Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P95

Oral Presentations

Effects of Osteoporosis on Vestibular
Function
Alexander Gertel, MD (Presenter); Khalil Keefe Rahman;
Erin Mulry; Michael Bowe; Kourosh Parham, MD, PhD
Objectives: There is evidence to show a strong association
between benign paroxysmal positional vertigo (BPPV) and
osteoporosis. Calcium dysregulation may underlie both disorders, leading to the degeneration of the otoconia. Otolin-1 is
an otoconia framework protein that has been proposed as a
vestibular system biomarker. Vestibular-evoked myogenic
potentials (VEMPs) are used to detect vestibular dysfunction.
We hypothesized high rates of abnormal VEMPs and otolin-1
in subjects with osteoporosis.
Methods: Fourteen random reference subjects and 9 subjects with osteoporosis were prospectively recruited. Otolin-1
was measured in all subjects and VEMPs, positional testing,
calcium, parathyroid hormone, urine N-telopeptide (NTX),
and bone density scan scores were collected in the osteoporosis group. A comparison of otolin-1 between the osteoporosis
group and the reference group was carried out and the relationship between various measures was examined.
Results: The osteoporosis group did not differ significantly in
otolin-1 serum concentrations from the reference group. In total,
67% of the osteoporosis group had abnormal VEMPs. Abnormal
VEMPs did not correlate significantly with o- tolin-1. Within the

osteoporosis group, patients who had a higher urine NTX/creatinine ratio had higher serum otolin-1 concentrations (rs = 0.6833,
P = .04). There was no correlation between otolin-1 concentration and serum calcium or bone density scan scores.
Conclusions: This study suggests that osteoporosis patients
have high rates of vestibular dysfunction and extends previous
findings of the strong association between osteoporosis and
BPPV. A strong significant correlation between bone turnover
markers and serum otolin-1 further supports the impact of calcium dysregulation on the vestibular system.
Effects of Quinolone and Poloxamer Otic
Suspension on Tympanic Membrane of Rats
Carolyn Ojano Dirain, PhD (Presenter);
Patrick J. Antonelli, MD
Objectives: Quinolone ear drops at standard clinical concentrations, delivered twice daily for 10 days, can cause tympanic membrane perforations (TMPs) in intact rat tympanic membranes
(TMs). A newly available single-dose otic preparation contains
ciprofloxacin 6% suspended in a thermo reversible poloxamer (ie,
liquid at cool temperatures and gel at body temperature). This
study aimed to evaluate if a single application of 6% quinolone in
poloxamer suspension promotes the development of TMPs in
intact TMs.
Methods: Rats were randomized to 5 groups (10/group),
with 1 ear receiving a single otic instillation of 16% poloxamer 407 or 188, which are found in a commercial otic preparation and a wound dressing, respectively, or ofloxacin,
ciprofloxacin, or neomycin-all at 6% concentrations in suspension with 16% poloxamer 407. The contralateral ear
received saline. TMs were assessed over 42 days.
Results: No TMPs were seen in ears treated with saline,
poloxamer 407 or 188, or in ears treated with ofloxacin-,
-ciprofloxacin-, or neomycin-poloxamer suspension (all P >
.05). White precipitates were observed in the ear canal and/or
TM of cipro+poloxamer- and ofloxacin+poloxamer-treated
ears. The incidence of white precipitates was higher in only
the cipro+poloxamer-treated ears until day 10 (P < .0001 to
P = .0004). TM surface irregularities, which appeared to be
slight depressions of the pars tensa, were also observed
mostly in the cipro+poloxamer-treated ears beginning at
day 3, with 5 of 5 TMs still with pars tensa depressions at day
42 (P = .03 to P = .0033).
The Effects of Tobacco Use on Percutaneous
Auditory Osseointegrated Implant Complications
Lauren Gardiner (Presenter); Daniel H. Coelho, MD
Objectives: A study was conducted determine the association
(if any) between tobacco use and the development of postoperative skin complications in patients undergoing percutaneous
osseointegrated auditory implant (pOAI) surgery.
Methods: This was a single surgeon retrospective cohort
study in a tertiary neuro-otology practice at an academic medical center. A retrospective chart review was performed on all

Otology/Neurotology

drop in ECochG signal has been shown to correlate with a
decline in hearing outcomes. In the present study, an ECochGguided robotics-assisted CI insertion system was developed
and characterized that provides controlled and consistent electrode array insertions while monitoring and adapting to realtime ECochG signals.
Methods: The system comprises an electrode array insertion
drive unit, an extracochlear recording electrode module, and a
control console that interfaces with both components and the
surgeon. Here, a proof-of-concept benchtop study evaluated
the ability of the system to detect simulated ECochG signal
changes and robotically adapt the insertion in response. In
addition, the ECochG-guided insertion system was evaluated
in a pilot in vivo sheep study to characterize the signal-tonoise ratio and amplitude of ECochG recordings during
robotics--assisted insertions.
Results: The system exhibited a microvolt signal resolution
and a response time of <100 ms after signal change detection,
indicating the system can detect changes and respond approximately 5 times faster than a human. In addition, animal results
demonstrated the system was capable of recording ECochG signals with a high signal-to-noise ratio and sufficient amplitude.
Conclusions: An ECochG-guided robotics-assisted CI insertion system can both detect real-time drops in ECochG signals during electrode array insertions and immediately alter
the insertion motion. The system may provide a surgeon the
means to monitor and reduce CI insertion-related trauma
beyond manual insertion techniques for improved CI hearing
outcomes.

P95

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

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