Chris H Raine

Bradford Teaching Hospitals NHS Foundation Trust · ENT Dept

Background Malawi performed its first cochlear implantation in 2014. Since then, the number of users has grown. This larger cohort facilitates a more rigorous analysis of the hearing outcomes that have been achieved by the Malawi cochlear implant (CI) program. Methods Nineteen children with postlingual severe‐to‐profound deafness underwent unilate...

Background: In cases of congenital sensorineural hearing loss, testing for genetic etiologies and congenital cytomegalovirus (cCMV) infection have become common practice. Aims/objectives: The purpose of this study is to determine which specific testing methodologies should be used and when. Material and methods: We surveyed 20 practicing otola...

Background The place of tonsillectomy in the management of sore throat in adults remains uncertain. Objectives To establish the clinical effectiveness and cost-effectiveness of tonsillectomy, compared with conservative management, for tonsillitis in adults, and to evaluate the impact of alternative sore throat patient pathways. Design This was a...

Background: Tonsillectomy is regularly performed in adults with acute tonsillitis, but with scarce evidence. A reduction in tonsillectomies has coincided with an increase in acute adult hospitalisation for tonsillitis complications. We aimed to assess the clinical effectiveness and cost-effectiveness of conservative management versus tonsillectomy...

This study aimed to discover expert opinion on the surgical techniques and materials most likely to achieve maximum postoperative residual hearing preservation in cochlear implant (CI) surgery and to determine how these opinions have changed since 2010. A previously published questionnaire used in a study published in 2010 was adapted and expanded....

Purpose: To study the evolution of type D personality traits in older adults after cochlear implantation compared with a control group of severely hearing impaired older adults who did not receive a cochlear implant (CI). The influence of COVID-19 on this evolution was also explored. Type D personality combines a high degree of negative affectivity...

Background: The aim of this study was to find out how candidacy criteria have evolved differently across the globe. Methods: Candidacy criteria and outcome measurements applied in 19 HEARRING clinics were analyzed. Results: Candidacy criteria vary between clinics. Overall, both bilateral implantation and cochlear implantation in patients with...

Background and Objective The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACI...

Purpose Magnetic resonance imaging (MRI) is often used to visualize and diagnose soft tissues. Hearing implant (HI) recipients are likely to require at least one MRI scan during their lifetime. However, the MRI scanner can interact with the implant magnet, resulting in complications for the HI recipient. This survey, which was conducted in two phas...

Objective To evaluate one year outcomes of children with additional needs receiving cochlear implantation at the Yorkshire Auditory Implant Service (YAIS) over a ten-year period. Methods Retrospective chart review yielded 270 children who received cochlear implants (CIs) at YAIS between 2007 and 2017; 49 children were classified as having addition...

Objective: To compare the cognitive evolution of older adults with severe or profound hearing impairment after cochlear implantation with that of a matched group of older adults with severe hearing impairment who do not receive a cochlear implant (CI). Design: In this prospective, longitudinal, controlled, and multicenter study, 24 older CI user...

Patient experience of cochlear implantation using local anaesthesia

Objectives: This study presents the data collected through a database on the type and incidence of cochlear implant device failures and major complications and quantifies the risk of failures across time based on the Association for the Advancement of Medical Instrumentation (AAMI) CI86:2017 standard. Methods: Information on reliability of MED-EL c...

Objectives: The study aimed to determine the effect of interimplant interval and onset of profound deafness on sound localization in children with bilateral cochlear implants, controlling for cochlear implant manufacturer, age, and time since second implant. Design: The authors conducted a retrospective, observational study using routinely colle...

Background The Vibrant Soundbridge middle ear implant and the Bonebridge bone conducting hearing device are hearing implants that use radio frequency transmission to send information from the sound processor to the internal transducer. This reduces the risk of skin problems and infection but requires a more involved surgical procedure than competit...

