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Flashcards in Paediatric ENT - Otology Deck (19)
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1

What important consideration should we think of when examining an ENT problem?

Always examine all the regions.
If they have through pain dont just examine the throat, do the nose and ears as well

2

What might you pick up on in a kids history that would indicate hearing problems?

- Well...Ear symptoms
- Poor speech development
- Problems at school
- Behavioural Problems

Neonatal infections or maternal infections
Delivery issues such as being a premature baby or anoxia

3

How do we categorise hearing tests?

Subjective e.g. audiometry
Objective e.g. Otoacoustic Emissions

4

Children tend not to be compliant with conventional hearing tests.
What subjective tests can we use?

6-18 months = Distraction Test
1-3yrs = Visual Reinforced Audiometry
3-5yrs = Play Audiometry
4+ yrs = Pure tone audiometry like an adult

5

What objective hearing tests can we use on children?

- Otoacoustic Emissions (measures a sound produced by the inner ear during hearing, hearing loss reduces the OAEs)
- Tympanometry (measures inner ear pressure)
- Auditory Brain Stem Response

6

Common Paediatric conditions

- Otitis Media with Effusion (Glue ear)
- Otitis Externa
- Acute Otitis Media
- Chronic Otitis Media

7

What are the peak ages for Glue Ear?

2 and 5 yrs
80% have occured by age 10

8

What are the risk factrs for glue ear?

Day Care
Smoking
Cleft Paalte
Down Syndrome

9

What causes Glue ear?

- Dysfunction of the Eustachian Tube (Either due to messed up skull base or muscular immaturity)
- Adenoid Hypertrophy
- Resolving Acute Otitis Media

10

What does Otitis media with effusion look like?

- Hearing Loss
- Speech Delay
- Behavioural Problems
- Academic Decline

Signs on the Tympanic Membrane:
- Dull
- Visible Fluid level
- Bubbles

11

How do we treat otitis media with effusion?

Grommet:
- Most common
- Works itself out in ~1yr as the TM heals over

Autoinflation

Adenoidectomy

Hearing Aid

12

What causes otitis externa and how do we treat it?

Bacterial/fungal infection
Foreign Body
Allergy
Dermatitis

Treat it with:
- Aural Microsuction
- Topical Antibiotics
- Water Precautions (prevent it getting wet)

13

When is acute otitis media most common?

In the 3-18 months

14

How does acute otitis media present?

- Pain
- Fever
- Discharge

Short History of the above

15

What are some complications of acute otitis media

Perforation of the Tympanic Membrane. (keep it dry and treat infection)

Brain Abscess

16

What causes Acute Otitis Media

- Haemophilus Influenzae
- Strep Pneumonia
- Moraxella Catarrhalis

17

How do we treat acute otitis media?

With antibiotics or rest

If its recurrent:
Grommet & Adenoidectomy

18

What causes chronic otitis media?

Usually a Cholesteatoma or a perforated ear drum.

19

How do we treat a cholesteatoma

A mastoidectomy
Involves clearing out some of the mastoid air cells and parts of the middle ear