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Establishment of a bone-anchored auricular prosthesis (BAAP) program.

https://arctichealth.org/en/permalink/ahliterature187722
Source
Int J Pediatr Otorhinolaryngol. 2002 Dec 2;66(3):273-9
Publication Type
Article
Date
Dec-2-2002
Author
Brian W Rotenberg
Adrian L James
David Fisher
Jim Anderson
Blake C Papsin
Author Affiliation
Department of Otolaryngology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
Source
Int J Pediatr Otorhinolaryngol. 2002 Dec 2;66(3):273-9
Date
Dec-2-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Bone and Bones
Child
Cohort Studies
Congenital Abnormalities - diagnosis - surgery
Ear, External - abnormalities - surgery
Female
Hospitals, Pediatric
Humans
Male
Ontario
Osseointegration - physiology
Patient Selection
Prognosis
Prostheses and Implants
Prosthesis Design
Prosthesis Implantation - adverse effects - methods
Reconstructive Surgical Procedures - methods
Retrospective Studies
Sensitivity and specificity
Treatment Outcome
Abstract
Bone-anchored auricular prostheses (BAAPs) are indicated for treatment of congenital or acquired microtia in children. This paper reports on our experience in establishing a BAAP program, including treatment algorithms, protocols and a discussion of the methodology, complications and patient satisfaction.
Eleven consecutive children using BAAPs were reviewed. Outcome measures include patient selection criteria, long-term stability of the BAAP, skin reactions around the site, and patient satisfaction.
A patient selection program was developed and implemented, followed by a management protocol for surgery and follow-up. All children (100%) achieved osseointegration, with only one site revision necessary. A variable degree of skin irritation was noted in just over one third (39%) of cases. All children were satisfied with their prosthesis.
The use of BAAPs in a pediatric population is a safe and viable method to correct disfiguring microtia. The final result is generally very acceptable to the child.
PubMed ID
12443817 View in PubMed
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Impact of cleft palate type on the incidence of acquired cholesteatoma.

https://arctichealth.org/en/permalink/ahliterature116390
Source
Int J Pediatr Otorhinolaryngol. 2013 May;77(5):695-8
Publication Type
Article
Date
May-2013
Author
Luke Harris
Sharon L Cushing
Bradley Hubbard
David Fisher
Blake C Papsin
Adrian L James
Author Affiliation
Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Hospital for Sick Children, Toronto, Canada.
Source
Int J Pediatr Otorhinolaryngol. 2013 May;77(5):695-8
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Canada - epidemiology
Child
Child, Preschool
Cholesteatoma, Middle Ear - epidemiology - etiology
Cleft Palate - complications - epidemiology
Cohort Studies
Follow-Up Studies
Humans
Incidence
Retrospective Studies
Risk factors
Survival Analysis
Abstract
The objectives of this study were to determine the incidence of acquired cholesteatoma in children with congenital cleft palate, and to determine the impact of various cleft palate types (cleft lip and palate, cleft palate alone, submucous cleft palate) on the development of acquired cholesteatoma.
This is a retrospective cohort study spanning a 25-year period from 1981 to 2005. The Cleft Palate Registry at the Hospital for Sick Children in Toronto, Canada was cross-referenced with the hospital's surgical pathology database to identify all children with cleft palate and acquired cholesteatoma. Accuracy and completeness of the datasets were confirmed by comparison with hospital records and other databases.
There were 2737 children who underwent palatoplasty over the study period, and 44 of these children developed an acquired cholesteatoma. Adjusting for censored data by Kaplan Meier analysis, the incidence of cholesteatoma was 2.2% between the ages 5 and 18 years, or 0.2% per year. Acquired cholesteatoma was 3 times more common in cleft lip and palate than cleft palate alone (p=0.002, Kaplan Meier Log-rank survival analysis).
The rate of acquired cholesteatoma in children with cleft palate is approximately 200 times the baseline rate. Children, especially teenagers, with cleft lip and palate appear to be at significantly higher risk for acquired cholesteatoma than children with cleft palate alone.
PubMed ID
23402698 View in PubMed
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Low pediatric cochlear implant failure rate: contributing factors in large-volume practice.

