Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P126

Pediatric

P126
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.
Results: Thirty-five children at an average age of 11.1 years
Factors Impacting Parental Pursuit of
(SD, 3.4) met inclusion. Most presented with an epidural
Genetic Testing for Pediatric Patients With
abscess (37.1%). Hospitalizations lasted 12.9 days (SD, 7.7),
Bilateral Sensorineural Hearing Loss
45.7% required a second surgery, 11.4% required 3 or more
Audrey Schlachter (Presenter); Ching Siong; Dillon Davis;
surgeries, and 31.4% were readmitted within 60 days. Initial
Lauren Lichten, MS; Kavita K. Dedhia, MD
surgery for 28.6% included endoscopic frontal sinusotomy
Objectives: Hearing loss is the most common sensory deficit
with craniotomy, 34.3% had endoscopic sinus surgery without
in
the
United States, and up to 68% is due to a genetic etiolfrontal sinusotomy and frontal sinus cranialization, and 37.1%
ogy.
With
more than 115 genes identified in sensorineural
had either an endoscopic or neurosurgical procedure that did
hearing
loss
(SNHL), it is an integral part of the workup. The
not include direct drainage of the frontal sinus. Groups were
objective
of
our
study was to identify factors affecting genetic
similar with respect to demographics, severity of infection,
testing
uptake.
need for repeat surgery, length of stay, or readmission (P >
Methods: We performed a retrospective chart review in a
.05). Further, persistence of cranial neuropathies, seizures, or
tertiary
pediatric center. We identified 272 patients who were
major neurological sequelae after discharge were no different
evaluated
for hearing loss from August 2015 to February
among groups (P > .05).
2019.
Patients
with a confirmed diagnosis of SNHL, <18
Conclusions: Although endoscopic frontal sinusotomy was
years
at
the
time
of diagnosis, and no prior genetic evaluation
technically feasible, it provided no clinically measurable outwere
included.
Chi-square
analysis was performed comparing
comes advantage in this series.
factors affecting participants who did receive genetic testing
compared with those that did not receive testing.
Evaluating Short-term Outcomes of
Results: A total of 143 patients met our inclusion criteria.
Tracheostomy Procedures in a NICU Population
We
identified that younger age was significantly associated
With Variable Ventilator Settings
with increased likelihood of completing genetic testing (P =
Laura Banks Worobetz (Presenter); Erin R. Hamersley, DO;
.023). Findings were also suggestive of comorbidities having
Austin Gerwig; Edward Shepherd, MD;
an impact on pursuit of genetic testing (P = .067). Insurance,
Gregory J. Wiet, MD, MBS
sex, race, and other demographic factors did not show signifiObjectives: Premature infants often present with severe
cant influence between the 2 groups.
respiratory insufficiency requiring mechanical assistance and
Conclusions: Genetics testing is a vital component of the
possible tracheostomy. High ventilator pressures in patients
hearing loss workup; however, a significant number of famiwith severe disease may cause hesitation in performing tralies do not follow through with testing. In our practice, we
cheostomy out of concern for maintaining vent pressures posthave identified that younger age is associated with higher liketracheostomy placement. This study compares the short-term
lihood for testing. Further studies should focus on increasing
impacts of tracheostomies on patients with high ventilator setgenetic testing uptake in older children.
tings (HVS) compared with low ventilator settings (LVS).
Methods: A retrospective cohort study was conducted at a
Newborn Molecular Hearing Screening, an
single, tertiary, pediatric hospital examining all premature
Institutional Review: The Importance of
patients who required mechanical ventilation and tracheostomy
Molecular Testing With Newborn Hearing Screen
from 2008 to 2015. Patients were categorized as HVS based on
Megan Ballard, MD (Presenter); Pu Dai, MD; Denise Yan, MD;
criteria (>6 positive end-expiratory pressure, >25 peak inspiraDe-Min Han, MD, PhD; Christine M. D'Aguillo, MD; Robert C.
tory pressure [PIP], and/or >10 mean airway pressure [MAP])
Fifer, PhD; Xue-Zhong Liu, MD, PhD
determined by expertise from the lead pulmonologist and otoObjectives: Newborn hearing screening (NBHS) has
laryngologist. Preliminary analysis of collected data, up to 7
improved early detection of congenital hearing loss but fails to
days posttracheostomy, was performed using chi-square tests.
detect many cases caused by the most common genetic variResults: A total of 120 patients were included in this study;
ants. Newborn molecular screening can increase the likeli73 (61%) were male with a mean age of 131 ± 89 days at time
hood of hearing loss identification at birth.
of tracheostomy. Seventy-three patients (61%) were categoMethods: This is a University of Miami institutional
rized as HVS. No statistical significance was documented on
review of the genetic hearing loss studies conducted over the
intraoperative complications (P = .420), postoperative pneupast 5 years (2014-2019) comparing NBHS and genetic
monia development (P = .585), or mortality (P = .420). Both
molecular testing results. Our subjects were from Miami,
groups had slight, but not significant, decreases in ventilator
Florida, United States, and Beijing, China. The review
settings as well.
included more than 180,000 pediatric subjects, all of whom
Conclusions: Although performing tracheostomies on HVS
had NBHS and deafness-associated variant testing using the
patients has been traditionally avoided, our study exhibits no
CapitalBio +/− MiamiOtoGenes panel. In Beijing, all infants
difference between intraoperative complications, perioperain the province had NBHS and molecular testing. In Miami,
tive pneumonia, and ventilator requirements between HVS
we identified 10 children with known hearing loss, and retand LVS patients. Moving forward, we aim to examine the
rospectively compared their NBHS with our molecular
longer-term comparisons between these 2 groups.

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

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