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Biomedical subjects

D W Proops

Publications and source records attributed to D W Proops.

At least 19 recordsLinked to original sources
PubMed2001

Adult cochlear implantation: the Birmingham and United Kingdom experiences.

Cochlear implantation has been called a modern miracle and has probably exceeded the expectations of even its most ardent early pioneers. The capabilities of the preprogrammed brain permits patients, within minutes of activation, to appreciate common sounds not heard for many years and within days and weeks to comprehend open-set language without lip reading and even to use the telephone. In the last two decades, cochlear implantation has been widely accepted by the medical community, and rapid developments have been made in the technology and reliability of the devices by the manufacturers.

Adult↗
PubMed2000

Cosmetic tracheostomy locket: an attempt to improve the aesthetic component of tracheostomy tubes.

This paper demonstrates the need for a cosmetic device as a necessary adjunct to long-term tracheostomy care. Such devices are not available, at present, from tracheostomy tube manufacturers. The cosmetic tracheostomy cover plate is based on a silver Negus tracheostomy tube, to which the silver chain and cover plate (locket) are attached. The result, for the patient who tried it, was excellent.

Adult↗
PubMed2000

Post-cricoid web associated with Rubinstein-Taybi syndrome.

A case of dysphagia due to a post-cricoid web in a seven-year-old boy with Rubinstein-Taybi syndrome is presented. The main features of this syndrome are summarized with particular reference to dysphagia and with previous cases of post-cricoid webs in children reviewed.

Child↗
PubMed1999

Corrosion of a silver Negus tracheostomy tube.

Corrosion of silver tracheostomy tubes has previously been reported. In all of these reports, it occurred at the junction between the neck plate and the outer tube where an alloy of inferior corrosion resistance, compared to silver, has been used in the brazed joint. We present, to our knowledge, a previously unreported case of corrosion of the main body of the outer tube of a silver Negus tracheostomy tube where no such alloy is present.

Adult↗
PubMed1999

Medical, surgical and audiological complications of the first 100 adult cochlear implant patients in Birmingham.

Of the first 100 patients implanted on the Midland Cochlear Implant Programme the commonest aetiologies of deafness were idiopathic 31 per cent, meningitis 28 per cent and cochlear otosclerosis 16 per cent. The major complication rate was three per cent. The most severe was one individual who post-operatively developed a cerebral infarct and subsequently died. The minor complication rate was 39 per cent, all of which successfully resolved, and included 11 cases of wound infection, nine cases of vertigo, three transient facial palsies and two post-operative bleeds. Older patients and men were most likely to have a post-operative medical complication. Women were more likely to have an abnormal electrode insertion. Meningitis and otosclerosis were the most complicated aetiologies in terms of cochlear ossification and electrode insertion. A non-patient cochlea was associated with fewer active electrodes. In six cases which had been reported pre-operatively as showing patent cochleas, some form of obstructional ossification was encountered. Patients functioning with greater than 15 active electrodes performed better on auditory tests than patients with fewer than 15 active electrodes.

Adult↗
PubMed1999

Outcomes from adult implantation, the first 100 patients.

We present the outcome of implantation in the first 100 adult patients treated under the Midland Cochlear Implant Programme. All patients were post-lingually deaf with profound or total hearing loss. Performance was tested in lip-reading, implant only and combined lip-reading and implant modes using BKB sentences, connected discourse tracking (CDT) and environmental sound recognition. Assessments were made at nine and 18 months post-implant. The dominant aetiologies were idiopathic and meningitis. Meningitis was associated with the greatest numbers of ossified cochleas. Forty-three per cent of cases of partial ossification were identified only at surgery. Four per cent of patients became non-users of their devices, however the majority used their implants for more than 12 hours each day. The mean scores at nine months post-implant, in the implant only mode, were for environmental sound recognition 56.7 per cent, for BKB sentences 46.6 per cent (80 per cent of patients scored above 0 per cent) and for CDT 31.2 words per minute (w.p.m.) (62 per cent scored above zero per cent). In the combined lip reading and implant mode the mean scores, at nine months, were for BKB sentences 81.5 per cent and for CDT 65.8 w.p.m. All results were sustained at 18 months. Patients reported that implantation significantly reduced their hearing handicap. Pre-operative measures of depression were also significantly reduced at nine months post-implant. Results were sustained at 18 months. Post-operative audiological outcomes in the electrical stimulation only mode correlated significantly with length of profound deafness. Results suggest that performance outcome is also related to the number of active electrodes.

