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Hearing Disorders: HELP
Articles from Swansea
Based on 17 articles published since 2010
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These are the 17 published articles about Hearing Disorders that originated from Swansea during 2010-2020.
 
+ Citations + Abstracts
1 Review The genetic basis of auditory neuropathy spectrum disorder (ANSD). 2011

Manchaiah, Vinaya K C / Zhao, Fei / Danesh, Ali A / Duprey, Rachel. ·Long Term & Chronic Conditions Centre, College of Human & Health Sciences, Swansea University, United Kingdom. V.K.C.Manchaiah@swansea.ac.uk ·Int J Pediatr Otorhinolaryngol · Pubmed #21176974.

ABSTRACT: OBJECTIVE: Auditory neuropathy is a hearing disorder where outer hair cell function within the cochlea is normal, but inner hair cell and/or the auditory nerve function is disrupted. It is a heterogeneous disorder which can have either congenital or acquired causes. Furthermore, the aetiology of auditory neuropathy is vast, which may include prematurity, hyperbilirubinaemia, anoxia, hypoxia, congenital brain anomalies, ototoxic drug exposure, and genetic factors. It is estimated that approximately 40% of cases have an underlying genetic basis, which can be inherited in both syndromic and non syndromic conditions. This review paper provides an overview of the genetic conditions associated with auditory neuropathy spectrum disorders (ANSDs) and highlights some of the defective genes that have been found to be linked to the pathological auditory changes. METHOD: Literature search was conducted using a number of resources including textbooks, professional journals and the relevant websites. RESULTS: The largest proportion of auditory neuropathy spectrum disorders (ANSDs) is due to genetic factors which can be syndromic, non-syndromic or mitochondrial related. The inheritance pattern can include all the four main types of inheritances such as autosomal dominant, autosomal recessive, X-linked and mitochondrial. CONCLUSION: This paper has provided an overview of mutation with some of the genes and/or loci discovered to be the cause for auditory neuropathy spectrum disorders (ANSDs). It has been noted that different gene mutations may trigger different pathological changes in patients with this disorder. These discoveries have provided us with vital information as to the sites of pathology in auditory neuropathy spectrum disorders (ANSDs), and the results highlight the heterogeneity of the disorder.

2 Article Implantation of bone-anchored hearing device using a three-dimensional template in a child. 2020

Puttasiddaiah, P M / Goodrum, H / Browning, S T. ·Department of Otolaryngology, Morriston Hospital, Swansea, Wales, UK. · Reconstructive Maxillofacial Laboratory, Morriston Hospital, Swansea, Wales, UK. ·J Laryngol Otol · Pubmed #32079553.

ABSTRACT: BACKGROUND: Implantation of bone-anchored hearing devices is performed to improve hearing in patients with chronic suppurative otitis media who cannot wear a conventional hearing aid. The surgical procedure can be safely performed in children aged over five years. CASE REPORT: A 15-year-old patient with bilateral chronic suppurative otitis media and conductive hearing loss underwent the procedure to implant a bone-anchored hearing device but was found to have skull thickness of less than 2.5 mm and the procedure was abandoned. A computed tomography scan of the skull was undertaken and a three-dimensional template was reconstructed to identify appropriate thickness of the skull to implant the abutment during a second procedure. CONCLUSION: Bone-anchored hearing devices can be implanted by prior imaging and using a template to identify the area of appropriate skull thickness to implant the abutment safely.

3 Article Hearing impairment and daily-life fatigue: a qualitative study. 2019

Holman, Jack A / Drummond, Avril / Hughes, Sarah E / Naylor, Graham. ·a Hearing Sciences (Scottish Section), Division of Clinical Neuroscience , School of Medicine, University of Nottingham , Glasgow , UK. · b School of Health Sciences, University of Nottingham , Nottingham , UK. · c School of Medicine, Swansea University , Swansea , UK. · d South Wales Cochlear Implant Programme , Bridgend , UK. ·Int J Audiol · Pubmed #31032678.

