K P Gibbin's research while affiliated with University of Nottingham and other places

Publications (69)

Article
The differential diagnosis of a cervical mass detected antenatally or postnatally includes cystic hygroma and very rarely, teratoma. Even with present day high resolution imaging techniques, including MRI, a teratoma may be indistinguishable from a cystic hygroma radiologically. We present two cases of cervical teratoma. Experience with the first c...
Article
Tracheostomy is a procedure that was known before the birth of Christ. The mortality and morbidity associated with paediatric tracheostomy is higher than adults. The changing indications, surgical procedure, types of tubes and various aspects of management of paediatric tracheostomies are discussed.
Article
To determine durability of cochlear implant devices in a large paediatric cohort. Retrospective review of database records of children consecutively implanted between 1989 and March 2002. The records of 363 children were studied. The review examined cases requiring explantation of the implant device for device failure with or without reimplantation...
Article
To report the short- and long-term complications encountered in a large number of consecutive children undergoing implantation in a single center. The current study also describes the management and sequelae of each complication. Prospective study assessing the surgical findings and complications of deaf children undergoing implantation. Pediatric...
Article
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...
Article
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...
Article
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...
Article
Neonates and infants are obligate nasal breathers and nasal obstruction in this age group can be a life threatening emergency. Even though the commonest cause for nasal obstruction is nasal oedema, bony stenosis of the posterior choanae or pyriform aperture is quite common and may be seen on CT scans. We describe a case of mid-nasal stenosis in a n...
Article
Nottingham Children's Implant Profile (NChIP) is a profile designed to assess candidate children for cochlear implantation. It includes the demographic details of the children (chronological age and duration of deafness), medical and radiological conditions, the outcomes of audiological assessments, language and speech abilities, multiple handicaps...
Article
Nottingham children's implant profile (NChIP) is a systematic framework to assess deaf children before implantation taking into account not only the well-known factors (age, duration of deafness) but also family and support services, expectations, children's cognitive abilities and learning style. The aim of the present paper is to assess the predi...
Article
Following the reports of a cluster of meningitis cases in recently implanted patients the FDA issued cautionary advice relating to the risk of meningitis after cochlear implantation (US Food and Drug Administration, 2002). Similar advice and a national reporting call has been issued by the Department of Health in the UK (Medical Devices Agency, 200...
Article
Cochlear implantation has become routine in the management of children and adults with profound sensorineural hearing loss. In rare cases postoperative infections necessitate removal of the implant. We present six such cases that have been managed within our programme. Extensive infected granulation tissue was found around the implant at exploratio...
Article
Tracheostomies in children are increasingly performed for chronic medical conditions. There are no published studies reporting the experience of children with a tracheostomy in school. Such information would be valuable in planning the care and education of these children. The aims of this study were to identify those children with a tracheostomy i...
Article
The combined use of integrity testing (IT) and impedance telemetry (ImTe) intra-operatively is evaluated. One hundred and fifty children implanted with the Nucleus device were studied. In 81% of patients, normal results were obtained on all electrodes from both ImTe and IT. In seven cases where the back-up device was used, the intra-operative analy...
Article
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...
Article
When a syllable such as "sea" or "she" is spoken, listeners with normal hearing extract evidence of the fricative consonant from both the fricative noise and the following vocalic segment. If the fricative noise is made ambiguous, listeners may still perceive "s" or "sh" categorically, depending on information in the vocalic segment. Do children wh...
Article
The protracted and multidisciplinary nature of paediatric cochlear implantation presents particular challenges in addressing issues of clinical governance. The implantation process is one that involves many disciplines in acute and community settings over several years. Reviews the difficulties presented by a protracted, multidisciplinary intervent...
Article
To examine the feasibility of cochlear implantation in children younger than 2 years regarding surgery and functional outcomes. Prospective study. Tertiary pediatric cochlear implant center. A consecutive sample of 12 children younger than 2 years at the time of cochlear implantation (8 boys and 4 girls). The cause of hearing loss was meningitis in...
Article
Children with Large Vestibular Aqueduct Syndrome (LVAS) frequently develop speech and language skills prior to deterioration of their hearing. Operations designed to halt the progression of hearing loss have largely failed so the question of Cochlear Implantation in these children has arisen. It had been suggested that there would be technical diff...
