Paediatric ENT - Laryngology

Question 1

What causes most sore throats?

Answer 1

Tonsilitis

Question 2

Explain the microorganisms causing tonsilitis?

Answer 2

If bacterial - Most likely Beta Haemolytic Strep (e.g. Strep Pyogenes)

If Viral - Most likely EBV (Epstein Barr)

Question 3

What are the major complciations of tonsillitis?

Answer 3

Quinsy - A peritonsillar Abscess

Glomerulonephritis - due to strep spread

Question 4

How do we treat quinsy?

Answer 4

Drainage and Abx

Question 5

How do we treat tonsillitis?

Answer 5

Supportive Care

Antibiotics

Question 6

What makes children more prone to airway issues than adults?

Answer 6

• Short neck
• Narrow Subglottic Issues
• Larger tongue, tonsils and epiglottis relative to rest of airway

Question 7

What would you expect to see in the history of a child with laryngeal airway problems?

Answer 7

• History of Foreign Body
• Recent Illness
• Stridor (Inspiratory)
• Feeding Issues

Question 8

List some common pediatric laryngeal problems

Answer 8

Epiglottitis
Laryngomalacia- poorly developed voice box

Neck Abscess

Lumps:

• Thyroglossal cyst
• Branchial Cyst
• Cystic Hygroma
• Cervical Lymphadenopathy

Question 9

What is a cystic Hygroma?

Answer 9

Large cyst like cavities of lymphatic tissue, contains lymph

Question 10

How do we manage epiglotitis?

Answer 10

Airway support

IV Abx +/- Steroids

Question 11

What is laryngomalacia?

Answer 11

Poor/late development of the laryngeal cartilages.

Causes the cartilage to collapse as you breath so yo end up with stridor, more often when laying prone

Question 12

How do we handle laryngomalacia?

Answer 12

If its not causing them problems we leave it as the cartilage usually develops eventually.