Iain A Bruce

Iain A Bruce
Manchester University Hospitals NHS Foundation Trust · Paediatric ENT

MD , FRCS (ORL- HNS)

About

198
Publications
32,551
Reads
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2,756
Citations
Citations since 2017
74 Research Items
1701 Citations
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Introduction
Professor Iain A Bruce currently works at the Department of Paediatric Otolaryngology (ENT), Royal Manchester Children’s Hospital, Central Manchester University Hospitals NHS Foundation Trust. His research interests compliment his clinical subspecialisations: hearing loss, implantation otology, cochlear implants, cleft palate, childhood airway obstruction and Mucopolysaccharidosis (MPS).

Publications

Publications (198)
Article
Full-text available
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....
Article
Full-text available
Background Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meanin...
Chapter
Healthcare professionals and researchers in the field of cochlear implantation should continually strive to develop and clinically integrate novel research tools in order to improve audiological and surgical outcomes. In this chapter, two important research tools critical to precision medicine are explored. The concepts of Prognosis research and ma...
Chapter
Although the technical challenge has increased, along with the complexity of accessing the cochlea and electrode array insertion following the introduction of cochlear implant surgery in individuals with inner ear malformations and potentially useable residual natural hearing, CI surgery remains an operation that is generally safe and associated wi...
Preprint
Background: Single-sided deafness (SSD) often has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms of these interventions (outcome domains) are until now reported inconsistently in clinical trials. Inconsistency in reporting of outcome measures preve...
Article
Importance: Aminoglycosides are commonly prescribed antibiotics used for the treatment of neonatal sepsis. The MT-RNR1 m.1555A>G variant predisposes to profound aminoglycoside-induced ototoxicity (AIO). Current genotyping approaches take several days, which is unfeasible in acute settings. Objective: To develop a rapid point-of-care test (POCT)...
Article
Objectives: There is an unmet need to match the anticipated natural history of hearing loss (HL) in enlarged vestibular aqueduct (EVA) with clinical management strategies. The objectives of this study are therefore to provide a detailed case characterization of an EVA cohort and explore the relationship between candidate prognostic factors and tim...
Article
Full-text available
Background International stakeholder participation is important in the development of core outcome sets (COS). Stakeholders from varying regions may value health outcomes differently. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a COSfor gastric cancer surgery...
Article
Full-text available
Background International stakeholder participation is important in the development of core outcome sets (COS). Stakeholders from varying regions may value health outcomes differently. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a COS for gastric cancer surgery...
Article
Full-text available
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...
Article
Objectives: To explore the impact of COVID-19 on the management and outcomes of acute paediatric mastoiditis across the UK. Design: National retrospective and prospective audit SETTING: 48 UK secondary care ENT departments PARTICIPANTS: Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis. Main o...
Article
Background: A dose of 5mg/kg lidocaine is considered appropriate for paediatric airway topicalisation. Existing literature suggests younger children are susceptible to toxic lidocaine plasma levels and achieve this at a faster rate. Aims: The primary outcome of this study was to ascertain peak plasma lidocaine levels after topicalisation for air...
Article
• Outcomes following adenotonsillectomy for paediatric obstructive sleep apnoea from our centre support the paediatric national safety strategy recommendations published in 2019 • Age and significant comorbidities are key factors in determining post-operative complication risk following adenotonsillectomy in paediatric patients with obstructive sle...
Article
Full-text available
Background Surgery is the primary treatment that can offer potential cure for gastric cancer, but is associated with significant risks. Identifying optimal surgical approaches should be based on comparing outcomes from well designed trials. Currently, trials report different outcomes, making synthesis of evidence difficult. To address this, the aim...
Article
Full-text available
Background Core outcome sets (COS) should be relevant to key stakeholders and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to be...
Article
Full-text available
Introduction In conjunction with a beta-lactam, aminoglycosides are the first-choice antibiotic for empirical treatment of sepsis in the neonatal period. The m.1555A>G variant predisposes to ototoxicity after aminoglycoside administration and has a prevalence of 1 in 500. Current genetic testing can take over 24 hours, an unacceptable delay in the...
Article
Full-text available
• Genetic aetiologies are an important cause of congenital ear anomalies and hearing impairment. • Next-generation sequencing (NGS) strategies, such as targeted gene panels or clinical exome sequencing (CES) are effective tools in the diagnosis of patients with inherited hearing impairment, with clear advantages over previous genetic testing approa...
