Cochlear implantation in a district general hospital: problems and complications in the first five years

1997 ◽  
Vol 111 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Melanie M. Collins ◽  
Maurice H. Hawthorne ◽  
Kamal El-Hmd
Keyword(s):  
Cochlear Implant ◽  
General Hospital ◽  
Cochlear Implantation ◽  
District General Hospital ◽  
Complication Rates ◽  
The North ◽  
Major Complications

AbstractFifty-three patients, 34 adults and 19 children have been implanted over the first five years of the cochlear implant programme at the North Riding Infirmary (NRI). For a small centre, based at a district general hospital, our complication rates compare favourably with others: 11.7 per cent adult and 10.5 per cent paediatric major complications. Data on all our patients was gathered prospectively as part of the national cochlear implant programme, and we report and discuss all complications from this centre.

scholarly journals Complications of cochlear implantation surgery in Zagazig University Hospitals

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Alaa Eldin M. Elfeky ◽  
Adly A. Tantawy ◽  
Asmaa M. Ibrahim ◽  
Ibrahim M. Saber ◽  
Said Abdel-Monem
Keyword(s):  
Facial Nerve ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Csf Leak ◽  
Facial Nerve Paralysis ◽  
Complication Rates ◽  
Chorda Tympani Nerve ◽  
University Hospitals ◽  
Nerve Paralysis ◽  
Major Complications

Abstract Background Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon’s skill and clinical expertise in managing various cochlear implant cases improve with years of experience, the complication rates ideally come down over time. This article is intended to describe the most common surgical complications of cochlear implantation in Zagazig University Hospitals. This retrospective study included 130 patients who underwent cochlear implantation in Zagazig University Hospitals from 2016 to 2018. The patients were 61 males and 69 females; their ages ranged between 2 and 6 years old with a mean age of 4.3. This study aims to provide feedback on the common complications of CI surgery at our institution to help the reduction of its incidence in the future. Results One hundred thirty cases of cochlear implants were performed in our department between 2016 and 2018. Sixty complications were recorded, including 27 cases of minor and 21 cases of major complications. Minor complications were flap wound infection in 4 cases (3.1%), chorda tympani nerve injury in 7 cases (5.4%), postoperative vertigo and vomiting in 3 cases (2.3%), injury of EAC in 7 cases (5.4%), wound seroma/hematoma in 4 cases (3.1%), and facial nerve twitching in 2 cases (1.5%). Major complications were electrode extrusion in 2 cases (1.5%), CSOM in 1 case (0.8%), CSF leak in 8 cases (6.1%), magnet migration in 3 cases (2.3%), total facial nerve paralysis in 5 cases (3.8%), and device failure in 2 cases (1.5%). Conclusion The overall incidence of major complications is low. The majority of minor complications can be effectively managed with conservative measures. Cochlear implantation remains a safe and effective surgical procedure.

scholarly journals 668 The Consequences to Emergency Surgery During COVID19 Pandemic in a UK District General Hospital in The North East of England

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Evans ◽  
C Ng
Keyword(s):  
Surgical Treatment ◽  
General Hospital ◽  
Emergency Surgery ◽  
Early Identification ◽  
District General Hospital ◽  
Public Confidence ◽  
Surgical Services ◽  
North East ◽  
The North ◽  
Initial Reduction

Abstract Aim COVID19 pandemic has significantly affected surgical services. We aim to review its effects on our theatre output and risk of encountering COVID 19 cases. Method Serial record of operations performed locally were reviewed from start of UK COVID19 pandemic lockdown on 23rd March 2020 to 13th July 2020 after it was lifted. A weekly average by month of operations and the percentage of COVID19 cases diagnosed within 30 days of the procedure were noted. Results 733 operations performed through this period. In March, 33 operations/week performed, 88.4% emergency and 7% diagnosed with COVID19. April, 31 operations /week performed, 95.9% emergency and 10.6% diagnosed with COVID19. May 46 operations /week performed, 94.5% emergency and 3.3% diagnosed with COVID19. June 56 operations /week, 80.9% emergency and less than 0.01% diagnosed with COVID19. By July 80 operations/week, 59.4% emergency and none diagnosed with COVID 19. Since testing capacity increased, only 6 of the 27 operated were diagnosed with COVID19. Conclusions There was initial reduction to non-emergency workload. However, this has gradually shifted as protocols are in place improve public confidence to return for surgical treatment. Mandatory admission testing allows early identification and remains essential for planning of services and protecting the workforce.