Aged↗
PubMed1999

Imaging for cochlear implants.

All patients in the Birmingham Cochlear Implant Programme underwent computerized tomography (CT) scanning and were assessed and images interpreted by the main author. Of the first 100 cases, 20 were considered to have abnormalities of the inner ears by CT imaging. It is concluded that the commonest abnormality was cochlear otospongiosis followed by labyrinthitis ossificans. Otospongiosis is well shown by CT which gives a good predicator of luminal patency. However, labyrinthus obliterans, although usually apparent on CT, is not reliably shown in all cases and T2 weighted magnetic resonance imaging (MRI) is better.

Cochlea↗
PubMed1999

Tinnitus, cochlear implants and how they affect patients.

The relationship between tinnitus and cochlear implantation is an important issue that needs to be established because it may affect implant use. In this study 99 patients over 15 years of age completed pre- and post-cochlear implantation questionnaires, and underwent performance testing. The findings show that after implantation, there was marked suppression of tinnitus in both implanted and contralateral ears whilst the implant was off, and this was further enhanced when the implant was switched on. These effects are probably a combination of local and central factors. Presence of tinnitus, before or after implantation, had no detrimental effects on performance. In conclusion, providing all other factors permit, this study recommends implanting the ear with the worst tinnitus.

Adult↗
PubMed1996

The Birmingham bone anchored hearing aid programme: surgical methods and complications.

Since 1988, 309 patients have been referred to the Birmingham bone anchored hearing aid programme for assessment. One hundred and eighty-eight have been fitted with bone anchored hearing aids (BAHA). Of these 169 have been fitted with a BAHA alone and 20 with a BAHA and auricular prosthesis(es). Only four (2.1 per cent) are not wearing their BAHAs. Three cases because the hearing had continued to deteriorate and in one case because of repeated failure to integrate. Nineteen patients (10.1 per cent) have lost fixtures but all but one of these have been successfully reimplanted. Of these 19 patients 10 (52.6 per cent) were syndromal and 10 (52.6 per cent) were under 16 years of age. A surgical method has been evolved both to cope with predictable failure of integration and soft tissue control.

Adolescent↗
PubMed1996

The Birmingham bone anchored hearing aid programme: referrals, selection, rehabilitation, philosophy and adult results.

The Birmingham bone anchored hearing aid team is part of the Birmingham osseointegrated programme. In the first seven years of its existence it has received 309 referrals. Twenty-six per cent had suffered a congenital conductive hearing loss and 74 per cent had an acquired conductive hearing loss; the majority secondary to chronic suppurative otitis media. This report is of 68 out of 106 adults wearing bone anchored hearing aids (BAHAs). Ninety-eight per cent showed audiological improvement with the congenital group demonstrating marginally the best free-field thresholds and speech discrimination. Questionnaire data as to the patient experience confirms the benefits especially hearing in noise, and comfort, and the vast majority were more satisfied with the bone anchored hearing aid than their previous aid.

Adult↗
PubMed1996

The bone anchored hearing aid (BAHA) in chronic suppurative otitis media (CSOM).

Bone anchored hearing aids are gaining wide acceptability in the treatment of patients with congenital ear problems, chronic suppurative otitis media (CSOM) and in some cases otosclerosis. To date little information on the effect of the bone anchored hearing aid on the symptoms of chronic suppurative otitis is available. This retrospective study based on notes review and telephone interviews was to assess the outcome of bone anchored hearing aid surgery in patients with CSOM in terms of: ear discharge; surgical techniques and complications; the number of hours the aid is worn compared with the previous aid. One hundred and forty-two patients were fitted with bone anchored hearing aids without additional prostheses in Birmingham between 1989 and 1995. Sixty-nine (48.5 per cent) of these were for chronic suppurative otitis media, 45 of these were female and 24 were male with a mean age of 58 years. Most (85 per cent) had undergone previous ear surgery with 65 per cent having mastoid surgery. Ninety-eight per cent of this patient group had undergone single stage surgery and 65 per cent under local anaesthetic as a day case. A variety of techniques for soft tissue reduction were employed. The mean follow-up time for these patients was 24 months (range one month to seven years). No patients experienced worse discharge following their BAHA and 84 per cent had significantly reduced discharge, 16 per cent had no change. Complications included skin reactions, 15; failure to integrate, one; late loss of fixture, three. Seventy-three per cent wore their bone anchored hearing aid more than eight hours per day and 58 per cent were more satisfied with their bone anchored hearing aid than their previous aid.