https://arctichealth.org/en/permalink/ahliterature128642
Source
Arch Otolaryngol Head Neck Surg. 2011 Dec;137(12):1190-6
Publication Type
Article
Date
Dec-2011
Author
Antoine Eskander
Karen A Gordon
Latif Kadhim
Vicky Papaioannou
Sharon L Cushing
Adrian L James
Blake C Papsin
Author Affiliation
Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 190 Elizabeth St, Toronto, Ontario, Canada. antoine.eskander@utoronto.ca
Source
Arch Otolaryngol Head Neck Surg. 2011 Dec;137(12):1190-6
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Child, Preschool
Cochlear Implants - statistics & numerical data
Deafness - congenital - rehabilitation
Female
Follow-Up Studies
Humans
Infant
Kaplan-Meier Estimate
Male
Ontario
Prosthesis Design
Prosthesis Failure
Replantation
Retrospective Studies
Risk factors
Speech Reception Threshold Test
Young Adult
Abstract
To evaluate the rate of cochlear implant (CI) failure and CI reimplantation (CIri) in our population of children receiving implants by means of a technique that includes device fixation with suture to cortical bone.
Retrospective analysis from January 1990 to June 2010.
Tertiary pediatric hospital.
A total of 971 devices were provided to 738 children (5575 implant-years).
Cochlear implant explants and CIri.
Surgical findings at CIri were assessed by device model. The Pediatric Ranked Order Speech Perception score and the Phonetically Balanced Kindergarten score were used to make comparisons of hearing ability before and after CIri.
Thirty-four patients have undergone CIri in our pediatric center during the past 20 years. Excluding 7 of these patients who received their initial implant at other centers, our rate of CIri was 2.9%. Mean (SD) time to device failure was 61 (43) months. A disproportionately high number of patients (7 of 35 [20%]) requiring CIri had meningitis before implantation. After CIri, children maintained or improved their best speech performance measured before device failure, with only 2 children showing a significant reduction in speech perception after CIri.
A very low rate of failure occurs in children who receive CI devices, and several factors may account for this low rate. Children who develop meningitis before CI appear to be at an increased risk of device failure.
PubMed ID
22183896 View in PubMed
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Parental and program's decision making in paediatric simultaneous bilateral cochlear implantation: who says no and why?

https://arctichealth.org/en/permalink/ahliterature149600
Source
Int J Pediatr Otorhinolaryngol. 2009 Oct;73(10):1325-8
Publication Type
Article
Date
Oct-2009
Author
James D Ramsden
Vicky Papaioannou
Karen A Gordon
Adrian L James
Blake C Papsin
Author Affiliation
Cochlear Implant Program, The Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada. james.ramsden@orh.nhs.uk
Source
Int J Pediatr Otorhinolaryngol. 2009 Oct;73(10):1325-8
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Child, Preschool
Cochlear Implantation - adverse effects - methods
Cochlear Implants
Cohort Studies
Deafness - surgery
Decision Making
Equipment Failure
Female
Follow-Up Studies
Hearing Loss, Sensorineural - diagnosis - surgery
Hospitals, Pediatric
Humans
Infant
Male
Ontario
Parents - psychology
Patient Selection
Risk assessment
Sex Factors
Statistics, nonparametric
Time Factors
Treatment Outcome
Abstract
To evaluate initial candidacy for bilateral simultaneous cochlear implantation in children.
Prospective case series.
Tertiary academic pediatric hospital.
As part of our research protocol all children eligible for cochlear implantation were assessed for suitability to receive a simultaneous bilateral implant. Over a 12-month period (January to December 2007) 78 children received a total of 95 cochlear implants. Children with sequential second implants (24), revision cases (4), and out of province recipients (4) were excluded. The remaining 46 patients were assessed for bilateral simultaneous implantation.
Team/parental decision to proceed with bilateral simultaneous implantation.
17 children (37%) received simultaneous bilateral implants. 29 children (63%) were not considered suitable for simultaneous bilateral implantation. Reasons included developmental delay (10), residual borderline hearing in the second ear (9), parental/patient refusal (6), abnormally poor speech development for age (2), and abnormal cochlear anatomy precluding implantation (2). None were considered unsuitable for the more prolonged operative procedure on medical grounds.
Although bilateral implantation is thought to produce the optimal auditory outcome, not all patients are suitable, nor do all parents wish to proceed, when assessed for simultaneous implantation. Some of these patients are likely to be candidates for sequential bilateral implantation in due course.
PubMed ID
19616316 View in PubMed
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