The Experts below are selected from a list of 498 Experts worldwide ranked by ideXlab platform
Martin J Burton - One of the best experts on this subject based on the ideXlab platform.
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extracts from the cochrane library Grommets ventilation tubes for hearing loss associated with otitis media with effusion in children
Otolaryngology-Head and Neck Surgery, 2011Co-Authors: Martin J Burton, Craig S Derkay, Richard M RosenfeldAbstract:The Cochrane Corner is a quarterly section in the journal that highlights systematic reviews relevant to otolaryngology–head and neck surgery, with invited commentary to aid clinical decision making. This installment features an updated Cochrane review “Grommets (Ventilation Tubes) for Hearing Loss Associated with Otitis Media with Effusion in Children” that reinforces the modest benefits demonstrated in the original review published in 2005.
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Grommets ventilation tubes for hearing loss associated with otitis media with effusion in children
Cochrane Database of Systematic Reviews, 2010Co-Authors: George G Browning, Maroeska M Rovers, Ian Williamson, Jorgen Lous, Martin J BurtonAbstract:Background Otitis media with effusion (OME; 'glue ear') is common in childhood and surgical treatment with Grommets (ventilation tubes) is widespread but controversial. Objectives To assess the effectiveness of Grommet insertion compared with myringotomy or non-surgical treatment in children with OME. Search strategy We searched the Cochrane ENT Disorders Group Trials Register, other electronic databases and additional sources for published and unpublished trials (most recent search: 22 March 2010). Selection criteria Randomised controlled trials evaluating the effect of Grommets. Outcomes studied included hearing level, duration of middle ear effusion, language and speech development, cognitive development, behaviour and adverse effects. Data collection and analysis Data from studies were extracted by two authors and checked by the other authors. Main results We included 10 trials (1728 participants). Some trials randomised children (Grommets versus no Grommets), others ears (Grommet one ear only). The severity of OME in children varied between trials. Only one 'by child' study (MRC: TARGET) had particularly stringent audiometric entry criteria. No trial was identified that used long-term Grommets.Grommets were mainly beneficial in the first six months by which time natural resolution lead to improved hearing in the non-surgically treated children also. Only one high quality trial that randomised children (N = 211) reported results at three months; the mean hearing level was 12 dB better (95% CI 10 to 14 dB) in those treated with Grommets as compared to the controls. Meta-analyses of three high quality trials (N = 523) showed a benefit of 4 dB (95% CI 2 to 6 dB) at six to nine months. At 12 and 18 months follow up no differences in mean hearing levels were found.Data from three trials that randomised ears (N = 230 ears) showed similar effects to the trials that randomised children. At four to six months mean hearing level was 10 dB better in the Grommet ear (95% CI 5 to 16 dB), and at 7 to 12 months and 18 to 24 months was 6 dB (95% CI 2 to 10 dB) and 5 dB (95% CI 3 to 8 dB) dB better.No effect was found on language or speech development or for behaviour, cognitive or quality of life outcomes.Tympanosclerosis was seen in about a third of ears that received Grommets. Otorrhoea was common in infants, but in older children (three to seven years) occurred in Authors' conclusions In children with OME the effect of Grommets on hearing, as measured by standard tests, appears small and diminishes after six to nine months by which time natural resolution also leads to improved hearing in the non-surgically treated children. No effect was found on other child outcomes but data on these were sparse. No study has been performed in children with established speech, language, learning or developmental problems so no conclusions can be made regarding treatment of such children.
Irma Bowen Historic Clothing G. Collection - One of the best experts on this subject based on the ideXlab platform.