ABSTRACT:

4 Article Oral steroids for hearing loss associated with otitis media with effusion in children aged 2-8 years: the OSTRICH RCT. 2018

Francis, Nick A / Waldron, Cherry-Ann / Cannings-John, Rebecca / Thomas-Jones, Emma / Winfield, Thomas / Shepherd, Victoria / Harris, Debbie / Hood, Kerenza / Fitzsimmons, Deborah / Roberts, Amanda / Powell, Colin Ve / Gal, Micaela / Jones, Sarah / Butler, Christopher C. ·Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK. · Centre for Trials Research, Cardiff University, Cardiff, UK. · College of Human and Health Sciences, Swansea University, Swansea, UK. · Cardiff & Vale University Health Board, Child Health Directorate, St David's Children Centre, Cardiff, UK. · Department of General Paediatrics, Children's Hospital for Wales, Cardiff, UK. · Involving People Network, Health and Care Research Wales, Cardiff, UK. · Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. ·Health Technol Assess · Pubmed #30407151.

ABSTRACT: BACKGROUND: Children with hearing loss associated with otitis media with effusion (OME) are commonly managed through surgical intervention, hearing aids or watchful waiting. A safe, inexpensive, effective medical treatment would enhance treatment options. Small, poorly conducted trials have found a short-term benefit from oral steroids. OBJECTIVE: To determine the clinical effectiveness and cost-effectiveness of a 7-day course of oral steroids in improving hearing at 5 weeks in children with persistent OME symptoms and current bilateral OME and hearing loss demonstrated by audiometry. DESIGN: Double-blind, individually randomised, placebo-controlled trial. SETTING: Ear, nose and throat outpatient or paediatric audiology and audiovestibular medicine clinics in Wales and England. PARTICIPANTS: Children aged 2-8 years, with symptoms of hearing loss attributable to OME for at least 3 months, a diagnosis of bilateral OME made on the day of recruitment and audiometry-confirmed hearing loss. INTERVENTIONS: A 7-day course of oral soluble prednisolone, as a single daily dose of 20 mg for children aged 2-5 years or 30 mg for 6- to 8-year-olds, or matched placebo. MAIN OUTCOME MEASURES: Acceptable hearing at 5 weeks from randomisation. Secondary outcomes comprised acceptable hearing at 6 and 12 months, tympanometry, otoscopic findings, health-care consultations related to OME and other resource use, proportion of children who had ventilation tube (grommet) surgery at 6 and 12 months, adverse effects, symptoms, functional health status, health-related quality of life, short- and longer-term cost-effectiveness. RESULTS: A total of 389 children were randomised. Satisfactory hearing at 5 weeks was achieved by 39.9% and 32.8% in the oral steroid and placebo groups, respectively (absolute difference of 7.1%, 95% confidence interval -2.8% to 16.8%; number needed to treat = 14). This difference was not statistically significant. The secondary outcomes were consistent with the picture of a small or no benefit, and we found no subgroups that achieved a meaningful benefit from oral steroids. The economic analysis showed that treatment with oral steroids was more expensive and accrued fewer quality-adjusted life-years than treatment as usual. However, the differences were small and not statistically significant, and the sensitivity analyses demonstrated large variation in the results. CONCLUSIONS: OME in children with documented hearing loss and attributable symptoms for at least 3 months has a high rate of spontaneous resolution. Discussions about watchful waiting and other interventions will be enhanced by this evidence. The findings of this study suggest that any benefit from a short course of oral steroids for OME is likely to be small and of questionable clinical significance, and that the treatment is unlikely to be cost-effective and, therefore, their use cannot be recommended. FUTURE WORK: Studies exploring optimal approaches to sharing natural history data and enhancing shared decision-making are needed for this condition. TRIAL REGISTRATION: Current Controlled Trials ISRCTN49798431 and EudraCT 2012-005123-32. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in