Objectives: To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines...

we think we implant all children at an optimal time; in reality there are delays in obtaining referrals, assessing; evaluating social need and dealing with patients with special needs

prospective review of congenital and progress paediatric CI candidates. Outcomes were evaluated using sound localisation and speech in quiet and noise. Simultaneous performed better in general terms. With time the interval in sequential surgery is important but with time improvement is seen

It is important to appreciate the long term implications of the fact that Cochlear Implants have internal magnets. During the course of a lifetime a child who has been implanted will require an MRI scan. The process of informing patients / parents is poor and should be a formal part of consenting

Objectives: Cochlear implantation (CI) under local anaesthetic (LA) has previously been shown to be a successful and safe option for a specific group of patients (e.g. elderly and significant co-morbidity). We aim to discuss our practice and obtain qualitative information about patient experience from our cohort of patients at the Yorkshire Auditor...

We report a case of a 3 year old boy with bilateral profound sensorineural hearing loss diagnosed from New Born Hearing Screening, with severe form of VACTERL association. He was referred to our Cochlear Implant Unit for assessment with regard to the possibility of cochlear implantation. MRI findings have showed bilateral vestibulocochlear cystic a...

One of the many parameters that can affect cochlear implant (CI) users’ performance is the site of presentation of electrical stimulation, from the CI, to the auditory nerve. Evoked compound action potential (ECAP) measurements are commonly used to verify nerve function by stimulating one electrode contact in the cochlea and recording the resulting...

Objectives: The diagnosis of non-organic hearing loss (NOHL) is a difficult but important issue during the assessment process for cochlear implantation (CI). We aim to identify the key factors in identifying patients with NOHL during CI assessment and present our local screening protocol for NOHL. Methods: A retrospective review of patients referre...

Introduction: Whilst unilateral cochlear implantation (CI) has significantly improved the quality of life for patients with severe to profound sensorineural hearing loss, binaural hearing with a second cochlear implant (CI2) can offer additional benefits for speech understanding in noise and sound localisation. For children these skills are importa...

Data from 127 children who received bilateral cochlear implants in either simultaneous or sequential procedures took part in sound-source localization accuracy testing via 3- or 5-forced choice procedures via the A-B York Crescent of Sound. RMS errors were calculated. Multiple variable linear regression analyses found significant effects of age at...

INTRODUCTION: Prelingually deafened adults are a heterogeneous group of patients. A number of factors, such as aetiology of deafness, communication mode and residual hearing can affect post implantation outcomes. Age at implantation and duration of deafness have been found to have the most significant impact on post implant outcome measures. Adoles...

INTRODUCTION: Prelingually deafened adults are a heterogeneous group of patients. A number of factors, such as aetiology of deafness, communication mode and residual hearing can affect post implantation outcomes. Age at implantation and duration of deafness have been found to have the most significant impact on post implant outcome measures. Adoles...

Cochlear implant (CI) intervention is expensive and accessed mainly by developed countries. The introduction of Universal Newborn Hearing Screening and funding via a public health service give children better access to CIs. However for adults large disparities exist between utilization and estimated prevalence. In the UK CI selection criteria are r...

Objectives: To determine and evaluate the time clinics needed to complete the sub-processes involved in the first-fitting and follow-up fitting of people with a cochlear implant. Methods: Eight HEARRING clinics completed a questionnaire recording how long it took to complete the sub-processes involved in first-fitting and follow-up fitting cochl...

Objectives: Both electrophysiological and behavioural studies suggest that auditory deprivation during the first months and years of life can impair listening skills. Electrophysiological studies indicate that 3½ years may be a critical age for the development of symmetrical cortical responses in children using bilateral cochlear implants. This st...

Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program....

Objective: To document changes in speech reception thresholds (SRTs) and spatial release from masking (SRM) for sequentially implanted children at 2 and 4 years after they received their second cochlear implant (CI2). Methods: Participants were 17 children who consistently used two sequentially implanted and optimally programmed CIs. SRTs were meas...

Knowledge of long-term outcomes in sequential implantation is needed for optimum candidacy selection and patient counselling. Studies to date describe speech outcomes up to two years post 2nd implant only. Up to this point results are asymmetrical across ears, with 1st-implanted ears providing better speech reception thresholds (SRTs), and less spa...

