How common are URTIs in kids?
Very, its quite normal to get up to 8 episodes a year of up to 15 days at a time.
When do the sinuses develop?
- Ethmoid/Maxillary by or just after birth
- Sphenoid around 5yrs
- Frontal at 7-8yrs
What kind of exams are there for kiddies noseseses?
An otoscopic exam
Most children wont be compliant with a flexible or rigid nasoendoscopy
What are the dangers of a foreign body?
Might get into airway
If stuck might cause pain or infection
If battery it can erode tissue, so needs immediate removal
How does sinusitis present?
Acute or chronic
Most common: Thick Nasal Mucous, Plugged Nose & Face Pain
Sometimes: Fever, Headaches, Olfactory Disturbance, Sore Throat and cough
How do we treat Sinusitis?
Antimicrobials
So B-lactams or macrolides
What are the complications of sinusitis?
= Nasal Polyps
= Periorbital Cellulitis - inflammation/infection of eyelid and skin around eye
= Intracranial Abscess
Detail a Congenital nasal condition picked up in early childhood?
Choanal Atresia
Unilateral or bilateral blockage of the nose by abnormal membrane or bone.
Shows up in babes with trouble feeding (cant breath through nose whne feeding and obvs mouth is in use)
If unilateral will show up later in childhood.
Which gender gets more epitaxis?
Boys
What causes most paediatric epistaxis?
Digital Trauma i.e. nose picking
What part of the nose tends to bleed most?
Little’s Area, a region at the front of the nose containing kesselbachs plexus.
A region where all the arteries of the nose anastomose so its very prone to bleeds and is also within reach of fingers
How do we manage epistaxis?
- First Aid as per
- Antibiotic Ointments e.g. Naseptin or Bactroban
- Cauterise
- Nasal Packing (Ant/post/both)
How do we go about cauterising the nose?
Local anaesthetic with Silver nitrate
General Anaesthetic with Diathermy (electrically induced heat)
