Comparison of Outcomes After Cochlear Implantation in a Veteran Versus Nonveteran Population.

Objective: To evaluate for equivalence in postoperative changes of speech recognition scores in a veteran patient population undergoing cochlear implantation (CI) compared to matched nonveteran patients.

Study Design: Retrospective chart review.

Setting: Tertiary referral center.

Microsecretory Adenocarcinoma of the Ear Canal: Novel Cutaneous Analog of a Salivary Gland Neoplasm.

Microsecretory adenocarcinoma (MSA) of the salivary gland is a new entity recently added to the World Health Organization Classification of Head and Neck Tumors. This tumor is characterized by a recurrent MEF2C-SS18 translocation. We present a nodular tumor confined to the dermis of the ear canal of a 44-year-old patient, which demonstrated classic histopathologic features and molecular alteration of MSA.

A Novel Performance-Based Paradigm of Care for Cochlear Implant Follow-Up.

Objectives: Utilize a multi-institutional outcomes database to determine expected performance for adult cochlear implant (CI) users. Estimate the percentage of patients who are high performers and achieve performance plateau.

Study Design: Retrospective database study.

Real-World Compliance With Follow-up in 2,554 Cochlear Implant Recipients: An Analysis of the HERMES Database.

Background: Traditional paradigms of care recommend close audiology follow-up and regular speech perception outcomes assessment indefinitely for cochlear implant (CI) recipients after device activation. However, there is scant published data on actual compliance with this paradigm in clinical practice.

Methods: A multi-center cochlear implant database was queried to identify follow-up rates after cochlear implantation.

Benefits of a Hearing Registry: Cochlear Implant Candidacy in Quiet Versus Noise in 1,611 Patients.

Purpose This retrospective study used a cochlear implant registry to determine how performing speech recognition candidacy testing in quiet versus noise influenced patient selection, speech recognition, and self-report outcomes. Method Database queries identified 1,611 cochlear implant recipients who were divided into three implant candidacy qualifying groups based on preoperative speech perception scores (≤ 40% correct) on the AzBio sentence test: quiet qualifying group, +10 dB SNR qualifying group, and +5 dB SNR qualifying group. These groups were evaluated for demographic and preoperative hearing characteristics.

Assessing Cochlear Implant Performance in Older Adults Using a Single, Universal Outcome Measure Created With Imputation in HERMES.

Objective: In the era of big data, it is critical to aggregate results across different institutions. This is a major challenge for cochlear implant (CI) research given multiple, incompatible outcome measures. We use a large, national CI database to develop a formula to convert between the two most common measures: Consonant-Nucleus-Consonant word (CNCw) and Arizona Biomedical (AzBio).

Pilot study on the use of data mining to identify cochlear implant candidates.

Objectives: The goal of this pilot study was to determine the clinical utility of data-mining software that screens for cochlear implant (CI) candidacy.

Methods: The Auditory Implant Initiative developed a software module that screens for CI candidates via integration with a software system (Noah 4) that serves as a depository for hearing test data. To identify candidates, patient audiograms from one practice were exported into the screening module.

Assessing Cochlear Implant Outcomes in Older Adults Using HERMES: A National Web-based Database.

Objective: Cochlear implant (CI) outcomes research has been largely limited to retrospective or single-institution studies in the United States. The objective is to demonstrate the feasibility of using a novel, national, web-based CI database through evaluating CI outcomes in older adults.

Study Design: Analysis of a prospective, national, web-based database designed for CI outcome tracking (HERMES; HIPAA-secure, Encrypted, Research Management and Evaluation Solution).

Creating a framework for data sharing in cochlear implant research.

Objectives: To summarize the development process of a national database that was designed to facilitate communication and collaboration, improve care, and create a framework for aggregate data sharing in cochlear implant (CI) research.

Methods: A group of nationally represented, multidisciplinary CI providers cooperated to define a standard set of data elements to incorporate into a database built by them in association with a group of computer scientists and software designers. CI centers across the USA, then, joined the non-profit Auditory Implant Initiative to use the database for their own clinical purposes and to help contribute to the national de-identified dataset for research and analytics.

Clinical evaluation of a bioresorbable implant for medialization of the middle turbinate in sinus surgery.

