Otolaryngology Commons^™

Endotyping Obstructive Sleep Apnea In Infants With Micrognathia, Alexis Dominic, Zarmina Ehsan, Baha Al-Shawwa Md, Karishma Rao, Blake A. Welker, Meghan Tracy, Andrew Li, Alessandra Manoylova-Vedder, Shiyuan Chen, Shu-Ching Chen, Members Of The Data Science And Analytics Innovation Center (Dsaic), John P. Dahl, Janelle Noel-Macdonnell

Posters

No abstract provided.

Cartilage Ring Formation In Chick Trachea, Yashica Sharma, Samuel Q. Mellentine, John Dahl, Jennifer C. Kasemeier

Posters

No abstract provided.

Comparative Analysis Of Fsrt And Srs For Vestibular Schwannoma Using A Large Multi-Institutional Dataset, Ian Argento, Bs, Daniel Uralov, Md, Jacob Beiriger, Md, Anika Walia, Bs, Kalena Liu, Bs, Wenyin Shi, Md, Jacob B. Hunter, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) both achieve high control rates of vestibular schwannomas (VS), but their comparative effects on functional outcomes remain uncertain. Prior studies are limited by small sample sizes and heterogeneous methods.

Methods: Deidentified data were analyzed from 100 healthcare organizations through TriNetX. Adults with VS (ICD-10: D33.3) and sensorineural hearing loss (H90.A/H90.1–H90.8) were included. Patients with neurofibromatosis or prior surgical resection were excluded. Treatment cohorts consisted of single-session SRS or ≥2-sessions of FSRT. Propensity score matching (1:1) yielded 909 patients per cohort. Outcomes—including hearing loss, cerebral edema, hydrocephalus, and cranial nerve …

Comparing Treatment Effectiveness And Patient-Reported Outcome Measures Of Four Treatment Options For Obstructive Sleep Apnea, Robert Diecidue, Dmd, Md, Phd, Mba, Msph, Joseph Harrington, Bs, Erika L. Manning, Phd, Md, Mph, Colin T. Huntley, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract

- There are four common treatment modalities for obstructive sleep apnea (OSA)

• CPAP, MAD, UAS, MMA

- Retrospective data was examined to compare efficacies between these treatments for patients treated with one of these four OSA therapies.

• Primary outcome: Mean disease alleviation (MDA) - calculated value based on improvement of AHI adjusted by compliance.
• Secondary outcomes: Patient reported outcome measures (PROMs) - ESS, PRAQ, SAQLI

- It was found that the greatest mean disease alleviation was found in patients who underwent MMA. PROMs showed the most significant improvement in daytime sleepiness (ESS) for MMA.

The Relevance Of Age, Bmi, And Right Versus Left Ear Surgery To The Incidence Of Taste Disturbance After Stapes Surgery, Jonathan Ong, Dennis Bojrab Ii

Posters

• Many factors such as age and body mass index (BMI) have been shown to influence post-operative outcomes in patients undergoing stapedectomy/stapedotomy.

• This study examines these factors to see if they have any impact on the incidence of taste disturbance, a commonly reported complication of stapes surgery.1

• Our study predicts that BMI and age are correlated with the incidence of taste disturbance post-operatively following stapes surgery.

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosisand candidiasis from the fungus Candida albicansare both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Development Of Adult Multidisciplinary Tracheostomy Rounding Teams: Prevalence, Template For Starting, And Analysis For Diffusion Of Innovation, Tony Satroplus, Teresa Y. Rodriguez, Bennett J. Berning, Sarah Schmoker, Robert Morrison, Jayme Dowdall

Posters and Presentations: Otolaryngology

Educational Objective: At the conclusion of this presentation, the participants should be able to (a) Describe the prevalence of adult tracheostomy teams in the Middle Section; (b) Outline the impact of dedicated tracheostomy rounding teams; (c) Craft strategies for multidisciplinary rounding team including the necessary personnel; (d) Identify accelerants and barriers to incorporation of the team at their institution or community. Objectives: Multidisciplinary tracheostomy rounding teams have been found to decrease days to speech and decannulation and decrease adverse events. The need of such teams and the characteristics that increase or inhibit the tracheostomy rounding team's implementation rates have not …

Improving The Usability And Usage Of A Tracheostomy Order Set, Tony Satroplus, Teresa Y. Rodriguez, Jordon Flynn, Carly Garcia, Bennett J. Berning, Jayme Dowdall