5 Article Participants' experiences of an Internet-based cognitive behavioural therapy intervention for tinnitus. 2018

Beukes, Eldré W / Manchaiah, Vinaya / Davies, Alice S A / Allen, Peter M / Baguley, David M / Andersson, Gerhard. ·a Department of Vision and Hearing Sciences , Anglia Ruskin University , Cambridge , UK. · b Department of Speech and Hearing Sciences , Lamar University , Beaumont , TX , USA. · c Department of Speech and Hearing, School of Allied Health Sciences , Manipal University , Manipal , Karnataka , India. · d Audiology India , Mysore , Karnataka , India. · e College of Human and Health Sciences , Swansea University , Swansea , UK. · f Audiology Department, Princess of Wales Hospital , Bridgend , UK. · g Vision and Eye Research Unit , Anglia Ruskin University , Cambridge , UK. · h National Institute for Health Research, Nottingham Biomedical Research Centre , Nottingham , UK. · i Hearing Sciences, Division of Clinical Neuroscience, School of Medicine , University of Nottingham , Nottingham , UK. · j Nottingham University Hospitals , Nottingham , UK. · k Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden. · l Department of Clinical Neuroscience, Division of Psychiatry , Karolinska Institute , Stockholm , Sweden. ·Int J Audiol · Pubmed #30295113.

ABSTRACT: OBJECTIVE: This study aimed to explore participants' experiences after undertaking an Internet-based cognitive behavioural therapy intervention (ICBT) for tinnitus. DESIGN: Semi-structured telephone interviews were conducted 6-8 months after participants undertook the ICBT intervention. Qualitative thematic analysis was used to interpret the interview data. STUDY SAMPLE: A purposeful sampling strategy was used to identify a diverse range of participants. Semi-structured interviews were carried out with 15 participants. The mean age was 58.5 years, 7 men and 8 women participated. RESULTS: The analysis generated the following main themes: (1) expectations and motivation for doing the intervention, (2) experiences of the intervention, (3) intervention engagement and (4) intervention effects. Most participants' expectations were hopeful that the intervention would lessen the impact of their tinnitus. Aspects of the intervention that were beneficial, as well as difficult, were identified together with the impact they had on engagement. Intervention effects were evident on both tinnitus and activities of daily life. CONCLUSIONS: The benefits described by participants indicate the potential of ICBT as an alternate form of intervention delivery. The difficulties that hampered engagement need to be addressed to enhance the application and to optimise the clinical acceptability of ICBT for tinnitus.

6 Article Oral steroids for resolution of otitis media with effusion in children (OSTRICH): a double-blinded, placebo-controlled randomised trial. 2018

Francis, Nick A / Cannings-John, Rebecca / Waldron, Cherry-Ann / Thomas-Jones, Emma / Winfield, Tom / Shepherd, Victoria / Harris, Debbie / Hood, Kerenza / Fitzsimmons, Deborah / Roberts, Amanda / Powell, Colin / Gal, Micaela / Butler, Christopher C. ·Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK. Electronic address: francisna@cardiff.ac.uk. · Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK. · Swansea Centre for Health Economics, College of Human Health Sciences, Swansea University, Singleton Park, Swansea, UK. · Cardiff and Vale University Health Board, Child Health Directorate, St David's Children Centre, Cowbridge Road East, Cardiff, UK. · Department of General Paediatrics, Children's Hospital for Wales, Heath Park, Cardiff, UK. · Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK. · Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK. ·Lancet · Pubmed #30152390.

ABSTRACT: BACKGROUND: Children with persistent hearing loss due to otitis media with effusion are commonly managed by surgical intervention. A safe, cheap, and effective medical treatment would enhance treatment options. Underpowered, poor-quality trials have found short-term benefit from oral steroids. We aimed to investigate whether a short course of oral steroids would achieve acceptable hearing in children with persistent otitis media with effusion and hearing loss. METHODS: In this individually randomised, parallel, double-blinded, placebo-controlled trial we recruited children aged 2-8 years with symptoms attributable to otitis media with effusion for at least 3 months and with confirmed bilateral hearing loss. Participants were recruited from 20 ear, nose, and throat (ENT), paediatric audiology, and audiovestibular medicine outpatient departments in England and Wales. Participants were randomly allocated (1:1) to sequentially numbered identical prednisolone (oral steroid) or placebo packs by use of computer-generated random permuted block sizes stratified by site and child's age. The primary outcome was audiometry-confirmed acceptable hearing at 5 weeks. All analyses were by intention to treat. This trial is registered with the ISRCTN Registry, number ISRCTN49798431. FINDINGS: Between March 20, 2014, and April 5, 2016, 1018 children were screened, of whom 389 were randomised. 200 were assigned to receive oral steroids and 189 to receive placebo. Hearing at 5 weeks was assessed in 183 children in the oral steroid group and in 180 in the placebo group. Acceptable hearing was observed in 73 (40%) children in the oral steroid group and in 59 (33%) in the placebo group (absolute difference 7% [95% CI -3 to 17], number needed to treat 14; adjusted odds ratio 1·36 [95% CI 0·88-2·11]; p=0·16). There was no evidence of any significant differences in adverse events or quality-of-life measures between the groups. INTERPRETATION: Otitis media with effusion in children with documented hearing loss and attributable symptoms for at least 3 months has a high rate of spontaneous resolution. A short course of oral prednisolone is not an effective treatment for most children aged 2-8 years with persistent otitis media with effusion, but is well tolerated. One in 14 children might achieve improved hearing but not quality of life. Discussions about watchful waiting and other interventions will be supported by this evidence. FUNDING: National Institute for Health Research (NIHR) Health Technology Assessment programme.

