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DEAFNESS-EARLY DETECTION IN CHILDRENAT BIRTH- AUROPALPEBRAL REFLEX & STARTLE REFLEX
AT 3 MONTHS- BLINKING & FROWNING IN RESPONSE TO SOUND
AT 5 MONTHS- EYE TURNING TO SOUND SOURCE
AT 6 MONTHS- HEAD TURNING TO SOUND SOURCE
AT 10-12 MONTHS- SOUND IDENTIFICATION AT ANY PLANE & TRIES TO SAY 1 OR 2 WORDS
OVER 2 YEARS- CAN COMPLY TO REQUESTS & DEMANDS
BETWEEN 2-5 YEARS- CAN PERFORM SOMETHING/ COMPREHEND
ACUTE SUPPURATIVE OTITIS MEDIA: C/F
EXCESSIVE CRYING AT NIGHT
SEVERE THROBBING EAR PAIN
PYREXIA OF UNKNOWN ORIGIN WITH NAUSEA/ VOMITING
DEAFNESS OR RARELY AUTOPHONY
BLOOD STAINED MUCOID DISCHARGE
CONGESTED/ BULGED T.M. WITH/ WITHOUT PERFORATION
COUGH & COLD WITH FEVER (ASSOCIATED/ WITHIN A WK)
ACUTE SUPPURATIVE OTITIS MEDIA: TREATMENT
ANY EAR DROP IS CONTRA-INDICATED WHEN THERE IS NO PERFORATION OR OTOMYCOSIS
DRY HOT FOMENTATION/ DRY MOPPING OF DISCHARGE IF PRESENT
STEAM INHALATION IN URTI
PARACETAMOL FOR FEVER/ IBUPROFEN FOR PAIN (15-20 mg/kg)
AMOXYCILLIN OR CEPHALEXIN (20-40 mg/kg IN DIVIDED DOSES)
XYLOMETAZOLINE (0.1 %-ADULTS & 0.05 %-CHILDREN)
OTOTOXIC DRUGS
AMINOGLYCOSIDES (STREPTOMYCIN & GENTAMICIN-VERTIGO, REST-DEAFNESS/ TINNITUS)
DIURETICS
QUININE & CHLOROQUINE
SALICYLATES
ANTI-CANCER DRUGS
OTOTOXIC DRUGS (CONT.)
PARENTERAL ADMINISTRATION IS MORE VULNERABLE
IN PREGNANCY THESE DRUGS MAY PASS THE PLACENTAL BARRIER TO AFFECT
THE FOETUS. SO EITHER AVOID OR IF NO OTHER OPTION THEN DISCONTINUE
WHEN OTOTOXICITY OCCURS
BLEEDING PER EAR
EAR CANAL INJURY
T.M. RUPTURE
HEAD INJURY WITH/ WITHOUT TEMPORAL BONE FRACTURE
AURAL GRANULATION OR GROWTH
TREATMENT: DO NOT PACK THE EAR
AVOID EAR DROPS & OIL/ WATER ENTRY
PARACETAMOL/ IBUPROFEN
AMOXYCILLIN/ CEPHALEXIN
NASAL POLYPS
INFLAMMATORY POLYP: ANTROCHOANAL & ETHMOIDAL
FUNGAL POLYP: RHINOSPORIDIOSIS
OTHER SWELLINGS APPEARING AS POLYPS: HYPERTROPHIED INFERIOR TURBINATE,
NASAL ANGIOMA, ANGIOFIBROMA, INVERTED PAPILLOMA, CARCINOMA,
MENINGOCELE, ENCEPHALOCELE, MENINGO-ENCEPHALOCELE
NASAL POLYPS (CONT.)NASAL OBSTRUCTION
SNEEZING
NASAL DISCHARGE
HYPOSMIA/ ANOSMIA
HEADACHE/ FACIAL PAIN
OCC. EPISTAXIS
TREATMENT: MOSTLY SURGICAL (FUNCTIONAL ENDOSCOPIC SINUS SURGERY)
ACUTE SINUSITIS (< 6 WKS)NASAL OBSTRUCTION WITH DISCHARGE
SEVERE HEADACHE/ FACIAL PAIN
FEVER
