Comparative outcomes between endoscopic and microscopic approaches in pediatric type-1 tympanoplasty.

Objectives: Type-1 tympanoplasty is a surgical procedure employed to repair the tympanic membrane, when ossicular reconstruction is not required. Historically, this was performed via a microscopic approach utilizing either a transcanal, endaural, or postauricular incision. Recently, there has been a growing shift toward the use of transcanal endoscopic ear surgery (TEES), eliminating the need for an endaural or postauricular incision.

Symptomatology in Unilateral Versus Bilateral Superior Canal Dehiscence Patients Undergoing Unilateral Surgery.

Objective: To compare symptomatology in patients with unilateral versus bilateral superior semicircular canal dehiscence who underwent unilateral surgical repair.

Study Design: Retrospective cohort study.

Setting: Single surgeon series at tertiary academic medical center from 2002 to 2021.

Predictors of non-primary auditory and vestibular symptom persistence following surgical repair of superior canal dehiscence syndrome.

Objective: Patients with superior canal dehiscence syndrome (SCDS) can present with a plethora of auditory and/or vestibular symptoms associated with a bony defect of the superior semicircular canal. While surgical repair is a reasonable option for patients with significant localizing symptoms, the degree of clinical improvement will vary among patients and poses challenges in outcome prediction. This study aims to assess the relationship between preoperative and postoperative symptoms and identify predictors of symptom persistence following repair.

Surgical Navigation in the Anterior Skull Base Using 3-Dimensional Endoscopy and Surface Reconstruction.

Importance: Image guidance is an important adjunct for endoscopic sinus and skull base surgery. However, current systems require bulky external tracking equipment, and their use can interrupt efficient surgical workflow.

Objective: To evaluate a trackerless surgical navigation system using 3-dimensional (3D) endoscopy and simultaneous localization and mapping (SLAM) algorithms in the anterior skull base.

An External Validation Study for Automated Segmentation of Vestibular Schwannoma.

Objective: To validate how an automated model for vestibular schwannoma (VS) segmentation developed on an external homogeneous dataset performs when applied to internal heterogeneous data.

Patients: The external dataset comprised 242 patients with previously untreated, sporadic unilateral VS undergoing Gamma Knife radiosurgery, with homogeneous magnetic resonance imaging (MRI) scans. The internal dataset comprised 10 patients from our institution, with heterogeneous MRI scans.

A Proof-of-Concept Computer Vision Approach for Measurement of Tympanic Membrane Perforations.

Objective: Size, an important characteristic of a tympanic membrane perforation (TMP), is commonly assessed with gross estimation via visual inspection, a practice which is prone to inaccuracy. Herein, we demonstrate feasibility of a proof-of-concept computer vision model for estimating TMP size in a small set of perforations.

Methods: An open-source deep learning architecture was used to train a model to segment and calculate the area of a perforation and the visualized tympanic membrane (TM) in a set of endoscopic images of mostly anterior and relatively small TMPs.

Proof-of-Concept Computer Vision Model for Instrument and Anatomy Detection During Transcanal Endoscopic Ear Surgery.

High-definition video captured during transcanal endoscopic ear surgery (TEES) can serve as imaging data for computer vision algorithms. This report describes a proof-of-concept model for automated anatomy and instrument detection during TEES.

AI Model Versus Clinician Otoscopy in the Operative Setting for Otitis Media Diagnosis.

Prior work has demonstrated improved accuracy in otitis media diagnosis based on otoscopy using artificial intelligence (AI)-based approaches compared to clinician evaluation. However, this difference in accuracy has not been shown in a setting resembling the point-of-care. In this study, we compare the diagnostic accuracy of a machine-learning model to that of pediatricians using standard handheld otoscopes.

Auditory and Vestibular Symptom Improvement With Surgery for Superior Canal Dehiscence Syndrome.

Objective: (1) To measure the change in auditory and vestibular symptoms following superior canal dehiscence (SCD) surgery, and (2) to determine differences in clinical features and surgical outcomes between superior canal dehiscence syndrome (SCDS) patients with primarily auditory or vestibular complaints.

Study Design: Retrospective cohort study.

Setting: Single surgeon series at the tertiary academic medical center from 2002 to 2021.

Development of a Predictive Model for Persistent Dizziness Following Vestibular Schwannoma Surgery.

Objective: In an era of vestibular schwannoma (VS) surgery where functional preservation is increasingly emphasized, persistent postoperative dizziness is a relatively understudied functional outcome. The primary objective was to develop a predictive model to identify patients at risk for developing persistent postoperative dizziness after VS resection.

Methods: Retrospective review of patients who underwent VS surgery at our institution with a minimum of 12 months of postoperative follow-up.

Hospital-Negotiated Pricing of Cochlear Implants.

Access to cochlear implantation can be restricted by financial burden, and little is known about the extent to which cochlear implant (CI) devices prices may vary between hospitals or manufacturers. We performed a cross-sectional analysis of private payer-negotiated prices for CI devices. In total, 161 hospitals were analyzed.

