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K S Sirimanna

Publications and source records attributed to K S Sirimanna.

13 recordsLinked to original sources
PubMed2007

Updated surgical experience with bone-anchored hearing aids in children.

BACKGROUND: We present the results of a retrospective review of children undergoing implantation with bone-anchored hearing aids (BAHAs) at the Great Ormond Street Hospital for Children. METHODS: The case notes of 71 children undergoing BAHA placement at the Great Ormond Street Hospital for Children between December 1990 and August 2002 were reviewed. Outcome measures included hearing thresholds, incidence of fixture loss, skin reaction and need for revision. Quality of life outcomes were also measured. RESULTS: Eighty-five ears had been implanted. Fifty-four per cent of children had experienced no complications, 42 per cent had required revision surgery and 26 per cent had experienced fixture loss at some point. Young age at implantation was associated with an adverse outcome. Trauma and failure of osseointegration had been the commonest reasons for failure. A skin reaction around the abutment had occurred at some point in 37 per cent of children but had persisted for longer than six months in only 9 per cent; this had been associated with fixture loss. The use of fixture site split skin grafts had reduced problems with skin hypertrophy and hair overgrowth. Hearing thresholds when using BAHAs had been comparable to those when using bone conduction hearing aids. However, BAHAs had significant additional benefits in terms of sound quality, ease of use and overall quality of life. CONCLUSION: Bone-anchored hearing aids provide significant benefits over other types of hearing aid, both audiologically and in terms of quality of life. Careful selection of candidates and meticulous follow up are required in order to minimize complications.

Adolescent↗
PubMed2001

Management of the hearing impaired infant.

With the advent of new testing methods for screening and confirmation of hearing loss in the newborn and setting up neonatal screening programs across the country, significant number of children with hearing loss are being diagnosed very early. Although still considered as one of the best behavioural tests in the competent hands, distraction testing is becoming superseded by more refined and controlled techniques such as visual reinforcement audiometry which is capable of determining a more complete audiometric profile of an infant from about the age of 6 months. A combination of these methods has allowed audiologists to bring down the average age of diagnosis of permanent congenital hearing impairment (PCHI) from over 2 years to well below 12 months. At the same time, increasingly complex and sophisticated hearing instruments are being developed to address traditional problems and also to deliver better amplified speech. Habilitating a neonate with a hearing loss is often challenging and requires a significant amount of resources, expertise and experience. Determining the infant's amplification needs could be difficult, as often the audiometric information is not complete. Further, selecting a suitable hearing instrument for an infant from a vast range is not easy and measuring the outcome after fitting hearing aids, especially in a few months old infant, can be extremely hard. With professionals becoming more confident in implanting younger children and realizing the benefits of early implantation, especially for speech & language development, there is a growing demand for referring infants as early as possible to the implant teams. Providing amplification is only the beginning of the process of habilitation. A multidisciplinary team approach is extremely important in this process and inclusion of the parents in the multidisciplinary team managing the infant often leads to a much improved outcome. There is growing evidence that early diagnosis and habilitation of PCHI leads to better speech and language development and more children being educated in the mainstream setting.

Acoustic Impedance Tests↗
PubMed2001

Occipital meningocele and Mondini deformity of the cochlea.

We present two cases of a previously unreported association between occipital meningocele and Mondini deformity of the cochlea. The probability of the association is supported by the intimate relationship between the development of these structures; the existence of dysembryoplastic factors that can cause both abnormalities; and the universal existence of cochlear abnormalities in anencephalic foetuses. The importance of considering the association is emphasized, in terms of early identification and referral of children with hearing loss, and avoidance of duplication of investigations.

Child, Preschool↗
PubMed1995

Alport's syndrome: can carriers be identified by audiometry?

Alport's syndrome is characterized by familial nephropathy with haematuria, sensorineural hearing loss and ocular abnormalities. It is transmitted as an X-linked dominant condition. In the affected males the symptoms are severe compared with females who show a more variable clinical picture due to the effect of lyonization of the X-chromosome. The diagnosis of carriers of genetic disease is extremely valuable for the purpose of counselling the patients as well as their relatives. A number of attempts have been made in the past to diagnose these carriers. Some studies have shown that it is possible to diagnose carriers of conditions where hearing loss is a symptom, by sensitive audiometric techniques. In this study we examined obligate and possible carriers of Alport's syndrome with pure-tone audiometry (PTA) and the audioscan method. We found that all obligate carriers and a predictable proportion of possible carriers had either a hearing loss on PTA or a mid frequency notch in the audioscan.

Adult↗
PubMed1994

Early complications of packing after nasal surgery with three different materials.