Subdural haematoma: a complication of cochlear implantation

2004 ◽  
Vol 118 (12) ◽  
pp. 980-982 ◽  
Author(s):  
V.S. Sunkaraneni ◽  
A. Banerjee ◽  
R.F. Gray
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Sensorineural Hearing Loss ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Subdural Haematoma ◽  
Sensorineural Hearing ◽  
Deep Well ◽  
Major Complications ◽  
Emissary Veins

Cochlear implants have transformed the treatment of sensorineural hearing loss. They have few major complications. The authors describe the case of a man fitted with a cochlear implant who suffered a postoperative subdural haematoma. The haematoma is thought to have been caused by bleeding from emissary veins opened by the drill passages used to anchor the sutures for the receiver/stimulator. The authors have abandoned tie down sutures in cochlear implants, preferring an appropriately deep well with squared-off rims, which would secure the implant in place. They have had no further complications of this nature.

scholarly journals A review of the outcomes of rigid medical thoracoscopy in a large UK district general hospital

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Avinash Aujayeb ◽  
Karl Jackson
Keyword(s):  
General Hospital ◽  
Chronic Inflammation ◽  
District General Hospital ◽  
Diagnostic Sensitivity ◽  
Hospital Death ◽  
Complication Rates ◽  
Large Variability ◽  
Access Port ◽  
Radiographic Findings ◽  
Medical Thoracoscopy

AbstractObjectivesLocal anesthetic medical thoracoscopy (LAT) is a well-established diagnostic, therapeutic, and preventative intervention in undiagnosed pleural effusions with a high diagnostic sensitivity and low complication rates. There is a large variability in practice. We describe a nine-year experience in a large district general hospital in England.MethodsTwo hundred seventy-five patients had LAT between January 2010 and December 2018. Data on outcomes and complications were obtained from the patients’ notes, electronic records, laboratory, and radiographic findings.ResultsThe main diagnoses were malignant pleural mesothelioma (MPM) (n=110, 40%), chronic inflammation/fibrinous pleuritis (77, 28%), lung cancer (26, 9.5%), and breast cancer (16, 6%). LAT failed to diagnose cancer in 7/275 patients (false-negative rate 2.5%, diagnostic sensitivity 97.5%). Out of the 105 patients with chronic inflammation/fibrinous pleuritis or atypical proliferative processes, 21 (20%) were subsequently diagnosed with malignancy. Talcum pleurodesis was performed in 146 patients, and was successful in 86%. Seventy eight (28%) patients had trapped lung; 27 of those had a repeat procedure. The median length of stay was 3.96 days. There was one hospital death (0.3% mortality). Complications of LAT included pleural (3, 1%) and wound infections (4, 1.4%), persistent air leaks (9, 3.2%), subcutaneous emphysema (10, 3.6%), and tumor extension to the access port (1, 0.3%).ConclusionsIn this cohort, LAT was safe, effective, and enabled high diagnostic sensitivity. Further areas of study include optimal sedation and anesthetic pathways and combining LAT with indwelling pleural catheters (IPC).

scholarly journals A District General Hospital Experience of Patients Receiving Apixaban, Dabigatran, Rivaroxaban or Warfarin for Anticoagulation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4733-4733 ◽  
Author(s):  
Lewis Raiman ◽  
Richard H Antbring ◽  
Abed Abu-Sitta ◽  
Faris N Al-Refaie
Keyword(s):  
United Kingdom ◽  
General Hospital ◽  
Conflicts Of Interest ◽  
Oral Anticoagulants ◽  
District General Hospital ◽  
Bleeding Complications ◽  
Published Data ◽  
Complication Rates ◽  
Common Causes ◽  
The Impact