Background: During endoscopic sinus surgery (ESS), postoperative lateralization of the middle turbinate can lead to scarring and obstruction of key drainage pathways, including the osteomeatal complex. The technique of suturing the middle turbinate to the nasal septum to enhance exposure can be difficult and time consuming. This study presents the first clinical results using the Middle Turbinate Implant (MTI), a device composed of absorbable copolymer polylactide-co-glycolide and intended to medialize the middle turbinate during surgical procedures such as ESS.

Steroids for improving recovery following tonsillectomy in children.

Background: This is an update of a Cochrane Review first published in The Cochrane Library in Issue 1, 2003.Tonsillectomy continues to be one of the most common surgical procedures performed worldwide. Despite advances in anesthetic and surgical techniques, post-tonsillectomy morbidity remains a significant clinical problem.

How does the absence or presence of subglottal medialization affect glottal airflow?

Objectives: Our previous work has shown that the symmetric, smooth, convergent shape of the subglottis reduces turbulent airflow at the glottal entrance. Medialization thyroplasty may alter the glottal shape and is very likely to introduce some degree of glottal asymmetry, which could result in increased turbulence and a reduction in voice quality. This study reports the effects of medializing and not medializing the subglottis in silicone models of human cadaveric larynges.

Comparing quality at an ambulatory surgery center and a hospital-based facility: preliminary findings.

Objective: To measure the quality of outpatient surgery in an ambulatory surgery center (ASC) compared to a hospital-based facility (HBF) in a multidimensional manner.

Study Design: Cross-sectional survey based on chart review.

Setting: Pediatric academic health center.

Spontaneous nasal septal perforation with antiangiogenic bevacizumab therapy.

Otolaryngologists should be made aware of a newer cause of nasal septal perforations resulting from the more recent antiangiogenic therapy used to treat malignancies. This case describes a 52-year-old white woman who developed a spontaneous nasal septal perforation after given the antiangiogenic drug, bevacizumab, for metastatic ovarian cancer treatment. Bevacizumab is a recently developed monoclonal antibody against vascular endothelial growth factor receptor used to inhibit angiogenesis.

Acquired tracheoesophageal fistula following disc-battery ingestion: can we watch and wait?

Acquired tracheoesophageal fistulas (TEF) are rare but dangerous complications of disc-battery ingestion. Management approaches include endoscopic or open surgical repair. Unfortunately, these procedures can be complicated by high rates of recurrent laryngeal nerve injury, tracheal stenosis, recurrent fistula and significant patient mortality.

Patients' commitment to their primary physician and why it matters.

Purpose: The patient-physician relationship is the cornerstone of health care service delivery. The objectives of this study were to assess the contribution of relationship commitment along with trust to patient-physician relationships and to evaluate the association of commitment and trust with adherence to medical advice and healthy eating behaviors.

Methods: To test the proposed model, we developed a questionnaire that included both existing scales and a scale constructed specifically for the study; the questions addressed trust, commitment, adherence to physicians' medical recommendations, and healthy eating behavior.

Neonatal alcohol exposure increases malondialdehyde (MDA) and glutathione (GSH) levels in the developing cerebellum.

It has been suggested that developmental alcohol-induced brain damage is mediated through increases in oxidative stress. In this study, the concentrations of malondialdehyde (MDA) and reduced glutathione (GSH) were measured to indicate alcohol-mediated oxidative stress. In addition, the ability of two known antioxidants, melatonin (MEL) and lazaroid U-83836E (U), to attenuate alcohol-induced oxidative stress was investigated.

Antioxidant pretreatment does not ameliorate alcohol-induced Purkinje cell loss in the developing rat cerebellum.

Background: Recent research has suggested that oxidative stress is a potential mechanism for alcohol-induced injury and that supplementation with antioxidants can ameliorate alcohol-induced damage. In this study, two known antioxidants, melatonin and U83836E, were assessed for their effectiveness in blocking the expected alcohol-induced cerebellar Purkinje cell loss in neonatal rat pups.

Methods: Sprague-Dawley rat pups were artificially reared from postnatal days (PDs) 4-9 and were exposed to either alcohol or antioxidants (melatonin or U83836E) individually or in combination.