Article
Full-text available
Purpose The increased adoption of genomic strategies in the clinic makes it imperative for diagnostic laboratories to improve the efficiency of variant interpretation. Clinical exome sequencing (CES) is becoming a valuable diagnostic tool, capable of meeting the diagnostic demand imposed by the vast array of different rare monogenic disorders. We h...
Article
Full-text available
Objective Cleft palate (CP) can affect breathing, leading to sleep-disordered breathing (SDB). Sleep position can affect SDB, but the optimum sleep position for infants with CP is unknown. We aimed to determine the design of a pragmatic study to investigate the effect of the 2 routinely advised sleep positions in infants with CP on oxygen saturatio...
Article
Full-text available
Introduction The craniofacial abnormalities found in infants with cleft palate (CP) decrease their airway patency and increase their risk of obstructive sleep apnoea (OSA). We hypothesise that optimising sleep position in infants with CP may improve airway patency and offer a ‘low-cost, high-impact’ intervention to prevent the negative impacts of O...
Preprint
Full-text available
Background A dose of 5mg/kg lidocaine is considered appropriate for paediatric airway topicalisation. Existing literature suggests younger children are susceptible to toxic lidocaine plasma levels and achieve this at a faster rate. Aims The primary outcome of this study was to ascertain peak plasma lidocaine levels after topicalisation for airway e...
Article
Full-text available
Objective Systematically review the current literature for evidence on the “real-life” benefits of hearing preservation cochlear implantation (HPCI) for children and adults. Design Systematic search of Pubmed, MEDLINE, EMBASE, CINHAL and Cochrane Library for MesH terms hearing¸ preservation and cochlear implantation. Inclusion criteria were the “r...
Preprint
Full-text available
Background International stakeholder participation is important in the development of core outcome sets (COS). Stakeholders, however, may value health outcomes differently when regional differences are considered. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a...
Article
Abstract Objective: There is a need to highlight individual prognostic factors determining hearing loss in enlarged (wide) vestibular aqueduct, as currently clinicians cannot counsel parents about the expected clinical course, nor provide individualized hearing rehabilitation plans following identification at newborn screening. We apply a novel met...
Article
Full-text available
Objectives/Hypothesis Otolaryngology instructional videos available online are often of poor quality. The objective of this article was to establish international consensus recommendations for the production of educational surgical videos in otolaryngology. Study Design DELPHI survey. Methods Twenty‐seven international respondents participated in...
Article
Introduction: Standardized outcome measures are importantfor accurately monitoring the language development of pre-lingually deaf children receiving auditory implants. Current commonly used outcome measures are time-consuming,limiting the practicality of regular testing. To address these limitations, the Manchester Spoken Language Development Scale...
Preprint
Full-text available
Background Core outcome sets (COS) should be relevant to key stakeholders and widely applicable so that researchers are willing to use them when designing trials. Many COS developers have utilised online Delphi surveys which enable wider international stakeholder participation. Despite broader participation, most international COS projects have res...
Article
Full-text available
Background: Single-sided deafness (SSD) describes the presence of a unilateral severe to profound sensorineural hearing loss. SSD disrupts spatial hearing and understanding speech in background noise. It has functional, psychological and social consequences. Potential options for rehabilitation include hearing aids and auditory implants. Benefits...
Preprint
Full-text available
Background Core outcome sets (COS) should be relevant to key stakeholders, and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to b...
Article
Full-text available
Objective The reporting of outcomes in surgical trials for gastric cancer is inconsistent. The GASTROS study ( GA stric Cancer S urgery TR ials R eported O utcome S tandardisation) aims to address this by developing a core outcome set (COS) for use in all future trials within this field. A COS should reflect the views of all stakeholders, including...
Article
Objective: USH2A-related disorders are characterised by genetic and phenotypic heterogeneity, and are associated with a spectrum of sensory deficits, ranging from deaf blindness to blindness with normal hearing. It has been previously proposed that the presence of specific USH2A alleles can be predictive of unaffected hearing. This study reports t...
Article
Full-text available
Background: A pattern of major and minor congenital anomalies, facial dysmorphic features, and neurodevelopmental difficulties, including cognitive and social impairments has been reported in some children exposed to sodium valproate (VPA) during pregnancy. Recognition of the increased risks of in utero exposure to VPA for congenital malformations...
