I write in response to your request for information in relation to KTP laser for use in Cholesteatoma surgeries within NHS Lothian.

Transcription

1 Lothian NHS Board = Waverley Gate 2-4 Waterloo Place Edinburgh EH1 3EG = Telephone: Dear Date: 25/01/2016 Our Ref: 624 Enquiries to : Richard Mutch Extension: Direct Line: richard.mutch@nhslothian.scot.nhs.uk FREEDOM OF INFORMATION CHOLESTEATOMA SURGERIES I write in response to your request for information in relation to KTP laser for use in Cholesteatoma surgeries within NHS Lothian. I have been provided with information to help answer your request by Dr Alok Sharma, Consultant Paediatric Otologist/Otolaryngologist NHS Lothian. 1. Do you have a KTP laser for use in Cholesteatoma surgeries? There is a KTP laser at St John s Hospital for use in Cholesteatoma surgery. 2. If you are planning on getting one soon, what date are you planning on getting one? There are plans for one KTP Laser for the Royal Hospital for Sick Children (RHSC). This will either be before or when relocated to the new site in If you already have the KTP laser for cholesteatoma surgeries: a), is it routinely available for cholesteatoma surgeries? b) is it maintained and staff trained to use it? At St Johns it is used regularly. It is planned for it to be used regularly at the RHSC and arrangements will be made to train nurses in KTP who already have laser training, and ENT nurses in theatres.

2 4. Are there any issues that are preventing you from routinely using the KTP laser? At St Johns, laser trained nurse are occasionally not available (however this is much improved recently). At the RHSC there is not presently a KTP laser. 5. Are you doing your tympanoplasty surgery for cholesteatoma as a day case or overnight stay? For adults. For Children. Type 1 tympanoplasty as daycase, other tympanoplasty or combined approach tympanomastoidectomy is an overnight stay. 6. If as a day case, why is it not an overnight stay? As stated in the above cases, not clinically required. 7. Are you doing your mastoidectomy surgery for cholesteatoma as a day case or overnight stay? For adults. For Children. Mastoidectomies are overnight stay in children. Reason is children who have had anaesthesia for 4 hours not really daycase. Can remove and examine wounds next day. Prefer children on bed rest and taking it easy first few hours post any reconstruction, easier for this with overnight stay. 8. If as a day case, why is it not an overnight stay? Page 2 of 5

3 9. What is your standard follow up period of time for a second look following tympanoplasty? Second look combined approach tympanomastoidectomy (not tympanoplasty wrong nomenclature) is usually at 9 to 12 months (the service aim at 9 months within the paediatric population). Second look is dependent on hearing outcome and extent of disease. Patients may get NON EPI MRI scan at 6 months and 12 months, but this depends on the child, disease and discussion with the family. 10. Are you routinely using CT or MRI to gauge the extent of cholesteatoma growth? All patients get a CT pre-operatively, not for diagnosis in most case, but for anatomy of middle ear cleft to plan surgery i.e. prominence of sinus, level of tegmen (is a CAT scan feasible). Subsequently any scanning is Non Echo Planar MRI, but not appropriate for all patients. 11. Do you have a cholesteatoma leaflet? Yes/No If so, please attach. There is no cholesteatoma leaflet, but we have a mastoid surgery leaflet. The service takes time with parents to explain aetiology, and why surgery and a surgical approach, i.e. take consent before listing for mastoid surgery. We are in the process of setting up a not for profit group to support patients with Cholesteatoma. These are not questions that can be answered in term of the Freedom of Information (Scotland) Act 2002, as you are asking for opinion and not for previously recorded facts. 12. Would you like to be involved in the clinical advisory group? If yes put name. Page 3 of 5

4 13. Would you find a leaflet for patients explaining cholesteatoma helpful if we could provide one? Yes/No 14. If we provided a poster about the support group would you be happy to display this in ENT/Audiology? Yes/No 15. Do your ENT surgeons feel that cholesteatoma surgery could be more effective if delivered as a regional service to enable the surgeons to have access to the laser and have more experience in c-toma opearations? Yes/No 16. We wish to put some of this information on our website, do we have permission to publish the data in raw format? Yes. 17. We wish to summarise the national trends, lists and statistics from the data returned from all hospitals and put this on our website, do we have permission to summarise the data? Yes. Page 4 of 5

5 I hope the information provided helps with your request. If you are unhappy with our response to your request, you do have the right to request us to review it. Your request should be made within 40 working days of receipt of this letter, and we will reply within 20 working days of receipt. If our decision is unchanged following a review and you remain dissatisfied with this, you then have the right to make a formal complaint to the Scottish Information Commissioner. If you require a review of our decision to be carried out, please write to the FOI Reviewer at the address at the head of this letter. The review will be undertaken by a Reviewer who was not involved in the original decision-making process. FOI responses (subject to redaction of personal information) may appear on NHS Lothian s Freedom of Information website at: Yours sincerely ALAN BOYTER Director of Human Resources and Organisational Development Cc: Chief Executive Page 5 of 5