Paediatric ENT

Question 1

Causes of acute OM

Answer 1

HMS
Haemophilia influenzae
Morexilla catharrils
Strep pneumoniae

Question 2

What is considered recurrent OM

Answer 2

3 episodes in 6 months
4 episodes in a year

Prophylactic abx given if so

Question 3

When and what abx given in AOM

Answer 3

Less than 2, immunocompromised, perforation or discharge or pain for over 48 hours

Amoxicillin

Clarithromycin if allergic, erythromycin if pregnant

Question 4

Presentation of acute OM

Answer 4

Ear pain, pyrexia and reduced hearing

Red bulging and loss of light reflex on otoscopy

Question 5

What is the presentation of glue ear

Answer 5

Painless reduction in hearing

Bimodal presentation at 2 and 4-5 years

Question 6

What conditions commonly have glue ear

Answer 6

Down’s syndrome and cleft palate

Question 7

Ix for glue ear

Answer 7

Audio gram shows a bone air gap, with tympanogram having a flat trace

Question 8

When are grommets inserted for omwe

Answer 8

25-30 dba bone air gap or significant developmental issues

Ventilates the middle ear cleft

Question 9

TM perforation
Causes and mx

Answer 9

Pain then pop followed by discharge
Caused by infection, baro trauma or direct trauma (direct causes pos TM perf)

No tx if no infection and allows to heal in 6-8 weeks

If infected prescribe abx

Myringoplasty if not healed after 8 weeks