A New Community-to-Hospital Specialist Otology Pathway Using Telemedicine: A Pilot Study of 50 Patients.

Introduction: Pathway innovation using smartphone otoscopy and tablet-based audiometry technologies to deliver ear and hearing services via trained audiologists may improve efficiency of the service. An ENT-integrated-community-ear service (ENTICES-combining community audiology management, remote ENT review and novel technologies) was piloted. We aimed to assess the efficiency and safety of ENTICES.

Management and Clinical Outcomes of 37 Patients with Necrotizing Otitis Externa: Retrospective Review of a Standardized 6-Week Treatment Pathway.

Background: Necrotizing otitis externa is an invasive infection, affecting older patients, with significant associated morbidity. Despite this, there are no randomized controlled trials that address management, and therefore, treatment approaches may vary considerably. We describe the management and outcomes of 37 patients managed using a multidisciplinary treatment pathway for necrotizing otitis externa over a 5-year period.

Do Filling Defects of the Vestibule Represent a Neuroradiological Marker for Congenital Cytomegalovirus? A Retrospective Case Series.

Introduction: The aim of this study was to investigate whether radiological marker(s) of the inner ear can be detected in congenital cytomegalovirus (cCMV) patients with severe-profound sensorineural hearing loss.

Methods: A retrospective imaging review of confirmed cCMV paediatric patients that had undergone consecutive cochlear implantation was performed at a tertiary hospital. Available pre- and postoperative imaging was examined, and abnormalities of the labyrinth were catalogued by a consultant neuroradiologist in the study group and control group.

Cochlear implant outcomes in patients with Meniere's disease: a large case series.

Objective: To perform a matched cohort study to assess whether patients with Meniere's Disease (MD) require more intensive auditory rehabilitation following cochlear implantation (CI) and identify factors that may affect outcomes in patients with MD.

Methods: A retrospective case review was performed. MD and control patients were matched for age, biological sex, implant manufacturer and electrode design.

The Impact of Personal Protective Equipment on Speech Discrimination and Verbal Communication in the Operating Room and the Role of Audio Communication Devices.

Introduction: Recent work has highlighted communication difficulties when wearing personal protective equipment (PPE) in the clinical setting, but currently, there are little objective data on its effects. We assessed the impact of PPE on verbal communication in a simulated operating room and evaluated use of an audio communication device.

Methodology: Frontline health professionals across specialties including surgery, anesthetics, and nursing undertook speech discrimination testing with and without standardized levels of PPE in a simulated operating room environment.

Delivery of remote otology care: a UK pilot feasibility study.

Introduction: The COVID-19 pandemic has catalysed the need to implement the National Health Service Long-Term Plan to deliver more care in the community and to reduce face-to-face hospital appointments by up to 33%. This study aimed to assess the feasibility of a remote otology service from triage through to delivery.

Methods: New adult otology referrals at a tertiary ear, nose and throat (ENT) hospital aged between 18 and 70 with hearing loss or tinnitus were included.

Cochlear Implantation in Elderly Patients: Survival Duration, Hearing Outcomes, Complication Rates, and Cost Utility.

Introduction: The prevalence of hearing loss and its consequences is increasing as the elderly population grows. As the guidelines for cochlear implantation (CI) expand, the number of elderly CI recipients is also increasing. We report complication rates, survival duration, and audiological outcomes for CI recipients aged 80 years and over and discuss the cost utility of CI in this age group.

Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development.

Objective: Evidence for the management of acute otitis externa (AOE) is limited, with unclear diagnostic criteria and variably reported outcome measures that may not reflect key stakeholder priorities. We aimed to develop 1) a definition, 2) diagnostic criteria and 3) a core outcome set (COS) for AOE.

Study Design: COS development according to Core Outcome Measures in Effectiveness Trials (COMET) methodology and parallel consensus selection of diagnostic criteria/definition.

Sudden irreversible hearing loss post COVID-19.

Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis.

Prognostic factors for outcomes of idiopathic sudden sensorineural hearing loss: protocol for the SeaSHeL national prospective cohort study.

Introduction: The mainstay of treatment for idiopathic sudden sensorineural hearing loss (SSNHL) includes oral steroids, intratympanic steroid injections or a combination of both. The National Institute for Health and Care Excellence, in their recent hearing loss guidelines, highlighted the paucity of evidence assessing the comparative effectiveness of these treatments; and the National Institute for Health Research (NIHR) Health Technology Assessment Programme has since released a commissioned call for a trial to identify the most effective route of administration of steroids as a first-line treatment for idiopathic SSNHL. For such trials to be run effectively, reliable information is needed on patients with SSNHL: where they present, numbers, demographics, treatment pathways, as well as outcomes.

