Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P104

Otology/Neurotology

P104
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.
intact tympanic membrane (TM). Herein, we report on the
Three cases of middle ear cholesteatoma history (type I/II)
feasibility of incus and umbo OCT-DV measurements coland 1 case of ear canal cholesteatoma (type III) were reported.
lected in awake human subjects with normal hearing.
Conclusions: CHL, bifid uvula/cleft palate, and TM perforaMethods: Patients with normal hearing, confirmed via
tions after PET placement are more common in type I and II
threshold audiometry, were included. OCT-DV was used to
LDS compared with types III and IV. Patients with type I and II
measure sound-induced ossicular displacement. Measurements,
LDS should undergo early and regular audio-otologic evaluation
normalized by ear canal pressure, were obtained at the umbo and
and receive appropriate management for middle ear pathologies
incus in response to 390- and 781-Hz stimulus tones. Feasibility
while understanding the wide clinical spectrum of LDS.
of measurements across subjects and mean normalized umbo
and incus peak-to-peak displacements were analyzed.
Otologic Findings in Staff Members With
Results: Bilateral OCT-DV was performed on 19 subjects.
Extended Use of Powered Air-Purifying
At 390 Hz, 30 umbo and 29 incus measurements were obtained
Respirators
(79% and 76% of total study population, respectively). At
Emily K. Gall, MD (Presenter); Samih J. Nassif, MD; Jonathon
781 Hz, 37 umbo and 33 incus measurements were obtained
Sillman, MD; Alison Schlothauer, AuD; Susan McDonald, MA;
(97% and 87% of the total study population, respectively).
Kathryn Y. Noonan, MD
Mean normalized displacement at the umbo was 77.8 ± 41.2
Objectives: (1) Characterize the different types of otologic
nm/Pa at 390 Hz and 81.5 ± 41.0 nm/Pa at 781 Hz. Mean norsymptoms
in frontline staff with prolonged powered airmalized displacement at the incus was 42.3 ± 21.3 nm/Pa at
purifying
respirator
(PAPR) use. (2) Quantify changes in hear390 Hz and 35.9 ± 21.1 nm/Pa at 781 Hz. The ratio of umbo to
ing
thresholds
as
determined
by audiometry in frontline staff
incus normalized displacement was 2.1 ± 1.3 at 390 Hz (n =
with
prolonged
PAPR
use.
(3)
Evaluate the effect of aural
25 ears) and 2.9 ± 1.9 at 781 Hz (n = 32 ears).
protection
on
both
symptom
persistence
and reversal of audioConclusions: OCT-DV is a promising tool to noninvasively
metric
threshold
shifts.
assess ossicular mobility in the clinical setting in most patients.
Methods: This is a prospective study of hearing loss in hosFuture use of OCT-DV to assess umbo to incus velocity ratio may
pital
staff wearing PAPR, occurring from May 2020 to June
assist in the diagnosis and localization of conductive hearing loss.
2020. Subjects underwent audiograms, as well as an otologic
exam to detail their symptoms, time wearing PAPR, and use of
Otologic and Audiologic Manifestations
ear plugs. Outcome measures were hearing changes on audioin Loeys-Dietz Syndrome
gram and symptoms of tinnitus, increased hearing difficulty,
Jun Woo Jeon (Presenter); Julie Christensen, MS;
or aural fullness.
Christopher K. Zalewski, PhD; Jennifer Chisholm;
Results: Eight staff members with PAPR exposure underAlaina Magnani; Caeden Dempsey; Marjohn Rasooly;
went
a standard audiometric evaluation. Tinnitus was reported
Pamela Guerrerio, MD, PhD; Carmen C. Brewer, PhD;
by
6
staff
members, aural fullness by 4, and temporary hearing
Hung J. Kim, MD
loss by 3. PAPR noise levels measured inside and outside the
Objectives: Loeys-Dietz syndrome (LDS) is a rare, genetic
hood were 87 dB HL and 78 dB HL, respectively. The longest
connective tissue disorder characterized by a wide spectrum of
continuous use was 5 hours and the longest cumulative daily
aortic aneurysm, arterial tortuosity, and various extravascular
use was 10 hours. Three staff had evidence of mild sensoriabnormalities. This study describes the audio-otologic manineural noise notch or hearing loss. Afterwards, staff members
festations of LDS within its subtypes.
were counseled to reduce length of PAPR use and commence
Methods: Audiologic and otologic evaluations were proear plug use. Decreased symptoms and improvement in hearspectively conducted on 32 patients (64 ears; ages 2-60 years;
ing were noted on repeat evaluation.
22 male) with genetically confirmed LDS between July 2018
Conclusions: Extended PAPR use without aural protection
and October 2019 at a tertiary research medical center. Patients
may be associated with the development of tinnitus and poswere categorized by LDS subtypes (I-IV) based on affected
sibly temporary threshold shifts. Health care professionals
genes (TGFBR1, TGFBR2, SMAD3, or TGFB2, respectively).
should be counseled appropriately for the duration of the panClinical and audiometric characteristics including degree/type
demic to prevent permanent hearing loss.
of hearing loss (conductive [CHL] or sensorineural [SNHL])
were analyzed.
Otopathologic Findings in Temporal Bones
Results: LDS types I to IV included 11, 10, 4, and 7 patients,
From Patients With CHARGE Syndrome
respectively. A total of 13 ears (20.3%: 11 CHL and 2 SNHL)
Rafael C. Monsanto, MD (Presenter); Renata Malimpensa
had hearing loss. CHL was detected in type I (8 ears [36%];
Knoll, MD; Norma de Oliveira Penido, MD, PhD;
4 mild/4 moderate) and type II (3 ears [15%]; 2 mild/1 moderMio Uchiyama; Grace Park; Michael M. Paparella, MD;
ate), and there was 1 ear with mild SNHL each in type III and
Sebahattin Cureoglu, MD
IV. Bifid uvula and/or cleft palate were present in 7 (64%)
Objectives: CHARGE syndrome is a rare polymalformative
type I and 5 (50%) type II patients. Five of 9 patients in type I/
disease associated with several otologic problems. Data
II with a history of pressure ear tube (PET) placement ended
regarding otopathologic changes in CHARGE syndrome are
up with nonhealing tympanic membrane (TM) perforations.

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

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