Pediatric ENT Flashcards
(26 cards)
Cholesteatoma
- Consists of trapped epithelial tissue that grows beneath the surface of tympanic membrane
- Appears as a white, cystic mass within or behind the TM
- Causes progressive hearing loss
- If not surgically removed, can erode mastoid bone, ossicles, inner ear, and even cranium
Prevention of hearing loss
- Prevention of erythroblastosis fetalis, hyperbilirubinemia (high bilirubin can effect hearing loss), and congenital rubella
- Avoidance of ototoxic antibiotics when possible (i.e. aminoglycosides)
- Reduction of exposure to loud noise in environment, including music (headphones), firecrackers, and shots from cap pistols
Acute Otitis Media (AOM)
suppurative infection of middle ear cavity 80% get better without antibiotics ear tugging is not a reliable sign TM won't luff, will see pus often follows an URI
severe AOM
o Moderate or severe otalgia, or
o Otalgia at least 48 hours, or
o Temperature ≥39ºC (102.2ºF)
non-severe AOM
o Mild otalgia for less than 48 hours
o Temperature ‹39ºC (102.2ºF)
AOM antibiotic treatment
amoxicillin
90mg/kg/day for 10 days
or augmentin, ceftin or rocephin
when to offer tubes
o 3 episodes in 6 months, OR
o 4 episodes in 1 year, with 1 in past 6 mos
o Serous fluid > 12 weeks
o Complicated AOM
• Got mastoiditis or meningitis, had to be admitted
AOM Prevention
promote breast-feeding for at least the first 6 months of life
• Decrease modifiable risk factors
o Eliminate exposure to passive tobacco smoke
o Avoid “bottle-propping”
• Prevnar (Pneumococcal vaccine) –
o Dosed at 2,4,6, and 12-15 months
o Early data suggests deadly strains decreased, but overall incidence of AOM unchanged
otitis externa definition and cause
inflammation of the skin in the ear canal
commonly caused by water trapped in canal from swimming in lakes for pools
Otitis externa pathogens
staphlycoccus aureus
pseudomonas aeruginosa
otitis externa symptoms
pain, tugging of external ear
can get green discharge
no cold symptoms
OE treatment
combo drops: antibiotic/corticosteroid
choanal atresia
nasal obstruction, 90% are bony
allergic rhinitis triad
asthma, allergy, atopic dermatitis
allergic rhinitis physical exam pearls
allergic shiners – collection of blood below eyes
allergic salute – line across nose
acute bacterial sinusitis pathogens
- S. pneumoniae
- H. influenzae
- M. catarrhalis
acute bacterial sinusitis diagnostic criteria
o Persistent illness >10 days without improvement or
o Worsening course (cough, nasal d/c, new fever) or
o Severe onset (fever ≥39ºC or purulent nasal discharge at least 3 days)
hand foot mouth disease virus
coxsakie A16 virus
Ethmoid development
at birth
maxillary development
at birth
sphenoid development
5 years
frontal development
7-8 years
cleft lip definition
failure of the maxillary and median nasal processes to fuse
feeding difficulties
repair at first 2-10 weeks of life
cleft palate
midline fissure of the palate, failure of 2 to fuse
speech difficulty, otitis media
repair at 6-18 months
