Cholesteatoma: a disease of the poor (socially deprived)?

Khalid-Raja, Mamoona; Tikka, Theofano; Coulson, Chris

doi:10.1007/s00405-014-3285-y

Cited by 10 publications

(10 citation statements)

References 19 publications

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“…examined UK Hospital Episode Statistics data for cholesteatoma surgery and found a positive association with the deprivation index of the health authority. 50 No relationship between the presence of chronic otitis media at the age of nine and indicators of social deprivation were found here when using the social circumstances of the family rather than of the area.…”

Section: Discussionmentioning

confidence: 59%

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

et al. 2020

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Objective This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine. Method This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children were used as the control group. Results Univariate analysis demonstrated an association between chronic otitis media and otorrhoea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. Conclusion The association between chronic otitis media and otorrhoea, abnormal tympanograms and grommets supports the role of the Eustachian tube and otitis media (with effusion or acute) in the pathogenesis of chronic otitis media. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding and siblings) were not found to be significant predictors in this analysis.

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Section: Discussionmentioning

confidence: 59%

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

et al. 2020

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“…Khalid-Raja et al analysed hospital episode statistics data to estimate that, over the four selected years between 2005 and 2012, an average of 5074 patients underwent operations for cholesteatoma per year. 16 Using the same Office of Population Censuses and Surveys Classification of Interventions and Procedures codes, 4635 patients had similar surgery in 2019. 17 These patients are routinely followed up for a number of years; therefore, clinical surveillance can represent a significant burden in otology clinics.…”

Section: Discussionmentioning

confidence: 99%

Delivery of remote otology care: a UK pilot feasibility study

et al. 2022

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IntroductionThe COVID-19 pandemic has catalysed the need to implement the National Health Service Long-Term Plan to deliver more care in the community and to reduce face-to-face hospital appointments by up to 33%. This study aimed to assess the feasibility of a remote otology service from triage through to delivery.MethodsNew adult otology referrals at a tertiary ear, nose and throat (ENT) hospital aged between 18 and 70 with hearing loss or tinnitus were included. Patients attended an audiology-led community clinic where they underwent a focused history, audiometric testing, and a smartphone-based application and otoscope (Tympa System) was used to capture still and video images of their eardrums. The information was reviewed by ENT clinicians using a remote review platform with a subset of patients subsequently undergoing an in-person review to measure concordance between the two assessments.Results58 patients participated. 75% of patients had their pathways shortened by one hospital visit with 65% avoiding any hospital attendances. 24% required an additional face-to-face appointment due to incomplete views of the tympanic membrane or need for additional examinations. Electronic validation by a blinded consultant otologist demonstrated a diagnosis concordance of 95%, and concordance between remote-review and in-person consultations in the 12 patients who agreed to attend for an in-person review was 83.3%. 98% of patients were satisfied with the pathway.ConclusionThis pilot service is feasible, safe and non-inferior to the traditional outpatient model in the included patient group. There is potential for the development of a community audiology-led service or use for general practioner advice and guidance.

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“…While the relative publication rate of cholesteatoma and OME is declining, these diseases continue to impact patient quality of life and carry a significant financial burden [11,12]. Given the financial burden of these common maladies and the increasing prevalence, more opportunities for future research could be placed on prevention, diagnostics, and treatments that would help lower costs [11,12,13].…”

Section: Discussionmentioning

confidence: 99%