Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P227

Poster Presentations

Conversion of Baha Connect to Baha
Attract: Our Surgical Experience
Andrea L. Gentile (Presenter); C. Bruce MacDonald, MD
Objectives: To review our clinical and surgical experience in
exchanging the Baha Connect to the Baha Attract.
Methods: This study is a retrospective chart review and a tertiary referral center of a single surgeon from 2007 to 2016.
Twelve patients who had previously undergone placement of a
Baha Connect who then underwent conversion to a Baha Attract
were reviewed. The following data were collected: type of hearing loss, type of Baha Connect surgery, number of revision surgeries for Baha Connect, age at conversion, reason for conversion,
and time from placement of Baha Connect to the conversion.
Results: Five patients had the abutments removed in clinic
and allowed the hole to close prior to surgery. Seven patients
had the abutment removed at the time of surgery. In 11 of
12 patients, we were able to use the previously placed implant
to attach the new magnet and screw.
Conclusions: Currently there is no standardized protocol for
converting the Baha Connect to the Baha Attract. Removing
the abutment prior to surgery is our preferred method because
of the potential complications when dealing with the thin skin
flap at the time of surgery. However, we had no serious complications with either method and determined that either were
viable options depending on patient and surgeon preference.

Correlation Between Facial Anatomy
Variances and the Incidence of Artifacts
During Video Head Impulse Test
Kwang Hyun Byun (Presenter); Ji Eun Choi, MD;
Jae Yun Jung; Min Young Lee, MD, PhD
Objectives: Video Head Impulse Test (VHIT) is a useful test
that can quantitatively measure the gain of vestibular ocular
reflex (VOR) from the semicircular canal and confirm the
presence of corrective saccade eye movement. However, the
head rotational speed and eye movement of the patients are
measured with accelerometers and imaging devices attached to
the goggles, which can lead to inappropriate errors depending
on the inspector's proficiency. In this study, we looked at the
errors in VHIT and their associations with facial structures.
Methods: Nine healthy adults without any vertigo history
were chosen for prospective study. Facial photos of subjects
were taken, and head ratio, centralization ratio (interpupil distance/interzygoma distance), glabella and rhinion height ratio,
and rhinion and nasal tip height ratio were measured. After
facial parameter measurement, experienced and nonexperienced inspectors performed VHIT on each subject to collect
artifacts such as rejection ratio, rebound ratio, and notch duration ratio.
Results: Frequently observed errors (rejection ratio, notch
duration ratio, rebound ratio) showed no significant correlation with head ratio or centralization ratio. Although each
inspector's VHIT artifacts differed by facial structures, the
lower rhinion or nasal tip height led to more artifacts. The
pupil ratio was correlated with artifacts only in the measurement of horizontal semicircular canals.
Conclusions: With this study, we could conclude that certain
artifact incidences are related to some facial structures, but
correlations may vary depending on the proficiency of the
inspectors, which is expected to require more detailed research
in the future.
Data Logging in Cochlear Implant Patients:
A Retrospective Study of Daily Device Use
and Speech Perception Outcomes
Sarah Ridge (Presenter); Dana Egra-Dagan, MSc;
Elliott D. Kozin, MD; Daniel J. Lee, MD;
Kevin Franck, PhD, MBA
Objectives: Cochlear implant (CI) technology provides variable improvement in sound and speech perception to patients
with hearing loss (HL). In this study, we use CI data log analysis to investigate factors that may affect speech perception
outcomes (aim 1) and daily device use (aim 2).
Methods: A retrospective review was performed using CI
data logs from clinical software databases at a tertiary referral
hospital. The most recent data logs of 167 patients, dated 2013
to 2018, were analyzed. The study population included unilateral CI users, age 7 years or older at implantation, who have
CI processor data logs spanning at least 30 days. Speech perception score (consonant-nucleus-consonant [CNC] word recognition) and hours of daily CI use were the main outcomes

Otology/Neurotology

intratemporal complications. The lateral semicircular canal is
the most commonly affected site. Traditional repair of
cholesteatoma-induced labyrinthine fistulas involved leaving
cholesteatoma matrix intact over the fistula and more frequent
utilization of canal-wall-down (CWD) mastoidectomy.
Multiple factors influence operative strategy, including symptoms, fistula size, other associated complications, status of the
contralateral ear, overall health, and feasibility of staged procedures. This study describes 1 institution's experience in
management of labyrinthine fistulas utilizing more frequent
conservative approaches (canal-wall-up [CWU]).
Methods: After institutional review board approval, retrospective chart review for key terms such as labyrinthine fistula, chronic otitis media, and cholesteatoma was conducted
from 2012 to 2017. Cases involving cholesteatoma and labyrinthine fistula were analyzed.
Results: Twenty-one cases of cholesteatoma-induced labyrinthine fistula were identified, of which 12 (57%) were
revision cases. Cholesteatoma involved mesotympanum, retrotympanum, epitympanum, and antrum in 90% of cases; protympanum in 38% of cases; and hypotympanum in 29% of
cases. Fistula was identified preoperatively in 56% of cases.
Fifteen (71%) cases underwent a CWU mastoidectomy. Six
(29%) cases required CWD. Fourteen of 16 (87.5%) ears with
pre- and postoperative audiograms maintained serviceable
hearing, 10 (71%) of which were CWU.
Conclusions: This study highlights more frequent use of
CWU approach and staged surgeries in patients with labyrinthine fistulas. This strategy can be safely used in appropriately
selected patients with reliable follow-up.

P227

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

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