Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P275

Poster Presentations

Objectives: Laryngomalacia (LM) is the most common
cause of stridor in neonates, with a usually benign course;
however, in severe cases, surgical management is required
with supraglottoplasty (SGP). This is a procedure that manipulates the upper airways, requiring close postoperative care;
nevertheless, there is little information published about this
topic and its economic impact.
Methods: Supraglottoplasty is performed in our institution in
children with severe LM using cold-steel instrumentation
under endoscopic vision and general anesthesia. Postoperatively,
patients are either extubated and sent to a pediatric ward or
kept under orotracheal intubation and sent to an intensive care
unit (ICU). This is an observational retrospective study in
which the charts of children who underwent SPG were
reviewed. Patients were separated into 2 groups: those who
required ICU stay (group A) and those who did not (group B).
Their medical outcomes, defined as resolution of stridor and
weight gain, were assessed. The health care costs among them
were also compared.
Results: Eighteen children with severe LM had SGP performed by the same surgeon. Group A included 11 patients
(61%), with an average hospital length of stay of 9 days and an
average cost of hospital stay of Mex$40,000 (US$2127); 45%
of patients in group A had associated comorbidities. Group B
included 7 patients (39%), with an average hospital length of
stay of 4.4 days and an average health care cost of Mex$12,000
(US$638). None of these patients had comorbidities. In addition, 100% of patients in both groups had resolution of their
LM.
Conclusions: SPG is an effective treatment for LM.
Postoperatively, patients may be observed at an ICU or a pediatric ward with similar medical results; however, health care
costs are much greater in patients who require ICU stay.
Hearing Impairments in Children Living With
Human Immunodeficiency Virus in Haiti
Asitha D. L. Jayawardena, MD (Presenter); Vienna
Valeriani, RN, MPH; James L. Netterville, MD; Nathaniel
Segaren, MD, MPH, MBA; Shaina Lamour; Daphnee
Michel, MD; John Corkery, MSc
Objectives: Children living with HIV in low-resourced settings are a vulnerable population and are at increased risk for
hearing loss. It is not fully understood whether it is the HIV
itself or the potentially ototoxic antiretrovirals (ARVs) that
cause decreased hearing in these individuals.
Methods: A cross-sectional study of 176 HIV+ children
(aged 9-17 years) was conducted in Port-au-Prince, Haiti,

from March to April 2019. The children underwent a clinically validated smartphone-based audiometric evaluation
using a brief pure tone audiological screening followed by a
more comprehensive pure tone audiometry assessment if the
initial screening failed. In addition to audiometric data, hearing history (frequency of ear infections, otorrhea, otalgia, and
parental perception of hearing loss) and HIV history (duration
of ARVs and viral load) were also collected and analyzed.
Results: Of 176 participants, 77.3% passed the initial
screening. Of those who failed, 12.8% had severe or profound
hearing loss and 30.8% moderate hearing loss in either ear.
Hearing loss was associated with a history of frequent ear
infections (odds ratio [OR], 6.8; CI, 1.6-29.0) but not with
duration of ARVs (OR, 1.03; CI, 0.83-1.27) or viral load (OR,
1.00; CI, 1.00-1.00).
Conclusions: Children who are HIV+ have a higher prevalence of hearing loss than what would be expected for children
living without HIV. In addition, hearing loss was found to be
associated with incidence of otitis media, but not duration of
ARV, an important finding given the potential ototoxicity of
these medications. The higher incidence of hearing loss in this
at-risk population portends the need for cost-effective policies
on screening, identification, and treatment of hearing loss in
children living with HIV in low-resource settings.
Identifying Causes of Threshold Shift in
Large Vestibular Aqueduct Syndrome:
A Pilot Study via Patient Questionnaire
Kristin Tissera (Presenter); Alisha Williams, MPH;
Sophie Consorti; Leila A. Mankarious, MD
Objectives: Large vestibular aqueduct syndrome (LVAS) is a
common cause of sensorineural hearing loss in the pediatric
population. Within the temporal bone, the aqueduct is thought
to play a key role in inner ear pressure and fluid homeostasis.
External factors that involve changes in barometric pressure
have been cited as precipitating further hearing loss in those
with LVAS.
Methods: A questionnaire was posed to patients with LVAS,
via telephone and mail. Of 96 patients who were contacted, 24
provided responses. The questions asked were regarding histories of plane flights, trips to mountainous regions, deep diving
when swimming, head trauma, subsequent perceived hearing
loss, and subsequent return of hearing. Patients' hearing was
tested via behavioral audiogram every 6 months to 1 year.
Results: Of 18 patients who took flights, 2 reported a temporary hearing loss of minutes to hours with no change in the
patients' audiograms obtained months later. Of 12 patients
who took trips to mountainous regions, no patients reported
losing hearing and all audiograms within months of the travel
were stable. Of 22 patients who reported swimming and deep
diving, none reported hearing loss. Of 7 patients who reported
head trauma, 4 reported losing hearing. Of those 4, 2 reported
that hearing levels never returned to normal, whereas 2
reported that hearing returned to baseline after a matter of
hours. Audiograms confirmed that of the 4 patients with

Pediatric

Health Care Costs and Medical Outcomes
in the Postoperative Management Following
Supraglottoplasty in a Tertiary Care Center
Enrique Gerardo Ortiz Hernandez, MD (Presenter);
Eloy Sánchez-Hernández, MD; Daniela Oceguera Reyes;
Andrea Mendoza Michel; Eduardo Lopez Orozco;
Abraham De Jesús Valle-Rojas, MD

P275

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

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