Read the following publications:
Rosenfeld R.M., Shin, J.J., Schwartz, S.R., Coggins, R, Cagnon, L, et al. (2016). Clinical practice guideline: Otitis media with effusion (Update). Otolaryngol Head Neck Surg, 154(1 Suppl):S1-S41.
Lieberthal, A.S., Carroll, A.E., Chonmaitree, T, Ganiats, T.G., et al. (2013). Diagnosis and management of acute otitis media. Pediatrics, 131(3):e964-99.
Rosenfeld, R.M., Kay, D. (2003) Natural history of untreated otitis media. Laryngoscope, 113(10):1645-57.
1.
Discuss epidemiologic risk factors for otitis media.
2.
Differentiate acute otitis media from otitis media with effusion. Compare the sensitivity and specificity of pneumatic otoscopy and tympanometry for diagnosis of middle ear effusion.
3.
Discuss the role of the Eustachian tube in the pathogenesis of OM.
4.
What organisms are involved in acute otitis media (AOM)? Do viruses play a role in AOM?
5.
Discuss clinical factors associated with the decision to treat versus observe AOM. Include a discussion of the natural history of AOM.
6.
Discuss the initial antibiotic choice for a non-allergic child with acute otitis media. Include consideration of typical antibacterial resistance patterns for common AOM pathogens.
7.
Discuss the natural history of recurrent AOM and the impact of tympanostomy tubes on this condition.
8.
Discuss the natural history of otitis media with effusion (OME), including differences between OME identified after AOM and OME of unknown duration.
9.
When should an audiogram be performed in a child with otitis media with effusion (OME)? Should an audiogram always be preformed after tympanostomy tube placement?
10.
Discuss the primary indications for undertaking active management of OME.
11.
What is the role of adenoidectomy in the management of otitis media? Does age of patient matter?
12.
A 2-year-old child presents with bilateral OME of 4 months duration and mild CHL. What are your recommendations? How would these change based on the following: a) history of Down syndrome b) underlying SNHL c) history of frequent no-shows to providers d) precocious speech and language development e) developing tympanic membrane retraction pockets?
13.
What is the efficacy of oral and nasal steroids in treatment of otitis media with effusion?
14.
Describe some different types of tympanostomy tubes. Does the type of tympanostomy tube matter?
15.
When should you do a myringotomy alone versus myringotomy with tympanostomy tube placement?
16.
Why are post-operative otic drops used? Do they help prevent blockage of the tympanostomy tube?
Reference(s):
Jeon, E., Park, Y.-S., Lee, S.-K., Chang, K.-H., Park, S.-Y., Park, K.-H., & Lee, D.-H. (2007). Factors of the blockage of ventilation tubes in the immediate postoperative period. European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery, 264(12), 1393–1397.
17.
When should you replace a tympanostomy tube that has fallen out? Are there any long-term sequelae of tympanostomy tubes?