Medicare Reimbursement Trends for Facility Performed Otolaryngology Procedures: 2000-2019.

Objective: There is a paucity of data regarding financial trends for procedural reimbursements in otolaryngology. The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for the 20 most commonly billed otolaryngology procedures from 2000 to 2019.

Study Design: Analysis of physician reimbursement.

Analysis of MRI Volumetric Changes After Hypofractionated Stereotactic Radiation Therapy for Benign Intracranial Neoplasms.

Purpose: To quantitatively assess volumetric changes after hypofractionated stereotactic radiation therapy (HFSRT) in patients treated for vestibular schwannomas and meningiomas.

Methods And Materials: We retrospectively reviewed records of patients treated with HFSRT at our institution from 2002 to 2014. Patients received a median dose of 25 Gy in 5 fractions.

Diagnosing Large Vestibular Aqueduct: Radiological Review of High-Resolution CT Versus High-Resolution Volumetric MRI.

Objectives: To compare the diagnostic yield of high-resolution volumetric T2-weighted MRI (HRT2-MRI) with high-resolution computed tomography (HRCT) for diagnosis of large vestibular aqueduct (LVA).

Study Design: Three board-certified neuroradiologists performed an independent, blinded radiological review for diagnosing LVA with 2:1 age-matched controls on patients with both HRCT and HRT2-MRI imaging.

Setting: Tertiary referral center.

Measurement of cochlear length using the 'A' value for cochlea basal diameter: A feasibility study.

Objectives: To determine whether the cochlea basal diameter (A value) measurement can be consistently and precisely obtained from high-resolution temporal bone imaging for use in cochlear length estimation.

Methods: A feasibility study at a tertiary referral center was performed using the temporal bone CTs of 40 consecutive patients. The distance from the round window to the lateral wall was measured for each cochlea by two independent reviewers, a neuroradiologist and an otolaryngologist.

Magnetic Resonance Imaging Assessment of Vascular Contact of the Facial Nerve in the Asymptomatic Patient.

 The objective of this study was to determine the prevalence of facial nerve vascular contact on magnetic resonance imaging (MRI) in patients without hemifacial spasm (HFS).  Our radiology database was queried to identify consecutive adult patients without a history of HFS, intracranial tumor, brain radiation therapy, intracranial surgery, traumatic brain injury, or trigeminal nerve vascular compression. One hundred high-resolution MRIs of the posterior fossa were independently reviewed by two neuroradiologists for facial nerve vascular contact (200 sides).

Pantopaque contrast mimicking intracanalicular vestibular schwannoma.

Pantopaque (iophendylate) is an oily contrast medium historically used during spine imaging. Due to its persistence in the subarachnoid space and the potential to lead to severe arachnoiditis, it is no longer used today. We present a 40-year-old male with new-onset headaches, imbalance, and vertigo.

Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care.

Purpose: The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems.

Method: Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting.

Postural orthostatic tachycardia syndrome for the otolaryngologist.

Objective: To describe the postural orthostatic tachycardia syndrome (POTS), including clinical presentation, pathophysiology, diagnostic methods, and current management models.

Data Sources: PubMed, Cochrane Library were searched for articles available prior to October 30, 2015.

Methods: Review of the available English-language literature.

Labyrinthine concussion following gunshot injury: A case report.

Objective: Labyrinthine concussion due to a postauricular gunshot wound has not been well reported.

Design: Retrospective chart review.

Study Sample: We describe an otherwise healthy 22-year-old male who received a gunshot wound to the left mastoid and subsequently reported hearing loss and rotational vertigo.

Craniocervical Pneumatization: Estimation of Prevalence and Imaging of Treatment Response.

Objective: Estimate the prevalence of craniocervical pneumatization (CCP) and describe successful treatment of this condition with clinical and radiologic correlation.

Patients: Individuals with documented CCP on computed tomography (CT).

Intervention(s): CT scans of the head, temporal bone, face, neck, and cervical spine.