7 Article Removal of external ear canal exostoses by piezo surgery: a novel technique. 2018

Puttasiddaiah, P M / Browning, S T. ·Department of Otolaryngology,Morriston Hospital,Swansea,Wales,UK. ·J Laryngol Otol · Pubmed #30099978.

ABSTRACT: BACKGROUND: External auditory canal exostoses are known to occur in patients who engage in cold-water sports. Although the majority of patients with exostosis remain asymptomatic, larger lesions can cause wax impaction, conductive hearing loss and predispose to recurrent otitis externa. OBJECTIVE: A novel technique is described of using a piezo saw to excise exostoses that are symptomatic. The piezo saw is used to perform various procedures, but its use in removing exostoses has not been described in the literature. CONCLUSION: Excision of exostoses of the ear canal using a piezo saw is a safe technique and patients have a speedy recovery. This paper describes a new technique for removing exostoses.

8 Article Qualitative, multimethod study of behavioural and attitudinal responses to cochlear implantation from the patient and healthcare professional perspective in Australia and the UK: study protocol. 2018

Rapport, Frances / Bierbaum, Mia / McMahon, Catherine / Boisvert, Isabelle / Lau, Annie / Braithwaite, Jeffrey / Hughes, Sarah. ·Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia. · Macquarie University Centre for Implementation of Hearing Research, Sydney, New South Wales, Australia. · The HEARing Cooperative Research Centre, Sydney, New South Wales, Australia. · South Wales Cochlear Implant Programme, Abertawe Bro Morgannwg University Health Board, Bridgend, UK. · Swansea University Medical School, Swansea, UK. ·BMJ Open · Pubmed #29844099.

ABSTRACT: INTRODUCTION: The growing prevalence of adults with 'severe or greater' hearing loss globally is of great concern, with hearing loss leading to diminished communication, and impacting on an individual's quality of life (QoL). Cochlear implants (CI) are a recommended device for people with severe or greater, sensorineural hearing loss, who obtain limited benefits from conventional hearing aids (HA), and through improved speech perception, CIs can improve the QoL of recipients. Despite this, utilisation of CIs is low. METHODS AND ANALYSIS: This qualitative, multiphase and multimethod dual-site study (Australia and the UK) explores patients' and healthcare professionals' behaviours and attitudes to cochlear implantation. Participants include general practitioners, audiologists and older adults with severe or greater hearing loss, who are HA users, CI users and CI candidates. Using purposive time frame sampling, participants will be recruited to take part in focus groups or individual interviews, and will each complete a demographic questionnaire and a qualitative proforma. The study aims to conduct 147 data capture events across a sample of 49 participants, or until data saturation occurs. Schema and thematic analysis with extensive group work will be used to analyse data alongside reporting of demographic and participant characteristics. ETHICS AND DISSEMINATION: Ethics approval for this study was granted by Macquarie University (HREC: 5201700539), and the study will abide by Australian National Health and Medical Research Council ethical guidelines. Study findings will be published through peer-reviewed journal articles, and disseminated through public and academic conference presentations, participant information sheets and a funders' final report.

