Jonathan L Levine

Comparison of Multi-Test Device Skin Testing and Modified RAST Results

The initial purpose of this study was to determine the potential correlation between allergy test results obtained with the Multi-Test skin testing method and the radioallergosorbent test (RAST) blood test (used as a “standard”). Twenty patients with a history and physical examination findings suggestive of inhalant allergy underwent both a Multi-Test system screen (14 antigens plus histamine and glycerine controls) and RAST testing. The relationship between wheal size and Multi-Test system grade for each antigen and the corresponding RAST class was studied. The correlation between positive Multi-Test system and RAST results was poor, with an average agreement by antigen of 56.26% and overall agreement of 67.86%. However, the overall agreement between negative Multi-Test system results (≠1+) and negative RAST results (≠class I) was 95.15%, with an average agreement by antigen of 83.99%. On the basis of results of this preliminary study, it appears that a negative Multi-Test system result indicates that significant inhalant allergy is unlikely, whereas a positive Multi-Test system result necessitates follow-up with more definitive testing by additional skin testing or RAST. (Otolaryngol Head Neck Surg 1998;118:797–9.)

09:30: Expression Patterns in the Injured Cochlea Microenvironment

ynx and the contribution of individual structures (palate/tonsils, tongue, epiglottis, and lateral pharyngeal walls) to upper airway obstruction. Test-retest reliability was determined separately for the blinded and unblinded surgeons based on the agreement between the surgeon’s ratings for the two DISE procedures. RESULTS: Twenty-eight patients (6 female; 22 male) were studied with DISE. Preoperative polysomnography findings included a mean apnea-hypopnea index of 33.3 16.4 and a lowest oxygen saturation was 78.4 8.4%. For the DISE ratings, there was moderate-good agreement (weighted kappa 0.41-0.63) for the degree of obstruction at the level of the palate and hypopharynx. Agreement regarding the contribution of individual structures was moderate-good (Cohen’s kappa 0.44-0.71). Greater agreement was demonstrated for the unblinded surgeon ratings. CONCLUSIONS: The inter-rater reliability of DISE is moderate-good.

11:06: Malpractice Litigation after Tonsillectomy: 156 Cases

three sessions for 3% of the patients. Postoperative pain was rated at 3 or 4 on a visual analog scale for only 2-3 days. Postoperative bleeding and scarring did not occur. Over 90% of patients remain satisfied after a minimum follow-up of six months. CONCLUSIONS: Laser ablation of the palatine tonsils can be a useful alternative to tonsillectomy in adults. Marsupilization of cryptic tonsil pockets utilizing CO2 laser has proven effective in patients with cryptic tonsillitis and halitosis.

10:06: Endoscopic Microvascular Decompression

t-test were used for analysis. RESULTS: No significant difference was found for high frequency hearing loss, DPOAE, ABR and MLR in the users. High frequency hearing loss was seen in subjects using the phone for more than 4 years (P 0.040). Users with complaints like aural fullness or tinnitus had prolonged I-III interpeak latency compared to those with no complaints (P 0.04). There was a significant difference in Pa wave amplitude values between the users and the controls on the left side (P 0.015). CONCLUSIONS: Long-term use of mobile phones may cause inner ear damage. Presence of ear symptoms like fullness may be an early warning sign.

11:24: Implementation of Advanced Clinical Access: Lessons Learned

OBJECTIVES: Examine litigation trends for injury claims related to sino-nasal disease. METHODS: A retrospective review of 70 jury verdict or settlement results was obtained from a computerized database. Reviews compiled data on plaintiff age and gender, defendant specialty, surgical or medical complications and resulting morbidity, claimed basis for malpractice claim, state jurisdiction, year case decided, and amount of verdict or settlement. RESULTS: Defendants prevailed in 73% of the cases. Average awards and settlements were

11:14: Medical Malpractice and Sino-Nasal Disease

1,226,166 and

09:58: Audiological Disturbances in Long-Term Mobile Phone Users

958,000, respectively. The most common allegations included neurologic deficit (47%), failure to diagnose or delay in diagnosis (34%), and medical complication (31%). Age did not seem to predict verdict but younger patients had higher awards (

22: The Epidermold Formation and Congenital Cholesteatoma

1.34 million vs.

Postnatal persistence of epidermoid rests in the human middle ear.

442,000). Females prevailed less often than males (19% vs. 39%) and received lower average monetary results (

10:14: Intratympanic Steroids in Children

740,000 vs.