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Boots, purple leather high-laced, 1915-1920, side and front view
University of New Hampshire Scholars\u27 Repository, 2019Co-Authors: Irma Bowen Historic Clothing G. CollectionAbstract:1915-1920. High-laced walking boots. Dark purple glacé leather with a vamp (toe) coming to an oval point in front and extending in back to the middle of the arch of the foot. The quarters (back) are closely sculpted around the heel of the foot, emphasizing the ankle. The top has a center-front closed-tab opening with twenty pairs of metal Grommets for lacing, closing over a fleece-lined tongue with a brown lace tipped with narrow metal aiglets. The tongue meets the level of the top of the lacing tabs. Perforated decoration flanks the lacing Grommets and runs along the seam of the vamp and top. The continuous leather sole incorporates a leather-covered French/Louis heel. Lined with cotton, and with a band of leather at the top where a maker\u27s label is stamped. The sole is stamped as well. Professionally made. Machine-sewn.https://scholars.unh.edu/bowen_collection/1216/thumbnail.jp
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Boots, purple leather high-laced, 1915-1920, top and sole view
University of New Hampshire Scholars\u27 Repository, 2019Co-Authors: Irma Bowen Historic Clothing G. CollectionAbstract:1915-1920. High-laced walking boots. Dark purple glacé leather with a vamp (toe) coming to an oval point in front and extending in back to the middle of the arch of the foot. The quarters (back) are closely sculpted around the heel of the foot, emphasizing the ankle. The top has a center-front closed-tab opening with twenty pairs of metal Grommets for lacing, closing over a fleece-lined tongue with a brown lace tipped with narrow metal aiglets. The tongue meets the level of the top of the lacing tabs. Perforated decoration flanks the lacing Grommets and runs along the seam of the vamp and top. The continuous leather sole incorporates a leather-covered French/Louis heel. Lined with cotton, and with a band of leather at the top where a maker\u27s label is stamped. The sole is stamped as well. Professionally made. Machine-sewn.https://scholars.unh.edu/bowen_collection/1217/thumbnail.jp
Peter R Thorne - One of the best experts on this subject based on the ideXlab platform.
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can an advanced audiology led service reduce waiting times for paediatric ear nose and throat outpatient services
Journal of Paediatrics and Child Health, 2020Co-Authors: Michelle A Pokorny, Peter R Thorne, Bernard C S Whitfield, Arier C Lee, Wayne J WilsonAbstract:AIM Children with middle ear disease often experience lengthy delays waiting for outpatient paediatric ear nose and throat (ENT) services. This study aimed to investigate whether an alternative service delivery model using audiologists working in an expanded scope of practice reduced waiting times for children to access such services. METHODS A total of 131 children consecutively referred to a large ENT outpatient service in Queensland, Australia, for middle ear and hearing concerns were prospectively allocated to either a standard ENT service or an advanced audiology (AA)-led service. Waiting times and attendance rates were collected and compared between the two patient groups. RESULTS The median waiting time from referral to first offered appointment was 96 days for children in the AA-led service versus 417.5 days for children in the standard ENT service. Seventy-nine percent of children in the AA-led service attended their first offered appointment versus 61% in the standard ENT service. For children receiving Grommets, the median waiting time from initial referral to Grommet insertion was 226 days for children in the AA-led service versus 627 days for children in the standard ENT service. CONCLUSION The AA-led service was an effective alternative pathway to reduce waiting times for children referred to ENT services with middle ear and hearing concerns.
