Paediatric ENT Surgery Flashcards
what are common symptoms of otology?
Hearing loss Otalgia (earache) Otorrhoea (discharge) Tinnitus Vertigo
what puts you at risk of sensorineural hearing loss ?
family history
meningitis
perinatal sepsis (Toxoplasmosis,Rubella,C.M.V.,Herpes)
what tests are done during the universal neonatal screening?
otoacoustic emmisions
Auditory Brainstem Response
what hearing test is done at 6-18 months?
distraction test
what hearing test is done at 12 months – 3 years?
Visually Reinforced Audiometry
what hearing test is done at 3 – 5years?
Play Audiometry
what hearing test is done after 4 years?
Pure Tone Audiometry
what part of the ear does tympanometry test measure?
condition of the middle ear and mobility of the eardrum
what is Otitis media with effusion?
thick or sticky fluid behind the eardrum in the middle ear. It occurs without an ear infection.
what are symptoms of Otitis media with effusion?
hearing loss
speech delay
behavioural problems
academic decline
what causes Otitis media with effusion?
Eustachian tube dysfunction
adenoidal hypertrophy
resolving acute otitis media-effusion remains in middles ear for weeks
what does autoinflation using valsalve achieve?
Helps child pop their ears by equalising pressure in middle ear
describe the surgical advice management of Otitis media with effusion?
grommet insertion-benefit for hearing/ speech/ behaviour
+/- adenoidectomy:
better long term effect
recurrent o.m.e
what is Otitis media with thicker effusion known as?
serous otitis media
glue ear
what are the risk factors of O.M.E.
80% before 10years
2 peaks – 18 months and 4 years
m>f
parental smoking
what are investigative signs of O.M.E.
dull tm
fluid level
bubbles
what is the difference between children with an ear infection and children with OME?
children with OME do not act sick
what is the Acute otitis media?
painful type of middle ear infection
what is the common incidence of Acute otitis media?
peak incidence 3-18months
m=f
what are the symptoms of A.O.M.?
short history pain +++ fever systemic upset (sleep disturbance) ear discharge
what is the microbiology of A.O.M.?
haemophilus influenza
strep. pneumonia
moraxella catarrhalis
what is the A.O.M. management?
analgesia
antibiotics (amoxycillin / co-amoxiclav)
what is acute mastoiditis?
When the mastoid cells become infected or inflamed, often as a result of an unresolved middle ear infection
what are extracranial complications of A.O.M.
acute mastoiditis facial nerve palsy ossicular / cochlear damage labyrinthitis chronic perforation
what are intracranial complications of A.O.M.
febrile convulsion
brain abscess
meningitis
sub/extradural empyema
what is surgical management of recurrent/ complicated a.o.m?
grommet insertion
+/- adenoidectomy
what are some examples of hearing aids?
bone anchored hearing aid
cochlear implant
what are common symptoms of rhinology?
Nasal obstruction +/- snoring Nasal discharge Epistaxis Sense of smell Sinus discomfort
what are common tests of rhinology?
Nasal speculum
Auriscope (Otoscope)
Spatula test
Nasal endoscopy
what are common investigations of rhinology?
Allergy tests (R.A.S.T./ Skin prick testing) Plain X-ray (Adenoid hypertrophy) CT scanning (Choanal atresia)
what is epistaxis?
nosebleed
what are causes of epistaxis?
digital trauma
consider coagulpathy/haematological abnormality
what is the treatment of epistaxis?
Appropriate first aid
Antibiotic ointments
Cautery (Silver Nitrate)
Nasal packing
what causes nasal obstruction?
rhinitis (allergic/non-allergic)
adenoidal hypertrophy
foreign body
what is the treatment for nasal obstruction?
decongestants steroids nasal hygeine – saline douching diathermy/ reduce turbinates adenoidectomy
what is Periorbital cellulitis?
inflammation and infection of the eyelid and portions of skin around the eye
complication of ethmoid sinusitis
what is orbital cellulitis?
is inflammation of eye tissues behind the orbital septum.
when are nasal polyps common?
adults, rare in children(suspect CF)
what are common symptoms of laryngology?
sore throat/odynophagia dysphagia hoarseness stridor drooling neck lump
what is a common sign of a thyroglossal cyst?
Cyst connected to tongue so stick tongue out and it moves upward
what are causes of tonsillitis?
viral infection (rhinoviruses) bacterial (beta-haemolytic streptococci)
what is the management of acute tonsillitis?
penicillin v +/- anaerobic cover
avoid amoxycillin/ampicilin
antiseptic gargle (difflam)
analgesia
surgical
drain tonsillar abscess (quinsy)
airway obstruction
tonsillectomy (recurent/malignancy)
what is stertor?
Noisy breathing due to obstruction above the larynx
what is stridor?
Noisy breathing due to obstruction at or below the larynx
what is ronchi?
coarse rattling respiratory sounds
Due to narrowing of the lower respiratory airways
what is croup?
infection that leads to swelling inside the wind pipe, produces classic symptoms of “barking” cough
what is Laryngomalacia?
most common cause of stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation,
