Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P214

P214
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.
cutting/piercing instrument (10%, 9/90), unarmed fight/brawl
(10%, 9/90), and assault by firearm/explosive (8.9%, 8/90).
Unintentional injuries accounted for 55.56% (50/90), whereas
6.67% (6/90) of injuries were self-inflicted. Blunt trauma was
responsible for 67.78% (61/90) of injuries, whereas 31.11%
(28/90) of cases were due to penetrating trauma.
Conclusions: Although relatively rare, laryngeal trauma is
associated with serious injury. An understanding of laryngeal
trauma may be important for evaluating existing and developing novel initiatives for injury treatment and prevention.
Etiologies and Risk Factors of Dysphonia:
A Retrospective Study of 998 Patients
Feras Mohammed Alkholaiwi, MD (Presenter)

Laryngology

Objectives: This study aimed to identify the etiologies and
risk factors of dysphonia in a treatment-seeking population.
Methods: A retrospective study, conducted from January
2013 to December 2017, included 998 patients who presented
for the first time to the otolaryngology clinic complaining of
dysphonia. Video laryngeal stroboscopy was performed on all
the patients. Information about the patients' age, sex, occupation, smoking history, and laryngeal pathology was included.
Patients were divided into the following age groups: 0 to
14 years (childhood), 15 to 24 years (adolescence), 25 to
44 years (young adulthood), 45 to 64 years (late adulthood),
and >65 years (seniors).
Results: In the 998 patients, the male-to-female ratio was
48:52, and 16% of the patients were smokers. Most of the
patients (37%) were in the 45 to 64 age group, 31% were in
the 25 to 44 age group, and 16% were 64 or older. Housewife
was the most frequent occupation (28.3%). Vocal fold polyps
(13.5%), vocal fold cysts (12.4%), gastroesophageal reflux
disease (GERD; 11.1%), and vocal fold paralysis (9.8%) were
the most common etiologies in the study. Nodules were more
common in women than men (13.8% vs 1.4%). Reinke's
edema was the dominant etiology in smokers (18.5%).
Velopharyngeal incompetence was the most common etiology
in children aged 14 or younger.
Conclusions: Vocal fold polyps, cysts, and GERD were the
dominant etiologies in this study. Most of the patients seeking
medical attention for dysphonia in this study were in the 45 to
64 age group. Vocal fold paralysis was the dominant etiology
in the patients that were retired.
Evaluation of Current Procedural Trends for
Laryngotracheal Stenosis Management in
Medicare Patients From 2010 to 2018
Debbie Rachel Pan, MD (Presenter)
Objectives: In-office procedures, such as intralesional steroid injections, are becoming increasingly used in the treatment of laryngotracheal stenosis (LTS). In the 2017 Current
Procedural Terminology (CPT) code set, new codes were
introduced for reporting therapeutic injections and specific
open treatment options for LTS. The aim of this study is to

characterize procedural trends in LTS management among
Medicare recipients from 2010 to 2018.
Methods: Annual Medicare Part B National Summary Data
Files were analyzed for CPT codes from 2010 to 2018 related
to LTS. Procedures analyzed included office-based therapeutic injections (31573), operative endoscopic dilations (31641
and 31528-9), and open tracheal resections (31780 and
31551-4).
Results: The number of open excisions remained constant
(97-100, 1.3% average annual growth), whereas endoscopic
dilations increased (3784-5796, 6.3% average annual growth).
When initial and subsequent endoscopic dilation procedures
were compared, there was no statistically significant difference
between average annual increase before and after the year
2016 for initial endoscopic dilations (P = .2518). However, the
average annual increase in subsequent endoscopic dilations
significantly dropped from 20.3% to 1.9% (P = .0093) after the
year 2016. The average payment per open excision surgery
was $788.70 compared with endoscopic dilation at $183.55
and therapeutic injections with laryngoscopy at $199.77.
Conclusions: The number of endoscopic dilations increased
from 2010 to 2018, outpacing open tracheal resection surgeries. Considering recent trends toward office-based therapeutic
injections reflected in new CPT codes, there is a correlating,
appreciable decline in the annual growth rate for repeat endoscopic dilation procedures.
Evaluation of Dysphagia After Anterior
Cervical Discectomy and Fusion
Rachel Kominsky, MD (Presenter); Claudia I. Cabrera, MD, MS;
Nelson Scott Howard, MD
Objectives: Dysphagia is a known complication after anterior cervical discectomy and fusion (ACDF), with an incidence up to 71% within the first 2 weeks after surgery and
12% to 14% of patients developing dysphagia greater than
1 year. There has not been a comparison made in incidence of
dysphagia in patients undergoing an equivalent surgery that is
not performed on the neck. Furthermore, the evaluation of
dysphagia after neck surgery has not been compared with the
evaluation of dysphagia after a surgery performed elsewhere.
Methods: A retrospective chart review was conducted at an
academic medical center to include patients who between
January 2014 and December 2019 carried a diagnosis of lumbar spinal fusion and dysphagia or cervical spinal fusion and
dysphagia. Chart review was performed to further characterize each patient's dysphagia, and its evaluation.
Results: In the time frame of the study, a total of 740 patients
had undergone either a lumbar spinal fusion surgery or a cervical spinal fusion surgery. There were 290 patients who had a
lumbar spinal fusion, with 10.3% who also experienced dysphagia. There were 450 patients who underwent an ACDF,
with 17.7% also diagnosed with dysphagia. In the lumbar spinal fusion and dysphagia group, 16% underwent a bedside
swallow evaluation, 16% underwent a modified barium swallow study (MBSS), and 3% underwent an esophagram. In the

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

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