Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P90

Otology/Neurotology

P90
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.
Methods: A retrospective review of primary stapes surgeries
hearing loss, and downward-sloping and "inverted U" audioperformed for otosclerosis from 2005 to 2017 at a large otology
metric curves significantly associated with worse prognosis of
referral center was conducted. Patients were divided into groups
hearing recovery following unilateral SSNHL.
based on their self-reported duration of hearing loss. Closure of
the air-bone gap (ABG) was the primary outcome measure.
Audiometric Outcomes Following Medial Graft
Results: A total of 508 patients undergoing stapes surgery
Tympanoplasty Using Loose Areolar Fascia
were included: 33%, 22%, 27%, and 18% had had hearing loss
Yin Ren, MD, PhD (Presenter); Kareem O. Tawfik, MD;
for <5 years, 5 to 10 years, 10 to 20 years, and >20 years,
Roberto A. Cueva, MD
respectively. Mean preoperative ABGs were 24.3, 26.9, 26.8,
Objectives: Persistent high-frequency conductive hearing
and 25.7 dB, respectively (P > .05), and mean postoperative
after tympanoplasty using temporalis fascia has been reported
ABGs were 9.3, 9.7, 11.0, and 12.2 dB, respectively (P = .01),
and may be related to structural properties of the reconstructed
for hearing loss duration of <5 years, 5 to 10 years, 10 to 20
tympanic membrane. Here, we aim to examine the audiometyears, and >20 years. There were no significant associations
ric outcomes after tympanic membrane perforation repair
between the duration of hearing loss and complication rates or
using areolar temporalis fascia.
the need for revision surgery.
Methods: A retrospective review of patients with tympanic
Conclusions: Although otosclerosis with longer duration of
membrane perforations undergoing tympanoplasty (with and
hearing loss may be associated with slightly poorer closure of
without mastoidectomy) at a tertiary referral center from
the ABG, surgical intervention remains worthwhile for these
July 2017 to August 2019 was performed. Demographics,
patients. Although far advanced otosclerosis has known poorer
-frequency-specific pure tone average (PTA) and air-bone gap
outcomes with stapes surgery, the duration of hearing loss is
(ABG), and perforation closure rates were examined.
an unreliable surrogate for this.
Results: A total of 115 patients were identified, and 83 had
complete data for analysis. The average age was 46 years with
Audiological and Clinical Profile of Sudden
a mean follow-up of 7.8 months. There were 59 (71%) priSensorineural Hearing Loss Patients:
mary repairs and 26 (29%) revisions. Loose areolar fascia was
Correlation With Hearing Prognosis
used as the graft material in 69% cases. The rate of successful
Rafael C. Monsanto, MD (Presenter); Adriana Perez Ferreira
perforation closure was 96% (92% in revision cases). Mean
Neto, MD; Line Dore Saint Jean; Lucas Sonzzini Ribeiro de
preoperative PTA was 44.1 ± 16.4 dB, which improved to 34.0
Souza; Norma de Oliveira Penido, MD, PhD
± 16.1 dB after surgery (P < .001), whereas the mean preopObjectives: Sudden sensorineural hearing loss (SSNHL) is a
erative ABG was 24.4 ± 9.8 dB and improved to 14.9 ± 9.8 dB
multifactorial and heterogeneous disorder. We aimed to char(P < .001). Significant ABG improvements occurred at both
acterize the audiological and clinical presentation of SSNHL
low frequencies (28.5 vs 15.9 dB, P < .001) and at 4000 Hz
and evaluate potential prognostic factors related to hearing
(23.4 vs 19.2 dB, P = .02). On multivariate analysis, a smaller
recovery.
preoperative ABG was associated with better postoperative
Methods: We performed a cohort study including 373 patients
ABG (P = .001).
from our institution's otology outpatient clinic who were diagConclusions: The use of loose areolar fascia for primary and
nosed with unilateral SSNHL over 20 years. All patients underrevision tympanoplasties has a high success rate of 96% and
went a standardized audiometric and clinical evaluation and
92%, respectively. It results in significant ABG closure at both
received high doses of oral prednisone or deflazacort as treatlow and high frequencies. A smaller preoperative ABG is prement. We collected patient information including age, sex,
dictive of better postoperative audiometric outcomes.
time between the onset of symptoms and the beginning of
treatment, associated symptoms, type of audiometric curve,
Broadening the Otologic Surgical Teaching
and degree of hearing loss. Using statistical analyses, we evalRepertoire With Video-Based Coaching
uated potential clinical factors that could correlate with the
Mallory J. Raymond (Presenter); Kareem Al-Mulki;
prognosis of hearing recovery.
Matthew Studer
Results: Unilateral SSNHL occurred in male and female
Objectives: Otologic surgical teaching is challenging, and
patients equally, more frequently in the age range of 40 to
resident operative experience often requires supplementation
60 years. Most patients had significant improvement in hearing
with other modalities. Video-based coaching is a novel tool
threshold and discrimination scores after 30 days of treatment
that may complement traditional teaching methods.
(P < .001). Several factors significantly associated with worse
Methods: In this mixed-methods pilot design, mastoidechearing recovery prognosis, including the beginning of treattomies performed by 8 otolaryngology residents were
ment after 15 days of hearing loss onset, the presence of vertigo,
recorded from operative microscopes at tertiary care centers
worse degrees of hearing loss and lower discrimination scores
and reviewed during coaching sessions with attendings.
in the initial audiogram, and the presence of downward-sloping
Residents completed a questionnaire on the degree to which
and "inverted U" curves in the initial audiogram (P < .05).
attendings discussed 12 topics and used 8 techniques both
Conclusions: Initiating treatment after 15 days of hearing
after their surgical and coaching sessions. Paired t tests
loss onset, the presence of vertigo, the severity of the initial

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

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