Paediatric otorhinolaryngology Flashcards
Give an example cause of conductive and sensironeural hearing loss
conductive - blockage eg tumour
sensironeural - problem with cochlear nerve
Give three potential differing types of hearing loss
congenital vs acquired
bilateral vs unilateral
conductive vs sensironeural
Give some examples of what may be found in the history of a child with ear problems/hearing loss
ear - pain, discharge, loss of function eg tinnitus/vertigo
speech development, maternal infection, behaviour problems, delivery and neonatal issues
What is often used to both look up a childs nose and their ears?
otoscope
The 4 subjective hearing tests
distraction test
visual reinforcement audiometry
play audiometry
pure tone audiometry
The 3 objective hearing tests
autoacoustic emission
auditory brain stem response
tympanometry
Risk factors of glue ear
day care, smoking, cleft palate, downs syndrome
5 possible treatments of glue ear
grommet, hearing aid, adenoidectomy, auto balloon inflation, BAHA
Symptoms of glue ear
academic decline, hearing loss, speech delay, behavioural problems
Signs of glue ear
dull tympanic membrane
fluid level and bubbles
3 causes of glue ear
large adenoids
acute otitis media resolving
Eustachian tube dysfunction
otitis externa treatment
aural suction, topical antibiotics
acute otitis media causative organisms
Moraxella catarrhalis, H influenza, strep pneumonia
Treatment of acute otitis media
grommet, adenoidectomy, antibiotics
What is a complication of acute otitis media?
can erode into the mastoid bone which requires a mastoidectomy and antibiotics
If there is chronic discharge and no resolving with grommet what is required?
mastoidectomy
ages of sinus development
0-4M: ethmoid, maxillary
3-7Y: sphenoid
8+= frontal
history of nose problems
discharge, loss of function, pain
snoring, problem feeding, foreign body
3 examinations of the nose/breathing
rigid nasal endoscopy
cold spatula test
otoscope
2 types of rhinitis and treatment
allergic and non allergic
nasal douching, antihistamines, nasal steroids
If you suspect large adenoids what should you ask about?
sleep apnoea/problems
Is a foreign body usually bilateral or unilateral?
unilateral
What condition are sinusitis with nasal polyps associated?
CF
Complication of sinusitis+polyps
periorbital cellulitis
choanal atresia
posterior end of nose unopen leading to recurrent infection and sinus problems, If bilateral cannot breathe
What should you consider in epistaxis apart from digital trauma?
coagulopathy/ haematological abnormality
Management of epistaxis
first aid, antibiotic ointments, packing, cauterisation
History of throat problems
pain, discharge, loss of function, snoring, drooling, aspiration
Tonsilitis causative agents
Bacterial - strep B and viral (EBV)
What is a risk to the kidneys of tonsillitis?
glomerulonephritis
Difference with acute and severe tonsillitis
supportive and antibiotics
steroids and IV antibiotics
Complication of tonsillitis
Quinsy - peritonsillar abscess
Differences in the anatomy of a child’s neck
large adenoids large epiglottis large tongue short neck sub glottis narrowest
Laryngomalacia
cartilage not well formed and soft
History of airway issues
foreign body, recent illness, feeding problems, stridor, epiglottis
Neck abscess treatment
drainage and IV antibiotic
4 types of neck abscesses
thyroglossal duct cyst
brachial cyst
cystic hygroma
cervical lymphadenopathy
Cystic hygroma
lymphatic problem
