Biomedical subjects

William M Luxford

Publications and source records attributed to William M Luxford.

5 recordsLinked to original sources

PubMed2006

Clinical performance of children following revision surgery for a cochlear implant.

OBJECTIVES: The purpose of this study was to describe the causes for revision surgery and to compare clinical performance before and after surgery in children who required electrode reinsertion. STUDY DESIGN AND SETTINGS: Soundfield thresholds and speech recognition scores were compared before device failure and following electrode reinsertion. Temporal bones from a deceased adult implant user who underwent bilateral revision implantation were analyzed. RESULTS: Histopathology in the adult temporal bones revealed new bone formation in the scala tympani and substantially reduced spiral ganglion counts, with open-set speech recognition realized. Of 28 children undergoing revision surgery, 18 required electrode reinsertion. With the exception of 1 patient with severe cochlear malformation, new electrode arrays were fully inserted without difficulty. Clinical outcomes between pre-device failure and post-electrode reinsertion did not differ statistically. CONCLUSION AND SIGNIFICANCE: Electrode reinsertion is technically feasible in the pediatric population. The majority of children recover their prerevision clinical performance. EBM RATING: C-4.

Adolescent↗

PubMed2004

Postoperative infection in cochlear implant patients.

OBJECTIVE: Recently, the association of meningitis with cochlear implants has raised concern over the safety of these devices. We examined the incidence of all postoperative infections in patients undergoing cochlear implant surgery. Study design and settings A retrospective chart review of all patients undergoing cochlear implants at a private tertiary referral center from 1993 to 2002 was performed. Cochlear implant surgeries in 462 adults and 271 children were reviewed. Patients with evidence of a postoperative infection or infectious complication related to cochlear implantation were identified, and data on patient characteristics, surgery, and treatment outcome were obtained. RESULTS: The overall incidence of postoperative infection in our cochlear implant series was 4.1%. Major infectious complications occurred in 3.0% of cases, and the majority of infections required surgical intervention. A history of chronic ear disease may increase the risk of infectious complications. There were no cases of meningitis. CONCLUSIONS: Cochlear implants remain a safe procedure with a low complication rate. The majority of infections can be managed without removing the implant device. Advances in surgical technique and flap design have decreased the occurrence of wound-related complications. However, identification of risk factors for infection and optimization of treatment regimens will further reduce the complications associated with postoperative infection.

Adult↗

PubMed2004

Surgical outcomes in patients with endolymphatic sac tumors.

OBJECTIVE: To determine the surgical outcomes in patients with endolymphatic sac tumors (ELSTs). STUDY DESIGN: Retrospective review of patients at a referral-based otology-neurotology practice. METHODS: A review of the records from the House Ear Clinic revealed 16 patients treated for ELSTs from 1971 to 2002. This article reports the treatment outcomes for the 14 patients for whom clinical data were available. RESULTS: Sensorineural hearing loss, tinnitus, and dizziness were the most common presenting signs and symptoms. Six patients presented with facial weakness, and three patients had symptoms characteristic of Menière's syndrome. One patient suffered from Von Hippel-Lindau disease. Patients underwent microsurgical removal and were followed for an average of 59.6 months. Patients that presented with normal facial function maintained excellent postoperative function, and hearing was preserved in two patients with small tumors. Two patients suffered persistent, progressive disease despite multiple attempts at microsurgical removal and radiotherapy. Both had incomplete resections of their initial tumors. A third patient developed a small recurrent tumor that was successfully managed by a second attempt at microsurgical removal. CONCLUSIONS: Taken together with other reports, these results suggest that ELSTs are best managed by complete surgical resection. This can generally be accomplished with minimal additional morbidity.

Adolescent↗

PubMed2003

Management of cholesteatoma: status of the canal wall.

OBJECTIVE/HYPOTHESIS: Management of chronic otitis media with cholesteatoma remains controversial. The purpose of the study is to examine factors associated with the surgical approach to manage cholesteatoma. STUDY DESIGN: A retrospective review. METHODS: A retrospective review was made of all primary cases of mastoid surgery for cholesteatoma performed at an otological center between 1995 and 2000. During the study period, 486 ears underwent surgery for cholesteatoma. Data included procedures performed, location and extent of the disease, residual and recurrent disease, complications, reasons for staging the surgery, and duration of follow-up. RESULTS: The canal wall remained intact in 68.5% of ears. The majority of the remainder of the patients underwent a canal wall down technique with mastoid obliteration. Residual cholesteatoma was found in 26.9% of second procedures and in 2.7% of third procedures. CONCLUSIONS: The majority of patients with cholesteatoma can be adequately managed with a canal intact tympanomastoidectomy with staging. Otolaryngologists should consider a two-staged procedure as a viable management approach for chronic otitis media with cholesteatoma.

Adolescent↗

PubMed2002

Cochlear and brainstem implantation.

Cochlear implantation is an established habilitative and rehabilitative option for profoundly deafened individuals over 1 year of age who derive limited benefit from conventional hearing aids. Auditory performance varies among individuals and is determined primarily by age at implantation, pre-existence of speech and language skills, and the time interval between onset of deafness and implantation. Successful implant users generally demonstrate improved auditory abilities and speech production skills beyond those achieved with hearing aids. Multichannel ABIs can provide useful auditory information to patients with NF-2 who have lost integrity of auditory nerves following removal of vestibular schwannomas. The implant allows for awareness of environmental sounds and, potentially, speech recognition. Most patients undergoing implantation demonstrate improved lip-reading skills, and exceptional performers achieve understanding of open-set speech.

Auditory Brain Stem Implants↗