectomy
Autoinflation
What are the signs and symptoms of otitis media with effusion?
Hearing loss Speech delay Behavioural problems Academic decline Imbalance Dull tympanic membrane Fluid level and bubbles behind tympanic memrane
What is the cause of otitis media with effusion?
Eustachian tube dysfunction
Adenoidal hypertrophy
Resolving AOM
What history should be taken in a child with a painful/discharging ear?
Associated symptoms
Duration
Hearing issues
What examination and investigation should be done for a child with a painful/discharging ear?
Otoscope
Pure tone audiometry
What are the common causes of a painful/discharging ear in children?
Otitis externa
Acute otitis media
Chronic otitis media
What is otitis externa and what does it result in?
Inflammation of outer ear
Results in closing of external auditory canal, causing pain and hearing loss
How is otitis externa treated?
Cleaning ear
Topical antibiotics
What is a history of acute otitis media?
Short history of pain, fever and discharge
What are the common causes of acute otitis media?
H influenza
Strep pneumonia
Moraxella catarrhalis
How is acute otitis media treated?
Antibiotics
Grommets and adenoidectomy if recurrent
What are the complications of acute otitis media?
Mastoidectomy
Brain abscess
How is mastoiditis treated?
IV antibiotics and possible surgery
What is chronic otitis media?
Chronic discharging ear or hearing loss despite grommets
When do the ethmoid and maxillary sinuses develop?
0-4 months
When do the sphenoid sinuses develop?
3-7 years
When do the frontal sinuses develop?
8+ years
What history should be taken when there is a blocked/runny nose?
Pain, discharge, loss of function
Foreign body
Feeding
Snoring, quality of sleep
What examinations should be carried out for a blocked/runny nose?
Otoscope
Cold spatula test
What are the common causes of a blocked/runny nose?
Rhinitis Large adenoids Foreign body Sinusitis and polyps Choanal atresia
What are the symptoms of rhinitis?
Runny nose
Lack of sense of smell
Blocked nose
Sneezing
What os the treatment for rhinitis?
Nasal douching
Antihistamines
Nasal steroids
What are the symptoms of large adenoids?
Runny nose Lack of sense of smell Blocked nose Sneezing Sleep apnoea
What are the symptoms of sinusitis and polyps?
Runny nose, lack of sense of smell, blocked nose, sneezing
What are sinusitis and polyps associated with?
Cystic fibrosis
What is the complication of sinusitis and polyps?
Periorbital cellulitis
What should be considered in severe/recurring epistaxis?
Coagulopathy
Haematological abnormality
How is epistaxis managed?
Appropriate first aid
Antibiotic ointments
Cautery
Nasal packing
What are the associated symptoms of sore throat?
Odynophagia, ear ache
Dysphagia, treating problems, hoarse voice
Snoring/drooling
What should be examined for a sore throat?
Treat, neck, ears and nose
How is tonsillitis treated?
Support and antibiotics
What are the complications of tonsillitis?
Peritonsillar abscess
What are the anatomicalmical causes of airway issues in children?
Large tongue, tonsils and epiglottis
Short neck
Narrow subglottis
What history should be taken in airway issues?
Foreign body
Recent illness
Feeding problems
Inspiratory stridor
What are the common causes of airway issues?
Anatomical
Foreign body
Epiglottis
Laryngomalacia
How is a neck abscess treated?
Drain
IV antibiotics
What are the common causes of neck lumps?
Thyroglossal cyst
Branchial cyst
Cystic hygroma
Cervical lymphadenopathy
