Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P111

function in preclinical models. This preclinical data supported
conducting a randomized, double-blind, placebo-controlled
clinical trial of FX-322 in patients with permanent noiseinduced or sudden sensorineural hearing loss. The first human
evidence of a signal of hearing restoration, as measured by
clinically meaningful improvements in speech intelligibility,
was presented in the late-breaking abstracts program (abstract
1209) at the AAO-HNSF 2019 Annual Meeting & OTO
Experience.
Methods: This noninterventional trial was conducted at 1 private US otolaryngology practice to assess the durability of
improvements in speech intelligibility in patients that showed
improvements at the end of the previous 3-month trial of FX-322.
The trial consented patients for a single clinic visit to assess otoscopy, audiometry, speech intelligibility, and adverse events.
Results: It was previously shown that 4 subjects had
Thornton-Raffin boundary significant improvements in word
recognition scores 3 months after a single intratympanic injection of FX-322. When these subjects returned for testing 12-21
months after FX-322 dosing, three-quarters of subjects had
maintained statistically significant and clinically meaningful
improvements in speech intelligibility.
Conclusions: These finding suggest that the potential regenerative effect of FX-322 is durable for up to 1-2 years in some
subjects. Ongoing clinical trials will further elucidate the
safety and efficacy of FX-322 as a potential regenerative treatment for permanent sensorineural hearing loss.
Trends in Opioid Prescriptions Following
Outpatient Otologic Surgery, 2005-2017
Shayna Portanova Cooperman (Presenter); Zhen Jason
Qian, MD; Michael C. Jin; Jennifer Alyono, MD, MS
Objectives: Previous work suggests patients' opioid intake
following otologic surgery is low compared with other surgery types. Here we investigate national opioid prescribing
patterns following outpatient otologic surgery.
Methods: A retrospective observational study of US health
care claims from 2005 to 2017 was conducted using Optum
Clinformatics DataMart. Perioperative opioid prescriptions
filled for outpatient otologic surgery for 13,108 privately
insured adults were queried. Procedures were categorized as
middle ear (n = 6589) or mastoidectomy (n = 4984) based on
Current Procedural Terminology codes. Multiple regression
was used to determine predictors of postoperative morphine
milligram equivalents (MME), including procedure type,
year of procedure, age, gender, education, income level, and
Elixhauser Comorbidity Index. Linear regression was also
run on a second database that included location information
but could not be linked to socioeconomic data.
Results: The median prescribed perioperative dose was
150 MMEs (interquartile range [IQR] = 125-224). Patients who
underwent mastoidectomy filled 25.0 MME more than middle
ear patients (P < .001, 95% CI, 21.15-28.92). Significant differences in MME filled were seen by age, sex, race, and educational attainment but not income level. Opioid quantity was also
significantly associated with geographic region, with the

P111
highest quantities filled in the southeast (193.84 MMEs, SD =
101.04) and lowest in the west (172.45, SD = 97.90). Nationally,
filled opioids increased from 2005 to 2015 and declined from
2015 to 2017.
Conclusions: Although the number of opioids filled perioperatively has declined in recent years, otologists should continue to be cognizant of potential overprescribing in light of
previous studies of patients' relatively low opioid intake.
Trends in Use and Timing of Intratympanic
Corticosteroid Injections for Newly Diagnosed
Sudden Sensorineural Hearing Loss
Michael C. Jin (Presenter); Zhen Jason Qian, MD; Shayna
Portanova Cooperman; Jennifer Alyono, MD, MS
Objectives: Oral steroids is a treatment mainstay for idiopathic sudden sensorineural hearing loss (SSNHL). Recent
studies suggest intratympanic (IT) steroid injections may be
effective as an alternate or adjunctive therapy. We investigated
nationwide trends in treatment patterns for SSNHL
Methods: The Truven MarketScan Database, a nationwide
claims data set, was canvassed for patients with SSNHL.
Inclusion required at least 2 audiologic tests within 30 days of
diagnosis, 1 corticosteroid treatment within 6 months of diagnosis, and continuous follow-up for 30 days prior and 180 days
after diagnosis. Multiple regression was used to assess trends
in treatment timing.
Results: A total of 23,479 SSNHL patients were identified
between 2007 and 2016. Of all patients, 85.9% received oral
steroids, 29.6% received IT steroids, and 15.5% received both.
In patients receiving oral steroids, a median of 32 days (interquartile range [IQR] 18-56) was prescribed. Patients receiving
IT steroids received a median of 1 (IQR 1-4) injections.
Between 2007 and 2016, IT steroid use increased from 17.3%
to 36.3% (R = 0.98, P < .001), whereas oral steroid use
decreased from 90.9% to 83.6% (R = −0.92, P < .001).
Bimodal steroid use increased from 8.2% to 19.9% (R = 0.97,
P < .001). Prior to 2011, patients receiving IT steroids rarely
received multiple injections (13.0%) but increased significantly after 2011 (14.2%-61.2%). Time to first injection has
decreased from 20.4 days to 10.4 days (R = −0.79, P = .007).
After adjusting for age and sex, a trend toward earlier IT steroid administration (P < .001), but not oral steroid administration (P = .837), was observed.
Conclusions: SSNHL management increasingly involves
early IT steroids, particularly repeat treatments, as an alternative or adjunctive option to oral steroids.
Understanding Residual Hearing Loss After Total
Drum Replacement Tympanoplasty Studied With
Wideband Acoustic Immittance
Kristine Elisabeth Eberhard (Presenter); Salwa Fatima Masud;
Hamza Khalid; Aaron K. Remenschneider, MD, MPH;
Hideko H. Nakajima, MD, PhD
Objectives: Despite total drum replacement tympanoplasty's high rates of perforation closure, about 20% to 60%

Otology/Neurotology

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

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