Reconstruction of Lateral Skull Base Defects: A Comparison of the Submental Flap to Free and Regional Flaps.

Objectives: To compare reconstructive techniques, operative times, duration of hospitalization, and need for subsequent flap revisions between reconstructive approaches to lateral skull base defects.

Study Design: Case series with chart review.

Setting: Tertiary academic referral center.

Cost Effectiveness of Childhood Cochlear Implantation and Deaf Education in Nicaragua: A Disability Adjusted Life Year Model.

Introduction: Cochlear implantation (CI) is a common intervention for severe-to-profound hearing loss in high-income countries, but is not commonly available to children in low resource environments. Owing in part to the device costs, CI has been assumed to be less economical than deaf education for low resource countries. The purpose of this study is to compare the cost effectiveness of the two interventions for children with severe-to-profound sensorineural hearing loss (SNHL) in a model using disability adjusted life years (DALYs).

Analysis of Intraoperative Radiographic Electrode Placement During Cochlear Implantation.

Objective: To investigate the clinical value of intraoperative plain radiographs in determining correct placement of cochlear implants.

Patients: All cochlear implant insertions over a 10-year period by a single surgeon.

Interventions: Cochlear implantation with intraoperative imaging.

Infected cochlear implant after large-volume nasal irrigation.

Objective: A patient with a well-healed, functional cochlear implant (CI) experienced a CI and mastoid infection shortly after initiating large-volume nasal irrigations after sinus surgery. The goal of this report is to bring attention to a rare complication and to question if large-volume nasal irrigation is safe in CI recipients.

Patients: Single patient at a tertiary care hospital.

Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

Objective: Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon.

Study Design: Case series with chart review.

Setting: Tertiary care center and residency program.

Clinical practice guideline: sudden hearing loss.

Objective: Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older).

Negative effect of deep cochlear implant electrode insertion on speech perception.

This case study details the evaluation, explantation, and subsequent reimplantation of a cochlear implant (CI) recipient with an unusually deep electrode array insertion. Although the positive value of sufficiently deep insertion and the effect of insertion variability have been researched, there are few data available that illustrate the detrimental effects on speech recognition when deep insertion corrupts optimal use of the CI. This unique case report challenges the assumption that deeper insertion will result in improved speech understanding and demonstrates the importance of fully evaluating recipients' complaints and recognizing the impact of frequency-to-place mismatch.

Cochlear implantation in developing countries as humanitarian service: physician attitudes and recommendations for best practice.

Objective: To make recommendations concerning cochlear implantation during humanitarian medical trips by exploring the attitudes of US cochlear implant surgeons.

Study Design: Cross-sectional survey.

Setting: Academic.

Are corticosteroid and antiviral treatments effective for bell palsy? A critically appraised topic.

Background: : Bell palsy is idiopathic peripheral facial weakness that typically resolves without severe clinical sequelae. Treatment with corticosteroids and antiviral drugs is often initiated to improve the likelihood of a favorable outcome.

Objective: : Are corticosteroid and antiviral medications effective in the treatment of Bell palsy?

Methods: : The objective was addressed through the development of a structured critically appraised topic.

Prevalence and timing of individual cochlear implant electrode failures.

Objective: To identify the prevalence of individual electrode failures as a result of open and short circuits in the Nucleus N24 and Freedom series and the Advanced Bionics CII and HR90k (Helix and 1J) devices.

Study Design: Retrospective chart review.

Setting: Tertiary referral center.

Phase 2 study examining magnesium-dependent tinnitus.

Background: Recent studies in noise-induced and idiopathic sensorineural hearing loss have suggested that magnesium supplementation may lessen both hearing loss and the severity of tinnitus in patients. Further epidemiological evidence indicates that all age groups of Americans fall short of the recommended daily allowance for magnesium by 100 mg daily.

Purpose: The purpose of this study was to examine any potential benefit in lessening the severity of tinnitus in patients taking supplemental magnesium.