Cochlear implant user perceptions of magnetic resonance imaging.

OBJECTIVES: To characterise opinions about needing to undergo MRI within the population of current cochlear implant (CI) users. BACKGROUND: Magnetic resonance imaging (MRI) of CI users is often associated with severe discomfort and magnet displacement. METHODS: A global online survey of 310 CI users was conducted between 22nd July and 13th September 2020. RESULTS: Only 55% of respondents had been told whether their model of CI could undergo MRI. 31% of respondents considered MRI when deciding whether to receive a CI, and 28% when deciding which CI model to have. 64% reported concerns related to their CI if needing MRI compared to 29% reporting concerns unrelated to their CI. Willingness to undergo MRI reduced when considering magnet removal, splinting, bandaging, local anaesthesia, lasting discomfort, an inability to use their CI, or a reduction in image quality because of their CI. The single most influential factor was the possibility of damaging their CI (63%). 59% of respondents would consider minor surgery to upgrade their retaining magnet to one of a rotating design. DISCUSSION: These findings highlight the heterogeneity of CI users' opinions about MRI. CONCLUSION: We suggest several opportunities for improving the dissemination of current and accurate MRI-related information for CI users.

Use of a novel drape 'tent' as an infection prevention control measure for mastoid surgery.

BACKGROUND: Mastoid surgery is an aerosol-generating procedure that involves the use of a high-speed drill, which produces a mixture of water, bone, blood and tissue that may contain the viable coronavirus disease 2019 pathogen. This potentially puts the surgeon and other operating theatre personnel at risk of acquiring the severe acute respiratory syndrome coronavirus-2 from contact with droplets or aerosols. The use of an additional drape designed to limit the spread of droplets and aerosols has been described; such drapes include the 'Southampton Tent' and 'OtoTent'. OBJECTIVES: To evaluate the use of a novel drape 'tent' that has advantages over established 'tent' designs in terms of having: (1) a CE marking; (2) no requirement for modification during assembly; and (3) no obstruction to the surgical visual field. RESULTS AND CONCLUSION: During mastoid surgery, the dispersion of macroscopic droplets and other particulate matter was confined within the novel drape 'tent'. Use of this drape 'tent' had no adverse effects upon the surgeon's manual dexterity or efficiency, the view of the surgical field, or the sterility. Hence, our findings support its use during mastoid surgery in the coronavirus disease 2019 era.

The AB-York crescent of sound: an apparatus for assessing spatial-listening skills in children and adults.

Modern health services need efficient tools for measuring outcomes from interventions, that is, tools of proven efficacy which make minimal demands on the time of clinicians in learning to administer tests and in interpreting results. This paper describes an apparatus designed to meet those requirements. The apparatus administers performance tests of spatial listening for children and adults with unilateral and bilateral cochlear implants. The apparatus was designed with guidance from clinicians. It possesses three key attributes: it is simple to use; the results of tests are scored automatically and are compared with reference data; the apparatus generates comprehensive personalized reports for individual participants that can be included in clinical notes. This paper describes the apparatus and reports results of a test measuring spatial release from masking of speech which illustrates the compatibility between the new apparatus and an older apparatus with which the reference data were gathered.

Bilateral or unilateral cochlear implantation for deaf children: an observational study.

OBJECTIVE: Cochlear implantation in one ear (unilateral implantation) has been the standard treatment for severe-profound childhood deafness. We assessed whether cochlear implantation in both ears (bilateral implantation) is associated with better listening skills, higher health-related quality of life (health utility) and higher general quality of life (QOL) than unilateral implantation. DESIGN: Cross-sectional observational study. SETTING: University of York. PARTICIPANTS: Fifty severely-profoundly deaf and 56 normally-hearing children recruited via a charity, the UK National Health Service and schools. INTERVENTIONS: Thirty of the deaf children had received bilateral cochlear implants; 20 had unilateral cochlear implants. MAIN OUTCOME MEASURES: Performance measures of children's listening skills; parental-proxy valuations of the deaf children's health utility obtained with the Health Utilities Index Mark 3 and of their QOL obtained with a visual analogue scale. RESULTS: On average, bilaterally-implanted children performed significantly better than unilaterally implanted children on tests of sound localisation and speech perception in noise. After conservative imputation of missing data and while controlling for confounds, bilateral implantation was associated with increases of 18.5% in accuracy of sound localisation (95% CI 5.9 to 31.1) and of 3.7 dB in speech perception in noise (95% CI 0.9 to 6.5). Bilaterally-implanted children did not perform as well as normally-hearing children, on average. Bilaterally- and unilaterally-implanted children did not differ significantly in parental ratings of health utility (difference in medians 0.05, p>0.05) or QOL (difference in medians 0.01, p>0.05). CONCLUSIONS: Compared with unilateral cochlear implantation, bilateral implantation is associated with better listening skills in severely-profoundly deaf children.