Text: Introduction: Policies regarding the provision of bilateral cochlear implants to children vary internationally. There is growing evidence that early and closely spaced procedures may lead to better spatial listening abilities for children born with a profound hearing loss. However no studies published to date have directly compared groups of...

Text: Introduction: The way in which auditory deprivation and cochlear implant technology interact to influence children's spatial listening is not yet fully understood. Greater understanding of these complex factors would help implant manufacturers and service providers to offer the best possible rehabilitation for hearing impaired children. We th...

In the UK it is comforting to have access to "free health care". However, nothing is for free in the true sense. Some 9.4% of the GDP is spent on the NHS. Methods of reducing costs are always on the political agendas. Emergencies cannot be controlled and have to be funded; non-­‐life saving surgery is the first place to restrict. Two examples of 'r...

There are numerous factors when deciding on the management of children with tympanic perforations. Success rates of type 1 tympanoplasties range widely. In the debate factors relating to success include age, otorrhoea at time of surgery, adenoids, characteristics of the defect, status of the contralateral ear. Similarly, surgical technique and surg...

The danger to public health posed by the growing resistance of micro-organisms to antimicrobial agents was recently highlighted by the Chief Medical Officer for England, Professor Dame Sally Davies, who likened the issue to a "ticking time bomb" and asked that the issue be placed on the national risk register of civil emergencies . We strongly supp...

Unlabelled: Abstract Conclusion: The comprehensive Hearing Preservation classification system presented in this paper is suitable for use for all cochlear implant users with measurable pre-operative residual hearing. If adopted as a universal reporting standard, as it was designed to be, it should prove highly beneficial by enabling future studies...

Unlabelled: Mucopolysaccharidoses (MPS) are a group of rare inherited metabolic disorders resulting from deficiencies of particular enzymes involved in the breakdown of glycosaminoglycans. Amongst the manifestations of MPS within the head and neck patients may develop conductive, mixed or sensorineural hearing loss. Objective: The main objective...

This presentation gave an overview of our spatial listening assessment clinic for children using bilateral cochlear implants, using the AB-York Crescent of Sound. Children aged 4 years or older using both implants were invited for assessment at 12, 24 or 48 months post-second/simultaneous bilateral cochlear implantation if their aided thresholds we...

Introduction: Every child and adult in the United Kingdom who fulfils the criteria for cochlear implantation is entitled to receive treatment under the National Health Service (NHS); children since 2009 are eligible for bilateral simultaneous implants and adults single implants unless they have additional sensory needs. History: During a period...

OBJECTIVE: To assess the selection criteria, surgical technique, audiologic, and quality of life outcomes for a novel, nonpercutaneous bone conductor hearing aid. STUDY DESIGN: Retrospective case review. SETTING: Secondary otology practice. PATIENTS: Eighteen patients (16 adults and 2 children). INTERVENTION: Implantation of unilateral (n = 16) or...

Objectives: A review of adults receiving cochlear implants (Cls) at the Yorkshire Cochlear Implant Service (YCIS) was performed to assess whether age affects use or outcomes. Methods: A retrospective analysis of all patients over the age of 50 implanted and habilitated at the YCIS was undertaken. Outcome measures included quality of life (QoL) q...

This is a consensus statement on pediatric cochlear implantation by the European Bilateral Pediatric Cochlear Implant Forum. The consensus statement was determined by review of current scientific literature to identify areas of scientific and clinical agreement of current understanding of bilateral cochlear implantation. The statement is "Currently...

Background / Purpose: Bilateral implantation creates the potential for binaural hearing, which allows listeners to localize sound sources and to improve the perception of speech in noise.The aim of the present study is to look at factors influencing the acquisition of these benefits, such as auditory experience and plasticity. Main conclusion:...

To compare the estimated cost-effectiveness of childhood (adeno)tonsillectomy vs medical therapy for recurrent sore throats from the intention-to-treat (ITT) analysis of a randomized controlled trial (RCT) with that modeled on the recorded timing of surgical interventions as observed in all participants irrespective of their original group allocati...

