ABOHNS Complex Pediatric Otolaryngology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Bilateral choanal atresia

Congenital bony or membranous obstruction of both posterior nasal apertures causing cyclical cyanosis in neonates relieved by crying; requires oral airway and prompt surgical repair.

CHARGE syndrome

Disorder with coloboma, heart defects, choanal atresia, growth retardation, genitourinary anomalies, and ear anomalies, usually from CHD7 mutation; bilateral choanal atresia warrants evaluation.

Juvenile nasopharyngeal angiofibroma

Benign but locally aggressive vascular tumor in adolescent males causing recurrent epistaxis and nasal obstruction; biopsy is contraindicated, and treatment is embolization plus surgical resection.

Kartagener syndrome

Primary ciliary dyskinesia variant with situs inversus, chronic sinusitis, and bronchiectasis; presents with chronic otitis media and sinus disease from infancy.

Laryngeal cleft types

Classified I to IV by distal extent: I interarytenoid, II through cricoid, III into cervical trachea, IV into thoracic trachea; aspiration is the hallmark symptom.

Recurrent respiratory papillomatosis

HPV 6/11-driven laryngeal papillomas causing hoarseness and airway obstruction; juvenile-onset presents in early childhood; managed with repeated excision and adjuvants in severe cases.

Peritonsillar abscess

Collection between tonsil capsule and superior constrictor causing trismus, uvular deviation, and muffled voice; treated with needle aspiration or incision and drainage plus antibiotics.

Cystic fibrosis nasal polyps

Nasal polyposis in a child under 12 is uncommon and should prompt sweat chloride or CFTR testing to evaluate for cystic fibrosis.

Stridor timing localization

Inspiratory stridor suggests supraglottic or laryngeal lesions; biphasic suggests glottic or subglottic; expiratory suggests tracheobronchial; fixed biphasic lesions worsen with inspiration.

Laryngomalacia

Most common cause of infant stridor, from omega-shaped epiglottis and redundant arytenoid tissue; worsens supine and with feeding; supraglottoplasty for severe failure to thrive or apnea.

Myer-Cotton grading

Subglottic stenosis severity: grade I under 50 percent, II 51 to 70, III 71 to 99, IV complete obstruction; guides choice of endoscopic versus open reconstruction.

Croup management

Laryngotracheobronchitis with barking cough and steeple sign; parainfluenza most common; dexamethasone for all and nebulized epinephrine for moderate to severe disease.

Epiglottitis

Acute supraglottic infection with drooling, tripod positioning, muffled voice, and fever; avoid throat examination and agitation; secure airway in the operating room.

Subglottic hemangioma

Vascular lesion causing progressive biphasic stridor and recurrent croup in infants; asymmetric subglottic narrowing on endoscopy; treated with propranolol and possibly laser or open excision.

Laryngeal web

Congenital glottic web from incomplete recanalization presenting with weak cry or aphonia; thin anterior webs divided endoscopically, thicker webs need keel or open repair.

Pediatric tracheostomy risks

Smaller tubes and compliant tissue increase risk of accidental decannulation and granulation tissue; careful sizing and caregiver training are essential.

Acute otitis media pathogens

Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis are most common; amoxicillin is first-line unless recent beta-lactam use or severe disease.

Tympanostomy tube indications

Recurrent acute otitis media (3 in 6 months or 4 in 12), chronic otitis media with effusion causing hearing loss or speech delay, and persistent effusion beyond 3 months with symptoms.

Congenital cholesteatoma

White mass behind an intact tympanic membrane in a child without prior ear disease; surgical removal often staged because of extension and recurrence risk.

Cochlear implant candidacy

Severe-to-profound bilateral sensorineural hearing loss with limited hearing aid benefit and an intact auditory nerve; imaging assesses cochlear and nerve anatomy before surgery.

Congenital CMV hearing loss

Leading nongenetic cause of pediatric sensorineural hearing loss; screen with urine or saliva PCR in infants with SNHL; hearing loss may be delayed or progressive.

Enlarged vestibular aqueduct

Most common inner ear malformation causing pediatric sensorineural hearing loss; loss may be progressive or stepwise after minor head trauma; MRI confirms diagnosis.

NF2 in children

Bilateral vestibular schwannomas in a child suggest neurofibromatosis type 2; screen for cutaneous schwannomas, cataracts, and other tumors; confirm with genetic testing.

Vestibular migraine

Common cause of pediatric vertigo with episodic dizziness, headache, and motion sensitivity; diagnosis is clinical, and treatment includes lifestyle and migraine prophylaxis.

Thyroglossal duct cyst

Midline neck mass that moves with tongue protrusion; treatment is Sistrunk procedure, which removes the cyst, tract, and central hyoid bone to reduce recurrence.

Branchial cleft cyst

Lateral neck mass anterior to the sternocleidomastoid; second cleft anomalies most common; treatment is complete surgical excision to prevent recurrent infection.

Lymphatic malformation

Cystic hygroma presenting as a transilluminating posterior triangle mass; may compromise airway; treated with sclerotherapy or sirolimus for extensive disease.

Fibromatosis colli

Sternocleidomastoid mass in neonates causing torticollis; managed conservatively with passive stretching; surgery is rarely needed.

Pediatric thyroid nodule

Nodules in children carry higher malignancy risk (about 20-25 percent) than in adults; evaluate with ultrasound and FNA; carcinoma often needs total thyroidectomy and neck dissection.

Rhabdomyosarcoma

Most common pediatric head and neck soft tissue sarcoma; parameningeal sites need aggressive local control plus chemotherapy; staging uses Intergroup Rhabdomyosarcoma Study grouping.

Microtia reconstruction

Autologous costal cartilage framework in staged Nagata or Brent technique, usually beginning at age 6-10 when rib cartilage is adequate; canaloplasty considered separately.

Cleft lip and palate timing

Lip repair around 3-6 months (rule of 10s); palate repair around 9-18 months; multidisciplinary team addresses feeding, speech, hearing, and dental needs.