paediatric ENT surgery

Question 1

what are some common symptoms related to otology?

Answer 1

hearing loss
otalgia
otorrhoea
tinnitus
vertigo

Question 2

what are some important aspects of paediatric history taking?

Answer 2

birth history - pre-term, traumatic birth, neonatal jaundice
breast vs bottle feeding
passive smoking

Question 3

what does snhl stand for

Answer 3

sensory neurone hearing loss

Question 4

what is the purpose of tympanometry?

Answer 4

to establish if the tympanic membrane moves normally in response to a pulse of air

Question 5

what are some symptoms of otitis media with effusion in children?

Answer 5

hearing loss
speech delay
behavioural problems
academic decline
imbalance

Question 6

what are some signs of otitis media with effusion

Answer 6

dull tympanic membrane
fluid level
bubbles

Question 7

what are 2 surgical options for OME?

Answer 7

grommet insertion

adenoidectomy

Question 8

when is an adenoidectomy indicated?

Answer 8

recurrent OME

Question 9

what are symptoms of acute OM?

Answer 9

short history
pain
fever
systemic upset (sleep disturbance)
ear discharge

Question 10

what is the aetiology of nasal obstruction?

Answer 10

rhinitis
adenoidal hypertrophy
foreign body

Question 11

how is nasal obstruction managed without surgery?

Answer 11

decongestants

steroids

Question 12

what are some surgical options for managing nasal obstruction?

Answer 12

diathermy/reduce turbinates
adenoidectomy
correct choanal atresia

Question 13

what is periorbital cellulitis a potential complication of?

Answer 13

complicated ethmoid sinusitis

Question 14

what are 2 MAJOR risks of periorbital cellulitis?

Answer 14

loss of sight

intracranial sepsis

Question 15

what is nasal polyposis a result of?

Answer 15

chronic rinosinusitis

Question 16

what are two pathologies you should consider in a child presenting with nasal polyposis?

Answer 16

cystic fibrosis

angiofibroma

Question 17

what are some common H & N symptoms that a child might present with?

Answer 17

sore throat/odynophagia
dysphagia
referred otalgia
snoring (stertor) form large tonsils
hoarseness
stridor
drooling
neck lump

Question 18

what are some common causes of neck lumps?

Answer 18

thyroglossal cyst
lymph node
branchial cyst

Question 19

`what tests would you request in a case of suspected tonsillitis?

Answer 19

EBV serology (epstein-barr virus antibodies)
FBC (RBC, WBC and Platelets)
U & E (electrolytes and urea)
CRP (C-reactive protein -sign of inflamation)

Question 20

how would you MEDICALLY manage acute tonsillitis?

Answer 20

penicillin
antiseptic gargle
analgesia
avoid amoxicillin/ampycillin

Question 21

how would you manage acute tonsillitis surgically?

Answer 21

drain tonsillar abscess

deal with any airway obstruction

Question 22

what is an absolute indication for a tonsillectomy?

Answer 22

obstructive sleep apnoea

Question 23

what is the definition of stertor?

Answer 23

noisy breathing due to obstruction above the larynx?

Question 24

what is the definition of stridor?

Answer 24

noisy breathing due to obstruction at or below the larynx

Question 25

what are the 3 types of stridor?

Answer 25

inspiratory
expiratory
biphasic

Question 26

what is ronchi?

Answer 26

noisy breathing due to narrowing of the lower respiratory airways

Question 27

what are some acute causes of stridor?

Answer 27

infective causes such as croup/epiglottitis

foreign body

Question 28

what are some chronic causes of stridor?

Answer 28

laryngomalacia (soft larynx - immature cartilage collapses inward during inspiration)
subglottic stenosis
vocal cord palsy

Question 29

what is the most important parameter that dictates medical intervention in children?

Answer 29

mental state - no crying is not good

Question 30

what is often seen in xrays of children with croup?

Answer 30

steeple sign

Question 31

what is the commonest cause of paediatric stridor?

Answer 31

laryngomalacia