paediatric ENT surgery Flashcards
what are some common symptoms related to otology?
hearing loss otalgia otorrhoea tinnitus vertigo
what are some important aspects of paediatric history taking?
birth history - pre-term, traumatic birth, neonatal jaundice
breast vs bottle feeding
passive smoking
what does snhl stand for
sensory neurone hearing loss
what is the purpose of tympanometry?
to establish if the tympanic membrane moves normally in response to a pulse of air
what are some symptoms of otitis media with effusion?
hearing loss speech delay behavioural problems academic decline imbalance
what are some signs of otitis media with effusion
dull tympanic membrane
fluid level
bubbles
what are 2 surgical options for OME?
grommet insertion
adenoidectomy
when is an adenoidectomy indicated?
recurrent OME
what are symptoms of acute OM?
short history pain fever systemic upset (sleep disturbance) ear discharge
what is the aetiology of nasal obstruction?
rhinitis
adenoidal hypertrophy
foreign body
how is nasal obstruction managed without surgery?
decongestants
steroids
what are some surgical options for managing nasal obstruction?
diathermy/reduce turbinates
adenoidectomy
correct choanal atresia
what is periorbital cellulitis a potential complication of?
complicated ethmoid sinusitis
what are 2 MAJOR risks of periorbital cellulitis?
loss of sight
intracranial sepsis
what is nasal polyposis a result of?
chronic rinosinusitis
what are two pathologies you should consider in a child presenting with nasal polyposis?
cystic fibrosis
angiofibroma
what are some common H & N symptoms that a child might present with?
sore throat/odynophagia dysphagia referred otalgia snoring (stertor) form large tonsils hoarseness stridor drooling neck lump
what are some common causes of neck lumps?
thyroglossal cyst
lymph node
branchial cyst
`what tests would you request in a case of suspected tonsillitis?
EBV serology
FBC
U & E
CRP
how would you MEDICALLY manage acute tonsillitis?
penicillin
antiseptic gargle
analgesia
avoid amoxicillin/ampycillin
how would you manage acute tonsillitis surgically?
drain tonsillar abscess
deal with any airway obstruction
what is an absolute indication for a tonsillectomy?
obstructive sleep apnoea
what is the definition of stertor?
noisy breathing due to obstruction above the larynx?
what is the definition of stridor?
noisy breathing due to obstruction at or below the larynx
what are the 3 types of stridor?
inspiratory
expiratory
biphasic
what is ronchi?
noisy breathing due to narrowing of the lower respiratory airways
what are some acute causes of stridor?
infective causes such as croup/epiglottitis
foreign body
what are some chronic causes of stridor?
laryngomalacia
subglottic stenosis
vocal cord palsy
what is the most important parameter that dictates medical intervention in children?
mental state - no crying is not good
what is often seen in xrays of children with croup?
steeple sign
what is the commonest cause of paediatric stridor?
laryngomalacia
