Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P164

P164
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
surgical correction is technically difficult and associated with
the inherent risks of operative intervention, and conservative
therapy often does not completely relieve patient symptoms.
The magnetic septal button was introduced in 2012, is easily
placed in clinic with topical anesthesia, and is an excellent
alternative for patients desiring nonsurgical management. The
purpose of this study is to report on patient satisfaction and
symptom improvement following placement of magnetic septal prosthesis.
Methods: A retrospective review was performed of patients
who underwent placement of a prefabricated magnetic septal
button between September 2017 and January 2019. A 3-month
postinsertion survey was used to assess subjective symptom
improvement and satisfaction with the button. A modification
to a previously published survey using a 1 to 6 scale, with
lower scores representing improvement in symptoms and
higher scores representing worsened symptoms, was used.
Results: Twelve patients were identified with full completion of the 3-month postinsertion survey. Average symptom
scores were nasal breathing (2.17 ± 1.28), crusting (2.75 ±
1.87), and epistaxis (2.08 ± 0.95), indicating moderate symptom improvement. The overall satisfaction score was 2.17 ±
1.14, corresponding to moderate satisfaction.
Conclusions: Magnetic septal buttons are a well-tolerated,
low-risk management option for nasal septal perforations and
may be considered as first-line treatment for patients electing
nonsurgical management.

Comprehensive

Ultrasound Elastography: A Novel
Technique to Detect Parotid Ductal Stenosis
Philippe L. Katz, MD (Presenter); Sam J. Daniel, MD
Objectives: Elastography, the computation of the spatial
variation of the elastic modulus of tissue, is an emerging medical imaging technique. Simply put, it examines tissue by
assessing its elasticity or rigidity. There are scarce data in the
literature on the use of elastography in salivary gland assessment. The purpose of our study was to compare standard
B-mode and Doppler ultrasonography with sonoelastography
in a population of patients with parotid obstructive symptoms
to compare these imaging modalities as we follow a large
cohort of patients with nonsialolithic obstructive pathology.
Methods: This is a retrospective review of a database on a
cohort of 75 patients presenting with parotid obstructive
symptoms examined between October 2014 and October 2017
by the senior author (P.L.K.). Data included findings from a
complete ultrasonography examination performed in B mode,
along with a color Doppler and elastography of both the symptomatic gland and the contralateral side. All examinations
were performed with an ultrasound machine Acuson S 2000
equipped with the program eSie Touch Elastography (Siemens
Ltd) and a probe of 9 MHz.
Results: There were 56 women and 19 men. The age range
was 25 to 63 years. All patients presented with signs of salivary
flow obstruction without lithiasis. All patients were initially
assessed with B-mode ultrasonography and Doppler and then

examined by sonoelastography. All patients had clearly visible
stenotic and dilated Stensen ducts segments with elastography
despite being poorly visible with B-mode ultrasonography.
Conclusions: Based on the results of this cohort, ultrasound
elastography sheds new light on the imaging of parotid ductal
pathology, allowing a more rapid and precise diagnosis than
any other imaging modality.
Unilateral Cochlear Implants for Bilateral
Severe, Profound, or Moderate Sloping to
Profound Sensorineural Hearing Loss
Craig A. Buchman, MD (Presenter); Brian A. Kaplan, MD
Objectives: Using a modified Delphi consensus process, our
group developed a series of consensus statements regarding
the use of unilateral cochlear implants (CIs) in adults with
severe, profound, or moderate sloping to profound bilateral
sensorineural hearing loss (SNHL). Here we present the process used and the final consensus statements.
Methods: The Delphi Consensus Group consists of 30 international (CI) experts. Statements were developed based on evidence identified from a systematic literature review. The
identified publications were screened manually against prespecified eligibility criteria, and relevant data were extracted from
included studies. A modified 3-step Delphi consensus process
was used to vote on and refine the statements, consisting of 2
rounds of questionnaires and a face-to-face meeting at a final
round. Consensus was defined a priori as agreement by at least
75% of respondents. At each round, the panel reviewed those
statements that had not yet reached the agreement threshold and
marked their level of agreement according to a 6-point Likert
response scale. Panel members were also invited to provide freetext comments on each statement. All statements were reviewed
and discussed at the face-to-face meeting.
Results: The Delphi Consensus Group has developed 20 consensus statements on the use of unilateral CI in adults with SNHL.
These statements provide recommendations on CI awareness (1);
diagnosis (3); surgical implications (2); clinical outcomes (7);
rehabilitation (1); association of hearing loss with cognition,
depression, and social isolation (5); and cost-effectiveness (1).
Conclusions: These consensus statements represent the first
step in the development of a set of international guidelines on
best practice for CI in adults with SNHL.
Visualization of the Subglottis by Transnasal
Fiberoptic Laryngoscopy: Does an Optimal
Posture Exist?
Julie A. Highland, MD (Presenter); Vanessa F. Torrecillas, MD;
Travis J. Haller, MD; Billie Bixby, MD; Aidin Iravani, MD;
Marshall E. Smith, MD
Objectives: During in-office laryngoscopy, a more distal
view of the subglottis and trachea is important, especially for
dyspnea workup and cancer staging, but visualization studies
are limited. This study seeks to assess the effect of discrete
posturing maneuvers during laryngoscopy for optimal visualization of the subglottic airway.

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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