Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P91

compared scores for questionnaire items between sessions.
Coaching sessions were analyzed and coded in terms of the
topics and techniques.
Results: Coaching sessions ran from 9 to 21 minutes. Across
subjects, an average of 1.65 ± 0.26 topics were discussed and
1.54 ± 0.49 techniques were used per minute. Surgical technique was discussed most of the time (34%) followed by anatomy (18%). The informing technique was used most often
(30%), followed by providing positive feedback (22.2%).
Residents indicated higher rates of discussion of 10 of the topics and 7 of the techniques during their coaching session compared with their surgical session. This difference approached
statistical significance for discussion of anatomy (8.25 vs
5.75, P = .079), progression (7.75 vs 4.75, P = .069), and utilization of positive (8.5 vs 5, P = .069) and constructive (8.25
vs 5.75, P = .063) feedback.
Conclusions: Mastoidectomy video-based coaching is a low
resource, time-efficient, and educationally dense modality. In
addition to offering perspective, it may promote higher rates of
discussion of anatomy and improve opportunities for feedback.
Chronic Otitis Media: Treatment and
Outcomes of Cholesteatoma in the Elderly
Claudia I. Cabrera, MD, MS (Presenter); Peter Luong, MS;
Victoria Huang; Sarah Mowry, MD
Objectives: The current base of literature on the incidence
and management of chronic otitis media in the elderly
(>65 years) is not robust. Most studies classify only children
and adults, with only a handful categorizing within adults
(younger and older). The aim of this study was to characterize
patients <65 and ≥65 years with cholesteatoma.
Methods: A retrospective review was conducted in adult
patients diagnosed with cholesteatoma at a single academic
medical center. Demographics, clinical characteristics, audiologic data, and treatment choices were reviewed. Variables
included were laterality of the ear involved, initial diagnosis,
treatment, and outcomes. Audiology data included air conduction hearing values used to calculate a pure tone average
(PTA), speech recognition threshold, and word recognition
score. Patients were grouped by age <65 and ≥65 years old.
Values of α < .05 were considered significant.
Results: A total of 150 patients were identified with cholesteatoma; 28 were >65 at time of diagnosis. Serial debridement
was more common in the group aged 65 and older (28% vs
6%, P < .01), and surgery was more common in the <65 group
(92.8% vs 76%, P < .01). Canal wall up was more common
among the younger population (43% vs 21%, P < .01), and
canal wall down was more common among the 65 and older
group (45% vs 24%, P < .001). There was no difference in
tympanoplasty, atticotomy, or canal wall reconstruction mastoidectomy between the groups.
Conclusions: Adults 65 years and older showed a tendency
toward a more complicated chronic ear disease. The additional comorbidities and the hearing loss derived from it
may affect treatment choices. Treatment of the elderly

P91
population must balance the need to address pathology
while mitigating the risks both of surgical and nonsurgical
management options.
Cochlear Implant Hearing Outcome
in Ménière's Disease
Chen-Yu Chien, MD, PhD (Presenter); Barbara Herrmann;
Anan Kulthaveesup; Steven D. Rauch, MD
Objectives: The aim of this retrospective single-institution
study was to evaluate the hearing outcome of cochlear implantation in cases deafened by Ménière's disease.
Methods: Our institutional database of 1500 consecutive
cochlear implant cases was reviewed to identify all cases of
deafness due to Ménière's disease. Twenty-four unilateral and
5 bilateral cochlear implant patients deafened by Ménière's disease were included. Preoperative and postoperative speech recognition scores and medical data were recorded and analyzed.
Results: Postoperative speech reception was significantly
greater than preoperative performance (P < .05). The average
monosyllabic word score of preoperative, and 1, 3, and
6 months, 1 year, and more than 1 year postoperatively were
9.5%, 37.1%, 46.1%, 54.1%, 59.1%, and 66.8%, respectively.
Although cochlear implantation achieved improvement of
monosyllabic word scores in all groups of Ménière patients,
those with no surgery, with endolymphatic sac surgery, and
with labyrinthectomy, the hearing benefit of cochlear implant
fell off steeply as a function of age after age 70. Postoperative
scores in bilateral cochlear implant were not significantly different between the first implanted ear, second implanted ear,
and binaural testing.
Conclusions: Cochlear implant in patients deafened by
Ménière's disease yields significant improvement in word recognition scores regardless of whether patients had received
medical treatment, endolymphatic sac surgery, or labyrinthectomy for their Ménière's disease prior to implantation. The
potential improvement in word recognition scores falls off
steeply as a function of age after age 70.
Cochlear Implantation Outcomes in
Observed Acoustic Neuromas:
A Preliminary Report
Elizabeth D. Stephenson, MD (Presenter); Elizabeth L.
Perkins, MD; Nauman F. Manzoor, MD; Marc L. Bennett, MD;
Alejandro Rivas, MD; Matthew R. O'Malley, MD;
David S. Haynes, MD
Objectives: Over the past decade, there has been a trend toward
observation for nongrowing acoustic neuromas (ANs). Although
serial magnetic resonance imaging (MRI) may demonstrate
minimal change in tumor size, patients may experience hearing
decline over time. Hearing rehabilitation remains challenging,
particularly in those with severe to profound loss. Cochlear
implantation (CI) is a potential option for hearing restoration.
Methods: Retrospective chart review at a tertiary referral
center revealed 808 patients with observed AN. Those who had

Otology/Neurotology

Oral Presentations

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

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