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Head and Neck > Paediatric Otorhinolaryngology > Flashcards

Paediatric Otorhinolaryngology Flashcards

1
Q

What are some reasons for hearing loss?

A

Congenital or acquired
Unilateral vs Bilateral
Conductive or sensorineural

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2
Q

What can be included in the history of child with hearing loss?

A

Ear symptoms - pain, discharge, loss of function
Speech development and school performance
Behavioural issues, Delivery issues, neonatal infections, growth, passive smoking, bottle feeding

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3
Q

How is a child assessed for hearing loss - subjective assessment of hearing?

A

Distraction test - 6-18 months
Visual reinforced audiometry - 12 months
Play audiometry - 3-5 years
Pure tone audiometry

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4
Q

How is a child assessed for hearing loss - objective assessment?

A

Otoacoustic emissions - all children when born
Auditory brain stem responses - looks at nerve function
Tympanometry - checks pressure of middle ear

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5
Q

What are the risk factors of otitis media with effusion/ glue ear?

A

Day care, smoking, cleft palate and down syndrome

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6
Q

What is the treatment of otitis media with effusion?

A

Is self limiting - so most improve by themselves
Treat with hearing aids or grommets and adenoidectomy

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7
Q

What the symptoms of otitis media with effusion?

A

Hearing loss, speech delay, behavioural problems and academic decline

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8
Q

What are the signs of otitis media with effusion?

A

Dull tympanic membrane
Fluid level and bubbles seen

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9
Q

Describe the aetiology of otitis media with effusion

A

Eustachian tube dysfunction - anatomy of skull base and muscular immaturity
Adenoidal hypertrophy
Resolving AOM

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10
Q

What is the treatment for otitis externa?

A

Aural micro-suction
Topical antibiotics
Water precautions

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11
Q

What is the common microbiology for acute otitis media?

A

Haemophilus influenza
Strep pneumonia
Moraxella catarrhalis

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12
Q

What is the treatment for acute otitis media?

A

Treat with antibiotics - co-amoxiclav
Grommets and adenoidectomy if recurrent

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13
Q

What is the treatment for chronic otitis media?

A

Requires mastoidectomy
Also topical steroids

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14
Q

What are the main symptoms of rhinology?

A

Blocked nose and runny nose

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15
Q

What is included in history of child with blocked/ runny nose?

A

Nasal symptoms - pain, discharge, loss of function - smell
History of foreign body
Feeding
Snoring and quality of sleep

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16
Q

What examinations are needed for child with blocked or runny nose?

A

Otoscope
Metal tongue depressor - misting
Rigid endoscopy - older children

17
Q

What is treatment for rhinitis?

A

Check if allergic or non-allergic
Allergen tests done (IgE)
Nasal douching, antihistamines and nasal steroids

18
Q

Describe sinusitis and polyps in children

A

Is rare. Can think of CF - association
Overlapping symptoms with rhinitis/ large adenoids
Acute sinusitis or chronic

19
Q

What is epistaxis?

A

Nosebleeds
Common, more males
Due usually to digital trauma
Consider coagulopathy or haematological abnormality

20
Q

Where is the most common area for nosebleeds to happen from?

A

Little’s area

21
Q

What is the management for epistaxis?

A

Appropriate first aid
Antibiotic ointments - Naseptin and Bactroban
Cautery - silver nitrate under LA and diathermy under GA
Nasal packing

22
Q

What symptoms are in laryngology?

A

Sore throat
Airway issues - stridor

23
Q

Describe tonsillitis

A

Inflammation of tonsils
Can be bacterial - strep. B or viral - EBV
Risk of glomerulonephritis
Supportive management and antibiotics for bacterial infection

24
Q

What are some anatomic and physiological causes for airway obstruction in children?

A

Large tongue, large tonsils, large epiglottis, short neck, sub glottis narrowest

25
Q

What is included in history of child with airway issues?

A

Usually an emergency
Foreign body, recent illness, feeding problems, stridor on inspiratory

26
Q

What is management for child with airway issues?

A

Blocks the airway
Need to intubate early
IV antibiotics and steroids

27
Q

Describe laryngomalacia

A

Laryngeal cartilages are soft - inward collapse of airways
Don’t usually need to treat
If breathing or feeding problems then can open up cartilages

28
Q

What are some causes of neck lumps?

A

Thyroglossal duct cyst
Branchial cyst
Cystic hygroma
Cervical lymphadenopathy

Head and Neck (14 decks)

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