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 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, had failed 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!