UNPLEASANT TASTE/ POST-NASAL DRIP
OCC. EPISTAXIS
TREATMENT: AMOXYCILLIN/ CIPROFLOXACIN
PARACETAMOL
CETIRIZINE/ LEVOCETIRIZINE
XYLOMETAZOLINE NASAL DROPS
CHRONIC SINUSITIS (> 6 WKS)NASAL OBSTRUCTION
DULL HEADACHE/ FACIAL PAIN
REPEATED HAWKING/ CLEARING OF THROAT
BLOCKING SENSATION OF THE EARS
INTERMITTENT HOARSENESS
TREATMENT: ORAL HYGIENE
NORMAL SALINE SPRAYS/ DROPS
ANTIBIOTICS
IF PERSISTING- SURGERY (FESS)
PATCH OVER TONSILS
ACUTE FOLLICULAR TONSILLITIS
FAUCEAL DIPHTHERIA (GREYISH WHITE PATCH, PSEUDO-MEMBRANE, TOXIC PATIENT & CERVICAL
LYMPHADENOPATHY. ALBERT STAINING. ANTI-DIPHTHERITIC SERUM 20,000-1,00,000 IU)
AGRANULOCYTOSIS (RELATIVE LYMPHOCYTOSIS)
INFECTIOUS MONONUCLEOSIS (EBV)
LEUKAEMIA/ SQUAMOUS CELL CA
VINCENT’S/ RARELY LUDWIG’S ANGINA
TRACHEOSTOMY
TRAUMA TO NECK & CHEST
CUT THROAT INJURY
LARYNGEAL GROWTH
SEVERE LARYNGEAL INFECTION
DIPHTHERIA
ACUTE LARYNGO-TRACHEO-BRONCHITIS IN CHILDREN
TRACHEOSTOMY (CONT.)WHENEVER YOU THINK OF TRACHEOSTOMY, DO IT
NEEDS 3 D CONSENT (DEATH BEFORE, DURING OR AFTER SURGERY)
VERTICAL MIDLINE INCISION FROM CRICOID TO SUPRASTERNAL NOTCH IN EXTENDED NECK POSITION
USUALLY DONE UNDER LOCAL ANAESTHESIA
THYROID ISTHMUS IS RETRACTED UPWARDS
OPENING DONE OVER 3RD & 4TH TRACHEAL RINGS
MOSTLY METALLIC TUBES ARE USED
TUBE IS FIXED TO THE NECK WITH TAPES
FOREIGN BODY THROAT
FISH BONE- COMMONEST F.B. BUT FOUND IN 60 % OF CASES ONLY (MANUAL PALPATION NEEDED)
TONSILS- MOST COMMON SITE
MOST OF THE FISH BONES, ARTIFICIAL DENTURES & PLASTIC MATERIALS ARE RADIO-LUCENT
RECENT SKIAGRAMS ARE NECESSARY
LATERAL VIEW IS MORE INFORMATIVE
MAY NEED I/L, D/L OR FOL FOR REMOVAL
MAY NEED BRONCHOSCOPY
MESSAGE CONGENITAL DEAFNESS SUSPICION INTRACTABLE VERTIGO- LABYRINTHITIS, CSOM,RTA, BPPV CSOM WITH INTRACRANIAL COMPLICATION, FACIAL PALSY BLEEDING EAR WITH FACIAL PALSY IN CHILD/ADULT UNILATERAL SNHL IN ADULTS INTRACTABLE EPISTAXIS ADULTS/ YOUNG, (JNA) IMPACTED OLD/RARE FB, LEECH & MAGGOT IN NOSE & NASOPHARYNX, TRACHEA RTA WITH CSF LEAK UNEXPLAINED HEADACHE & FACIAL PAIN, HEMIFACIAL SPASM HEAD NECK TUMORS, SUSPECTED LYMPHOMAS ORBITAL CELLULITIS & TUMORS UNEXPLAINED DYSPHAGIA, HOARSENESS, TRISMUS, STRIDOR IN CHILD CHRONIC DACRYOCYSTITIS, LACRIMAL CYSTS & ABSCESS NECK SPACE INFECTON MISCELLANEOUS
AWARENESS IN INDISCRIMINATE USE OF STEROID, ND