Posters and Presentations: Otolaryngology

Educational Objectives: At the conclusion of this presentation, the participants should be able to (a) understand the benefits of simplifying EMR order-sets; (b) simplify a commonly used procedure or order set which includes identifying stakeholders who should contribute to the discussions; (c) identify and overcome barriers that would inhibit implementation and efficiency Objectives: Usability of electronic medical records has been linked to concerns for patient safety and provider wellness. One concern is that an order set’s “end user” may be inexperienced with the complexities associated with the tracheostomy patient continuum. The formation and utility of an intuitive workflow in the …

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosis and candidiasis from the fungus Candida albicans are both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Predictors Of Icu Admission Following Endoscopic Endonasal Skull Base Surgery, Brandon Prentice, Max Dehaan, Adam Folbe

Posters

• Endoscopic Endonasal Skull Base Surgery (EESBS) encompasses a wide range of surgeries; pituitary adenoma resection is the most common of these.
• Patients routinely are admitted to the ICU post-operatively for monitoring of serious complications such as intracerebral hemorrhage and meningitis.
• Some complications such as diabetes insipidus, however, do not require a stay within the ICU and can be managed as an out-patient.
• Besides adding stress and discomfort to the patient, stays in the ICU are costly with one study reporting a cost of $2,902 per day.
• Previous studies identified preoperative hypertension and large tumor volume (>4500 mm3) as risk …

Hearing Durability And Trajectory After Radiosurgery For Vestibular Schwannoma, Christian G. Fritz, Dennis I. Bojrab Ii, Nathan C. Tu, Christopher A. Schutt, Dennis I. Bojrab, Seilesh C. Babu

Posters

INTRODUCTION
Vestibular schwannomas (VS) are benign skull base tumors arising from the eighth cranial nerve. Stereotactic radiosurgery (SRS) is emerging as treatment for smaller sized tumors with the intent being to prevent further tumor growth, thus avoiding mass-effect symptoms. Hearing outcomes are commonly presented as preservation of class A/B hearing (defined as Pure Tone Average (PTA) ≤50 dB with Word Recognition Score (WRS) ≥50 dB). Long-term follow-up data on hearing outcomes and hearing trajectory trends are limited.

Avoidance Of Maxillary Swing For Nasopharyngectomy Via Combined Open Lateral And Endoscopic Approach, S. Hamad Sagheer, Bs, Brian Swendseid, Md, Joseph M. Curry, Md, Mindy Rabinowitz, Md, Gurston Nyquist, Md, Marc R. Rosen, Md, James Evans, Md, Adam J. Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Posters

Objectives: Nasopharyngectomy performed via a solely endoscopic approach has limitations in access and feasibility, particularly regarding management of the carotid artery. To address these limitations, we report three cases with one cadaver dissection where nasopharyngectomy was performed via a combined open lateral an endoscopic approach. We highlight the benefits and technical considerations for this operative technique.

Study Design: Case Series

Methods: Patients diagnosed with recurrent nasopharyngeal carcinoma (NPC) that underwent combined open lateral and endoscopic nasopharyngectomy from 2016-2020 were analyzed. A cadaver dissection was also performed.

Results: We present the details of the approach and follow-up in three patients with …

Fat Graft For Parotidectomy Defect Reconstruction In The Setting Of Malignant Disease, S. Hamad Sagheer, Bs, Alexander Knops, Ba, Kurren Gill, Md, Vivian Xu, Bs, Howard Krein, Md, Phd, Ryan Heffelfinger, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Objectives: Currently, limited data examines the safety of utilizing fat transfers in the setting of malignant parotid disease. Here we evaluate the safety of fat graft reconstruction of parotidectomy defects in the setting of malignant disease.

Study Design: Retrospective cohort study

Methods: Electronic chart review of patients who underwent parotidectomy from 2012-2020 were reviewed.

Results: Three hundred and sixty-one patients were identified at a single institution who underwent parotidectomy, and 113 (31.3%) were for malignancy. One hundred and thirty-two patients underwent fat graft reconstruction (49.2%, n=65 for umbilical, 50.8%, n=67 for dermal). One-third of patients had malignant pathology (34.8%, n=46). …

Intraoperative Evaluation Of Nasal Valve Repair Interventions: A Prospective Analysis, Kurren Gill, Md, S. Hamad Sagheer, Bs, Cory Bovenzi, Md, Brian Yan, Ba, Howard Krein, Md, Phd, Ryan Heffelfinger, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Objectives: To allow for early identification and treatment of inadequate nasal valve repair interventions in the intraoperative setting, based on degree of nasal valve collapse quantified by suction-assisted pressure readings. Patient outcomes were measured by comparison of pre- and post-operative Nasal Obstruction Symptom Evaluation (NOSE) surveys.

Study Design: Prospective study.

Methods: All enrolled patients undergo suction-assisted evaluation of nasal valve collapse before surgical intervention. Patients randomized into the experimental group underwent repeat assessment after various nasal valve interventions, compared to a control group where adequacy of interventions was assessed by palpation of the nasal ala.