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effectiveness and safety of advanced audiology led triage in pediatric otolaryngology services
Ear and Hearing, 2020Co-Authors: Michelle A Pokorny, Wayne J Wilson, Bernard C S Whitfield, Peter R ThorneAbstract:OBJECTIVES: Expansion of the scopes of practice of allied health practitioners has the potential to improve the efficiency and cost-effectiveness of healthcare, given the identified shortages in medical personnel. Despite numerous examples in other allied health disciplines, this has yet to be applied to pediatric Audiology. This study aimed to investigate the effectiveness and safety of using audiologists with advanced training to independently triage children referred to otolaryngology (ORL) services, and compare the subsequent use of specialist resources, and postoperative Grommet care to a standard medical ORL service. DESIGN: One hundred twenty children consecutively referred to a large ORL outpatient service in Queensland, Australia, for middle ear and hearing concerns were prospectively allocated to either the ORL service or Advanced Audiology-led service. Demographic and clinical data were extracted from electronic medical records and compared between the two services. Clinical incidents and adverse events were recorded for the Advanced Audiology-led service. RESULTS: Approximately half of all children referred to ORL for middle ear or hearing concerns were discharged without requiring any treatment, with the remaining half offered surgical treatment. The Advanced Audiology-led model increased the proportion of children assessed by ORL that proceeded to surgery from 57% to 82% compared with the standard medical ORL model. Children followed up by the audiologists after Grommet insertion were more likely to be discharged independently and at the first postoperative review appointment compared with the standard medical ORL service. There were no reports of adverse events or long-term bilateral hearing loss after discharge by the Advanced Audiology-led service. CONCLUSIONS: These findings indicate that an Advanced Audiology-led service provides a safe and effective triaging model for the independent management of children not requiring treatment, and children requiring routine postoperative Grommet review, and improves the effective use of specialist resource compared with the standard medical ORL service.
Joseph E Kerschner - One of the best experts on this subject based on the ideXlab platform.
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long term results of armstrong beveled Grommet tympanostomy tubes in children
Laryngoscope, 2004Co-Authors: Richard D Lindstrom, Brian Reuben, Kenneth Jacobson, Valerie A Flanary, Joseph E KerschnerAbstract:Objective: Many different tympanostomy tubes have been developed with different sizes, shapes, compositions, and coatings. Despite the frequency of ventilation tube placement, very few large studies have examined the outcomes of patients receiving this procedure. An ideal tube would be easy to insert and would extrude at a predictable interval without complications. This study was performed to assess outcome measures and complication rates of the Armstrong beveled Grommet tube. Design: A retrospective case series of patients who had Armstrong beveled Grommet tympanostomy tubes placed over a 3 year period by two Children's Hospital of Wisconsin pediatric Otolaryngology staff. Main Outcome Measures: Patient age, diagnosis, operative findings, and time to tube extrusion were reviewed. Otorrhea, perforation, and cholesteatoma rates were also assessed. Results: Five hundred seven consecutive patients who had Armstrong tubes placed were reviewed. One thousand ninety-six Armstrong tubes were placed in these patients. Follow-up to extrusion rates were available for 756 tubes. The mean patient age at tube placement was 33.3 months, and the median age was 23 months. Mean and median times to extrusion were 16.5 and 15.5 months. One hundred sixty episodes of otorrhea were noted in 148 patients. Four patients had histories of cholesteatoma, none of which developed in conjunction with Armstrong tubes. Ten (1.32%) perforations that have not resolved over time were noted after Armstrong tube placement. Conclusions: Armstrong beveled Grommet tympanostomy tubes have complication rates comparable with those reported for Armstrong or other short-acting tubes in smaller series.
I. Smith - One of the best experts on this subject based on the ideXlab platform.
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how we do it the bradford Grommet trainer a model for training in myringotomy and Grommet insertion
Clinical Otolaryngology, 2005Co-Authors: W V Jesudason, I. SmithAbstract:Keypoints • Myringotomy and Grommet insertion is the most common operative procedure in otological practice. • We describe a simple, cheap and effective model for the junior trainee to develop the skills required for myringotomy and Grommet insertion without compromising patient safety. • As the materials required for our model are more readily available, it is more likely to gain widespread acceptance in ENT training.
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how we do it the bradford Grommet trainer a model for training in myringotomy and Grommet insertion
Clinical Otolaryngology, 2005Co-Authors: W V Jesudason, I. SmithAbstract:Myringotomy and Grommet insertion is the most common operative procedure in otological practice. We describe a simple, cheap and effective model for the junior trainee to develop the skills required for myringotomy and Grommet insertion without compromising patient safety. As the materials required for our model are more readily available, it is more likely to gain widespread acceptance in ENT training.
