Paediatric ENT Flashcards
special features of neonatal airways
small nares large head obligate nasal breather soft, small larynx high laryngeal position narrow epiglottis
signs/symptoms of airway obstruction in children
SOBOE or SOB cough choking cyanosis stridor/stertor pyrexia dysphonia dysphagia dusky skin tracheal tug sternal/subcostal recession
most common airway obstruction in children?
foreign body
what causes subglottic stenosis
traditionally ET tube causes scarring, less common in more modern practice
causes of subglottic stenosis in adults
idiopathic
vasculitis
treatment of subglottic stenosis in adults
laser division or dilatation
laryngo-tracheal resection/reconstruction
describe untreated progresion of respiratory distress
progresses to respiratory failure, leading to respiratory arrest and then cardiac arrest
management of airway obstruction in children
O2 heliox neb adrenaline steroid ABCDE fibre flexible endoscopy secure with ET or tracheostomy treat cause
pharmacotherapy used in endoscopy for airway obstruction
heliox neb budesonide dexamethasone neb adrenaline general anaesthesia
methods of endoscopy in children
direct laryngoscopy
microlaryngoscopy
exam with hopkins rods
laryngotracheobronchoscopy
core nasal problems?
block lost smell discharge facial pain sneeze itch crust epistaxis
secondary symptoms of nasal issues
dry mouth
sore throat
snoring
halitosis
types of allergic rhinitis?
Intermittent or persistent
management of allergic rhinitis
antihistamine, topical steroid or both allergen avoidance immunotherapy in select pt anticholinergics nasal douche
what type of rhinitis do nasal polyps fall under and how are they managed
non-allergic
oral and then topical steroids
if no response then surgical management
symptoms of acute infective rhinosinusitis
blocked nose
facial pain
discharge
how many cases of infective rhinosinusitis are viral
98%
treatment of infective rhinosinusitis
analgesia
decongestants
nasal douche
abx if failing
complications of bacterial rhinosinusitis
can progress to orbital cellulitis, life and sight threatening
can spread into cavernous sinus or dural venous sinus
what foreign body in nose needs immediate and urgent referral
button battery
side effect of long term nasal decongestants
rebound rhinitis
what side is nose usually deviated to in assault
right side, as people are generally right handed
when should a broken nose be assessed by ENT
either immediate following event, there and then
or 7-14 days post event
complication of nasal fracture
nasal trauma septal haematoma
leads to swelling of mucopericondrium and ischaemia of the cartilage
should be drained to prevent nasal collapse
