Does tympanostomy tube placement affect vestibular function in young children? Background: One of the most common questions we are asked as otolaryngologists is whether placement of ventilation tubes will help a child who has otitis media with an effusion (OME). OME is defined as the presence of a middle-ear effusion with signs or symptoms of an […]
What’s the Best Way to Use Outpatient Physician Extenders?
Are physician extenders a valuable asset to an outpatient otolaryngology practice? Background: Use of physician extenders, nurse practitioners and physician assistants is increasing in specialty and subspecialty medicine. The field of otolaryngology, however, is currently underrepresented. Study design: Contemporary review. Setting: Department of Otolaryngology and Communicative Sciences, University of Mississippi, Jackson. Synopsis: The authors proposed a framework of five […]
Cochlear Implants Improve Performance and Net Savings in Infants
Do the costs and benefits of cochlear implantation differ between infants and older children? Background: While many studies show more rapid auditory and cognitive development in early cochlear implantation, other studies report little difference in outcomes in a small sample of children, some implanted before 12 months of age and others implanted later. Additionally, the development […]
More Research Needed on Gamma Knife Surgery
Is quality of life (QOL) better after surgical removal of vestibular schwannoma or after gamma knife surgery? Background: Gamma knife surgery is becoming an increasingly popular method to manage vestibular schwannoma. As a less invasive modality, gamma knife surgery should improve QOL over surgical intervention. Study design: Prospective study. Setting: Gamma Knife Center, Michigan. Synopsis: Researchers relied on QOL […]
Consideration of Race, Ethnicity and Ancestry
Should race, ethnicity and ancestry be used as universal proxies for genetic, social and socioeconomic issues related to otolaryngology conditions? Background: Historically, race, ethnicity and ancestry have been associated with otolaryngology conditions such as nasopharyngeal carcinoma, otosclerosis, acoustic neuroma, sickle cell anemia, Burkitt’s lymphoma and skin malignancies. Advances in genetics could help otolaryngologists move beyond these […]
Preservation of Residual Hearing after Cochlear Implant Using SMA
Is residual hearing preserved after cochlear implantation with the suprameatal approach (SMA) technique? And, is there an alternative analysis to document the conservation of hearing more accurately? Background: The SMA is the most frequently used implantation technique for cochlear implantation. The SMA has received both criticism and praise since its introduction in 1999, but the question […]
Best Practice in Tympanoplasty
Does concomitant mastoidectomy improve outcomes for patients undergoing repair of tympanic membrane perforations? Background: Controversy currently exists regarding the appropriate treatment of tympanic membrane perforations resulting from chronic suppurative otitis media (CSOM) without cholesteatoma. Proponents for mastoidectomy contend that surgical opening of the mastoid pneumatic system buffers pressure changes in the middle ear and allows for […]
A Review of Contemporary Management of Vestibular Schwannomas
What are important parameters that should be considered in the treatment decisions for vestibular schwannomas? Background: The advent of stereotactic radiosurgery and its widespread use during the past decade have led to a reappraisal of the various management options for vestibular schwannomas, also known as acoustic neuromas. At the same time, novel chemotherapeutic agents, although still […]
Increasing Evidence that PDE-5 Inhibitors Can Cause Hearing Loss
While recent reports show that phosphodiesterase-5 (PDE-5) inhibitors can cause sudden sensorineural hearing loss (SSHL), what is the global experience of this phenomenon? Background: SSHL has been reported after the ingestion of a PDE-5 inhibitor such as Viagra. SSHL has been defined as hearing loss of at least 30 dB in three or more continuous frequencies […]
VR Simulator Training Improves Cadaveric Temporal Bone Dissection
Can supervised training with a virtual reality (VR) simulator improve performance in cadaver temporal bone dissection? Background: Cadaveric temporal bone dissection exercises are the cornerstones of otologic surgical training, but there is an increasing shortage of temporal bones worldwide and an increasing number of otorhinolaryngology trainees. The role of virtual reality (VR) is now recognized in […]
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