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Cutting-Edge Science Featured in Best of Orals Session

Twelve abstracts focusing on cutting-edge clinical and translational basic research in otolaryngology will be presented from 10:00 am-11:15 am today in Room C141 during the Best of Orals session.

The AAO-HNSF Program Advisory Committee chose the abstracts as the best submitted. They can be viewed in the September Abstract Program Supplement to Otolaryngology—Head and Neck Surgery. The session moderators are Eben L. Rosenthal, MD, and Sujana S. Chandrasekhar, MD.

Following are the presentations, with study summaries provided by the authors.

10:00 am: Correlation of Pediatric Sleep Endoscopy with Polysomnography

The study focused on the relationship between sleep study results and findings seen during drug-induced sleep endoscopy (DISE) in children with obstructive sleep apnea. Researchers found a significant correlation between the severity of anatomic obstruction on DISE with the apnea hypopnea index and the lowest oxygen saturation recorded on the sleep study.

John P. Dahl, MD, PhD, MBA; Craig Miller, MD; Patricia L. Purcell, MD; David A. Zopf, MD; David L. Horn, MD; Dylan K. Chan, MD, PhD; Sanjay R. Parikh, MD

10:06 am: Long-Term Outcomes of Cranial Nerve Stimulation for OSA

B. Tucker Woodson, MD; Joachim Maurer; M. Boyd Gillespie, MD, MSc; Nico de Vries, MD; Ryan J. Soose, MD; Jonathan Z. Baskin, MD; Tapan A. Padhya, MD

10:12 am: Implementation of a Clinical Care Pathway for Epistaxis Management

The study evaluated the pre-existing treatment pattern for management of severe epistaxis and then implemented a clinical care pathway to optimize treatment for patients.  The clinical care pathway resulted in decreased hospital stays, decreased duration of packings, increased sphenopalatine artery ligations, and improvement in admission to a proper hospital location.

Peter S. Vosler, MD, PhD; Jason I. Kass, MD, PhD; Eric W. Wang, MD; Carl H. Snyderman, MD, MBA

10:18 am: Ciprofloxacin Decreases Collagen in Tympanic Membrane Fibroblasts

The study looked at ciprofloxacin eardrops commonly used in cases of tympanic membrane (TM) perforation, including myringotomy with tympanostomy tube placement. Treatment of TM fibroblasts with 0.3 percent ciprofloxacin significantly reduced collagen and α-tubulin protein levels. These findings could explain TM healing problems associated with quinolone eardrops.

Nicklas C. Orobello; Carolyn O. Dirain, PhD; Maria Raye Anne V. Ng; Bailey A. Milne-Davies, AA; Patrick J. Antonelli, MD

10:24 am: Depression after Hearing Loss Treatment: Results from the SMART Study

The impact of hearing loss treatment on depression was examined in a prospective observation study of 134 adults greater than 50 years of age. Hearing aid and cochlear implant use resulted in significant improvement in the Geriatric Depression Scale at six and 12 months post-intervention.

Kevin J. Contrera, MPH; Josh Betz; Yoon Sung; Lingsheng Li; Janet S. Choi, MPH; Frank R. Lin, MD, PhD

10:30 am: Middle Ear Findings for Children with Conductive Hearing Loss

Conductive hearing loss (CHL) in an otherwise healthy ear is a diagnostic and treatment problem. In this study, 47 children with unknown etiology for CHL received an endoscopy of the middle ear with diagnosis and follow-up. The most common finding was an anomaly for stapes.

Juha T. Silvola, MD, PhD

10:36 am: Palliative Therapy of the Primary Tumor in M1 Head and Neck Cancer

Palliative surgery and/or radiotherapy have been shown to improve quality of life in patients with advanced cancer of the head and neck. This is the first study to utilize the national SEER database to prove improved survival in patients undergoing palliative therapy compared to no therapy.

Tapan D. Patel, MD; Emily Marchiano; Suat Kilic; Jean Anderson Eloy, MD; Soly Baredes, MD; Richard C. Park, MD

10:42 am: Congenital Cholesteatoma: Results Using Over-Under Tympanoplasty

This retrospective study focused on patients undergoing extirpation of congenital cholesteatoma via over-under tympanoplasty with or without mastoidectomy. Cases were staged using the Potsic classification system. Recidivism rates, complications, and postoperative audiometric outcomes were compared to prior studies. Researchers found the over-under tympanoplasty with or without mastoidectomy provided excellent exposure for removal of congenital cholesteatoma.

Aaron M. Metrailer, MD; Eric L. Slattery, MD; Seilesh Babu, MD; Michael J. Larouere, MD; Dennis I. Bojrab, MD

10:48 am: Magnesium Disorders Are Related to Hypocalcemia after Thyroidectomy

Hypocalcemia after thyroid surgery is common, and often requires treatment.  This study of Nationwide Inpatient Sample data showed disorders of magnesium metabolism are an independent risk factor for postoperative hypocalcemia, and are associated with increased costs and length of stay. This highlights the potential role of magnesium in reducing postoperative hypocalcemia, costs, and hospitalization.

Jason C. Nellis, MD; Ralph P. Tufano, MD, MBA; Christine G. Gourin, MD

10:54 am: Nerve Monitoring in Thyroid Surgery: Litigation Fears and Realities

Many surgeons report fear of malpractice litigation as a reason for using intraoperative nerve monitoring to protect the recurrent laryngeal nerve during thyroid surgery, despite its ambiguous efficacy. This study reviewed cases from four national legal databases and found that nerve monitoring plays little role in thyroid surgery litigation patterns.

Kenny J. Oh, JD; Jeffrey C. Liu, MD

11:00 am: Outcomes in Open and Endoscopic Repair of Esophageal Diverticulum

Endoscopic and open approaches are employed for treatment of Zenker’s diverticula. While the former is felt to be less morbid, the optimal treatment modality remains controversial. The study examined outcomes of both approaches using a nationwide database (ACS-NSQIP). Post-operative complications, readmission, re-operation, and length of stay did not differ between approaches.

J. Alexander Ivey; Brendan P. O’Connell, MD; M. Boyd Gillespie, MD, MSc

11:06 am—An Analysis of Adverse Events Reported with Balloon Sinus Procedures

Balloon dilation of the paranasal sinuses represents a relatively new option for surgically managing chronic rhinosinusitis. Using the OpenFDA website, this study evaluated the nature of adverse-event reporting for the procedure and found that while adverse events are uncommon, select ones can be severe and related to the particular sinus dilated.

Anthony A. Prince, MD; Neil Bhattacharyya, MD