Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P94

Otology/Neurotology

P94
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.
otitis media and cholesteatoma. However, there is a high revi(0.80-1.75), 1.15 (0.75-1.77), 1.21 (0.73-2.02), and 0.98
sion rate with surgery, which leads to increased health care
(0.53-1.80), respectively.
costs. Our hypothesis is that there will be no increased periopConclusions: As a correlate for pregnancy, the presence of a
erative costs and similar hearing outcomes when comparing
delivery and the number of deliveries were not statistically
those who receive an initial canal wall down (CWD) and those
significantly associated with an increased risk of developing
who have a CWD after prior CWU procedures.
otosclerosis. The results of the present study do not support
Methods: A retrospective chart review was performed on
the previously suspected association between pregnancy and
adult patients who underwent mastoid surgery for COM with
otosclerosis.
or without cholesteatoma. Patients were divided into groups
that had previous CWU surgery and were undergoing CWD
Declining Incidence of Otosclerosis
and those that were having an initial CWD mastoidectomy that
Substantiates Need for Reconsidering
was a canal wall down. Cost variables including prior surgerCurrent Residency Training Requirements in
ies, imaging costs, audiometric testing, and postoperative visits
the United States
were compared between the 2 groups using t-test analysis.
Douglas Totten (Presenter); John P. Marinelli; Samuel A.
Results: There were 61 patients, with equal distribution
Spear, MD; Sarah N. Bowe, MD; Matthew L. Carlson, MD
between groups. There was no significant difference with the
Objectives: Stapes surgery is a technically demanding procecost of postoperative visits, perioperative imaging, or revision
dure associated with high expectations (success defined by ≤10
surgeries between the 2 groups. Hearing outcomes based on
dB residual air-bone gap) and risk of sensorineural hearing
average speech reception threshold were similar between the
loss. Yet stapedectomy is consistently reported among the list
2 groups. There was a significant difference in total cost; the
of cases otolaryngology residents receive the least experience
revision group had a higher average cost by $6967.84, most of
with during training. The objective of this study was to apply
which was accounted for by the difference in the cost of the
recently characterized trends in the incidence of otosclerosis to
prior surgeries of $6488.53.
stapes surgery at training programs in the United States.
Conclusions: The revision CWD surgery group had increased
Methods: Data were obtained from the Rochester Epid-
total costs that could be attributed to the cost of previous suremiology Project supported by the National Institutes of
gery. Increased perioperative costs were not noted with the
Health. The incidence of surgically confirmed otosclerosis,
initial CWD surgery group for any individual variables. Initial
standardized by age and sex to the 2010 US Census total popCWD mastoidectomy should be considered in proper patient
ulation, was recently shown to have decreased from a peak of
populations to help decrease costs.
12.9 per 100,000 person-years in the early 1970s to a nadir of
2.1 by 2017. These data were applied to the distribution of
Critically Evaluating the Relationship
otolaryngology residents in the United States.
Between Pregnancy and Otosclerosis:
Results: Based on 2010 US Census data, approximately
A Case-Control Study
6825
new cases of stapedectomy are performed yearly across
Robert James Macielak, MD (Presenter); John P. Marinelli;
the
country.
With 305 otolaryngology residents per postgraduDouglas Totten; Christine Lohse, MS; Brandon Grossardt, MS;
ation
year
nationally,
an estimated 1425 residents form the
Matthew L. Carlson, MD
pool of those training in stapes surgery. If every new diagnosis
Objectives: Prior studies have suggested that pregnancy
of otosclerosis is surgically managed at academic training
incurs an increased risk for developing otosclerosis. The pricenters, then each resident could be exposed to only a maximary objective of the present work was to determine if such a
mum number of 4.8 cases per year. In addition, geographic
relationship exists through a case-control study.
region-specific rates will be presented.
Methods: A population-based, case-control study was perConclusions: These data likely represent an uppermost estiformed using the Rochester Epidemiology Project. Incident
mate of the average number of stapes cases otolaryngology
cases of otosclerosis were matched to 3 controls on age and
residents are exposed to yearly. These data support the removal
duration of medical record availability. Diagnosis and procedure
of "stapedectomy" from the list of 14 key indicator case
codes and supplemental birth data were used to determine the
requirements, as proficiency in stapedectomy is no longer a
number of distinct deliveries prior to the otosclerosis diagnosis
realistic expectation for US graduating residents in this era.
date for cases or the corresponding index date for controls.
Results: Median age at diagnosis for the 299 incident cases
Development and Characterization of an
was 42 years (interquartile range [IQR] 32-53), and median
Electrocochleography-Guided, Roboticsage at the index date for the 897 matched controls was 41 years
Assisted CI Insertion System
(IQR 32-53). Among all 1196 women studied, there were 147
Allan Henslee, PhD (Presenter); Matt Jackels; Parker Reineke;
(49%) cases and 419 (47%) controls with at least 1 prior delivMarlan R. Hansen, MD; Christopher R. Kaufmann, MD
ery. The odds ratio for the association of at least 1 delivery
with development of otosclerosis was 1.15 (95% CI, 0.84Objectives: Electrocochleography (ECochG) is increasingly
1.58; P = .38). Odds ratios for the associations of 1, 2, 3, or ≥4
being used during cochlear implant (CI) surgery to detect and
pregnancies with development of otosclerosis were 1.19
mitigate insertion-related intracochlear trauma, in which a

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

Table of Contents for the Digital Edition of Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts