Paeds ENT Flashcards
Differences between adults and childs ENT
Child has larger tongue in proportion to head
Eustachian tube is more horizontal
O2 requirement is double of an adults
Smaller airways, tinier lungs
What is the 1st hearing assessment a child will have?
Newborn hearing screening programme - within 5 weeks of birth
What is AOAE
Otoacoustic emissions (AOAE) - cochlea makes a sound because is stim’d
What is AABR?
Auditory brainstem response testing
ECG changes in response to sound
What is VRA?
Visual reinforcement audiometry
Turns head to sound and rewarded with visual reward
What is BVA
0-6m
Observed in norm vs during loud noise
What is performance test
For child >30 m
Child presented with stimulus in sound field
Must cooperate by playing the game
What is Play audiometry
Play action in response to sound
RF congenital hearing loss
Prematurity Downs FHx NICU stay Jaundice
Causes of AOM in paeds
Barotrauma
Bacterial
Viral
What % of kids have AOM before 3 v
80%
Predisposing factors AOM (6)
Enviro Bottle fed White/Indian Males Comorbidities FHX Winter
Sx AOM
Fever Headache Ear ache Irritable Poor feed Bulging ™ with reduced mobility
Mx AOM
Supportive
Who to give ABx for AOM
If <6 m
If at risk of complications
If Sx have persisted >4 days
Def recurrent AOM
AOM 3+ 6m /4 + 12m
Mx recurrent AOM
Will improve after 12 y/o
Tx each indiv
LT ABx - weekly azithromycin + grommets
Avoid pacifiers
PS OME
Effusion
Speech delay
School problems
Mild hearing impairment
O/E OME
-ve ME P- horizontal handle malleus Cone shaped pT Neoannular fold Blue/grey colour changes Opaque PT
Mx OME
Normally resolves in 3m
Grommet
Hearing aids
Valsava or otovent balloon
How long does it take for most Tymp membrane perfs to heal?
within 6 w usually
When should you refer a T M perf to ENT?
If severe bleed
If significant issues - tinnitus, vertigo, palsy
What is CSOM?
Inflammation + T M perforation
Mx CSOM
Cipro drops - perf/discharge
7 day amoglycoside drops
Sx mastoiditis (3)
Otalgia
HL
Swelling behind ear
O/E mastoiditis (4)
Pyrexia
Pinna down + forward
Loss post auric sinus
Post auric swelling
Mx mastoiditis (3)
Admit
IV Abx
Grommet +/- cortical mastoidectomy
