ROLE OF ENT IN PERINATAL PERIOD Dr Sheelu Srinivas Consultant ENT Surgeon Fortis Hospitals Bannerghetta Road
Newborn Hearing Screening Programme <ul><li>OTOLARYNGOLOGIC MANIFESTATIONS OF  PREGNANCY </li></ul>
OTOLARYNGOLOGIC MANIFESTATIONS OF  PREGNANCY <ul><li>Metabolic and physiologic changes during pregnancy </li></ul><ul><li>...
Rhinitis During Pregnancy :  <ul><li>Other underlying conditions – Allergic rhinitis – Rhinitis medicamentosa – Bacterial ...
RHINITIS RX <ul><li>AVOID TOPICAL DECONGESTANTS & SPRAY </li></ul><ul><li>SALINE NASAL SPRAY </li></ul><ul><li>Environment...
  Gastro esophageal Reflux     <ul><li>Reflux  • 50-75% of gravid women • Heartburn, sore throat, hoarseness • Third trime...
Gastro esophageal Reflux     <ul><li>Antireflux precautions, frequent small meals </li></ul><ul><li>Antacids, Sucralfate <...
Why newborn hearing screening? <ul><li>Two to four newborns, out of every 1,000, have hearing deficiency  </li></ul><ul><l...
It is estimated to be 30 times more common than other congenital defects, such as sickle cell anemia, cystic fibrosis, hyp...
Do we need a test? <ul><li>Initially, babies who are born with hearing loss do not look or behave any differently from bab...
When? <ul><li>The hearing screen is usually done before you leave the maternity unit. </li></ul>
What does it involve? <ul><li>A soft tip ear piece is placed in outer part of babies ear. </li></ul><ul><li>It sends click...
Results <ul><li>Given immediately </li></ul><ul><li>Either Pass/Refer </li></ul><ul><li>Even though child passes if he is ...
What if no response ? <ul><li>Second test in a week </li></ul><ul><li>Causes-  baby unsettled, background noises, ear flui...
Second test <ul><li>Similar to first </li></ul><ul><li>ABR/BERA </li></ul>
Do tests hurt? <ul><li>No </li></ul><ul><li>Soft tips/soft head phones </li></ul><ul><li>Keep child comfortable </li></ul>...
Is this universally available <ul><li>Not in India </li></ul><ul><li>   In most of the States in the U.S./UK/Europe, for i...
Is the test compulsory? <ul><li>Definitely for high risk baby </li></ul><ul><li>who may have passed the hearing screening ...
THANK YOU
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Role of ent in perinatal period

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Role of ent in perinatal period

