Post on 05-Jan-2016
transcript
Case Scenario#2
Lisa Gagnon, APRNConnecticut Pediatric Otolaryngology7th Annual Otolaryngology Symposium
Initial presentation……
• 8 y/o female presented to her pcp with acute ear pain/bulging ear drum
• Dx: AOM
• Prescribed routine antibiotics and supportive care
Case progression
• Went to ED: Severe pain, on abx for AOM• Reported dizziness/vertigo & headache• Reported significant hearing loss• No change in treatment, plan
ENT Evaluation
• 9 months following initial AOM episode referred to ENT, hadfailed screen at school,then pcp 1 mo ago.• Formal audio: Unilateral profound to severe SNHL
PMH/FH
PMH: “Used to be prone to OM” ~2 years ago, had 1 perforation (?which ear) -Past 2 years- No recurrent AOM/CSOM -Prior hearing screens nl -No other risk factors for SNHL
FH: Neg hx hearing loss, genetic/chromosomal abnl
Further Evaluation- SNHL
• CT scan of temporal bones- WNL
• Ophthamology exam- WNL
Suppurative Labrythitis
• Labyrinthitis is inflammatory disorder of the inner ear or labyrinth.
• Caused by bacteria or viruses entering labyrinth causing acute inflammation
• May have disorder of balance/vertigo• May develop SNHL
Inner Ear Anatomy
Treatment
• If due to AOM….immediate tympanocentesis and myringotomy/PE tube insertion
• Possible mastoidectomy• Parental antibiotics (initially)• HT
• SNHL Treatment and follow-up
Thank you!