Aged↗
PubMed1996

The Birmingham bone anchored hearing aid programme: paediatric experience and results.

Over a five-year period, 34 patients have been referred to the Birmingham bone anchored hearing aid programme, paediatric section, of who 21 are now wearing the bone anchored hearing aid (BAHA) and four are awaiting surgery for fitting of the BAHA. Of the patients assessed, found to be suitable and who proceeded to surgery for the BAHA, 44 per cent had Treacher Collins syndrome, 28 per cent had bilateral atresia or microtia, 16 per cent had Goldenhaar's syndrome, four per cent (one patient) had branchio-otorenal syndrome and eight per cent had chronic suppurative otitis media. This paper presents objective and subjective data collected from these patients. It is shown that the BAHA is a very effective hearing aid for children with congenital hearing loss.

Adolescent↗
PubMed1996

The bone anchored hearing aid--the third option for otosclerosis.

The bone anchored hearing aid (BAHA) has mainly been used for the treatment of hearing loss in patients with congenital conductive problems or chronic suppurative otitis media. In a five-year period, 32 otosclerotic patients have been referred to the Queen Elizabeth Hospital for consideration of a BAHA. Ten of these patients have been fitted and gained benefit compared to their previous hearing aid. The benefits are not necessarily those in hearing ability but in some cases relate to cosmetic or comfort improvements. This paper demonstrates that the BAHA offers a third treatment option for otosclerosis in patients who cannot or will not undergo stapedectomy and experience difficulty with conventional hearing aids.

Adult↗
PubMed1995

Juvenile hyaline fibromatosis.

A case of juvenile hyaline fibromatosis in a 7-year-old Asian boy is presented. This autosomal recessive inherited condition has not been described in the otolaryngology literature before. We demonstrate the benefits surgical intervention, for treatment of gingival hypertrophy, can bring to the patient and outline the other features of this rare condition. The literature on juvenile hyaline fibromatosis and infantile systemic hyalinosis is also reviewed.

Child↗
PubMed1995

Early diagnosis and treatment of Ramsay Hunt syndrome: the role of magnetic resonance imaging.

We present the case of a 47-year-old woman with left otalgia, rotatory vertigo, sensorineural hearing loss and acute facial nerve palsy. An enhanced magnetic resonance imaging (MRI) scan showed discrete enhancement of the facial and vestibulocochlear nerves in the left internal auditory canal as well as of the labyrinth. This appearance was compatible with that in Ramsay Hunt syndrome and acyclovir was started prior to the appearance of any vesicular eruption. The diagnosis was subsequently confirmed serologically. She regained full facial function but the sensorineural hearing loss persisted. The literature pertaining to the role of the MRI in acute facial palsies is reviewed.

Acyclovir↗
PubMed1995

In vitro production of parathyroid hormone-related protein by cholesteatoma and normal skin.

Severe inflammation and infection of the middle ear occasionally results in clinical evidence of bone resorption but with the addition of the cholesteatoma epithelium it becomes inevitable. This study examined production by the cholesteatoma epithelium of a bone resorbing factor, namely parathyroid hormone-related protein (PTH-rP), which would not be expected in inflammatory states alone. PTH-rP was detected in the conditioned medium of primary and secondary cell cultures derived from 12 cholesteatoma biopsies. The levels of PTH-rP were significantly greater than in control cultures of cells derived from normal scalp tissue. Production by the cholesteatoma epithelium may explain the increased incidence of bone resorption in this disease, particularly in cases where inflammation is minimal.

3T3 Cells↗
PubMed1995

An in vitro growth study on cholesteatoma and normal skin.

The ability of cholesteatoma to grow rapidly within the ear is well recognized. This study aimed to quantify the in vitro growth of cholesteatoma derived cells. Following removal of cholesteatoma explant cultures were established. Cellular outgrowths were subcultured and a colony forming assay performed. Cells were repeatedly passaged every 14 days until senescence was observed. In comparison with cells derived from normal scalp skin, cholesteatoma derived cells demonstrated a lower colony forming efficiency in both primary and secondary subcultures, achieved fewer passages and cell generations in serial culture, and achieved a lower total population expansion. No evidence was found to suggest an intrinsic loss of growth control. It is proposed that the majority of cholesteatoma is composed of cells with a limited capacity for growth. Explant studies suggested that these may be the progeny of more highly proliferative cells situated at the neck of the cholesteatoma sac.

3T3 Cells↗