13 Otitis media+effusion-Glue ear Common in childrenReduced hearing noticed by parents/teacherRecurrent ear infectionUnsteadiness- child falling overEffusions persist for weeks after AOM80% clear at 8 weeks
14 Signs of OME Dull retracted TM May show air-fluid level Conductive hearing loss(whisper test, Rinne/weber tests)OME persistant over 3 months ENT referral
15 Treatment Failed audio Flat tympanograms h/o >3 episodes in 6/12 or >4 in 12/12Grommet insertionEvaluate adenoids, especially in recurrent grommet insertions
16 Which ear needs syringing? Syringing the earWhich ear needs syringing?
26 Epistaxis Most common site – littles area Cause: Idiopathic, trauma (nose picking), dry mucosa, hypertension, coagulopathy, NSAID, Warfarin, tumoursTry naseptin cream for a short courseSilver nitrate cauteryElectrocautery/ packing/ surgery
36 Cord paralysis Breathy voice (air escape) B/L airway compromise P/H of thyroid, cardiovascular SxCord in paramedian positionRefer for investigations and treatment
37 Functional aphonia Psychogenic Only able to speak in forced whisper Normal coughSpastic dysphonia strained/strangled voiceOnset related to major life stressHyperadduction of true/false cordSpeech therapy, ? Botulinum toxin inj
38 Dysphagia Progressive dysphagia for solids structural lesion Dysphagia for liquids NeurologicalPainful swallow spasm of cricopharynx, ulcerSigns of refluxSigns of aspiration