Auditory brainstem response equipment

The Audiology Department at The Royal Children’s Hospital plays a crucial role in the diagnosis, monitoring and management of hearing health in children.

As it services patients from birth to 18 years old, there are a variety of assessment techniques and equipment used to evaluate hearing based on age and development.

The latest auditory brainstem response audiometry equipment is providing a specialised way to assess hearing in babies.

“We tell families to bring a hungry, tired baby to the clinic so the test can be conducted during the child’s natural sleep. Recording stickers are placed on the forehead and behind the ears which are all connected to a computer. Ear plugs are put in the baby’s ears where the computer can send different stimuli,” explains Christine Poulis, Manager of the Audiology Department.

“Testing commences after the baby is fed and falls asleep. The computer plays stimuli through the ear plugs, then measures the electric responses from the auditory nerve and brainstem.”

Six-week-old Alba having her hearing tested with the new equipment.

Previously, the equipment took longer to assess children as only one ear could be tested at a time.

The latest model of equipment means testing can be done in both ears simultaneously so families can have answers about their child’s hearing faster and in one appointment.

“Current research shows that hearing problems diagnosed and treated in the first three months of life result in better language outcomes for children.

“Thanks to the community’s generosity, we can continue to provide a high-quality service to all children with the best equipment on hand,” said Christine.

The auditory brainstem response equipment is one of 25 vital pieces of equipment that will be upgraded at The Royal Children’s Hospital thanks to the community’s support of the 2021 Good Friday Appeal.

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Mitral Valve Retractor

A unique piece of surgical equipment, the mitral valve retractor is designed specifically to assist surgeons conducting a mitral valve surgery.

The mitral valve is a very small valve located between the left heart chambers which lets blood flow through in a single direction.

When the valve doesn’t close, or becomes stiff, this is life threatening and requires open heart surgery to fix it.  

“This mitral valve retractor is used mainly on older children or young adults. At the RCH we conduct about 20 mitral valve repairs per year, and most of these patients are Indigenous Australian children presenting with rheumatic heart disease,” said Professor Christian Brizard, Director of the Cardiac Surgery Unit.

Rheumatic heart disease is a serious disease of the heart where one or more of the four heart valves is affected.

This results from acute rheumatic fever which means the heart lining swells and causes lingering damage.

The incidence of rheumatic heart disease in the Indigenous Australian population is one of the highest in the world. 

With the new mitral valve retractor, cardiac surgeons have greater visibility and stability of the surgical area as well as reducing the need for other additional assistance during the procedure.

The equipment will ensure that children from right across Australia can have this specialised surgery.

“We are always grateful to the Victorian community for their generosity in helping to fund advanced equipment which enables us to perform life-saving surgery – thank you,” said Christian.

The Mitral Valve Retractor is one of 25 vital pieces of equipment that will be upgraded at The Royal Children’s Hospital thanks to the community’s support of the 2021 Good Friday Appeal.

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Vital equipment upgrades

Thanks to the generosity of the Good Friday Appeal community, equipment vital to great patient care is being upgraded across The Royal Children’s Hospital. With the most advanced equipment, the RCH can continue to provide the best diagnosis and treatment for some of the sickest children in Victoria and beyond.

More than 25 different types of equipment will be bought, including state of the art operating tables for trauma surgery, bedside monitors for critically ill children in the Intensive Care Unit and a new suite of defibrillators to be used across the hospital.

Other equipment that will be bought includes:

  • A fibre-optic endoscope, which has a light and tiny camera at the end, allowing doctors to diagnose and treat gastrointestinal conditions.
  • A halo retractor system for trauma brain surgery, which is an essential piece of equipment for operations on the brain. The halo retractor system will be used to gently hold portions of the brain in place and gives surgeons greater access to perform complex procedures.
  • A portable video x-ray machine to give surgeons performing delicate hand and foot operations the ability to more easily find fractures and defects in the bones they are trying to repair.

Go behind the scenes in the Neurosurgery Theatre with Alison Wray, Director of Neurosurgery

Funds from the 2021 Good Friday Appeal have helped purchase a probe that attaches to the microscope used in brain surgery to help surgeons see around corners.

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nanoString technology

Every year in Australia, around 700 children are diagnosed with cancer. The time and accuracy of this diagnosis is crucial to their ongoing care. Thanks to support from the Good Friday Appeal, The Royal Children’s Hospital (RCH) now has access to nanoString technology to support the rapid identification and diagnosis of these cancers.

While there are nine common types of paediatric cancer, the individual tumour variants for paediatric brain and solid tumours can vary dramatically by their unique genetic alterations and treatment.

Kids like Oli, 3, who is being treated for neuroblastoma, will be helped by nanoString Technology

Luckily for patients at the RCH, the hospital is home to an expert team of pathologists who are able to utilise cutting edge technology to molecularly confirm the diagnosis.

“Kids get a very specific group of tumours that you don’t see in adults. While we can begin to narrow down the tumour type via a microscope, we need to complete testing at a molecular level to provide an integrated diagnosis,” said Colleen D’Arcy, Paediatric Pathologist at the RCH.

“The new nanoString technology allows us to test for up to 100 different genetic alterations within a tumour in one assay, which means we can get a diagnosis faster, with minimal amounts of tissue and provide molecular information to guide therapy,” said Dr D’Arcy.

The new nanoString technology works by taking a tissue sample from the patient’s tumour and comparing it against a panel of tumour-specific RNA sequences labelled with coloured ‘barcodes’, in the hopes of finding a diagnostic match.

The ability to screen for multiple tumour-specific RNA sequences at once as part of a panel is a major advancement from the previous process which required pathologists to test for only one genetic alteration at a time.

The new nanoString technology is also much faster than those previously used, cutting down the diagnosis time from weeks to just three days.

The best part is, it’s not just helping patients at the RCH, but also those from across Australia and New Zealand. 

“This is a really exciting advancement for not only the RCH, but for children in the Asia Pacific Region. Through the support of Good Friday Appeal funding, the nanoString technology will enable our team of pathologists to test up to 24 tumour samples from other paediatric hospitals in the region every week,” said Bronwyn Christiansen, Principal Scientist, Anatomical Pathology, Laboratory Services.

Thanks to support from the Good Friday Appeal, nanoString technology is providing faster pathways to diagnosis, which means patients can receive the best care possible, and enrol in dedicated clinical trials, giving them the greatest chance of successfully fighting their cancer.  

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