Paediatric ENT Surgery

Question 1

what are common symptoms of otology?

Answer 1

Hearing loss
Otalgia (earache)
Otorrhoea (discharge)
Tinnitus
Vertigo

Question 2

what puts you at risk of sensorineural hearing loss ?

Answer 2

family history
meningitis
perinatal sepsis (Toxoplasmosis,Rubella,C.M.V.,Herpes)

Question 3

what tests are done during the universal neonatal screening?

Answer 3

otoacoustic emmisions

Auditory Brainstem Response

Question 4

what hearing test is done at 6-18 months?

Answer 4

distraction test

Question 5

what hearing test is done at 12 months – 3 years?

Answer 5

Visually Reinforced Audiometry

Question 6

what hearing test is done at 3 – 5years?

Answer 6

Play Audiometry

Question 7

what hearing test is done after 4 years?

Answer 7

Pure Tone Audiometry

Question 8

what part of the ear does tympanometry test measure?

Answer 8

condition of the middle ear and mobility of the eardrum

Question 9

what is Otitis media with effusion?

Answer 9

thick or sticky fluid behind the eardrum in the middle ear. It occurs without an ear infection.

Question 10

what are symptoms of Otitis media with effusion?

Answer 10

hearing loss
speech delay
behavioural problems
academic decline

Question 11

what causes Otitis media with effusion?

Answer 11

Eustachian tube dysfunction
adenoidal hypertrophy
resolving acute otitis media-effusion remains in middles ear for weeks

Question 12

what does autoinflation using valsalve achieve?

Answer 12

Helps child pop their ears by equalising pressure in middle ear

Question 13

describe the surgical advice management of Otitis media with effusion?

Answer 13

grommet insertion-benefit for hearing/ speech/ behaviour
+/- adenoidectomy:
better long term effect
recurrent o.m.e

Question 14

what is Otitis media with thicker effusion known as?

Answer 14

serous otitis media

glue ear

Question 15

what are the risk factors of O.M.E.

Answer 15

80% before 10years
2 peaks – 18 months and 4 years
m>f
parental smoking

Question 16

what are investigative signs of O.M.E.

Answer 16

dull tm
fluid level
bubbles

Question 17

what is the difference between children with an ear infection and children with OME?

Answer 17

children with OME do not act sick

Question 18

what is the Acute otitis media?

Answer 18

painful type of middle ear infection

Question 19

what is the common incidence of Acute otitis media?

Answer 19

peak incidence 3-18months

m=f

Question 20

what are the symptoms of A.O.M.?

Answer 20

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

Question 21

what is the microbiology of A.O.M.?

Answer 21

haemophilus influenza
strep. pneumonia
moraxella catarrhalis

Question 22

what is the A.O.M. management?

Answer 22

analgesia

antibiotics (amoxycillin / co-amoxiclav)

Question 23

what is acute mastoiditis?

Answer 23

When the mastoid cells become infected or inflamed, often as a result of an unresolved middle ear infection

Question 24

what are extracranial complications of A.O.M.

Answer 24

acute mastoiditis
facial nerve palsy
ossicular / cochlear damage
labyrinthitis
chronic perforation

Question 25

what are intracranial complications of A.O.M.

Answer 25

febrile convulsion brain abscess meningitis sub/extradural empyema

Question 26

what is surgical management of recurrent/ complicated a.o.m?

Answer 26

grommet insertion | +/- adenoidectomy

Question 27

what are some examples of hearing aids?

Answer 27

bone anchored hearing aid | cochlear implant

Question 28

what are common symptoms of rhinology?

Answer 28

``` Nasal obstruction +/- snoring Nasal discharge Epistaxis Sense of smell Sinus discomfort ```

Question 29

what are common tests of rhinology?

Answer 29

Nasal speculum Auriscope (Otoscope) Spatula test Nasal endoscopy

Question 30

what are common investigations of rhinology?

Answer 30

``` Allergy tests (R.A.S.T./ Skin prick testing) Plain X-ray (Adenoid hypertrophy) CT scanning (Choanal atresia) ```

Question 31

what is epistaxis?

Answer 31

nosebleed

Question 32

what are causes of epistaxis?

Answer 32

digital trauma | consider coagulpathy/haematological abnormality

Question 33

what is the treatment of epistaxis?

Answer 33

Appropriate first aid Antibiotic ointments Cautery (Silver Nitrate) Nasal packing

Question 34

what causes nasal obstruction?

Answer 34

rhinitis (allergic/non-allergic) adenoidal hypertrophy foreign body

Question 35

what is the treatment for nasal obstruction?

Answer 35

``` decongestants steroids nasal hygeine – saline douching diathermy/ reduce turbinates adenoidectomy ```

Question 36

what is Periorbital cellulitis?

Answer 36

inflammation and infection of the eyelid and portions of skin around the eye complication of ethmoid sinusitis

Question 37

what is orbital cellulitis?

Answer 37

is inflammation of eye tissues behind the orbital septum.

Question 38

when are nasal polyps common?

Answer 38

adults, rare in children(suspect CF)

Question 39

what are common symptoms of laryngology?

Answer 39

``` sore throat/odynophagia dysphagia hoarseness stridor drooling neck lump ```

Question 40

what is a common sign of a thyroglossal cyst?

Answer 40

Cyst connected to tongue so stick tongue out and it moves upward

Question 41

what are causes of tonsillitis?

Answer 41

``` viral infection (rhinoviruses) bacterial (beta-haemolytic streptococci) ```

Question 42

what is the management of acute tonsillitis?

Answer 42

penicillin v +/- anaerobic cover avoid amoxycillin/ampicilin antiseptic gargle (difflam) analgesia surgical drain tonsillar abscess (quinsy) airway obstruction tonsillectomy (recurent/malignancy)

Question 43

what is stertor?

Answer 43

Noisy breathing due to obstruction above the larynx

Question 44

what is stridor?

Answer 44

Noisy breathing due to obstruction at or below the larynx

Question 45

what is ronchi?

Answer 45

coarse rattling respiratory sounds | Due to narrowing of the lower respiratory airways

Question 46

what is croup?

Answer 46

infection that leads to swelling inside the wind pipe, produces classic symptoms of "barking" cough

Question 47

what is Laryngomalacia?

Answer 47

most common cause of stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation,