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Paediatric ENT Surgery Flashcards

(59 cards)

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1
Q

Definition of otalgia

A

Ear ache

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2
Q

Definition of otorrhea

A

Ear discharge

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3
Q

What is the at risk paediatric group for otology symptoms?

A 
S.C.B.U
Family history 
Meningitis 
Perinatal sepsis
- toxoplasmosis
- rubella
- CMV
- Herpes
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4
Q

What are the paediatric hearing tests?

A

Universal neonatal screening
AOAE test
AABR test

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5
Q

What does the AOAE test stand for?

A

Automated otoacoustic emission

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6
Q

What does AABR stand for?

A

Automated auditory brainstem response

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7
Q

What age gets distraction tests?

A

6 - 18 months

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8
Q

What age gets Visual reforced audiometry (VRA)?

A

12 months - 3 years

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9
Q

What age gets play audiometry?

A

3 - 5 years

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10
Q

What age gets pure tone audiometry?

A

4+ years

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11
Q

How does tympanometry work?

A

A tympanometer creates a change in pressure in the ear canal

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12
Q

Peak ages to get otitis media with effusion

A

18/12 years and 4 years

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13
Q

What gender gets otitis media with effusion more?

A

M > F

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14
Q

At risk groups for OME

A 
Day care
Older siblings
Parental smoking
Cleft palate
Downs syndrome
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15
Q

Symptoms of OME

A 
Hearing loss
Speech delay 
Behavioural problems 
Academic decline
Imbalance
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16
Q

What does OME stand for?

A

Otitis media with effusion

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17
Q

Signs of OME

A

Dull TM
Fluid membrane
Bubbles

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18
Q

Causes/pathology of OME

A 
Eustachian tube dysfunction 
- anatomy of skull base
- muscular immaturity 
Adenoidal hypertrophy 
Resolving AOM
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19
Q

What reduces the risk of OME?

A

Breast feeding

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20
Q

Treatment of OME

A

Hearing aids
Grommet insertion
Adenoidectomy

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21
Q

Peak incidence of acute otitis media

A

3 - 18 months

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22
Q

What gender gets more acute otitis media?

A

M = F

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23
Q

Symptoms of acute otitis media

A 
Short history 
Very painful 
Fever
Systemic upset (sleep disturbance)
Ear discharge
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24
Q

Causative organisms for acute otitis media

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A

Haemophilus influenzae
Strep pneumonia
Moraxella catarrhalis

25
Signs of acute otitis media
Often vague Unwell screaming child Rubbing the ears High fever
26
What is the diagnostic test for acute otitis media?
Otoscopy
27
Treatment for acute otitis media
Analgesia - calpol vs ibruprofen | Antibiotics - amoxycillin/coamoxiclav, erythromycin second line
28
How long should antibiotics be taken for in acute otitis media?
5 - 7 days
29
How long would a long course of antibiotics be for?
4 - 6 weeks
30
When would you need a long course of antibiotics for in acute otitis media?
Recurrent AOM episodes
31
Complications of acute otitis media
``` Acute mastoiditis Mastoid abscess Facial nerve palsy Ossicular/cochlear damage Labyrinthitis Chronic perforation Febrile convulsion Brain abscess Meningitis Sub/extradural empyema ```
32
Treatment for recurrent/complicated AOM
Grommet insertion | +/- Adenoidectomy
33
What examinations are done to investigate nasal symptoms in children?
Nasal speculum Auriscope / otoscope Spatula test Nasal endoscopy
34
What gender of children gets epistaxis more?
M > F
35
Treatment of epistaxis
``` First air- press nose Antibiotic ointments - naseptin - Bactroban Cautery (burning) Nasal packing ```
36
Causes of nasal obstruction
Rhinitis Adenoidal hypertrophy Foreign body
37
Types of rhinitis
Allergic | Non-allergic
38
What would be a feature of nasal obstruction caused by a foreign body?
It would be unilateral
39
Treatment of nasal obstruction
``` Decongestants Steroids Nasal hygiene - saline douching Diathermy/reduce turbinates Adenoidectomy Correct choanal atresia ```
40
What is there a risk of with periorbital cellulitis?
Intracranial sepsis
41
Are nasal polyps rare or common in children?
Rare
42
Causes of nasal polyps in children
Chronic rhinosinusitis Cystic fibrosis Angiofibroma
43
Cause of bacterial tonsillitis
Beta haemolytic `streptococci
44
Treatment of acute tonsillitis
``` Penicillin +/- anaerobic cover Antiseptic gargle (difflam) Analgesia Drain tonsillar abscess Tonsillectomy ```
45
What antibiotics should be avoided in acute tonsillitis?
Amoxicillin | Ampicillin
46
What is a complication of acute tonsillitis?
Quinsy
47
What is a quinsy?
Peritonsillar abscess
48
Criteria for tonsillectomy
``` Recurrent tonsillitis 7 episodes >1 year Quinsy >1 Obstructive sleep apnoea Malignancy - rhabdomyosarcoma - lymphoma ```
49
Differences in a childs airway than an adults
``` Relative macroglossia Tonsillar hypertrophy Large epiglottis Short neck High larynx ```
50
Where is the narrowest part of a childs airway?
Subglottis
51
Where is the obstruction when a patient presents with a stertor?
Above larynx
52
Where is the obstruction when a patient presents with a stridor?
At or below larynx
53
What is cyanosis an extremely late sign of?
Upper airway obstruction
54
Causes of acute stridor
Infective (croup / epiglottis) | Foreign body
55
Causes of chronic stridor
Laryngomalacia Subglottis stenosis Vocal cord palsy
56
What sign on CXR is classically seen in croup?
Steeple sign
57
What is the commonest cause of paediatric stridor?
Laryngomalacia
58
Pathology of laryngomalacia
Redundancy of the tissues above the vocal cords The redundant tissue collapses inwards during inspiration and causes turbulence of inspired air The turbulence causes stridor
59
What sign may indicate a peritonsillar abscess?
Uvula deviation

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