ENT Paediatrics

Question 1

What is the assessment of hearing for 6-18 months?

Answer 1

Distraction test

Question 2

What is the hearing test for patients who are 1 - 3 years old?

Answer 2

Visual reinforced audiometry

Question 3

What is the hearing test for children aged 3-5 years old?

Answer 3

Play audiometry

Question 4

What is the test for patients who are 4 years or older?

Answer 4

Pure tone audiometry?

Question 5

What are the objective tests for the auditory systems?

Answer 5

• Otoacoustic Emissions
• Auditory Brain stem responses
• Tympanometry

Question 6

What are risk factors for otitis media?

Answer 6

Day care, smoking, cleft palate, down syndrome

Question 7

What is treatment of otitis media?

Answer 7

• Most improve by themselves
• Treat with hearing aids or grommets and adenoidectomy

Question 8

What are the complications associated with paediatric otitis media (with effusion)?

Answer 8

• HEARING LOSS
• SPEECH DELAY
• BEHAVIOURAL PROBLEMS
• ACADEMIC DECLINE
• (IMBALANCE)

Signs include:

Dull tympanic membrane

Fluid level

Bubbles

Question 9

What are the aetiologies of otiis media with effusion?

Answer 9

•EUSTACHIAN TUBE DYSFUNCTION

• ANATOMY OF SKULL BASE
• MUSCULAR IMMATURITY

•ADENOIDAL HYPERTROPHY

Question 10

Who is a bone anchored hearing aid given to?

Answer 10

Children with conductive hearing loss

Question 11

What is treatment for child with painful/discharging ear?

Answer 11

• Aural microsuction
• Topical antibiotics
• Water precautions

(clean ear, antibiotics, take care from water)

Question 12

What are the causative organisms for otitis media?

Answer 12

•Haemophilus influenza, strep pneumonia, Moraxella catarrhalis

Question 13

What is the treatment for otitis media?

Answer 13

• Treat with antibiotics (e.g. co-amoxiclav)
• Grommets + adenoidectomy if recurrent

Question 14

How long does it take for the eardrum to repair?

Answer 14

3 months

Question 15

What are the complications of acute otits media?

Answer 15

Mastoiditis, brain abscess

Question 16

When would you suspect cholesteatoma in children?

Answer 16

Chronic dischargine ear

Hearing loss despite grommets

Requires mastoidectomy

Question 17

What is rhinitis?

Answer 17

inflammation of the mucous membrane of the nose, caused by a virus infection (e.g. the common cold) or by an allergic reaction (e.g. hay fever).

Question 18

What is treatment for rhinitis?

Answer 18

Nasal douching

Antihistamines

Nasal steroids

Question 19

What can result from large adenoids?

Answer 19

Sleep apnoea

Question 20

What do the symptoms of sinusitis and polyps overlap with?

Answer 20

With rhinitis and large adenoids

Associated with cycstic fibrosis

Question 21

What is a complication of sinusitis?

Answer 21

Periorbital cellulitis

Question 22

What is choanal atresia?

Answer 22

Choanal atresia is a congenital disorderwhere the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue (membranous) due to failed recanalization of the nasal fossae during fetal development

Question 23

What is the treatment for choanal atresia?

Answer 23

However, the only definitive treatment is surgery to correct the defect by perforating the atresia to create a nasopharyngeal airway. If the blockage is caused by bone, this is drilled through and stent inserted.

Question 24

What is management of epistaxis?

Answer 24

Apropriate first aid

Antibiotic ointments:

NASEPTIN

BACTROBAN

Cautery:

Chemical by silver nitrate under local anaesthetic

Diathermy (using high frequency electrical currents) - General anaesthetic

Nasal Packing

Question 25

What are the causative organisms for tonsillitis?

Answer 25

•Bacterial (b haem Strep B) or viral (EBV)

Question 26

What is the treatment for tonsilitis?

Answer 26

Antibiotics

Question 27

What are the complications associated with tonsilitis?

Answer 27

Glomerulonephritis

Peritonsillar abscess (quinsy)

Question 28

What aspects of anatomy and physiology can cause airway issues in children?

Answer 28

• Large tongue
• Large tonsils
• Large epiglottis
• Short neck
• Sub glottis narrowest

Question 29

What is common in the history for patients that present with airway issues?

Answer 29

Recent illness

Feeding problems

Stridor

History of foreign body

Question 30

What is the treatment for epiglottitis?

Answer 30

IV antibiotics

Nebulisation

Steroids

Question 31

What is meant by laryngomalacia?

Answer 31

Is the most common cause of chronic stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction.

Question 32

What are the common neck lumps in children?

Answer 32

• THYROGLOSSAL DUCT CYST
• BRANCHIAL CYST
• CYSTIC HYGROMA
• CERVICAL LYPMHADENOPATHY - can be as a result of chronic tonsillitis

Question 33

What is a cystic hygroma?

Answer 33

Legion is more commonly referred to as a lymphatic malformation. Lymphatic malformation (LM). LMs usually affects the head and neck (~75%), with a predilection for the left side. Within the neck, the posterior triangle tends to be most frequently affected.

Lymphatic malformations are as a result of the following:

Failure of lymphatics to connect to the venous system

Abnormal budding of lymphatic tissue

Sequestered lymphatic rests that retain their embryonic growth potential