OBJECTIVE: To investigate and compare the early complications of nasal packing with three different packing materials after surgical trimming of nasal turbinates. DESIGN: From a group of patients admitted to two Ear, Nose and Throat Departments for surgical trimming of inferior turbinates, those who consented were included in this study. Randomised patient packs were used and randomisation was carried out by a third party not directly involved in the study. Patients' nostrils were packed with calcium sodium alginate (Kaltostat), glove finger packs or trousered paraffin gauze. SETTING: Two District General Hospitals (DGH) in the United Kingdom (UK) during the period from February 1989 to June 1990. SUBJECTS: 92 patients between the age of 16 years and 60 years who consented out of a population who were admitted to two DGHs for surgical trimming of inferior turbinates. MAIN OUTCOME MEASURES: The state of the nostrils in each patient was assessed by the authors (authors 1 and 3 in Hospital 1 and author 2 in Hospital 2) at the time of discharge and at a postoperative outpatient visit at 3 weeks after discharge. RESULTS: 5% of nostrils packed with calcium sodium alginate (Kaltostat), 27% of nostrils packed with glove finger packs and 20% of nostrils packed with paraffin trouser packs were found to have clots on discharge from the hospital. At the post-discharge followup, when each complication was considered separately, there were more complications in the group who had their nostrils packed for 48 hours (14.2%) than in those who had packs in for 24 hours (7.3%). Significantly less complications were seen at 3 weeks with paraffin gauze packs (6.6%) than in the other two packing material (13.9%). CONCLUSIONS: Our findings suggest that, of the pack types studied 1) nostrils packed with calcium sodium alginate (Kaltostat) leave less clots in the nostrils 2) leaving packing in for 48 hours produces significantly more complications in the early post-operative period especially with calcium sodium alginate.

Adolescent↗
PubMed1993

Pseudocyst of the auricle.

Sixteen cases of pseudocyst of the auricle seen in Matara, Sri Lanka over a two year period are reported. These were managed with needle aspiration and contour pressure dressing for one week with almost 100% success.

Adolescent↗
PubMed1992

A randomized study to compare calcium sodium alginate fibre with two commonly used materials for packing after nasal surgery.

A prospective randomized study was undertaken to compare the qualities of calcium sodium alginate (Kaltostat), trousered paraffin gauze, and glove finger packs as nasal packing material following the operation of partial inferior turbinectomy. All three types of packing material were found to be similarly effective in preventing bleeding whilst the packs were in situ. Calcium sodium alginate (Kaltostat) was associated with significantly less bleeding on pack removal than the other two packing materials. Further, irrespective of the material used, leaving the packs in situ for 48 hours produced significantly less bleeding than when they were removed after 24 hours.

Blood Loss, Surgical↗
PubMed1990

Anaesthesia of the tympanic membrane: comparison of EMLA cream and iontophoresis.

The authors undertook a study to evaluate the effectiveness of two methods for providing local anaesthesia of the tympanic membrane for the purpose of inserting a grommet. The methods compared were the application of EMLA (Eutectic Mixture of Local Anaesthetics) cream and the use of iontophoresis. Both methods seem to provide a satisfactory level of local anaesthesia. It was felt that where multiple procedures were to be performed in one outpatient session the use of EMLA cream might be a more efficient technique.

Adult↗
PubMed1990

Cavernous hemangioma of the internal auditory meatus.

A case is reported of angiomatous malformation involving the facial and vestibilocochlear nerves within the internal auditory meatus. The relative incidence of tumors and other space-occupying lesions occurring in this area is reviewed, along with the relative advantages of different imaging techniques.

Adult↗
PubMed1990

The use of long-acting penicillin in the prophylaxis of recurrent tonsillitis.

The authors report a study designed to explore the usefulness of long-acting penicillin in the management of recurrent tonsillitis. The trial, conducted in Sri Lanka, involved 179 patients aged 2 to 20 who had suffered multiple attacks of tonsillitis annually. The results showed a significant reduction in the number of attacks of tonsillitis experienced by the treated group, especially those aged 5 to 11, resulting in a drop in the number requiring tonsillectomy.

Adolescent↗
PubMed1989

Calcium alginate fibre (Kaltostat 2) for nasal packing after trimming of turbinates--a pilot study.

Following surgical trimming of the inferior turbinates, 32 nostrils were packed with Calcium alginate fibre (Kaltostat 2 gramme fibre packs 80:20 per cent calcium:sodium) for 36-48 hours to achieve haemostasis. There was no bleeding while the packs were in place or after they were removed. These results were compared with two retrospective groups of patients who had undergone the same surgical procedure but the nostrils had been packed with alternative materials.

Alginates↗