Article
Full-text available
Mucopolysaccharidoses type IVA (Morquio disease) is a rare, autosomal recessive lysosomal storage disease that causes both obstructive and restrictive airway pathology, with respiratory failure being the primary cause of death. This article provides original data on the longitudinal characterization of pulmonary function changes in children with Mu...
Article
Cleft lip and/or palate is the commonest congenital craniofacial abnormality affecting approximately 1 in 700 newborns each year. It comprises of a heterogenous group of disorders affecting facial growth and cosmesis, that are associated with increased risk of airway obstruction, sleep disordered breathing (SDB), glue ear and chronic ear disease, f...
Article
Full-text available
Objectives: With the advent of newborn hearing screening and early intervention, there is a growing interest in using supra-threshold obligatory cortical auditory evoked potentials (CAEPs) to complement established pediatric clinical test procedures. The aim of this study was to assess the feasibility, and parent acceptability, of recording infant...
Article
Full-text available
Introduction: Mucopolysaccharidosis (MPS) type IVA is a rare, autosomal recessive lysosomal storage disease causing substrate accumulation in various organs and tissues. MPS IVA is associated with both obstructive and restrictive airway disease, with the former often resulting in sleep disordered breathing (SDB). Respiratory failure is a primary c...
Article
Full-text available
The mucopolysaccharidoses (MPS) are a relatively uncommon group of inherited metabolic disorders, with significant negative implications for life span and aspects of quality of life. Their rarity means that producing evidence to guide best practice has often entailed assimilating findings from multiple studies. Core outcome sets (COS) are being inc...
Article
Inborn errors of metabolism (IEMs) whilst individually rare, as a group constitute a field which are placing increasing demands on pulmonologists. With the advent of new therapies such as enzyme replacement and gene therapy, early diagnosis and treatment of these conditions can impact on long term outcome, making their timely recognition and approp...
Article
Full-text available
Over the past two decades, significant technological advances have facilitated the identification of hundreds of genes associated with hearing loss. Variants in many of these genes result in severe congenital hearing loss with profound implications for the affected individual and their family. This review collates these advances, summarizing the cu...
Article
Objectives: Increasingly, children are considered for a unilateral cochlear implant (CI), even if the contralateral ear falls outside current audiological guidelines, especially if they are not considered to be reaching their educational potential. Here we present the outcomes of CI in children with potentially useable hearing in the contralateral...
Article
Objective: Brown–Vialetto–Van Laere syndrome (BVVL) is a rare neurodegenerative disorder associated with auditory neuropathy (AN). The decision process for CI in AN is evolving with increasing evidence of efficacy. We evaluated the benefit of CI in children with BVVL syndrome. Methods: A retrospective study reviewed the pre- and post-operative hear...
Article
Full-text available
Background The development of clinical guidelines for the surgical management of gastric cancer should be based on robust evidence from well-designed trials. Being able to reliably compare and combine the outcomes of these trials is a key factor in this process. Objectives To examine variation in outcome reporting by surgical trials for gastric ca...
Article
Congenital long QT syndrome (cLQTS) is an inherited cardiac ion channelopathy characterized by a long corrected-QT interval on the ECG, associated with a risk of syncope and sudden death as a result of arrhythmias. The archetypal arrhythmia associated with cLQTS is torsade de pointes which may degenerate into ventricular fibrillation. Children with...
Article
Full-text available
Introduction Mucopolysaccharide diseases are a group of lysosomal storage disorders caused by deficiencies of hydrolase enzymes, leading to pathological glycosaminoglycan accumulation. A number of mucopolysaccharidosis (MPS) types are characterised by severe airway disease, the aetiology of which is poorly understood. There is ongoing evidence of s...