Background / Purpose: To prevent potential loss of opportunity, children with a single cochlear implant if formally assessed by a professional multidisciplinary team could receive a sequential implant. Main conclusion: A Sequential Cochlear Implant Profile (SCIP) was agreed with commissioners to streamline the funding process; however, the cur...

To identify factors that significantly influence myringoplasty success. A retrospective study was performed of all adults and children who underwent myringoplasty from January 2005 to January 2010 in a teaching hospital. Outcome measures were tympanic membrane perforation closure and air-bone gap closure to within 20 dB HL. The factors assessed wer...

Acute loss of vision accompanied by profound loss of hearing is fortunately rare, but has a catastrophic effect on both the patient and their family. Re-establishing communication and spatial awareness are high priorities. We describe the case of a 45 year-old man who presented as a result of poisoning by ethylene glycol. Following assessment by cl...

Objectives: Prospective review of the assessment and outcomes of children with complex needs receiving cochlear implants (CIs) at the Yorkshire Cochlear Implant Service (YCIS). Methods: Nineteen children with complex needs were assessed pre-implant and 12 months post-implant switch-on using appropriate developmental-related audiology, categories...

Cochlear implantation is effective at restoring partial hearing to profoundly deaf adults, but not all patients receive equal benefit. The present study evaluated the effectiveness of a computer-based self-administered training package that was designed to improve speech perception among adults who had used cochlear implants for more than three yea...

To examine the clinical effectiveness and cost-effectiveness of tonsillectomy/adeno-tonsillectomy in children aged 4-15 years with recurrent sore throats in comparison with standard non-surgical management. A pragmatic randomised controlled trial with economic analysis comparing surgical intervention with conventional medical treatment in children...

Aim: Acute frontal sinusitis can present with serious complications and is currently treated by a variety of health care providers. This article reviews presentation and potential predictive factors in the management of frontal sinusitis Methods: Cases of acute frontal sinusitis presenting to a hospital department were identified in a retrospective...

Tonsillectomies are frequently performed, yet variations exist in tonsillectomy rates. Clinicians use guidelines, but complex psychosocial influences on childhood tonsillectomy include anecdotal evidence of parental enthusiasm. Studies indicate that undergoing preferred treatment improves outcome. Despite the enthusiasm with which tonsillectomy is...

Diseases of the temporal bone causing lower cranial nerve palsies are uncommon. In the presence of bony erosion, they are highly suggestive of a malignant process. However, when there is a clear history of otitis externa in an immunocompromised or diabetic patient, a diagnosis of osteomyelitis and secondary inflammatory mass should be considered. W...

Refsum's disease is a rare disorder characterized by accumulation of phytanic acid in plasma and tissues. The main clinical features are retinitis pigmentosa, cerebellar ataxia and chronic polyneuropathy. Sensorineural hearing loss of varying severity can be an additional feature. This study reports our experience with two patients with Refsum's di...

COCHLEAR IMPLANTS, 2ND EDITIONWaltzmanS B, RolandJ TJr, Eds Thieme Medical Publications2007, US ISBN 978 1 58890 413 3 pp 232 Price €89.95 US$99.95 - Volume 122 Issue 4 - C H Raine

Analysis of the cost implications and reasons for nonuse of cochlear implants in an established cochlear implant unit. Clinical data were analyzed retrospectively to construct a table of cochlear implant use over time to identify nonuse and to suggest the reasons for this. Yorkshire Cochlear Implant Service is a tertiary referral center. Three hund...

The thickness and quality of the skin overlying a cochlear implant is important for its integrity. It should be thick enough to protect the implant and prevent flap breakdown yet should not be so thick that it impedes the electronic signal or causes difficulty wearing the coil because of loss of the magnetic coupling. The principle of this study wa...

The aim of this study was to assess the impact on implant survival, abutment skin reaction and patient satisfaction in patients implanted with a bone-anchored hearing aid (BAHA), following the introduction of a multidisciplinary team (MDT) in 1997. Part prospective and retrospective analysis. Implant survival and cause of failures were recorded alo...