9 Article Social Connectedness and Perceived Listening Effort in Adult Cochlear Implant Users: A Grounded Theory to Establish Content Validity for a New Patient-Reported Outcome Measure. 2018

Hughes, Sarah E / Hutchings, Hayley A / Rapport, Frances L / McMahon, Catherine M / Boisvert, Isabelle. ·South Wales Cochlear Implant Programme, Bridgend, United Kingdom. · Swansea University Medical School, Swansea University, Swansea, United Kingdom. · The Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia. · Department of Linguistics (Audiology Section), Macquarie University, Sydney, New South Wales, Australia. · The HEARing Cooperative Research Centre, Melbourne, Victoria, Australia. ·Ear Hear · Pubmed #29424766.

ABSTRACT: OBJECTIVES: Individuals with hearing loss often report a need for increased effort when listening, particularly in challenging acoustic environments. Despite audiologists' recognition of the impact of listening effort on individuals' quality of life, there are currently no standardized clinical measures of listening effort, including patient-reported outcome measures (PROMs). To generate items and content for a new PROM, this qualitative study explored the perceptions, understanding, and experiences of listening effort in adults with severe-profound sensorineural hearing loss before and after cochlear implantation. DESIGN: Three focus groups (1 to 3) were conducted. Purposive sampling was used to recruit 17 participants from a cochlear implant (CI) center in the United Kingdom. The participants included adults (n = 15, mean age = 64.1 years, range 42 to 84 years) with acquired severe-profound sensorineural hearing loss who satisfied the UK's national candidacy criteria for cochlear implantation and their normal-hearing significant others (n = 2). Participants were CI candidates who used hearing aids (HAs) and were awaiting CI surgery or CI recipients who used a unilateral CI or a CI and contralateral HA (CI + HA). Data from a pilot focus group conducted with 2 CI recipients were included in the analysis. The data, verbatim transcripts of the focus group proceedings, were analyzed qualitatively using constructivist grounded theory (GT) methodology. RESULTS: A GT of listening effort in cochlear implantation was developed from participants' accounts. The participants provided rich, nuanced descriptions of the complex and multidimensional nature of their listening effort. Interpreting and integrating these descriptions through GT methodology, listening effort was described as the mental energy required to attend to and process the auditory signal, as well as the effort required to adapt to, and compensate for, a hearing loss. Analyses also suggested that listening effort for most participants was motivated by a need to maintain a sense of social connectedness (i.e., the subjective awareness of being in touch with one's social world). Before implantation, low social connectedness in the presence of high listening effort encouraged self-alienating behaviors and resulted in social isolation with adverse effects for participant's well-being and quality of life. A CI moderated but did not remove the requirement for listening effort. Listening effort, in combination with the improved auditory signal supplied by the CI, enabled most participants to listen and communicate more effectively. These participants reported a restored sense of social connectedness and an acceptance of the continued need for listening effort. CONCLUSIONS: Social connectedness, effort-reward balance, and listening effort as a multidimensional phenomenon were the core constructs identified as important to participants' experiences and understanding of listening effort. The study's findings suggest: (1) perceived listening effort is related to social and psychological factors and (2) these factors may influence how individuals with hearing loss report on the actual cognitive processing demands of listening. These findings provide evidence in support of the Framework for Understanding Effortful Listening a heuristic that describes listening effort as a function of both motivation and demands on cognitive capacity. This GT will inform item development and establish the content validity for a new PROM for measuring listening effort.

10 Article Patient-reported outcome measures (PROMs) for assessing perceived listening effort in hearing loss: protocol for a systematic review. 2017

Hughes, Sarah E / Rapport, Frances L / Boisvert, Isabelle / McMahon, Catherine M / Hutchings, Hayley A. ·Swansea University Medical School, Swansea University, Swansea, Wales, UK. · South Wales Cochlear Implant Programme, Princess of Wales Hospital, Bridgend, UK. · Australian Institute of Health Innovation, Macquarie University, New South Wales, Australia. · The HEARing CRC, Melbourne, Victoria, Australia. · Department of Linguistics (Audiology Section), Macquarie University, New South Wales, Australia. ·BMJ Open · Pubmed #28592576.