Article
The electrically evoked action potential (EAP) was recorded intra-operatively by use of neural response telemetry (NRT) on the Nucleus C124M cochlear implant. The aim of the present study was to investigate the EAP in young children immediately following implant surgery and whilst the children were still anaesthetized. The effect of data collection...
Article
Three groups of children undertook an interactive computer-based closed-set test of the ability to identify pre-recorded spoken words presented acoustically. The test was completed by 31/39 children with profound hearing loss who had used the Nucleus Spectra-22 cochlear-implant system for at least one year (Group A); by 30 children with normal hear...
Article
Cochlear implants are electronic prostheses that provide a high quality sense of hearing to severely and profoundly deaf children and adults. As improvements in surgical technique and device performance have occurred, indications for implantation have expanded.
Article
The future of paediatric otolaryngology - Volume 114 Issue 8 - Kevin P. Gibbin, Michael W. Saunders
Article
To test the hypothesis that children with clear promontory electrically evoked auditory brain stem responses (prom-EABRs) would outperform, after cochlear implantation, children who had no prom-EABR preoperatively. DesigN: A prospective study was undertaken on 47 implanted children assigning them to two groups (group A: 35 children with a clear wav...
Article
The intra-operative electrical auditory brainstem response (EABR), electrical stapedius reflex threshold (ESRT) and the early post-operative behavioural threshold level (T-level) were recorded in five children undergoing cochlear re-implantation. The aim of the study was to assess objectively the effect of re-implantation on intra-operative objecti...
Article
Hand-written operation notes are often produced as evidence in medico-legal cases. Incomplete and illegible notes, along with the use of confusing abbreviations, are a common source of weakness in a surgeon's defence. An audit of 100 sets of operation notes was carried out in a single otolaryngology department. Notes were scrutinised for the accura...
Article
This study compares the functional integrity of the auditory pathways of congenitally deaf and postmeningitically deaf children. We used the electrical auditory brain stem response evoked by promontory stimulation to assess 49 profoundly deaf children before cochlear implantation. The age at implantation ranged from 21 months to 15 years (mean 4.5...
Article
Assess the value of computed tomography (CT) in the evaluation of abnormalities in the cochlea and auditory pathways. We used CT to evaluate 108 children before cochlear implantation surgery. Children's ages at implantation ranged from 21 months to 16 years (mean age, 5.4 years). The etiology of deafness was meningitis in 44 children (40.8%), conge...
Article
To test the view that prelinguistic postmeningitic deaf (PMD) children outperform congenitally deaf children (CD) in the first year following cochlear implantation. We evaluated 85 children with ages (at implantation) ranging from 1.9 years to 13.5 years (mean age 5.4 years). The Listening Progress scale was used to assess the developing use of aud...
Article
To introduce four comprehensive electrical auditory brain stem response (EABR) parameters that objectively measure the input-output function and may be the base of comparison in related studies. In 53 children (106 ears), recordings of the EABR evoked by electrical stimulation at the promontory were made at the time of surgery after the child was a...
Article
A review of the surgical complications of the first 115 patients who received a cochlear implant in this program demonstrate a negligible complication rate in the perioperative period and a low complication rate in the long term. The surgical technique is described in detail and the reasons for this low complication rate are analysed.
Article
Susac's syndrome is extremely rare and is characterized by the clinical triad of encephalopathy, retinal artery occlusion and deafness. A case of this rare syndrome is presented and for the first time the fluctuating nature of the hearing loss is demonstrated. The site and nature of the hearing loss has been investigated. The value of neural hearin...
Article
Objective: To test the view that prelinguistic postmeningitic deaf (PMD) children outperform congenitally deaf children (CD) in the first year following cochlear implantation. Study Design and Patients: We evaluated 85 children with ages (at implantation) ranging from 1.9 years to 13.5 years (mean age 5.4 years). The Listening Progress scale was us...
Article
Full-text available
Cochlear implantation in the paediatric population is now an accepted method of rehabilitating profoundly or totally deaf children. The problems of cochlear implantation in children with other significant medical problems are examined. A retrospective review of the records of the first 45 children implanted at our centre was carried out. The review...
Article
The aim was to investigate the feasibility of recording the electrical auditory brain stem response (EABR) evoked by electrical stimulation at the promontory (Prom-EABR) as a tool to assist selection of the ear for cochlear implantation in young children. The study group consisted of young children for whom the decision to proceed with implantation...
