PMID- 23361337
OWN - NLM
STAT- MEDLINE
DCOM- 20140103
LR  - 20211021
IS  - 1433-0350 (Electronic)
IS  - 0256-7040 (Print)
IS  - 0256-7040 (Linking)
VI  - 29
IP  - 6
DP  - 2013 Jun
TI  - The tympanic membrane displacement analyser for monitoring intracranial pressure 
      in children.
PG  - 927-33
LID - 10.1007/s00381-013-2036-5 [doi]
AB  - PURPOSE: Raised intracranial pressure (ICP) is a potentially treatable cause of 
      morbidity and mortality but tools for monitoring are invasive. We sought to 
      investigate the utility of the tympanic membrane displacement (TMD) analyser for 
      non-invasive measurement of ICP in children. METHODS: We made TMD observations on 
      normal and acutely comatose children presenting to Kilifi District Hospital (KDH) 
      at the rural coast of Kenya and on children on follow-up for idiopathic 
      intracranial hypertension at Evelina Children's Hospital (ECH), in London, UK. 
      RESULTS: We recruited 63 patients (median age 3.3 (inter-quartile range (IQR) 
      2.0-4.3) years) at KDH and 14 children (median age 10 (IQR 5-11) years) at ECH. 
      We observed significantly higher (more negative) TMD measurements in KDH children 
      presenting with coma compared to normal children seen at the hospital's 
      outpatient department, in both semi-recumbent [mean -61.3 (95 % confidence 
      interval (95 % CI) -93.5 to 29.1) nl versus mean -7.1 (95 % CI -54.0 to 68.3) nl, 
      respectively; P = 0.03] and recumbent postures [mean -61.4 (95 % CI -93.4 to 
      -29.3) nl, n = 59) versus mean -25.9 (95 % CI -71.4 to 123.2) nl, respectively; 
      P = 0.03]. We also observed higher TMD measurements in ECH children with raised 
      ICP measurements, as indicated by lumbar puncture manometry, compared to those 
      with normal ICP, in both semi-recumbent [mean -259.3 (95 % CI -363.8 to -154.8) 
      nl versus mean 26.7 (95 % CI -52.3 to 105.7) nl, respectively; P < 0.01] and 
      recumbent postures [mean -137.5 (95 % CI -260.6 to -14.4) nl versus mean 96.6 
      (95 % CI 6.5 to 186.6) nl, respectively; P < 0.01]. CONCLUSION: The TMD analyser 
      has a potential utility in monitoring ICP in a variety of clinical circumstances.
FAU - Gwer, Samson
AU  - Gwer S
AD  - Department of Medical Physiology, School of Health Sciences, Kenyatta University, 
      Nairobi, Kenya. samgwer@gmail.com
FAU - Sheward, Victoria
AU  - Sheward V
FAU - Birch, Anthony
AU  - Birch A
FAU - Marchbanks, Robert
AU  - Marchbanks R
FAU - Idro, Richard
AU  - Idro R
FAU - Newton, Charles R
AU  - Newton CR
FAU - Kirkham, Fenella J
AU  - Kirkham FJ
FAU - Lin, Jean-Pierre
AU  - Lin JP
FAU - Lim, Ming
AU  - Lim M
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
GR  - 092654/WT_/Wellcome Trust/United Kingdom
GR  - 070114/WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130130
PL  - Germany
TA  - Childs Nerv Syst
JT  - Child's nervous system : ChNS : official journal of the International Society for 
      Pediatric Neurosurgery
JID - 8503227
SB  - IM
MH  - Acoustic Stimulation
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - *Intracranial Hypertension/diagnosis/pathology/physiopathology
MH  - Intracranial Pressure/*physiology
MH  - Malaria, Cerebral/physiopathology
MH  - Male
MH  - Retrospective Studies
MH  - Tympanic Membrane/*physiopathology
PMC - PMC3657347
EDAT- 2013/01/31 06:00
MHDA- 2014/01/05 06:00
PMCR- 2013/01/30
CRDT- 2013/01/31 06:00
PHST- 2013/01/04 00:00 [received]
PHST- 2013/01/15 00:00 [accepted]
PHST- 2013/01/31 06:00 [entrez]
PHST- 2013/01/31 06:00 [pubmed]
PHST- 2014/01/05 06:00 [medline]
PHST- 2013/01/30 00:00 [pmc-release]
AID - 2036 [pii]
AID - 10.1007/s00381-013-2036-5 [doi]
PST - ppublish
SO  - Childs Nerv Syst. 2013 Jun;29(6):927-33. doi: 10.1007/s00381-013-2036-5. Epub 
      2013 Jan 30.