Results: 20 patients who underwent …

Lifestyle Management For Individuals With Vestibular Disorders, Michelle Pock, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

Individuals with vestibular disorders have concerns that impact lifestyle including limiting activities of daily living, limiting participation in social events, difficulty driving, and difficulty working (Cohen, 2014). Occupational therapists are able to help individuals with vestibular disorders by task analyzing symptom provoking activities, assessing the impact of symptoms on occupations, providing adaptations, and providing ways to modify environments (Gronski, Neville, Kannenberg, & Cohen, 2017). While occupational therapists are qualified to provide services to sustain and improve the occupational performance of individuals with vestibular disorders, occupational therapy is not well represented in this area particularly in addressing lifestyle components for vestibular …

Moisture Chamber For Eye Care After Facial Nerve Injury, Ryan Rimmer, Md, Lauren Bogdan, Md, Gregory Epps, Md, Nikolaus Hjelm, Md, Erin Reilly, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Introduction

• Patients with various lesions of the head and neck may have compromise of facial nerve function.
• Facial nerve (CN VII) has various roles, including movement of facial muscles and, importantly, eye closure.
• When facial nerve is sacrificed or damaged during a surgical cases, steps are often taken intraop to surgically correct the deficit and allow eye closure. However, these patients may not immediately realize the benefit of these interventions.
• In the postop period, appropriate eye care is critical to prevent exposure keratopathy due to inability to close eye.
• Exposure keratopathy is damage to the cornea that occurs primarily due …

Treatment Summaries For Head And Neck Cancer Survivors: Improving Patient Self Efficacy And Survivorship Care, Michael C. Topf, Md, Jena Patel, Ramez Philips, Md, David Cognetti, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objective

• To determine if receiving treatment summaries enhances patient understanding and recall of cancer and treatment details, improves patient self efficacy, and serves as a useful patient tool after completion of head and neck (HNC) therapy

Cross-Departmental Educational Program On Complex Airway And Epistaxis Management, Adam Vasconcellos, Md, Meghan Crawley, Md, Michael Topf, Md, Ryan Gerritsen, Md, Dominick Gadaleta, Md, Joseph Spiegel, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Internists, emergency medicine physicians, and intensivists routinely provide essential care for patients with complex airways (i.e. tracheostomy and laryngectomy) and patients with epistaxis. Any of these physicians may serve as first responder in a complex airway or epistaxis emergency situation. Therefore, a basic understanding of complex airway and epistaxis management is essential. The otolaryngology department aims to provide our colleagues with fundamental take-home points to improve crossdepartmental care of these patients.

Sustainability And Outcomes Of A Standardized Aminoglycoside Induced Ototoxicity Monitoring Algorithm, Claire Elson, Christopher M. Oermann, Michelle Weltman, Ellen Meier

Posters

No abstract provided.

Gastric Pepsin In Post-Tympanostomy Tube Otorrhea, Jill N. D'Souza, Md, Erin Fields, Pa-C, Zhaoping He, Phd, Robert O' Reilly, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Introduction

Otorrhea is the most common complication following tympanostomy tube placement, with an incidence commonly reported at around 20%. Topical otic antibiotic drops are typically used for relief of otorrhea in children with tympanostomy tubes. In children with recurrent otorrhea, gastroesophageal reflux and extraesophageal reflux have been postulated to be involved in the pathogenesis of otitis media with effusion¹. Middle ear inflammation is thought to be mediated by proteolytic activity of pepsin, as well as by the decrease in pH associated with reflux of gastric acid through Eustachian tube. The goal of this study is to examine the …

Benefits Of A Surgical Safety Checklist For Otolaryngology Patients, Lindsay A. Goodstein, Md, Nadia K. Mostovych, Md, Michael B. Hall, Md, David Hsu, Md, David Cognetti, Md, Maurits S. Boon, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Introduction

The volume and complexity of knowledge today has exceeded any single individual's ability to manage it consistently without error despite advances in technology, years of training, and specialization of functions and responsibilities. Checklists have been employed since the 1930s in aviation and high-risk industries to prevent accidents caused by human error. Only recently has their use been introduced to surgery after the World Health Organization (WHO) heightened awareness of the significant number of deaths, about a half million worldwide, that occur each year as a result of avoidable surgical error.¹ With over 275,000 surgical procedures performed daily, an …

The Effects Of Formalized Team Training On Key Patient Outcomes In An Otolaryngology- Head And Neck Surgery Residency, Natalie Vercillo, Md, Adam Vasconcellos, Md, David Cognetti, Md, Maurits Boon, Md

