Paeds ENT Flashcards
What is otitis media?
- infection of the middle ear
- space between tympanic membrane and inner ear
What does the middle ear contain?
- cochlea
- vestibular apparatus
- nerves
- bacteria enters from eustachian tube
- infection often preceded by viral URTI
Which bacteria cause otitis media?
- MC: strep pneumoniae
- H. influenzae
- Moraxella catarrhalis
- S. aureus
How does otitis media present?
- ear pain
- reduced hearing
- URTI symptoms
- balance issues
- vertigo
- discharge
What is seen on examination in otitis media?
- bulging, red inflamed tympanic membrane
- hole if perforation
- discharge
What does a normal ear look like on otoscope?
- pearly-grey, translucent, shiny membrane
-cone of light reflecting - see malleus
How is otitis media managed?
- most resolve w/out Abx
- simple analgesia
What are some complications of otitis media?
- effusion
- (temporary) hearing loss
- perforated ear drum
- recurrent infection
- mastoiditis
- petrositis
- meningitis
When should Abx be prescribed in otitis media?
- significant co-morbidities
- systemically unwell
- immunocompromised
- <2 years with bilateral otitis media
- otorrhoea
When should a delayed prescription be used in otitis media?
- after 3 days if symptoms have not improved or worsened
Which Abx are prescribed for otitis media?
- 5-7 day course of amoxicillin
- alternatives: erythromycin
- clarithromycin
When should children with otitis media be referred for specialist assessment?
- <3 mo and temp >38ºC
- 3-6mo and temp >39ºC
What is mastoiditis?
- infection spread from middle ear in otitis media
- abscess formation in mastoid air spaces in temporal bone
- leads to post auricular swelling and mastoid tenderness
What are grommets?
- tiny tubes inserted into tympanic membrane
- allows fluid to drain from middle ear to ear canal
What is glue ear?
- otitis media with effusion
- middle ear filled with fluid
What is the Eustachian tube?
- connects middle ear to back of throat
- helps to drain fluid
- buildup if blocked
What is the main symptom of glue ear?
- hearing reduction or loss
- main complication is otitis media
How is glue ear investigated and what is seen?
- otoscopy
- dull tympanic membrane
- filled with air bubbles or fluid
How is glue ear managed?
- referral for audiometry
- conservative management: resolves within 3 months
What is the most common cause of tonsillitis?
- Group A strep (Strep pyogenes)
- Strep pneumoniae
Which tonsils most commonly get infected in tonsillitis?
- palatine
- either side of back of throat
How does tonsillitis present?
- fever
- sore throat
- painful swallowing
- poor oral intake
- headache
- vomiting
What is seen on examination of tonsillitis?
- red, inflamed, enlarged tonsils
- with or without white patches
Which age groups does tonsillitis affect?
- 5-10 years
- 15-20 years