Data
Laminin α-5immunoreactivity quantified in adenotonsillar samples from 8 MPS patients and compared to samples from 4 non-affected control individuals using Image J to calculate mean staining intensity from representative sections. (XLSX)
Data
Relative expression of inflammatory cytokines, IL-1α, IL-6, and TNF-α using quantitative PCR—ΔCт, ΔΔCт and 2−ΔCT are provided. (XLSX)
Data
Collagen IV immunoreactivity quantified in adenotonsillar samples from 8 MPS patients and compared to samples from 4 non-affected control individuals using Image J to calculate mean staining intensity from representative sections. (XLSX)
Data
Total GAG determined using the Blyscan assay. (XLSX)
Data
Heparan sulphate immunoreactivity quantified in adenotonsillar samples from 8 MPS patients and compared to samples from 4 non-affected control individuals using Image J to calculate mean staining intensity from representative sections. (XLSX)
Data
Relative expression of inflammatory cytokines, IL-1α, IL-6, and TNF-α determined from raw data provided in S6 Table. (XLSX)
Data
LAMP 2immunoreactivity quantified in adenotonsillar samples from 8 MPS patients and compared to samples from 4 non-affected control individuals using Image J to calculate mean staining intensity from representative sections. (XLSX)
Article
Full-text available
Objectives To scope current service provision across England for management of otitis media with effusion and hearing loss in children with Down syndrome; to explore professional decision making about managing otitis media with effusion and hearing loss; to explore patient and public views on the direction of future research. Design Mixed methods...
Chapter
Full-text available
Background: Inclusion cell disease (I-cell) is a rare autosomal recessive metabolic disease involving multiple organ systems, associated with a severely restricted life expectancy. No curative therapy is currently available, with management aimed at symptom palliation. Methods: We present a retrospective, single-centre, case series of children r...
Article
Full-text available
Temporary and permanent tracheostomies are required in children to manage actual or anticipated long‐term ventilatory support, to aid secretion management or to manage fixed upper airway obstruction. Tracheostomies may be required from the first few moments of life, with the majority performed in children < 4 years of age. Although similarities wit...
Article
Background: Mucopolysaccharide (MPS) diseases are a heterogeneous group of inherited, metabolic disorders characterized by accumulation of partially degraded glycosaminoglycans (GAG) in multiple organ systems. Due to accumulation in the airway, patients often present with multilevel airway obstruction and obstructive sleep apnoea (OSA). Adenotonsi...
Article
Objective: To identify outcomes relating to sleep-disordered breathing (SDB) that are relevant to parents, during the early weeks of caring for infants with cleft palate (CP), and compare these with clinical outcomes identified in a systematic search of research literature. Design: A qualitative study using telephone/face-to-face interviews with...
Article
The mucopolysaccharidoses (MPS) are a relatively uncommon group of inherited metabolic disorders, with significant negative implications for life span and aspects of quality of life. Their rarity means that producing evidence to guide best practice has often entailed assimilating findings from multiple studies. Core outcome sets (COS) are being inc...
Chapter
Full-text available
Cochlear implantation (CI), with attempted preservation of residual natural low-frequency hearing, is an increasingly accepted application of this technology, with potential benefits to the patient when listening in noise and in music appreciation. The full extent of the benefits of combining preserved natural hearing and electrical stimulation rem...
Article
Introduction There has been a growing shift towards endoscopic management of laryngeal procedures in pediatric otolaryngology. There still appears to be a shortage of pediatric otolaryngology programs and children's hospitals worldwide where physicians can learn and practice these skills. Laryngeal simulation models have the potential to be part of...
Article
Full-text available
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...
Article
In the UK, patient safety issues related to adult tracheostomies are well recognised. A number of reports from the National Patient Safety Agency and National Confidential Enquiry into Patient Outcome and Death highlighted recurrent themes with deficiencies in staff education, resources, equipment provision and emergency guidance.1,2. Similar patie...
Article
Full-text available
Background: Gastric cancer is one of the leading causes of cancer-related deaths worldwide. Whilst surgery is the mainstay of curative treatment, it is associated with significant risks. Surgical strategies for treating gastric cancer should be based on evidence from systematic reviews of well-designed randomised controlled trials. However, incons...
Article
Full-text available
Conclusion: Specialist practitioners face a clinical dilemma between adhering to standard 'back to sleep' guidance and responding to clinical assessment of respiratory effort for infants with cleft palate. In the absence of clear evidence, specialist centres rely on clinical judgement regarding respiratory problems to identify what they believe is...
Article
The percutaneous bone conduction device (P-OBCD) is a well-established method of hearing rehabilitation. However, it is associated with soft tissue complications involving the peri-abutment skin. The magnetic osseointegrated bone conduction (T-OBCD) device overcomes this by leaving an intact skin flap over the implant. The current study assesses th...
Article
Full-text available
Peptide-based hydrogels have attracted signific