ABSTRACT: INTRODUCTION: In the UK, it is estimated that a disabling hearing loss (HL) affects 1 in 6 people. HL has functional, economic and social-emotional consequences for affected individuals. Intervention for HL focuses on improving access to the auditory signal using hearing aids or cochlear implants. However, even if sounds are audible and speech is understood, individuals with HL often report increased effort when listening.Listening effort (LE) may be measured using self-reported measures such as patient-reported outcome measures (PROMs). PROMs are validated questionnaires completed by patients to measure their perceptions of their own functional status and well-being. When selecting a PROM for use in research or clinical practice, it is necessary to appraise the evidence of a PROM's acceptability to patients, validity, responsiveness and reliability. METHODS AND ANALYSIS: A systematic review of studies evaluating the measurement properties of PROMs available to measure LE in HL will be undertaken. MEDLINE, EMBASE, CINAHL, PsychINFO and Web of Science will be searched electronically. Reference lists of included studies, key journals and the grey literature will be hand-searched to identify further studies for inclusion. Two reviewers will independently complete title, abstract and full-text screening to determine study eligibility. Data on the characteristics of each study and each PROM will be extracted. Methodological quality of the included studies will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, the quality of included PROMs appraised and the credibility of the evidence assessed. A narrative synthesis will summarise extracted data. ETHICS AND DISSEMINATION: Ethical permission is not required, as this study uses data from published research. Dissemination will be through publication in peer-reviewed journals, conference presentations and the lead author's doctoral dissertation. Findings may inform the selection of PROMs used to measure LE in HL.

11 Article Oral steroids for the resolution of otitis media with effusion (OME) in children (OSTRICH): study protocol for a randomised controlled trial. 2016

Waldron, Cherry-Ann / Thomas-Jones, Emma / Cannings-John, Rebecca / Hood, Kerenza / Powell, Colin / Roberts, Amanda / Tomkinson, Alun / Fitzsimmons, Deborah / Gal, Micaela / Harris, Debbie / Shepherd, Victoria / Butler, Christopher C / Francis, Nicholas. ·South East Wales Trials Unit, Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4XW, UK. waldronc@cardiff.ac.uk. · South East Wales Trials Unit, Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4XW, UK. Thomas-JonesE@cardiff.ac.uk. · South East Wales Trials Unit, Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4XW, UK. CanningsRL@cardiff.ac.uk. · Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK. Hoodk1@cf.ac.uk. · Department of General Paediatrics, Children's Hospital for Wales, Heath Park, Cardiff, CF14 4XW, UK. PowellC7@cardiff.ac.uk. · Cardiff and Vale University Health Board, Child Health Directorate, St David's Children Centre, Cowbridge Road East, Cardiff, CF11 9XB, UK. Amanda.Roberts3@wales.nhs.uk. · Ear, Nose and Throat/Head and Neck Department, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK. Alun.Tomkinson@wales.nhs.uk. · College of Human Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK. D.Fitzsimmons@swansea.ac.uk. · Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK. GalM@cardiff.ac.uk. · South East Wales Trials Unit, Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4XW, UK. HarrisD15@cardiff.ac.uk. · South East Wales Trials Unit, Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4XW, UK. ShepherdVL1@cardiff.ac.uk. · The Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK. christopher.butler@phc.ox.ac.uk. · Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK. FrancisNA@cardiff.ac.uk. ·Trials · Pubmed #26931619.

ABSTRACT: BACKGROUND: Otitis media with effusion (OME) is an accumulation of fluid in the middle ear affecting about 80 % of children by the age of 4 years. While OME usually resolves spontaneously, it can affect speech, behaviour and development. Children with persistent hearing loss associated with OME are usually offered hearing aids or insertion of ventilation tubes through the tympanic membrane. Oral steroids may be a safe and effective treatment for OME, which could be delivered in primary care. Treatment with oral steroids has the potential to benefit large numbers of children and reduce the burden of care on them and on health services. However, previous trials have either been too small with too short a follow-up period, or of too poor quality to give a definite answer. The aim of the Oral Steroids for the Resolution of Otitis Media with Effusion in Children (OSTRICH) trial is to determine if a short course of oral steroids improves the hearing of children with OME in the short and longer term. METHODS/DESIGN: A total of 380 participants (children of 2 to 8 years of age) are recruited from Hospital Ear, Nose and Throat departments in Wales and England. A trained clinician seeks informed consent from parents of children with symptoms for at least 3 months that are attributable to OME and with confirmed bilateral hearing loss at study entry. Participants are randomised to a course of oral steroid or a matched placebo for 1 week. Outcomes include audiometry, tympanometry and otoscopy assessments; symptoms; adverse effects; functional health status; quality of life; resource use; and cost effectiveness. Participants are followed up at 5 weeks, and at 6 and 12 months after the day of randomisation. The primary outcome is audiometry-confirmed satisfactory hearing at 5 weeks. DISCUSSION: An important evidence gap exists regarding the clinical and cost effectiveness of short courses of oral steroid treatment for OME. Identifying an effective, safe, nonsurgical intervention for OME in children for use in primary care would be of great benefit to children, their families and the NHS. ISRCTN: ISRCTN49798431 (Registered 7 December 2012).