  1. 1. ROLE OF ENT IN PERINATAL PERIOD Dr Sheelu Srinivas Consultant ENT Surgeon Fortis Hospitals Bannerghetta Road
  2. 2. Newborn Hearing Screening Programme <ul><li>OTOLARYNGOLOGIC MANIFESTATIONS OF PREGNANCY </li></ul>
  3. 3. OTOLARYNGOLOGIC MANIFESTATIONS OF PREGNANCY <ul><li>Metabolic and physiologic changes during pregnancy </li></ul><ul><li>– Hearing & Balance </li></ul><ul><ul><li>– Bell's palsy </li></ul></ul><ul><ul><li>– Nasal symptoms </li></ul></ul><ul><ul><li>– Oral manifestations </li></ul></ul><ul><ul><li>– Aero digestive tract </li></ul></ul><ul><ul><li>– Thyroid </li></ul></ul><ul><ul><li>– Dermatologic manifestations </li></ul></ul>
  4. 4. Rhinitis During Pregnancy : <ul><li>Other underlying conditions – Allergic rhinitis – Rhinitis medicamentosa – Bacterial rhinosinusitis – Vasomotor rhinitis – Nasal polyps – Deviated septum </li></ul>
  5. 5. RHINITIS RX <ul><li>AVOID TOPICAL DECONGESTANTS & SPRAY </li></ul><ul><li>SALINE NASAL SPRAY </li></ul><ul><li>Environmental control </li></ul><ul><li>Antihistamines: chlorpheniramine (cat. B) </li></ul><ul><li>Loratidine and cetirizine (cat. B)• Only after 1st trimester </li></ul><ul><li>Intranasal corticosteroids </li></ul>
  6. 6. Gastro esophageal Reflux <ul><li>Reflux • 50-75% of gravid women • Heartburn, sore throat, hoarseness • Third trimester– Increased abdominal pressure – Decreased gastric emptying – Increased intestinal transit time? – Decreased LES pressure </li></ul>
  7. 7. Gastro esophageal Reflux <ul><li>Antireflux precautions, frequent small meals </li></ul><ul><li>Antacids, Sucralfate </li></ul><ul><ul><li>• H2 Blockers:– Cimetidine . Ranitidine - OK </li></ul></ul><ul><ul><li>• Proton pump inhibitors - after 1st trimester– </li></ul></ul>
  8. 8. Why newborn hearing screening? <ul><li>Two to four newborns, out of every 1,000, have hearing deficiency </li></ul><ul><li>among the high-risk babies, the number of hearing-impaired is 5 to 14 per cent. </li></ul><ul><li>High-riskers include those </li></ul><ul><li>birth weight was </li></ul><ul><li>less than 1.5 kg; </li></ul><ul><li>jaundice, </li></ul><ul><li>meningitis or birth asphyxia; </li></ul><ul><li>ventilation after birth; </li></ul><ul><li>family history of hearing loss </li></ul>
  9. 9. It is estimated to be 30 times more common than other congenital defects, such as sickle cell anemia, cystic fibrosis, hypothyroidism, etc. <ul><li>Deafness is one of the commonest congenital disabilities in the world. </li></ul>
  10. 10. Do we need a test? <ul><li>Initially, babies who are born with hearing loss do not look or behave any differently from babies who are hearing.  </li></ul><ul><li>However, undetected and untreated hearing loss has serious consequences on the acquisition of language skills as well as cognition and emotional and social development. </li></ul><ul><li>The first 6 months of a baby’s life are very crucial for the development of speech and language.   </li></ul>
  11. 11. When? <ul><li>The hearing screen is usually done before you leave the maternity unit. </li></ul>
  12. 12. What does it involve? <ul><li>A soft tip ear piece is placed in outer part of babies ear. </li></ul><ul><li>It sends clicking sounds down the ear </li></ul><ul><li>When an ear receives sound –cochlea responds with echo </li></ul><ul><li>Screening equipment picks up this response </li></ul>
  13. 13. Results <ul><li>Given immediately </li></ul><ul><li>Either Pass/Refer </li></ul><ul><li>Even though child passes if he is a high risker further assessment done </li></ul><ul><li>Up to 3 years ,every 6 months </li></ul>
  14. 14. What if no response ? <ul><li>Second test in a week </li></ul><ul><li>Causes- baby unsettled, background noises, ear fluid </li></ul>
  15. 15. Second test <ul><li>Similar to first </li></ul><ul><li>ABR/BERA </li></ul>
  16. 16. Do tests hurt? <ul><li>No </li></ul><ul><li>Soft tips/soft head phones </li></ul><ul><li>Keep child comfortable </li></ul><ul><li>Feed before test </li></ul><ul><li>Carry things to make comfortable </li></ul>
  17. 17. Is this universally available <ul><li>Not in India </li></ul><ul><li>  In most of the States in the U.S./UK/Europe, for instance, the neo-natal hearing testing is compulsory by law and the protocol is called `1-3-6' (meaning, all babies should have their hearing screened by the first month; diagnosed by the third month and be receiving hearing aids by six months.) </li></ul>
  18. 18. Is the test compulsory? <ul><li>Definitely for high risk baby </li></ul><ul><li>who may have passed the hearing screening should, nonetheless, receive audiologic monitoring every 6 months until age 3 years </li></ul>
  19. 19. THANK YOU

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