Article
With increasing use of imaging in the investigation of cerebello-pontine angle (CPA) tumours, the role of audio-vestibular and electrophysiological testing has changed. Field performance data on the efficiencies of these tests to screen for CPA tumours are lacking, but must be known to choose an appropriate testing strategy. A prospective observati...
Article
The electrically evoked auditory brainstem response (EABR) and stapedius reflex threshold (ESRT) are routinely recorded during implant surgery with the Nucleus 22 channel cochlear implant in the Nottingham Paediatric Cochlear Implant Programme and are extremely valuable in the management of young implanted children. These intraoperative tests were...
Article
Tracheostomy is more hazardous in children than in adults, and carries special risks in the very young. The past 20 years have seen a large shift in the age distribution of tracheostomy. Whereas formerly the operation was done largely for management of epiglottitis and laryngotracheobronchitis, today the prime indication is subglottic stenosis in i...
Article
Tracheostomy is more hazardous in children than in adults, and carries special risks in the very young. The past 20 years have seen a large shift in the age distribution of tracheostomy. Whereas formerly the operation was done largely for management of epiglottitis and laryngotracheobronchitis, today the prime indication is subglottic stenosis in i...
Article
Between 1991 and 1993, 13 children (25 hearing ears) underwent recordings of the auditory brain stem response (ABR) under a general anaesthetic. The anaesthetic technique was similar for each child. Fourteen of these ears had fluid aspirated after myringotomy with insertion of grommets prior to the auditory brain stem response investigation. On sub...
Article
The implantation of young children is widely accepted as a means of rehabilitating profoundly/totally deaf children. This paper will review the surgical aspects of implanting young children based on the first 50 children implanted in the Nottingham paediatric cochlear implant programme. Having thoroughly counselled the children's parents, the child...
Article
This paper reports the case of a six-week-old infant who presented with severe rhinitis and upper airway obstruction due to infection with Chlamydia trachomatis.
Article
We report a case of persistent epistaxis in a seven-month-old child with Wilms' tumour who had an associated von Willebrand's type bleeding diathesis. Correction of the bleeding diathesis to control the epistaxis required treatment of the tumour with chemotherapy.
Article
Tracheostomy has, in the past, been performed in the majority of children under one year with bilateral vocal fold paralysis. We present our experience of 11 cases over a ten-year period during which tracheostomy was avoided whenever possible. Ten cases were managed conservatively but in the youngest a tracheostomy was required. Full bilateral voca...
Article
This study investigates the accuracy of pre-operative high resolution computed tomographic (CT) scans in predicting the patency of the cochlea in children undergoing cochlear implantation. The first 26 children on the Nottingham Paediatric Cochlear Implant Programme were reviewed. CT scans were performed utilizing 1 mm contiguous sections and these...
Article
A child with well-documented total bilateral deafness as a result of meningitis contracted at the age of 2 years and 8 months demonstrated remarkably delayed recovery of hearing 14 months later. In the meantime cochlear implantation had been performed. Hearing returned partially in the nonimplanted ear and also in the ear implanted with a long mult...
Article
ENT surgeons may well be asked to remove cannabis from the external ear where it has been lodged for various reasons. We report two cases and review four other cases we found in the literature to illustrate some of the difficulties. It is important that anyone working with people who abuse drugs are aware that cannabis can be concealed in the exter...
Article
Munchausen syndrome by proxy (MSBP) is a rare condition in which a parent or guardian fabricates an illness in a child either by inducing physical signs or prevaricating. A case presenting as recurrent episodes of infant apnoea is reported. A high index of suspicion is required for the diagnosis and, therefore, the otolaryngologist must be familiar...
Article
Premature cartilaginous calcification and nasal hypoplasia following first trimester exposure to warfarin are known as the Foetal Warfarin Syndrome (FWS). There are over 40 cases reported in the literature, many of which describe breathing and feeding difficulties in the first few months of life. We report a case where a child had had difficulties...
Article
Isolated nasopharyngeal tuberculosis is a rare disease with very few cases having been reported in recent years. We report a case presenting in the United Kingdom with unilateral otalgia and otorrhoea.
Article
Premature cartilaginous calcification and nasal hypoplasia following first trimester exposure to warfarin are known as the Foetal Warfarin Syndrome (FWS). There are over 40 cases reported in the literature, many of which describe breathing and feeding difficulties in the first few months of life. We report a case where a child had had difficulties...