Generation of synthetic tympanic membrane images: Development, human validation, and clinical implications of synthetic data.

Synthetic clinical images could augment real medical image datasets, a novel approach in otolaryngology-head and neck surgery (OHNS). Our objective was to develop a generative adversarial network (GAN) for tympanic membrane images and to validate the quality of synthetic images with human reviewers. Our model was developed using a state-of-the-art GAN architecture, StyleGAN2-ADA.

Roid Rage: Historical Perspective on the Emergence of Oral Steroids as a Treatment of Idiopathic Sudden Sensorineural Hearing Loss.

Objectives: To review the historical circumstances that led to the emergence of corticosteroid therapy for idiopathic sudden sensorineural hearing loss (ISSNHL) and to discuss how this history has influenced current perspectives on the condition.

Methods: PubMed and Google scholar were used to identify articles of ISSNHL and oral corticoid steroid use. Historical articles accessed through our institutional medical library were also reviewed.

Development of a Predictive Model for Individualized Hearing Aid Benefit.

Objectives: To develop a model to predict individualized hearing aid benefit. To provide interpretations of model predictions on global and individual levels.

Methods: We compiled a data set of patients with hearing loss who trialed hearing aids and completed the Client Oriented Scale of Improvement (COSI) questionnaire, a validated patient-reported outcome measure of hearing aid benefit.

"Human vs Machine" Validation of a Deep Learning Algorithm for Pediatric Middle Ear Infection Diagnosis.

Objective: We compared the diagnostic performance of human clinicians with that of a neural network algorithm developed using a library of tympanic membrane images derived from children taken to the operating room with the intent of performing myringotomy and possible tube placement for recurrent acute otitis media (AOM) or otitis media with effusion (OME).

Study Design: Retrospective cohort study.

Setting: Tertiary academic medical center from 2018 to 2021.

A Rare Complication of Chronic Otitis Media: Central Skull Base Osteomyelitis Managed With Combined Endoscopic Transmastoid and Transsphenoidal Debridement.

Objective: This report describes a case of otogenic central skull base osteomyelitis (CSBO) requiring complex surgical intervention and reviews the literature on management of this entity.

Patient: A 76-year-old man presented with a nearly 20-year history of chronic otomastoiditis and cholesteatoma with ultimate progression to severe CSBO with involvement of the petrous apex, clivus, and craniocervical junction.

Interventions: CSBO was managed with culture-directed antibiotic therapy, hyperbaric oxygen, and surgical intervention including serial combined endoscopic transmastoid and transsphenoidal debridements.

Feeding Tube Placement Following Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma.

Objective: To identify factors that may predict the need for feeding tubes in patients undergoing transoral robotic surgery (TORS) in the perioperative setting.

Study Design: Retrospective chart review.

Setting: Academic tertiary center.

Impact of surgical margins on local control in patients undergoing single-modality transoral robotic surgery for HPV-related oropharyngeal squamous cell carcinoma.

Background: The impact of close surgical margins on oncologic outcomes in HPV-related oropharyngeal squamous cell carcinoma (HPV + OPSCC) is unclear.

Methods: Retrospective case series including patients undergoing single modality transoral robotic surgery (TORS) for HPV + OPSCC at three academic medical centers from 2010 to 2019. Outcomes were compared between patients with close surgical margins (<1 mm or requiring re-resection) and clear margins using the Kaplan-Meier method.

In situ hybridization for high risk HPV E6/E7 mRNA in oropharyngeal squamous cell carcinoma.

Objectives: To report a single institution's experience using human papillomavirus (HPV) E6/E7 mRNA in-situ hybridization (mRNA ISH) for HPV detection in oropharyngeal squamous cell carcinoma (OPSCC). To review the literature on HPV detection methods.

Study Design: Retrospective chart review, literature review.

Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2017.

Importance: The Merit-Based Incentive Payment System (MIPS) for Medicare is the largest pay-for-performance program in the history of health care. Although the Centers for Medicare & Medicaid Services (CMS) launched the MIPS in 2017, the participation and performance of otolaryngologists in this program remain unclear.

Objective: To characterize otolaryngologist participation and performance in the MIPS in 2017.

State-Sponsored Price Transparency Initiatives for Otolaryngologic Procedures in 2019.

This cross-sectional study examines the information provided by state-sponsored price transparency websites for outpatient otolaryngologic procedures.

Completion lymph node dissection for merkel cell carcinoma.

Background: Sentinel lymph node biopsy (SLNB) is widely used for Merkel cell carcinoma (MCC), however in SLNB positive MCC the role of completion lymph node dissection (CLND) with or without adjuvant radiation therapy is unclear.

Objective: Our goal was to determine the impact of CLND and adjuvant radiation therapy on survival in SLNB positive MCC.

Materials And Methods: We examined 447 patients with MCC with a positive SLNB in the National Cancer Data Base from 2012 to 2015.