12 Article Muckle-Wells syndrome: a treatable cause of congenital sensorineural hearing loss. 2013

Stew, B T / Fishpool, S J C / Owens, D / Quine, S. ·Department of ENT Surgery, Singleton Hospital, Swansea, UK. stewb@doctors.org.uk ·B-ENT · Pubmed #23909124.

ABSTRACT: Muckle-Wells syndrome (MWS) is a rare autosomal dominant condition with variable expression. It is a subset of auto-inflammatory diseases characterised by recurrent inflammatory crises and is associated with chronic recurrent urticaria, sensorineural deafness, periodic arthritis and secondary amyloidosis. The diagnosis of MWS is a clinical one with sufferers classically presenting in childhood with a moderate fever and non-pruiginous urticaria. We describe a case of a six-year-old girl who was successfully diagnosed and treated with Anakinra. Muckle and Wells originally described this syndrome in 1962; however, only recently was it discovered to be genetically linked to chromosome 1q44 and subsequently to missense mutations in the CIAS1/NALP3/PYPAF1 gene. Since then, treatment has evolved and it remains one of few treatable causes of congenital profound sensorineural hearing loss.

13 Article Family influences on the cognitive development of profoundly deaf children: exploring the effects of socioeconomic status and siblings. 2013

Macaulay, Catrin E / Ford, Ruth M. ·Department of Public Health and Policy Studies, Swansea University, Singleton Park, Swansea SA21 8PP, Wales, UK. C.E.Macaulay@swansea.ac.uk. ·J Deaf Stud Deaf Educ · Pubmed #23614903.

ABSTRACT: We evaluated the cognitive development of 48 profoundly deaf children from hearing families (born 1994-2002, mean age M = 8.0 years at time of test, none of whom had received early auditory-verbal therapy) as a function of family socioeconomic status and number of siblings. Overall, the deaf children matched a younger group of 47 hearing controls (M = 4.6 years) on verbal ability, theory of mind, and cognitive inhibition. Partial correlations (controlling for age) revealed positive relations in the hearing group between maternal education and inhibition, between number of younger siblings and references to emotions, and between number of close-in-age siblings and references to desires and false beliefs. In the deaf group, there were positive relations between household income and memory span, between maternal education and references to false beliefs, and between number of younger siblings and nonverbal ability. In contrast, deaf children with a greater number of older siblings aged ≤12 years showed inferior memory span, inhibition, belief understanding, picture-sequencing accuracy, and mental-state language, suggesting that they failed to compete successfully with older siblings for their parents' attention and material resources. We consider the implications of the findings for understanding birth-order effects on deaf and language-impaired children.

14 Article Use of the 'patient journey' model in the internet-based pre-fitting counseling of a person with hearing disability: study protocol for a randomized controlled trial. 2013

Manchaiah, Vinaya K C / Stephens, Dafydd / Andersson, Gerhard / Rönnberg, Jerker / Lunner, Thomas. ·Centre for Long Term and Chronic Conditions, College of Human and Health Sciences, Swansea University, Room 167, Glyndwr Building, Swansea SA2 8PP, United Kingdom. V.K.C.Manchaiah@swansea.ac.uk ·Trials · Pubmed #23347711.

