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Aims and objectives: The European Position Paper on Rhinosinusitis and Nasal Polyps provides treatment algorithms based on the mild/moderate/severe (MMS) classification. To date there has been no statistically validated stratification of the SNOT-22 score according to this classification. Methods: 65 consecutive patients diagnosed with CRS completed a SNOT-22, VAS and rated their symptoms according to MMS and impact on quality of life. Results: The median SNOT 22 scores varied between the 3 MMS categories. The interquartile ranges for the respective MMS groups were: Mild 8-17, Moderate 22.5-48, Severe 54-83. Median values for the respective MMs groups were: Mild 12, Moderate 36 and Severe 66. 15.38% of patients in the Mild category, 95.24% in the Moderate category and 100% in the Severe category feel their QoL is affected. There was a strongly positive correlation between the SNOT-22 and VAS scores. Conclusion: We propose a statistically validated definition for stratification of the SNOT-22, with Mild being defined on the SNOT-22 score as 8-20 inclusive, Moderate as >20-50 and Severe as >50.

The aim of this study is to determine the incidence and causes for cochlear explantation/re-implantation in children as a retrospective case review in a Quaternary paediatric Cochlear Implant (CI) Centre. The subjects included in the study were Paediatric CI patients requiring cochlear explantation/re-implantation. Outcome measurements were incidence and aetiology of device explantation/re-implantation. Patient age at implantation, aetiology of deafness, CI manufacturer, and timing of explantation/re P implantation were the independent variables. 778 paediatric cochlear implants were performed in 653 children between 1992 and January 2013. There were a total of 40 (5.1%) failed implants in 38 patients. The most common reason for explantation was device failure in 22 (2.8%). Risk factors for device failure were known manufacturing defect/device recall. Medical/surgical issues accounted for 18 (2.3%) implant failures. The mean time to explantation was 3 years 10 months. The incidence of explantation/re-implantation in our paediatric cochlear implant population is comparable to other published studies. The most common reason for explantation was device failure, however, the aetiology of deafness, in particular meningitis, does not appear to increase the risk of explantation as described in previous series.

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Objectives: Determine the incidence and risk factors for cochlear re-implantation in children. Methods: Retrospective case review in a quaternary pediatric cochlear implant (CI) center. Subjects studied: Pediatric CI patients requiring cochlear re-implantation. Interventions: Cochlear explantation/re-implantation. Outcome measures: Etiology and timing of device re-implantation, risk factors for revision surgery. Independent variables: patient age, side, surgeon, etiology of deafness, co-morbidities, CI manufacturer, incidence of re-implantation, timing of re-implantation. Results: Seven hundred and fifty-two pediatric cochlear implants were performed in 619 children between 1993 and 2013. 37 patients underwent 39 explanation/re-implantation procedures (5.2%). The most common reason for explantation/re-implantation was device failure in 21 (2.8%). Risk factors for device failure were preceding head trauma and known manufacturing defect/recalled device. Medical/surgical issues accounted for 18 (2.4%) re-implantations and changed over the study period. The mean time to re-implantation surgery was 4 years. Etiology of deafness did not correlate with the need for revision surgery. Conclusions: The incidence of re-implantation in our pediatric cochlear implant population is comparable to other published studies. However the etiology of deafness, in particular meningitis, does not appear to increase the risk of failure as described in previous series. The most common reason for re-implantation remains device failure.

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