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HTA
NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of project...
The speech perception and speech production performance following cochlear implantation of congenitally deaf children and children deafened by meningitis were analysed. Three groups consisting of 70 congenitally deaf children, 22 children deafened by meningitis before two years of age and 14 children deafened by meningitis after two years of age were compared. The group deafened by meningitis after two years of age demonstrated significantly better speech perception than the other two groups. Their speech production appeared better but did not achieve statistical significance compared with the other two groups. There was no significant difference in either speech perception or speech production between the congenitally deaf group and the group deafened by meningitis before two years of age.
Hairy polyps or dermoids of the oro- and naso-pharynx are benign lesions containing elements of both ectodermal and mesodermal origin. We report a case of a hairy polyp arising from the tonsil in a three-week-old infant. This presented as an intermittent swelling in the mouth, which was successfully removed under general anaesthesia. To our knowledge this is only the third case of a hairy polyp arising at this site to be reported. We discuss the terminology applied to these lesions and review the literature.
INTRODUCTIONCochlear implants are surgically inserted electrical devices that enable severely or profoundly deaf individuals to interpret sounds from their environment and communicate more effectively. As a result of their electrical nature, they are susceptible to electromagnetic interference and can be damaged by excessive electrical energy. Surgical diathermy is one source of such potentially damaging energy. The British Cochlear Implant Group guidelines advise that monopolar diathermy should not be used in the head and neck region in patients with cochlear implants and that bipolar diathermy should not be used within 2cm of the implant ().METHODSA questionnaire was provided to 36 surgeons working in different specialties in the head and neck region, inquiring as to their knowledge of the safety considerations when using diathermy in cochlear implant patients. Thirty-five surgeons provided responses.RESULTSOverall, 77% of the respondents were unaware of the existence of published guidelines. Even when given an option to seek advice, 11% erroneously felt it was safe to use monopolar diathermy above the clavicles with a cochlear implant in situ and 49% felt that there was no restriction on the use of bipolar diathermy.CONCLUSIONSThere is a significant deficit in the knowledge of safe operating practice in the rapidly expanding population of patients with cochlear implants which threatens patient safety. Through this publication we aim to increase awareness of these guidelines among members of the surgical community and this paper is intended to act as a point of reference to link through to the published safety guidelines.
We present a case of intracranial haemorrhage detected by ultrasound at 36 weeks gestation in a foetus who was ultimately diagnosed with severe factor V deficiency. An abnormality of the foetal heart rate, auscultated at a routine antenatal visit, prompted an investigation that led to an ultrasound examination and detection of an intracranial haemorrhage and low amniotic fluid volume. An intrauterine foetal demise was averted. The clinical scenario in this case raises the issue of how often a stillbirth with intracranial haemorrhage may result from unrecognized factor deficiency.
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