PAEDIATRIC COCHLEAR IMPLANTATION: EVALUATING OUTCOMES Ernst Thoutenhoofd, Sue Archbold, Sue Gregory, Mark Lutman, Thomas Nikolopoulos, Tracey Sach, (eds.) Whurr Publishers, 2005 ISBN 1 86156 366 3 Price £35.00 paperback) - - Volume 120 Issue 1 - C H Raine

This article categorizes cerebrospinal fluid leaks as traumatic or nontraumatic in origin. It explains the physiology of the milieu of cerebrospinal fluid that surrounds the brain and spinal cord. It then discusses the detection, assessment, causes, clinical presentation, and management related to clinical pathologies.

To date, our department has implanted 305 patients. Fourteen (4.5%) have had significant ossification with involvement of basal ± apical regions. Ossification affecting the round window niche or the first few millimetres of the basal coil does not usually present significant difficulties during surgery. The main reasons for notable fibrosis and oss...

The aim of this study was a retrospective review of all of our patients requiring reimplantation. Since 1990, 305 cochlear implants (CI) have been implanted in adults and children; 12 adults (8.5%) and 14 children (8.5%) have been reimplanted. The main reason has been due to internal device failure and identifiable trauma (6.5%). Other causes were...

Problem: The aim of this study was to evaluate the problems encountered in the development of a Bone Anchored Hearing Aid (BAHA) program in a district general hospital, over a period of 11 years. Patient satisfaction was also assessed.Methods: Patient records and a patients’ database were evaluated retrospectively. Demographics, pre- and postoperat...

Objectives: The objectives of this study were to estimate the cost-effectiveness of unilateral cochlear implantation for postlingually deafened adults; to study the impact on cost-effectiveness of relaxing criteria of candidacy to include patients who benefit from acoustic hearing aids; and to study the further impact of age at implantation and dur...

Objective: Outcomes from unilateral cochlear implantation in postlingually deafened adults are variable and difficult to predict precisely from data gathered before surgery. The objective was to derive and validate a method for specifying criteria of candidacy for implantation that takes this variability into account. Design: Accuracy of identif...

Objectives: The objectives of this study were to distinguish the equivalent-effectiveness, health-economic, and actuarial approaches to specifying criteria of candidacy for medical interventions; to apply the equivalent-effectiveness approach to unilateral cochlear implantation for postlingually deafened adults; and to determine whether the crite...

Cochlear implantation in adults with bilateral ossification following meningitis

Objectives: To investigate the issues for very young children, families and cochlear implant centres surrounding the transfer from a body worn (BW) speech processor to a behind-the-ear (BTE) speech processor. Study design: A group of 18 young children (median age 3.5 years) was transferred from a CIS PRO+ (BW) processor to a TEMPO+ (BTE) processor...

The ossified cochlea poses both concerns and challenges to any implant team. One of the surgical aims is to implant as many of an implant system's electrodes into the cochlea as close to the modiolus as possible, thus facilitating stimulation of the surviving cell bodies in the spiral ganglion. Within the field of otorhinolaryngology various surgic...

Cochlear implantation has now become a routine procedure in the management of severe to profound deafness. An initial survey was carried out in late 1997 of the surgeons carrying out implantation in the United Kingdom and Ireland, requesting details of medical and surgical aspects of cochlear implantation. A follow-up survey was conducted in early...

A case of familial prolonged QT interval and congenital sensorineural hearing loss is described emphasising the diagnostic and management implications. Jervell and Lange-Nielsen syndrome is important because of its potential association with sudden death in children with congenital sensorineural deafness. It is known to be associated with mutations...

Abstract Many cochlear implantees make use of the telephone, using speech processing strategies designed to encode live-voice speech. However telephone transmission distorts the speech signal. This study aims to characterize the acoustic distortions introduced by a standard landline telephone and evaluate CIS+ ‘telephone programmes’ designed to imp...