Article
The first case of an inhaled Montgomery Safe T-tube plug is reported. Both the surgeon and the patient should be aware of this possible complication and regular inspection of the plug is recommended. More than one plug should be provided with each T-tube.
Article
Cochlear implantation may now be considered as a method of managing children with profound sensory hearing loss who do not benefit from conventional amplification. It involves a team approach with integration of many skilled individuals, as well as the child and his or her parents and family. As William House has said, in 1991, 'The future is not i...
Article
An 11-year-old boy was identified as having a profound sensorineural hearing loss accompanied by clear click-evoked otoacoustic emissions. Further diagnostic testing by means of electrocochleography and auditory brainstem responses indicated a predominantly retrocochlear disorder with good cochlear function. However, radiological investigation rule...
Article
The authors have been carrying out routine extratympanic electrocochleography on patients for the past five years using a small silver/silver chloride surface electrode positioned in the ear canal close to the tympanic membrane. In early recording sessions the electrode was held in position using a conductive bentonite paste (Mason et al. 1980). Mo...
Article
Twenty patients complaining of tinnitus were investigated by extra tympanic electrocochleography (ECochG). Baseline ECochG recordings were carried out, followed by sequential recording after injections first of saline, as a control, and then after lignocaine in the dosage 1.5 mg/kg body weight. Significant improvement in the tinnitus was seen in 13...
Article
During routine extra-tympanic electrocochleographic (ECochG) recording we have observed that in many cases more cycles are seen in the cochlear microphonic (CM) recording than are present in the acoustic stimulus. We have termed this phenomenon CM 'ringing'. Ringing is present in 69% of our normal subjects and in 43% of patients with deafness of di...
Article
Eleven patients with classical Ménière's disorder were examined electrophysiologically using extratympanic electrocochleography. All had been fully investigated audiologically and by electronystagmography. In addition to the classical triad of symptoms, 7 complained also of fullness or blockage in the ear, this symptoms being associated with fluctu...
Article
A sample of 50 diabetics was compared with a control group matched for age and sex. Twenty-two of the diabetics were insulin-dependent. Subjects and controls were examined otologically and then tested audiometrically using pure tone audiometry, speech audiometry and tone decay after the method of Owens. No significant difference was found between t...

Citations

... Previous studies have reported that long-term ventilation was the most common indication for tracheostomy (range 20%-61%), followed by subglottic stenosis (range 14%-36.8%). 10,12,[32][33][34][35] The high rates of tracheostomy for weaning from ventilation in cardiac patients are likely related to our unit's status as a quaternary referral center for pediatric cardiac surgery. However, it is interesting that only 5.2% of our cohort underwent tracheostomy for subglottic stenosis as the primary indication, which may be a consequence of improvements in neonatal airway management and the greater application of modern endoscopic techniques to treat airway stenosis in recent years. ...
... In cochlear implant research, the most common physiological measures are the electrically evoked auditory brainstem response (EABR) and compound action potential (CAP). There are multiple reports of correlations between EABR and psychophysical threshold levels (Abbas and Brown, 1991a ;Brown et al., 1994;Mason et al., 1994;Miller et al., 1995a ;Beitel et al., 2000). However, in both human (Shallop et al., 1990;Brown et al., 1995) and animal Miller et al., 1995a) subjects, cases exist with large discrepancies in EABR and psychophysical threshold level, including cases in which subjects were able to perceive stimuli in the absence of a measurable EABR (Miyamoto, 1986 ;Brown et al., 1995;Miller et al., 1995a). ...
... Title and abstract screening identified 263 articles, and full-text eligibility assessment revealed 48 studies representing 36 unique cohorts that met criteria for this review. Of these, 34 studies representing 29 cohorts report HSUV for unilateral cochlear implant only (Harris et al. 1995;Wyatt et al. 1996;Palmer et al. 1999;Krabbe et al. 2000;Hogan et al. 2001;Francis et al. 2002;UK Cochlear Implant Study Group 2004a, 2004b, 2004cHawthorne et al. 2004;Lee et al. 2006;Klop et al. 2007;Damen et al. 2007;Klop et al. 2008;Lenarz et al. 2013;Arnoldner et al. 2014;Straatman et al. 2014;Zwolan et al. 2014;Runge et al. 2016;Manrique-Huarte et al. 2016;Lenarz et al. 2017;Sladen et al. 2017;Kasemsiri et al. 2018;Summerfield & Barton 2019;Theriou et al. 2019) and 14 studies representing 7 cohorts report HSUV for bilateral cochlear implants (Summerfield et al. 2002;Bichey et al. 2002;Summerfield et al. 2006;Bichey & Miyamoto 2008;Chen et al. 2014;Härkönen et al. 2015;Kuthubutheen et al. 2015;Smulders et al. 2016aSmulders et al. , 2016bRamakers et al. 2016;Kraaijenga et al. 2017;Cullington et al. 2018;Kraaijenga et al. 2019). ...
