COSM13: Otolaryngologists Share Research, Insights at Annual Meetings

In another presentation, Daniel McDonnall, PhD, director of research at Salt Lake City-based Ripple, a medical device manufacturer, said his firm has found—in a small, six-person study—that a pain-free “evoked blink” using facial electrical stimulation is feasible in facial paralysis patients. The technique involves multi-channel stimulation across the eyelid and is not feasible for long-term denervation patients, Dr. McDonnall said.

One of the biggest challenges was assessing pain level, he said, and researchers settled on a scale of 1 to 5, with 1 being barely perceptible and 5 being “very mildly irritating.”

“It’s really not something that’s clinically relevant if we can’t do this in a comfortable region,” he said. Plus, he said, the electrodes posed an engineering challenge because they need to be thin and flexible enough during their 10-year lifetime to allow flex tens of millions of times as patients blink.

Hearing Loss and Dementia

American Otological Society

In a population-based study featured at the Annual Spring Meeting of the American Otological Society, researchers led by Richard Gurgel, MD, assistant professor of otolaryngology-head and neck surgery at the University of Utah in Salt Lake City, found that hearing loss was an independent predictor of dementia and of faster decline in cognition.

The study, which began in 1995 and centered on Cache County in northern Utah, was remarkable in that 90 percent of the potential subjects were actually enrolled. That group was assessed for dementia using screening and an expert panel. Researchers found 4,463 subjects who were older than 65 and did not have dementia, thereby meeting the study’s criteria. Of these, 836 had hearing loss. Of those with hearing loss, 16.3 percent developed dementia, compared with just 12.1 percent of those without hearing loss (p<.001). It took an average of 10.3 years for those with hearing loss to develop dementia, compared with 11.9 for those who had no hearing loss (p <.001)

After controlling for factors including gender, age, education level and genetic risk, researchers found hearing loss to be an independent predictor of dementia. They also found, after controlling for other factors, that hearing loss was associated with faster decline on the Modified Mini Mental State Examination, at a rate of 0.26 points worse per year than those without hearing loss.

Dr. Gurgel acknowledged that the assessment of hearing loss was done qualitatively, not quantitatively. He also cautioned that it was an epidemiological study that reveals associations and not necessarily causes.