ENT

Question 1

What are 3 potential consequences of hearing loss?

Answer 1

1) Academic underachievement
2) Social problems e.g. behavioural
3) Speech and language delay

Question 2

In what 3 ways does hearing loss usually present itself?

Answer 2

1) Parent’s concern
2) Speech/ behavioural/ educational problems
3) Screening (Incidentally)

Question 3

What are the 3 types of hearing loss?

Answer 3

1) Conductive hearing
2) Senso-neural
3) Mixed

Question 4

What are the main causes of conductive hearing loss?

Answer 4

1) Glue ear
2) Ear wax
3) Otitis media
4) Perforated ear drum

Question 5

What is the main management of conductive hearing loss?

Answer 5

1) Watchful waiting (Can resolve on its own)
2) Grommet insertion
3) Temporary hearing aid
(Usually ENT managed)

Question 6

What are the main RF for sensori-neural hearing loss?

Answer 6

1) Family history
2) Consanguinity
3) SCBU

Question 7

How is sensori-neural hearing loss managed?

Answer 7

Cochlea Implants/Hearing aid –> By the paediatrician

Question 8

How is mixed hearing loss managed?

Answer 8

Manage conductive hearing loss first then offer a hearing aid

Question 9

At what points is hearing tested in children?

Answer 9

1) New-born hearing screening
2) School entry hearing test
3) Long term monitoring in high risk groups

Question 10

Is the new born screening test an objective or subjective test?

Answer 10

Objective: Resp/No resp
If there are concerns, pt followed up with evoked response audiometry

Question 11

What are the main aims in testing hearing?

Answer 11

1) To test frequency range (Hz)
2) Measure hearing threshold (dB)
3) Obtain single ear info

Question 12

What are the 4 types of subjective hearing testing?

Answer 12

1) Behavioural observational audiometry
2) Distraction testing
3) Visual reinforcement audiometry
4) Performance testing/play audiometry

Question 13

What are the causes and symptoms of acute otitis media?

Answer 13

C: Strep Pneumoniae, H Influenzae.
S/S: Pain, fever, malaise, otorrhoea

Question 14

What are the complications and treatment of acute otitis media?

Answer 14

Comp: a) E-Cranial: TM perforation, mastoiditis
b) I-Cranial: meningitis, abscess
T: Watch/Wait, Analgesia, Offer Abx/grommet if persistent

Question 15

How does a grommet work?

Answer 15

• Keeps middle ear aerated
• Allows for fluid drainage from middle ear (Prevents accumulation)

Question 16

When is a grommet indicated?

Answer 16

1) Recurrent AOM
2) Chronic otitis media + effusion
3) ET dysfunction

Question 17

What is the treatment and general cause of glue ear?

Answer 17

Cause: Otitis media & effusion
C: Infection (45% after AOM)

Question 18

What are the RF for glue ear?

Answer 18

Older sibling.
Male.
Nursery attendance.
Parental smoking.
Allergies.

Question 19

What are the criteria for considering a tonsillectomy?

Answer 19

1. > 7 episodes of acute tonsilitis in a year.
2. OSA or sleep-deprived breathing.

Question 20

What is the immediate management for acute epiglottitis?

Answer 20

Anaesthetist and ENT surgeon