Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P98

Otology/Neurotology

P98
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.
pathogenic genetic variants in a large cohort of adults and
to outcomes under general anesthesia. Although we report the
children with cochlear implants.
largest sample size to date, the 2 groups in this study are not
Methods: A prospective study was conducted in which all
uniform, leaving potential for sampling bias. Further study on
patients undergoing cochlear implantation at the University of
the risks and benefits of local anesthesia for stapes surgery is
Iowa were evaluated for genetic variants in all genes known to
needed.
be associated with nonsyndromic hearing loss, as well as several genes implicated in common syndromes. Genes were
Hearing Preservation Outcomes Following
interrogated by massively parallel sequencing using the
Implantation With New Flexible Lateral Wall Array
OtoSCOPE panel. Clinical data included demographic data,
Abhinav Ettyreddy, MD (Presenter); Nedim Durakovic, MD;
pattern of hearing loss, age at onset of hearing loss, newborn
Noel Dwyer, AuD; Jonathan McJunkin, MD; Cameron C.
hearing screen results, age at first implant, model of implant,
Wick, MD; Jacques A. Herzog, MD; Craig A. Buchman, MD
laterality, and preoperative imaging results.
Objectives: With advances in electrode design and surgical
Results: A total of 459 patients with cochlear implants
technique, hearing preservation has become an important
underwent genetic testing. One hundred underwent cochlear
aspect in cochlear implant surgery. In this study, we assess
implantation as children (age 18 or under). A total of 128 had
hearing preservation outcomes with a new flexible, lateral
positive genetic testing results, and the remaining 331 were
wall array (HiFocus SlimJ).
negative. In total, 46 genes were identified as carrying pathoMethods: A retrospective review was conducted of patients
genic or likely pathogenic genetic variants. The top 5 genes
>18 years of age who underwent implantation with the
implicated were GJB2 (20 patients, 16%), TMPRSS3 (13,
HiFocus SlimJ electrode between January 2018 and January
10%), SLC26A4 (10, 8%), MYO7A (9, 7%), and POU4F3 (6,
2020 at a tertiary care hospital. Primary outcome measures
5%). Pediatric patients had a higher diagnostic rate.
included preoperative/postoperative audiometric data and
Conclusions: To our knowledge, this data set of cochlear
imaging findings.
implant users is the largest to include comprehensive genetic
Results: Eighteen patients were included in the study, with a
testing and as such lays the groundwork for additional studies
mean age of 68 years (range, 24-84 years). All patients underon the relationship between genetic variation and cochlear
went a round window implantation and, 16 of 18 (89%) had a
implant performance.
full insertion. There were no tip-rolls on x-ray. Postoperative
computed tomography scan demonstrated a mean apical inserHearing Outcomes and Complications in
tion angle of 406.6° (SD = 44.2°) with no scala vestibuli transStapes Surgery for Otosclerosis Performed
locations. Hearing preservation was defined as thresholds <80
Under General or Local Anesthesia
dB at 125, 250, or 500 Hz. Twelve patients (12/18, 67.7%) had
Alexander L. Luryi, MD (Presenter); Amy E. Schettino;
partial low-frequency hearing preservation. Among these
Seilesh Babu, MD; Dennis Bojrab, MD; Elias M.
patients, the average preoperative low-frequency pure tone
Michaelides, MD; Christopher A. Schutt, MD
average was 46.1 dB (SD = 15.25) with a threshold shift to
Objectives: Stapes surgery is highly successful in reducing or
75.2 dB (SD = 20.1) postoperatively. The mean 3-month coneliminating the audiometric air-bone gap (ABG) related to otosonant-nucleus-consonant (CNC) score was 44.3% (n = 14,
sclerosis and can be performed under local or general anesthesia.
SD = 26.9) compared with 11.9% (n = 18, SD = 10.6) preoperaLiterature on relative outcomes of these 2 methods is lacking.
tively. For patients with hearing preservation, the mean 3-month
Methods: A retrospective review of primary stapes surgery
CNC scores were 47.8% (n = 9, SD = 23.7) whereas those withfor otosclerosis at a large otology referral center from 2005 to
out preservation were 38.2% (n = 5, SD = 34.1, P = .5).
2017 was conducted, grouping patients by the use of local vs
Conclusions: The HiFocus SlimJ electrode allows for heargeneral anesthesia. Preoperative and postoperative ABGs
ing preservation with low rates of electrode translocation.
were primary measures.
Further research is needed to determine intraoperative factors
Results: A total of 508 patients undergoing stapes surgery
that may help predict and improve hearing preservation rates.
were included; 28% underwent stapes surgery under local
anesthesia and 72% received general anesthesia. Patients
Histopathological Assessment of Schwannoma
receiving local anesthesia were more likely to be older than
Development in the Geniculate Ganglion of a
70 years (11% vs 4%, P = .002) and were more likely to be
Genetically Engineered NF2 Mouse Model
female (70% vs 61%, P = .03). Mean preoperative ABGs
Shabnam Ghazizadeh, MD (Presenter); Marco M.
were 24.1 and 26.4 dB for patients undergoing local and genGiovannini, MD, PhD; Jeremie Vitte, PhD; Maie St. John, MD, PhD
eral anesthesia, respectively (P = .03). Mean postoperative
ABGs were 11.7 and 9.8 dB for patients undergoing local and
Objectives: The geniculate ganglion fossa is the most comgeneral anesthesia, respectively (P = .02). Postoperative prosmon site for occurrence of facial nerve schwannomas in
thesis displacement was more common in the local anesthesia
humans. Because no systemic therapies are currently available
group (5.6% vs 0.8%, P = .001).
to treat such tumors, xenograft models can be extremely helpConclusions: Contrary to limited prior data, hearing outcomes
ful in facilitating the development and evaluation of novel
following stapes surgery under local anesthesia may be inferior
therapeutic agents in preclinical trials. An understanding of the

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

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