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Case Scenario#2

Case Scenario#2. Lisa Gagnon, APRN Connecticut Pediatric Otolaryngology 7 th 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.

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Case Scenario#2

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  1. Case Scenario#2 Lisa Gagnon, APRN Connecticut Pediatric Otolaryngology 7th Annual Otolaryngology Symposium

  2. 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

  3. Case progression • Went to ED: Severe pain, on abx for AOM • Reported dizziness/vertigo & headache • Reported significant hearing loss • No change in treatment, plan

  4. ENT Evaluation • 9 months following initial AOM episode referred to ENT, had failed screen at school, then pcp 1 moago. • Formal audio: Unilateral profound to severe SNHL

  5. 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: Neghx hearing loss, genetic/chromosomal abnl

  6. Further Evaluation- SNHL • CT scan of temporal bones- WNL • Ophthamologyexam- WNL

  7. SuppurativeLabrythitis • 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

  8. Inner Ear Anatomy

  9. Treatment • If due to AOM….immediate tympanocentesis and myringotomy/PE tube insertion • Possible mastoidectomy • Parental antibiotics (initially) • HT • SNHL Treatment and follow-up

  10. Thank you!

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