Department of Otolaryngology - Head and Neck Surgery Posters

BACKGROUND

• Errors in medical care have consistently been linked to communication failures among team members. TeamSTEPPS^® is a team training system which was co-developed by the Department of Defense and the Agency for Healthcare Research and Quality (AHRQ) which provides a full curriculum of ways to improve patient safety through four main skills: communication, mutual support, leadership and situation monitoring¹.
• Training in these skills through TeamSTEPPS^® has been shown to improve patient safety and outcomes by reducing destructive barriers within the healthcare field such as poor communication, conflicts, ambiguous responsibilities of each team member, hierarchical constraints …

Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria For The Allocation Of Dual Kidneys In Adults, Jill N. D'Souza, Md, Katherine Mckee-Cole, Md, Abigail Strang, Md, Patrick Barth, Md, Aaron Chidekel, Md, Udayan Shah, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract:

Objective The recognition of wound-related complications following pediatric tracheotomy is on the rise. These complications can have a significant impact on clinical course as well as on hospital healthcare costs to the tracheotomy dependent child and family

Methods A tracheotomy database was created in 2000 and reviewed for incidence of major and minor complications.

Setting Tertiary Care Pediatric Referral Center

Results We identified a post-tracheotomy complication rate of 19.9%, of which the most common complication was wound breakdown (65% of complications).

Conclusion Rate of post-tracheotomy wound-care complications is 12.9%. Wound description is subjective and prone to inter-observer variability. A …

Benefits Of Wireless Telephone Technologies For Bilaterally Implanted Adults, Louisa Liang, Au.D., Paula Marcinkevich, Au.D.

Department of Otolaryngology - Head and Neck Surgery Posters

Introduction

Cochlear implant (CI) recipients often have difficulty conversing on the telephone, particularly in noise. Successful use of landline and cellular telephones also can be limited because of less-than-optimal phone placement with respect to the sound processor microphone. One solution for recipients of Advanced Bionics cochlear implants may be the use of new streaming technologies from Phonak to improve the ability to talk on the phone. In addition to reducing interference caused by noise, use of these technologies is not strictly placement-dependent and also allows bilateral/bimodal recipients to take advantage of hearing with two ears.

The primary objective of this …

Cerebrospinal Fluid Leak After Microvascular Reconstruction Of Large Craniofacial Defects With Orbital Exenteration, Kurren Gill, Ba, David Hsu, Md, Patrick Tassone, Md,, John Pluta, Md, Gurston G. Nyquist, Md, Howard Krein, Md, Phd, Jurij Bilyk, Md, Ann P. Murchison, Md, Alfred Iloreta, Md, James J. Evans, Md, Ryan N. Heffelfinger, Md, Joseph M. Curry, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract

Objectives: To assess risk factors for cerebrospinal fluid (CSF) leak after microvascular reconstruction of extensive cranio-orbitofacial resection with orbital exenteration (CFOE).

Study Design: Retrospective Case Series

Methods: 70 consecutive patients at a tertiary hospital underwent 76 procedures with microvascular reconstruction of CFOE defects. Patients were stratified by extent of skull base exposure and presence or absence of dural resection. Patients with exposure of the orbital apex and roof alone were classified as minimal skullbase exposure (MSE, n=32). Those with exposure beyond the orbital apex and roof were classified as significant skullbase exposure (SSE, n=38), including those with dural resection …

Thyroid Cancer Metabolism: A Review, Kurren Gill, Ba, Patrick Tassone, Md,, James Hamilton, Md, Nikolaus Hjelm, Md, Adam J. Luginbuhl, Md, David Cognetti, Md, Madalina Tuluc, Md, Ubaldo E. Martinez-Outshoorn, Md, Jennifer Johnson, Md, Joseph Curry, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract

Metabolic dysregulation within the tumor microenvironment (TME) is critical to the process of tumorigenesis in various cancer types. Thyrocyte metabolism in papillary and anaplastic thyroid cancer, however, remains poorly characterized, and studies analyzing the role of multicompartment metabolism in thyrocyte oncogenesis are sparse. We present a review of the current knowledge on cellular metabolism in non-cancerous and cancerous thyroid tissues, focusing on the monocarboxylate transporters MCT1 and MCT4, and on a transporter of the outer mitochondrial membrane TOMM20. Understanding the metabolic phenotype of tumor cells and associated stromal cells in thyroid cancer can have profound implications on the use …

The Throat And The Voice: The Complete Text, Jacob Solis Cohen M.D.

The Throat and the Voice, by J. Solis Cohen, M.D. 1879

The complete text of the 1879 volume, by J. Solis Cohen, M.D. Solis Cohen was a pioneer in laryngeal surgery and Lecturer on Laryngology and Diseases of the Chest at Jefferson Medical College from 1867-1927. 159 pages.