Abstract Introduction Novel oral anticoagulants (NOACs) are becoming increasingly more prevalent as a preventative measure for venous thromboembolism and stroke prevention in atrial fibrillation (AF)1. NOACs are considered non inferior to Vitamin K antagonists (VKAs) in terms of efficacy and clinical trial evidence has suggested lower rates of complications with the use of NOACs2. There is limited published literature on the complication rates of NOAC use in the district general hospital setting. In this retrospective study, the bleeding rates amongst patients on oral anticoagulants in a district general hospital in the United Kingdom were established. Methods All patients prescribed a NOAC (Rivaroxaban, dabigatran or apixaban) or a VKA at the Princess Alexandra Hospital, a district general hospital in Harlow, United Kingdom, between 01/01/2015 and 31/12/2015 were identified from hospital pharmacy records. Electronic patient hospital records of these individuals were reviewed to identify indication for anticoagulation and any subsequent bleeding complications after initiating therapy as classified according to ICD-10 up until 31st of June 2016. Results A total of 521 patients were prescribed a NOAC. 283 patients were prescribed Rivaroxaban, 217 patients Apixaban and 21 patients were prescribed Dabigatran. 969 patients were prescribed a VKA. From 1st of January 2015 to June 31st 2016, 5.9% of NOAC patients suffered a bleed requiring a hospital visit during this time, versus 7.1% patients on a VKA. Amongst patients prescribed a NOAC, common causes of bleeding included GI haemorrhage (34.5%), epistaxis (38.0%), haemoptysis (13.8%). Amongst patients prescribed a VKA, common causes of bleeding included gastrointestinal bleeding (57.0%), epistaxis (25.2%), haemoptysis (11.9%). Rates of cerebral haemorrhage were low in both groups (0.77% of patients prescribed a NOAC and 0.61% of patients prescribed a VKA). Conclusion This data illustrates real-world experience of bleeding rates requiring hospital admission of patients on NOACs and VKA. The data suggests a lower bleeding complication rate amongst a district general hospital patient population taking NOAC compared to VKA, in keeping with previously published data. References 1. Beyer-Westendorf J, Förster K, Pannach S, Ebertz F, Gelbricht V, Thieme C, Michalski F, Köhler C, Werth S, Sahin K, Tittl L. Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry. Blood. 2014 Aug 7;124(6):955-62. 2. Chai-Adisaksopha C, Crowther M, Isayama T, Lim W. The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis. Blood. 2014 Oct 9;124(15):2450-8. Disclosures No relevant conflicts of interest to declare.

scholarly journals Complications following adult cochlear implantation: experience in Manchester

2004 ◽  
Vol 118 (6) ◽  
pp. 417-420 ◽  
Author(s):  
K. M. J. Green ◽  
Y. M. Bhatt ◽  
S. R. Saeed ◽  
R. T. Ramsden
Keyword(s):  
Cochlear Implant ◽  
Effective Treatment ◽  
Conservative Management ◽  
Cochlear Implantation ◽  
Major Complication ◽  
Medical Problem ◽  
Auditory Stimulation ◽  
Implant Surgery ◽  
Major Complications

Cochlear implantation is regarded as a safe and effective treatment for the profoundly deaf. However, a proportion of patients suffer complications after implant surgery. This paper examines the complications encountered in 240 adult cochlear implant operations performed in Manchester between June 1988 and June 2002. Minor complications were defined as those that either settled spontaneously or with conservative management. The total number of minor complications was 61 (25.4 per cent of cases). Non-auditory stimulation, which resolved with implant reprogramming, was present in 53 cases (22.1 per cent). Major complications were defined as those requiring further surgery, explantation or causing a significant medical problem, and occurred in 15 patients (6.25 per cent). These included implant extrusion, implant sepsis, electrode migration, flap-related problems, and persistent non-auditory stimulation. Nine of the 15 patients suffering a major complication required explantation. There were no post-operative deaths, cases of meningitis, nor persistent facial palsies in the series.

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