Medication ENT + Surgery

Question 1

Penicillin V

Answer 1

Tonsillitis

10 days

Question 2

Amoxicillin

Answer 2

Sinusitis

Otitis media

Question 3

Flucloxacillin

Answer 3

Staph infection including cellulitis
Often used in chronic cellulitis without polyp
Use macrolide if allergic

Question 4

Gentamicin ear drop

Answer 4

Otitis externa as pseudomonas common

Use with caution if perforated due to risk of otototicty

Question 5

Ciprofloxacin (quinolone)

Answer 5

Unlicsned but used as no risk of toxicity
Otitis extern
Otitis media with perforated TM

Question 6

Anti-fungal

Answer 6

Fungal otitis externa

Question 7

Topical nasal steroid

Answer 7

Allergic rhinitis
Chronic sinusitis
Usually take 2-3 weeks to work

Question 8

Oral steroid

Answer 8

Significant nasal polyp
In conjunction with Ax for acute sinusitis
Bells palsy
Sudden onset acute sensorineural loss

Question 9

Anti-histamine

Answer 9

Rhinitis

If take systemic get anti-cholinergic SE

Question 10

Prochlorperaizne

Answer 10

Dopamine antagonist for N+V

Don’t take for more than 2 weeks

Question 11

Betahistine

Answer 11

Improve blood flow and reduce pressure

Not sure of evidence

Question 12

Intratympaic dexamethasone or gentamicin

Answer 12

Reduces vestibular nerve function

Dex preferred to gent due to risk of ototoxicity

Question 13

Indications for grommet

Answer 13

Otitis media with effusion >3 months

Recurrent acute otitis media

Question 14

What is a grommet

Answer 14

Ventilation tube to help ventilate the middle ear

GA or LA

Question 15

Peri-op care

Answer 15

Keep dry 2 weeks
Audiogram 6-12 weeks
Usually self extrude in 12 months and TM heals

Question 16

Complications

Answer 16

Infection
Tympanosclerosis (scarring)
TMperforation

Question 17

When is a myringoplasty / tympanoplasty recommended

Answer 17

Fix a perforated TM

Question 18

What is an ossiculoplasty

Answer 18

Reconstruction of ossicles

Question 19

When is a mastoidectomy indicated

Answer 19

CHolestoma

Cochlear implant

Question 20

Complications

Answer 20

Bleeding
Infection
Hearing loss - audiogram at 6-12 weeks
Disturbance of taste
Facial weakness 
CSF leak

Question 21

What are indications for tonsillectomy

Answer 21

Recurrent tonsillitis
QUinsy
OSA
Suspected malignancy

Question 22

What are CI / cautions for tonsillectomy and adenoidectomy

Answer 22

Coagulopathy
Acute infection
Cleft palate

Question 23

Complications

Answer 23

Primary haemorrhage within 24 hours
Secondary haemorrhage - day 4-7
Infection
Dental injury
Taste disturbance 
2 weeks of work

Question 24

Indications for adenoidectomy

Answer 24

Nasal obstruction +_ OSA

Recurrent otitis media

Question 25

What are indications for sinus surgery

Answer 25

``` Acute or chronic sinusitis not relieved by medical Nasal polyp Orbital complications Drainage of mucocele Endonasal tumour Access to skull base ```

Question 26

What are complications

Answer 26

``` Bleeding Infection Injury to nasolacrimal duct Orbital injury - rarely diplopia and blind CSF leak Anosmia ```

Question 27

Indications for parotidectomy

Answer 27

Neoplasm

Question 28

What are complications

Answer 28

Bleeding Haematoma Facial weakness Require drain for 48 hours after to avoid wound haematoma

Question 29

Indications for thyroidectomy

Answer 29

Malignancy | COmpression Sx

Question 30

What are risks

Answer 30

``` Bleeding Need for surgical drain post op Infection Damage to external laryngeal nerve - Unilateral = hoarse - Bilateral = obstructed airway HYpocalcaemia due to parathyroid injury Thyroid storm if hyperthyroid ```

Question 31

When is neck dissection indicated

Answer 31

Metastatic carcinoma

Question 32

What are complications

Answer 32

``` Bleeding Haematoma Infetion Nerve damage Facial lympoedema ```

Question 33

What is a tracheostomy

Answer 33

A surgically created opening in front of trachea | Can be elective or emergency

Question 34

Indications

Answer 34

Airway obstruction | Weaning from ventilation as reduces dead space

Question 35

Complications

Answer 35

``` Bleeding Dislodged tube Blocked tube Infection Subcutaneous emphysema Pneumothorax or pneumomediastinum ```

Question 36

What is needed post op

Answer 36

Humidifcation and regular suction Care of inner tube to avoid blockage Stoma wound care Remove tube as soon as possible