ABSTRACT: BACKGROUND: Hearing impairment is one of the most frequent chronic conditions. Persons with a hearing impairment (PHI) have various experiences during their 'journey' through hearing loss. In our previous studies we have developed a 'patient journey' model of PHI and their communication partners (CPs). We suggest this model could be useful in internet-based pre-fitting counseling of a person with hearing disability (PHD). METHODS/DESIGN: A randomized controlled trial (RCT) with waiting list control (WLC) design will be used in this study. One hundred and fifty eight participants with self-reported hearing disability (that is, score > 20 in the Hearing Handicap Questionnaire (HHQ)) will be recruited to participate in this study. They will be assigned to one of two groups (79 participants in each group): (1) Information and counseling provision using the 'patient journey' model; and (2) WLC. They will participate in a 30 day (4 weeks) internet-based counseling program based on the 'patient journey' model. Various outcome measures which focuses on hearing disability, depression and anxiety, readiness to change and acceptance of hearing disability will be administered pre (one week before) and post (one week and six months after) intervention to evaluate the effectiveness of counseling. DISCUSSION: Internet-based counseling is being introduced as a viable option for audiological rehabilitation. We predict that the 'patient journey' model will have several advantages during counseling of a PHD. Such a program, if proven effective, could yield cost and time-efficient ways of managing hearing disability. TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration System NCT01611129.

15 Article The 'patient journey' of adults with sudden-onset acquired hearing impairment: a pilot study. 2012

Manchaiah, V K C / Stephens, D. ·Centre for Long Term and Chronic Conditions, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom. V.K.C.Manchaiah@swansea.ac.uk ·J Laryngol Otol · Pubmed #22214561.

ABSTRACT: OBJECTIVE: A previous study examined the 'patient journey' of adults with gradual-onset acquired hearing impairment. This study examined the same for adults with sudden-onset acquired hearing impairment, and assessed differences. STUDY DESIGN: Data were collected from 16 audiologists, using the Ida Institute template, and from four adults with sudden-onset acquired hearing impairment, through semi-structured interviews. Data were analysed using thematic analysis and presented using a process mapping model. RESULTS: A patient journey template for sudden-onset acquired hearing impairment was developed based on the professionals' and patients' perspectives. The main difference between these two groups' perspectives was seen in the self-evaluation phase: some stages within this phase were recognised by the patients but not by the professionals. The main difference between the current and the previous study was the absence of a pre-awareness phase in the journey described by patients with sudden-onset acquired hearing impairment, compared with that described by patients with gradual-onset acquired hearing impairment. CONCLUSION: Patient journey templates could be useful counselling tools for ear and hearing healthcare specialists. However, such templates should be used only as a baseline; it is important to take a detailed case history to understand each patient's unique experience, including the psychosocial impact of hearing impairment.

16 Article Visual reinforcement audiometry: an Adobe Flash based approach. 2010

Atherton, Steve. ·Morriston Hospital, ABM University Health Board, Swansea, Wales, UK. ·J Vis Commun Med · Pubmed #20828255.

ABSTRACT: Visual Reinforcement Audiometry (VRA) is a key behavioural test for young children. It is central to the diagnosis of hearing-impaired infants (1) . Habituation to the visual reinforcement can give misleading results. Medical Illustration ABM University Health Board has designed a collection of Flash animations to overcome this.

17 Article Microsuction aural toilet in ENT outpatients: a questionnaire to evaluate the patient experience. 2010

Addams-Williams, J / Howarth, A / Phillipps, J J. ·Department of Otorhinolaryngology, Head and Neck Surgery, Singleton Hospital, Sketty, Swansea, SA2 8QA, UK. addamswilliamsjh@doctors.org.uk ·Eur Arch Otorhinolaryngol · Pubmed #20607265.

ABSTRACT: Microsuction toilet of debris from the ear canal is a commonly performed procedure within the ENT outpatient clinic. This department has received two complaints from patients following microsuction aural toilet over the past year. These cases will be discussed. We wish to assess the frequency of side effects following aural microsuction in our department. A prospective questionnaire studied 164 patients undergoing aural microsuction over a 3 month period. From the total of 164 patients surveyed, only 74 (45%) did not report any adverse effects. Patients with mastoid cavities reported higher levels of vertigo when compared to those with normal ears (p < 0.001). A high proportion of patients have reported adverse side effects following aural microsuction. Medical staff should also be aware that certain patient subgroups are more prone to adverse effects. It would be appropriate to ensure that patients are counselled before suction takes place.