... Despite the widely accepted efficacy and cost-effectiveness of the device, only 5% to 10% of patients who would benefit from CI undergo CIE to formally determine candidacy. 1,[3][4][5][6][7][8][9][10][11][12] This underutilization of technology is secondary to several factors, including but not limited to limited regional access, poor understanding of the technology by primary care providers resulting in low referral rates for hearing loss, and lack of established referral guidelines for clinicians. 2,[12][13][14][15] With regards to the question of when to refer a patient, there are currently no established guidelines, and candidacy testing protocols (eg, incorporation of noise or signal-to-noise ratio) may vary greatly among institutions. ...
... 29 The ESS can help mitigate these risks by starting discussions with the family and involving social work services early in the admission. Regarding respiratory support, patients who receive tracheostomy prior to discharge also face a range of daily physical challenges, from adjusting to swallowing and speaking, [30][31][32] to psychological aspects of their altered physical appearance. 33 Furthermore, a number of complications can present after discharge such as hemorrhage, tube dislodgement, infection, stenosis, and fistulizations. ...
... It's important to get a diagnosis as soon as possible when dealing with a newborn with a large lump in the neck region. Cystic hygroma, hemangioma, lipoma, dermoid cyst, congenital goiter, cervical meningocele, occipital encephalocele, bronchogenic cyst, branchial cleft cyst, thyroglossal duct cyst, and teratoma are all possible diagnosis for a congenital neck tumor [10,11]. ...
... Title and abstract screening identified 263 articles, and full-text eligibility assessment revealed 48 studies representing 36 unique cohorts that met criteria for this review. Of these, 34 studies representing 29 cohorts report HSUV for unilateral cochlear implant only (Harris et al. 1995;Wyatt et al. 1996;Palmer et al. 1999;Krabbe et al. 2000;Hogan et al. 2001;Francis et al. 2002;UK Cochlear Implant Study Group 2004a, 2004b, 2004cHawthorne et al. 2004;Lee et al. 2006;Klop et al. 2007;Damen et al. 2007;Klop et al. 2008;Lenarz et al. 2013;Arnoldner et al. 2014;Straatman et al. 2014;Zwolan et al. 2014;Runge et al. 2016;Manrique-Huarte et al. 2016;Lenarz et al. 2017;Sladen et al. 2017;Kasemsiri et al. 2018;Summerfield & Barton 2019;Theriou et al. 2019) and 14 studies representing 7 cohorts report HSUV for bilateral cochlear implants (Summerfield et al. 2002;Bichey et al. 2002;Summerfield et al. 2006;Bichey & Miyamoto 2008;Chen et al. 2014;Härkönen et al. 2015;Kuthubutheen et al. 2015;Smulders et al. 2016aSmulders et al. , 2016bRamakers et al. 2016;Kraaijenga et al. 2017;Cullington et al. 2018;Kraaijenga et al. 2019). ...
... There have been a few case reports describing CSF fistulas caused by various inner ear malformations including bony defects in the stapedial footplate, margin of the oval window, tegmen tympani, and roof of the eustachian tube. [3][4][5] Our report further details the management option of performing EAC closure, CSF fistula repair, and CI placement concurrently. ...
... The removal of this triangle was described in canal wall down mastoidectomy; however, in other middle ear surgeries the endaural incision was described involving only the first and second Lempert incisions and avoid doing the third incision (8,9) . Extended endaural incision in CI was first described involving the same first and second Lempert incision (2,3,5) . ...
... Previous research regarding intraoperative testing has verified its efficacy in evaluating electrode placement (4,6,7,(9)(10)(11)(12). However, many otologists question the usefulness of testing on every patient. ...