- ItemPatient-related benefits for adults with cochlear implantation : a multicultural longitudinal observational study(S. Karger AG, Basel, 2017-07-19) Lenarz, Thomas; Muller, Lida; Czerniejewska-Wolska, Hanna; Varela, Hector Valles; Dotu, Cesar Orus; Durko, Marcin; Irujo, Alicia Huarte; Piszczatowski, Bartosz; Zadrożniak, Marek; Irwin, Colin; Graham, Petra L.; Wyss, JosieENGLISH ABSTRACT: To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. Design: This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. Subjects: Two hundred ninety-one routinely treated, unilateral CI recipients, aged 13-81 years, from 9 clinics across 4 countries. Results: Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). Conclusions: Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers.
- ItemThe simple bread tag – a menace to society?(Health and Medical Publishing Group, 2015) Karro, Ryan; Goussard, Pierre; Loock, James; Gie, RobertENGLISH ABSTRACT: Foreign bodies (FBs) are potentially life-threatening when inhaled by a child, depending on where they lodge. Symptoms can range from acute upper airway obstruction to mild, vague respiratory complaints. Between 80% and 90% of inhaled FBs occlude the bronchi, while the larynx is a less common site. The commonest inhaled paediatric FBs are organic, e.g. seeds or nuts. Plastic FBs are less common and more difficult to diagnose. They are generally radiolucent on lateral neck radiographs and are often clear and thin. We report three cases of an unusual plastic laryngeal FB, the bread tag. Plastic bread tags were first reported in the medical literature as an ingested gastrointestinal FB in 1975. Since then, over 20 cases of gastrointestinal complications have been described. We report what is to our knowledge the first paediatric case of an inhaled bread tag, and also the first case series, briefly discuss the symptoms and options for removal of laryngeal FBs, and highlight the dangers of the apparently harmless bread tag. Images of the bread tags in situ and after their removal are included.
- ItemTimpanoplastiekoperasies in septiese gevalle : 'n nuwe tegniek(HMPG, 1981-08) Wagenfeld, D. J. H.The very high incidence of postoperative sepsis in tympanoplasty operations on ears with infected cholesteatoma prompted the development of a new technique to improve the control of local infection. An irrigation tube is placed into the mastoid antrum at the time of operation, through which the ear is irrigated in the postoperative period with an antibiotic solution. In 25 tympanomastoidectomy operations, only 6 patients developed postoperative sepsis, 5 of which were due to faulty administration of the antibiotic. In 13 tympanoplasty operations, 6 patients had an unsuccessful outcome. Four of these were due to poor patient selection. Systemic antibiotics are given immediately preoperatively, and continued in the postoperative period until the course has been completed.
- ItemThe implications of early detection and pre-school habilitation of the hearing-impaired child : with special reference to the Provincial Paedo-audiological Centre, Tygerberg Hospital(Health and Medical Publishing Group -- HMPG, 1981-11) Du Toit, C. J.The basic handicap of deafness, viz. the lack of natural communication skills, can be overcome by early detection of the defect and pre-school habilitation. In congenital deafness this dramatically improves the outlook for these children as regards the acquisition of normal speech, education in normal schools and emotional, social and economic integration into society. Planning for this is the responsibility of the Department of Health and Social Welfare and the provincial hospital administrations.
- ItemSubjective pulsatile tinnitus cured by carotid endarterectomy(Health & Medical Publishing Group, 1989-05) Louwrens, H. D.; Botha, J.; Van der Merwe, D. M.A 70-year-old woman with unilateral pulsatile tinnitus was relieved of the complaint after carotid endarterectomy. Internal carotid artery stenosis presenting with pulsatile tinnitus is rare. Endarterectomy can relieve symptoms if the correct diagnosis is made.