ENT - Paediatrics Flashcards
(26 cards)
What are some common otological symptoms?
- HEARING LOSS
- OTORRHEA
- OTALGIA
- TINNITUS
- VERTIGO
What examinations for hearing loss are possible for children of different ages?
- 6-18 Months: Distraction test
- 12 months – 3 years: Visual reinforced audiometry
- 3 - 5 years: Play audiometry
- 4 years +: Pure tone audiometry
What investigations can be done to test a child’s hearing?
- Otoacoustic Emissions
- Auditory Brain stem responses
- Tympanometry
What is an otoacoustic emissions test?
- An otoacoustic emission is a sound generated by the inner ear, the sound disappears after the inner ear has been damaged
- Testing for the OAE can test the function of the inner ear
What are some risk factors for otitis media with effusion in children?
- Day care
- smoking
- cleft palate
- down syndrome
What are the symptoms of otitis media with effusion?
Symptoms:
- HEARING LOSS
- SPEECH DELAY
- BEHAVIOURAL PROBLEMS
- ACADEMIC DECLINE
- (IMBALANCE)
What are the clinical signs of otitis media with effusion?
DULL TM
FLUID LEVEL
BUBBLES
How is otitis media with effusion treated in children?
- Hearing aids
- Grommet (tympanostomy tube - keeps middle ear aerated and allows fluid to seep)
What causes otitis media with effusion in children?
EUSTACHIAN TUBE DYSFUNCTION
- ANATOMY OF SKULL BASE
- MUSCULAR IMMATURITY
- ADENOIDAL HYPERTROPHY (hyperplasia of pharyngeal tonsils)
- RESOLVING A.O.M.
What are some possible causes of discharge +/- pain in a childs ear?
- Otitis externa
- Acute otitis media
How is otitis media treated in children?
- Aural microsuction
- Topical antibiotics
- Water precautions
What bacteria most commonly cause acute otitis media in children? Treatment?
- Haemophilus influenza, strep pneumonia, Moraxella catarrhalis
- Treat with antibiotics (e.g. co-amoxiclav)
- Grommets + adenoidectomy if recurrent
What investigations are used in chronic otitis media (cholesteatoma) in children? Treatment?
- CT scan
- Mastoidectomy to treat
What are the symptoms of chronic otitis media in children?
- Chronic discharging ear
- hearing loss despite grommets
What are some rhinology related symptoms often found in children?
- BLOCKED NOSE
- RUNNY NOSE
- SNEEZING
- REDUCED SENSE OF SMELL
- FACIAL PAIN
What are some causes of blocked / runny nose in children?
- Rhinitis (allergic or non-allergic)
- Enlarged adenoid glands
- Foreign body
- Sinusitis & polyps
- Choanal atresia
What are nasal polyps? Risk factors?
- soft, painless, noncancerous growths on the lining of your nasal passages or sinuses
- They result from chronic inflammation and are associated with asthma, recurring infection, allergies, drug sensitivity or immune disorders
What is Choanal atresia?
- Congenital disorder where the nasal passage is blocked
What is epistaxis?
- Acute hemorrhage from the nostril, nasal cavity, or nasopharynx (nosebleed)
- May be due to coagulopathy / haematological disorder
What is Little’s Area? Where is it found?
- Anastamoses of vasculature in nose, severe epistaxis if compromised
- Found on the anterior nasal septum and is an anastomosis of 5 arteries: anterior ethmoidal artery, posterior ethmoidal artery, sphenopalatine artery, greater palatine artery, and the septal branch of the superior labial artery
What is the treatment for epistaxis?
Antibiotic ointments
- NASEPTIN
- BACTROBAN
Cautery
- Silver Nitrate under LA
- Diathermy under GA
What are some common symptoms in Laryngology?
SORE THROAT
AIRWAY ISSUES
HOARSENESS
DYSPHAGIA
What is a common cause of sore throat in children? Treatment?
- Tonsilitis (Risk of glomerulonephritis - post infective)
- Bacterial (b haem Strep B) or viral (EBV)
- Antibiotics to treat
What are some possible anatomical causes of airway issues in children?
- Large tongue
- Large tonsils
- Large/Floppy epiglottis
- Short neck
- Sub glottis narrowest
- Foreign body occlusion
