Andrew P. Reid

An autonomous surgical robot for drilling a cochleostomy: preliminary porcine trial

Objective:u2002 To produce an autonomous drilling robot capable of performing a bony cochleostomy whilst minimising the damage to the underlying cochlear endosteum.

The role of bone anchored hearing aids in children with Down syndrome

OBJECTIVESnTo evaluate complication rates and outcomes of children with Down syndrome fitted with a Bone Anchored Hearing Aid (Baha). To evaluate whether the Bone Anchored Hearing Aid is a successful form of aural rehabilitation in children with Down syndrome from a patients perspective.nnnSTUDY DESIGNnRetrospective case analysis and postal questionnaire study.nnnSETTINGnThe Birmingham Childrens Hospital, UK.nnnMETHODSnA total of 15 children were fitted with a Baha between February 1992 and February 2007. The age range was 2-15 years. A postal questionnaire was sent to each family. The Glasgow Childrens Benefit Inventory (GCBI) was used in this study.nnnOUTCOME MEASURESnImplantation results, skin reactions and other complications were recorded. Quality of life after receiving a Baha was assessed with the GCBI.nnnRESULTSnAll 15 patients are using their Baha 7 days a week for more than 8h a day after a follow-up of 14 months with continuing audiological benefit. No fixtures were lost, and skin problems were encountered in 3 (20%). Regarding quality of life, all 15 patients had improved social and physical functioning as a result of better hearing.nnnCONCLUSIONSnBaha has an important role in the overall management of individuals with Down syndrome after conventional hearing aids and/or ventilation tubes have been considered or already failed. This study has shown a 20% rate of soft tissue reaction and there were no fixture losses in this group. No significant increase in complication rates was identified in children with Down syndrome. Finally, there was a significantly improved quality of life in children with Down syndrome after receiving their Baha. There was a high patient/carer satisfaction with Baha. Two of our series had bilateral two stage fixture procedures without any complications. More consideration should be given to bilateral bone anchored hearing aids in this group.

A ten‐year review of soft tissue reactions around percutaneous titanium implants for auricular prosthesis

Soft tissue reactions around abutments are the most common complications of percutaneous osseointegrated implants. The main objective of this study was to review our series of osseointegrated implants, evaluate the degree of adverse skin reactions around the auricular abutments, and compare with skin reactions in the pediatric bone‐anchored hearing aid (BAHA) population. The reason for comparing these two groups was the difference in abutment shape and position in skin with different characteristics.

Bone-Anchored Hearing Aids versus Conventional Hearing Aids

Hearing amplification technology has been evolving since the 19th century. Currently in most audiology departments, the mainstay of hearing rehabilitation is performed with conventional air and bone conduction aids. These are cost-effective, non-invasive hearing aids but are not without their drawbacks. This chapter explores the advantages and disadvantages of conventional hearing aids compared with the bone-anchored hearing aids. Although the bone-anchored hearing aids are a more expensive invasive option, there is increasing evidence that the benefits outweigh the disadvantages. Users report improved quality of life, health status and audiological rehabilitation.

Magnetic resonance imaging and bone anchored hearing implants: Pediatric considerations

OBJECTIVEnRecent developments in bone conduction hearing systems have seen the introduction of transcutaneous devices comprising of magnetic components. Our aim was to identify the number of children implanted with a traditional, non-magnetic percutaneous bone anchored hearing implant (BAHI) who would not have been eligible for a transcutaneous implant based on magnetic resonance imaging (MRI) need.nnnMETHODSnA retrospective case review of 206 children who had a percutaneous BAHI at the Birmingham Childrens Hospital (January 2009-October 2012) for auditory rehabilitation.nnnRESULTSnTwenty-eight percent (56/206) of children required at least one MRI scan after receiving a BAHI and 10 percent of patients (20/206) required two or more MRI scans. The main indication for MRI scanning was for neurological co-morbidities; a MRI brain was the most common scan performed.nnnCONCLUSIONnAlthough transcutaneous hearing devices/middle ear implants have their clear benefits, it may be argued that these relatively more invasive surgical procedures may not be the best option for the child who will require MRI scanning at some point in the future. Clinicians should be mindful of any need for MRI scanning when considering implant choices in the pediatric population.

Perioperative considerations for children undergoing bone anchored hearing device surgery: an observational study

The objective of the study was to identify important factors in the perioperative management of children undergoing bone anchored hearing device (BAHD) surgery in a paediatric tertiary centre. We also aim to compare current practice and identify any changes in practice with the previous study carried out in the same paediatric tertiary centre in 2000. Children undergoing BAHD surgery between January 2008 and January 2011 were identified on a departmental database. A retrospective case note review was performed and compared with data collected prior to 2000. In the study period, 194 children were identified to have had BAHD surgery. 134 case notes were available for analysis and of these children, 353 anaesthetics were identified. 45.5xa0% of the children had a recognised syndrome or dysmorphism and 17xa0% had a congenital cardiac anomaly. 16xa0% of the children were classified as a grade 3 or 4 laryngoscopy, but 83.3xa0% were managed with a laryngeal mask. 11.9xa0% of the children had an intraoperative complication and 4.8xa0% a postoperative complication. 88.4xa0% of children were managed as day cases. Compared with the previous study in 2000, there was a smaller proportion of syndromic or dysmorphic children and a larger proportion of children were managed with a laryngeal mask. As BAHD surgery has become more common and as its indications have expanded, the perioperative management has evolved. The proportion of children with congenital heart disease has remained constant, but there has been a marked reduction in the number of children with syndromes involving the head and neck. We have found that even in complex craniofacial cases, the laryngeal mask is increasingly being used with good results. However, advanced paediatric airway experience was still required in a small number of cases, heightening the awareness that specialised paediatric support services are necessary for a comprehensive BAHD programme.