Paediatric ENT - Rhinology

Question 1

How common are URTIs in kids?

Answer 1

Very, its quite normal to get up to 8 episodes a year of up to 15 days at a time.

Question 2

When do the sinuses develop? [3]

Answer 2

• Ethmoid/Maxillary by or just after birth
• Sphenoid around 5yrs
• Frontal at 7-8yrs

Question 3

What are the dangers of a foreign body? [3]

Answer 3

Might get into airway
If stuck might cause pain or infection
If battery it can erode tissue, so needs immediate removal

Question 4

How does sinusitis present? [5]

Answer 4

Acute or chronic
Most common: Thick Nasal Mucous, Plugged Nose & Face Pain
Sometimes: Fever
Headaches, Olfactory Disturbance
Sore Throat and cough

Question 5

How do we treat Sinusitis in an acute presentation? [3]

Answer 5

• analgesia, intranasal decongestants or saline (poor evidence base)
• intranasal corticosteroids if present for >10d
• PHENOXYMETHYLPENICILLIN if severe or CO-AMOXICLAV if systemically very unwell

Question 6

What are the complications of sinusitis? [5]

Answer 6

= Nasal Polyps
= Periorbital Cellulitis - inflammation/infection of eyelid and skin around eye
= Intracranial Abscess
= Mucoceles, pyoceles
= Osteomyelitis of frontal bone

Question 7

Choanal atresia

Presentation [3]

Answer 7

Choanal Atresia

Unilateral or bilateral blockage of the nose by abnormal membrane or bone.

Shows up in babes with trouble feeding (cant breath through nose whne feeding and obvs mouth is in use)

If unilateral will show up later in childhood.

Question 8

Which gender gets more epistaxis?

Answer 8

Boys

Question 9

What causes most paediatric epistaxis?

Answer 9

Digital Trauma i.e. nose picking