EAR, NOSE AND THROAT

OTITIS MEDIA

Introduction

5 min

Introduce yourself and the group

Provide rationale for the session and relevance to clinical practice

Outline learning objectives:

Take a focused history from a patient presenting with acute otitis media and consider possible complications
Demonstrate a focused ear, nose and throat examination and present findings at the level of an FY1 doctor
Discuss relevant investigations and management plan for patients presenting with acute otitis media

Explain structure of session

Total time:

60 min

Number of students:

1-5

Grade of students:

3rd to 5th year medical students

Created by:

Dr Ysabelle Embury-Young

Uploaded:

16th October 2019

Last updated:

16th October 2019

Resources needed for this session:

Pen, paper, prescription chart, otoscope

Students can scan the QR code opposite to view all investigation results on their phone as you work through the session.

Resources linked to this session:

Activity 1: History Taking and Examination

15 min

Ask the student(s) to take a focused history; to include history of presenting complaint, past medical history, drug and allergy history, social history, family history and system review.

Following this, ask another student to demonstrate a focused ENT examination. If required, explain (or ask the students to explain) the relevant anatomy as they perform the examination.

Activity 2: Diagnostic Reasoning and Case Based Discussion

10 min

Ask one of the students to summarise the key points of history and examination. Discuss:

possible differential diagnoses for the patient's presentation
aetiology of acute otitis media
acute complications of acute otitis media including: mastoiditis, meningitis, sinus thrombosis, facial nerve palsy

Discuss chronic otitis media as a complication of acute otitis media, including: importance of intervention in children to avoid long-term hearing loss and/or language development issues; management options available.

Activity 3: Relevant Clinical Anatomy

5 min

Using the image opposite, identify the major landmarks, including:

lateral process of malleus
cone of light
pars tensa
pars flacida
umbo

Using the images below, discuss

Example 1.

Example 2.

Example 3.

Activity 4: Prescribing

5 min

Ask the student(s) to find the local guidelines for the management of acute otitis media. Using a drug chart, ask the student(s) to prescribe an appropriate first line antibiotic.