Paediatric ENT - Otology Flashcards

1
Q

What important consideration should we think of when examining an ENT problem?

A

Always examine all the regions.

If they have through pain dont just examine the throat, do the nose and ears as well

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2
Q

What might you pick up on in a kids history that would indicate hearing problems?

A
  • Well…Ear symptoms
  • Poor speech development
  • Problems at school
  • Behavioural Problems

Neonatal infections or maternal infections
Delivery issues such as being a premature baby or anoxia

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3
Q

How do we categorise hearing tests?

A

Subjective e.g. audiometry

Objective e.g. Otoacoustic Emissions

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4
Q

Children tend not to be compliant with conventional hearing tests.
What subjective tests can we use?

A

6-18 months = Distraction Test
1-3yrs = Visual Reinforced Audiometry
3-5yrs = Play Audiometry
4+ yrs = Pure tone audiometry like an adult

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5
Q

What objective hearing tests can we use on children?

A
  • Otoacoustic Emissions (measures a sound produced by the inner ear during hearing, hearing loss reduces the OAEs)
  • Tympanometry (measures inner ear pressure)
  • Auditory Brain Stem Response
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6
Q

Common Paediatric conditions

A
  • Otitis Media with Effusion (Glue ear)
  • Otitis Externa
  • Acute Otitis Media
  • Chronic Otitis Media
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7
Q

What are the peak ages for Glue Ear?

A

2 and 5 yrs

80% have occured by age 10

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8
Q

What are the risk factrs for glue ear?

A

Day Care
Smoking
Cleft Paalte
Down Syndrome

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9
Q

What causes Glue ear?

A
  • Dysfunction of the Eustachian Tube (Either due to messed up skull base or muscular immaturity)
  • Adenoid Hypertrophy
  • Resolving Acute Otitis Media
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10
Q

What does Otitis media with effusion look like?

A
  • Hearing Loss
  • Speech Delay
  • Behavioural Problems
  • Academic Decline

Signs on the Tympanic Membrane:

  • Dull
  • Visible Fluid level
  • Bubbles
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11
Q

How do we treat otitis media with effusion?

A

Grommet:

  • Most common
  • Works itself out in ~1yr as the TM heals over

Autoinflation

Adenoidectomy

Hearing Aid

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12
Q

What causes otitis externa and how do we treat it?

A

Bacterial/fungal infection
Foreign Body
Allergy
Dermatitis

Treat it with:

  • Aural Microsuction
  • Topical Antibiotics
  • Water Precautions (prevent it getting wet)
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13
Q

When is acute otitis media most common?

A

In the 3-18 months

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14
Q

How does acute otitis media present?

A
  • Pain
  • Fever
  • Discharge

Short History of the above

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15
Q

What are some complications of acute otitis media

A

Perforation of the Tympanic Membrane. (keep it dry and treat infection)

Brain Abscess

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16
Q

What causes Acute Otitis Media

A
  • Haemophilus Influenzae
  • Strep Pneumonia
  • Moraxella Catarrhalis
17
Q

How do we treat acute otitis media?

A

With antibiotics or rest

If its recurrent:
Grommet & Adenoidectomy

18
Q

What causes chronic otitis media?

A

Usually a Cholesteatoma or a perforated ear drum.

19
Q

How do we treat a cholesteatoma

A

A mastoidectomy

Involves clearing out some of the mastoid air cells and parts of the middle ear