Initial outcomes from universal newborn hearing screening in Avon.

OBJECTIVE: The Avon Area Health Authority was a first-phase site for introduction of universal newborn screening in the UK. The aims of this study were: to review the programme's results to date; to assess the impact screening would have on other services (e.g. the cochlear implant programme); and to assess the longer term outcome for children identified by the screening programme. PATIENTS: All children identified by the Avon universal newborn hearing screening programme between April 2002 and July 2006. RESULTS: Fifty-four children with a bilateral hearing impairment of worse than 40 dBHL were identified from a screened population of approximately 44 000. Nine of these children were put forward for cochlear implantation, and seven had been implanted at the time of writing. Thirteen of these children were identified with possible auditory neuropathy or dys-synchrony. All the newborn hearing screening programme criteria assessed were met. CONCLUSIONS: The screening programme was effective. Some areas may need review in order to optimise patient care.

Long-term outcome of children undergoing surgery for suspected perilymph fistula.

UNLABELLED: A number of authors have suggested that surgery for suspected perilymph fistula is effective in preventing deterioration of hearing and in improving hearing in some cases in the short term. We present long-term hearing outcome data from 35 children who underwent exploration for presumed perilymph fistula at The Children's Hospital, Sydney, Australia, between 1985 and 1992. METHODS: The pre-operative audiological data (mean of 500, 1000, 2000 and 4000 Hz results) were compared with the most recently available data (range two to 15 years) and the six-month post-operative data. RESULTS: The short-term results showed no significant change in hearing at six months, with a subsequent, statistically significant progression of hearing loss in both operated and non-operated ears (Wilcoxon signed rank test: operated ear, p < 0.017; non-operated ear, p < 0.009). CONCLUSION: In this case series, exploratory surgery for correction of suspected perilymph fistula did not prevent progression of long-term hearing loss.

Efficacy of Gyrus diego microdissector at varying oscillation speeds.

OBJECTIVE: To determine the efficacy of the Gyrus diego microdissector at increasing oscillation speeds, using an in vitro tissue model. BACKGROUND: It had not previously been established whether microdissectors were more efficient at higher or lower speeds. METHODS: We investigated the effect of varying microdissector oscillation speeds on the weight of material aspirated in a given time. A 4 mm straight blade was used with constant suction strength. Jelly and liver were used to simulate polyps and muscle plus connective tissue, respectively. Water was used as a control. Repeat readings were taken at speeds of 1000, 2000, 3000, 4000 and 5000 rpm. Data were analysed using linear bivariate regression. RESULTS: The results showed significant linear trends in the cases of liver and jelly, with faster cutter speeds being associated with higher aspiration rates. CONCLUSION: These results suggest that microdissector efficacy increases with speed, up to 5000 rpm.

Otolaryngological requirements for recreational self-contained underwater breathing apparatus (SCUBA) diving.

Recreational self-contained underwater breathing apparatus (SCUBA) diving continues to grow in popularity. Medical requirements to be 'fit to dive' vary throughout the world, from self-certification to a full medical examination prior to training. This review discusses the relative merits of the most commonly used guidelines for recreational SCUBA diving, with reference to common diving-related otorhinolaryngological conditions. Areas of controversy, such as fitness to dive after rhinological and otological surgery, are discussed. The authors suggest that a unified approach from the various recreational SCUBA diving organizations involved would aid in clarification for divers and physicians alike. The difficulties in achieving such a unified approach, however, should not be underestimated.

Underestimation of meningococci in tonsillar tissue by nasopharyngeal swabbing.

The relation between carriage of Neisseria meningitidis and progression to invasive disease is not fully understood. We assessed the rate of N. meningitidis carriage by conventional swabbing and immunohistochemistry in patients undergoing tonsillectomy. Swabbing detected only a quarter of carriers, and bacteria were identified beneath the mucosal surface in tonsillar tissue by immunochemical testing. Our results indicate that N. meningitidis is more widespread in the population than previously thought, and have broad implications for disease prevention and cure.

Trigeminal neurinoma presenting with trismus.

We describe a patient with trigeminal neurinoma whose main presenting symptom was trismus. This has not previously been reported in the literature. We review the previously described symptoms and signs of trigeminal neurinoma.