Hearing Preservation Outcomes With Standard Length Electrodes in Adult Cochlear Implantation and the Uptake of Electroacoustic Stimulation.

Background: Cochlear implantation with preservation of residual low-frequency hearing enables patients to utilize acoustic and electrical stimulation. It is widely accepted that preservation of residual low-frequency hearing is beneficial in both background noise and for music appreciation. The extent to which patients may benefit is not fully understood, but the importance of these concepts is reflected in electrode design developments and also refinement of surgical technique.

Stapes Surgery for 121 Patients With Mixed Hearing Loss.

This study aims to determine the benefit of stapes surgery for otosclerosis in 121 patients with a mixed hearing loss and a preoperative bone conduction (BC) threshold >30 dB. Average postoperative air conduction (AC) improved from 61.5 dB to 34.

A systematic review on prevention and management of wound infections from cochlear implantation.

Objective Of Review: Surgical site infections are a recognised complication of cochlear implant (CI) surgery with significant morbidity. Our aim was to search for the optimum prevention and management strategy to deal with this issue.

Type Of Review: Systematic review.

Stapes Surgery for Profound Hearing Loss Secondary to Otosclerosis.

The objective of this study is to evaluate stapes surgery in patients with otosclerosis and "profound" hearing loss. This means they meet hearing threshold criteria for cochlear implantation (CI). We performed a retrospective study and patient questionnaire.

Hearing Preservation With Standard Length Electrodes in Pediatric Cochlear Implantation.

Objective: Preserving low frequencies following cochlear implantation improves outcomes and allows patients to use a combination of electrical and acoustic stimulation. This importance has been reflected in advances in electrode design and refined surgical techniques. Full insertion of standard length electrodes may be advantageous over shortened electrodes because more electrodes can be activated over time if low frequency hearing loss progresses.

Head and neck teratomas in children--A series of 23 cases at Great Ormond Street Hospital.

Objective: Head and neck teratomas are rare and malignant change is rarer still. This is a report detailing all of the teratomas treated by the ear, nose and throat or craniofacial teams over the last 28 years at our institution. Examining the common presenting and radiological features as well as our success rates compared to the current literature.

Primary cervical ganglioneuroblastoma.

Objectives: Ganglioneuroblastomas represent a histological subgroup of the rare neuroblastic tumours with intermediate malignant potential arising from neural crest progenitor cells of sympathetic nerves. Diagnosis can often be difficult based on imaging alone. We describe 4 cases of children presenting with a solitary neck mass with histology ultimately revealing ganglioneuroblastoma.

Acute airway obstruction secondary to vocal fold heterotopic ossification.

A 29-year old man of Eritrean origin presented with acute stridor and respiratory distress on a background 1 year history of progressive breathing difficulty and worsening inspiratory stridor. Fibreoptic laryngoscopy revealed an indeterminate swelling of the left vocal fold leaving no clear airway visible. The patient refused surgical tracheostomy.

Improving dosing of gentamicin in the obese patient: a 3-cycle drug chart and case note audit.

Objectives: To assess the use of an electronic dose calculator to improve accuracy in the use of a complex Gentamicin prescription policy and assess turnaround time of blood sampling to dose delivery in an NHS hospital.

Design: Retrospective review of drug chart, case notes and hospital antibiotic database.

Setting: University Hospitals Bristol, UK PARTICIPANTS: Patients receiving once daily intravenous gentamicin using the trust protocol, during the same time window for 3 consecutive years.

Cricopharyngeal dilatation for the long-term treatment of dysphagia in oculopharyngeal muscular dystrophy.

Oculopharyngeal muscular dystrophy (OPMD) is a rare autosomal dominant, progressive degenerative muscle disorder featuring dysphagia with limited therapeutic options. The aim of this study was to evaluate the safety and efficacy of repeated endoscopic dilatation for OPMD over a 15-year period. All patients seen at our Regional Swallowing Clinic with OPMD confirmed by genetic analysis were included.

Informed consent in trauma: does written information improve patient recall of risks? A prospective randomised study.

Informed consent is vital to good surgical practice. Pain, sedative medication and psychological distress resulting from trauma are likely to adversely affect a patient's ability to understand and retain information thus impairing the quality of the consent process. This study aims to assess whether provision of written information improves trauma patient's recall of the risks associated with their surgery.