Kevin Hur

Health disparities among adults with voice problems in the United States

To assess differences in access to care and healthcare utilization among adults who reported voice problems in 2012.

Geographic health disparities in the Los Angeles pediatric esophageal foreign body population

OBJECTIVE To assess geographical sociodemographic differences in the pediatric esophageal foreign body population of Los Angeles. METHODS We retrospectively reviewed the medical records of 128 consecutive pediatric patients at Childrens Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a retained foreign body in the esophagus removed by rigid or flexible esophagoscopy. Sociodemographic information including zip code of residence was extracted and analyzed with Chi-square, Fishers exact test, and multivariable logistic regression. RESULTS The average age of patients with a retained esophageal foreign body in this study was 2.5 years old, 52.3% were male, 91.4% had no past medical history, 53.1% were Hispanic, 82.0% had public health insurance, and 63.3% were transfers from an outside hospital. The most common foreign body removed was a coin. There were no significant differences in gender, race, type of health insurance, or income between patients that lived within 10 miles of CHLA versus farther than 10 miles. On multivariable analysis, zip codes with a high volume of esophageal foreign bodies were more likely to be lower income neighborhoods. Gender, race, type of health insurance, and distance from CHLA were not risk factors for zip codes with a high volume of esophageal foreign bodies. CONCLUSION Geographic areas in the greater Los Angeles community with a high volume of retained esophageal foreign bodies requiring endoscopic removal at our institution are associated with lower income neighborhoods. Further studies should be performed to better understand health disparities within the U.S. pediatric esophageal foreign body population.

Determinants and Evaluation of Nasal Airflow Perception

Abstract The sensation of nasal airflow, or nasal airway patency, is an important consideration in the treatment outcome of nasal airway obstruction. Clinicians striving to optimize the nasal passageway have relied on techniques aimed at decreasing peak airway resistance across nasal valves. Nonetheless, the evaluation of the nasal airway is multifaceted, and the objective determinants of subjective nasal patency remain incompletely elucidated. While rhinomanometry, peak nasal inspiratory airflow, and acoustic rhinometry have traditionally been used in research to focus on resistance as a measure of patency, an emerging body of evidence suggests that subjective nasal patency is more significantly correlated to the dynamic change of nasal mucosal temperature. The objective of this review is to provide the technical background on nasal airflow perception and intranasal trigeminal function as crucial to those performing functional and aesthetic rhinosurgery.

Paranasal Rosai-Dorfman Disease with Osseous Destruction

Rosai-Dorfman disease is a rare histiocytic proliferative disorder of unknown etiology typically characterized by cervical lymphadenopathy. Extranodal involvement often manifests in the head and neck region. We present a 10-year-old male who presented to our hospital with left epiphora from an aggressive paranasal mass invading the left orbit with osseous destruction. The mass was surgically biopsied and debulked with histopathological examination revealing Rosai-Dorfman disease. Although rarely found in the sinuses, Rosai-Dorfman disease should be considered when evaluating sinonasal masses.

Association of alterations in smell and taste with depression in older adults: Association of Smell and Taste with Depression

Examine the relationship between depression and changes in smell or taste.

Adjunct steroids in the treatment of peritonsillar abscess: A systematic review

This study systematically reviews the existing literature on the efficacy of adjuvant corticosteroids in improving clinical outcomes after peritonsillar abscess (PTA) drainage.

Geographic health disparities in the Los Angeles pediatric neck abscess population

OBJECTIVE To assess geographical sociodemographic differences in neck abscesses that require surgical drainage in Los Angeles. STUDY DESIGN retrospective review. METHODS We reviewed the medical records of 119 consecutive pediatric patients at Childrens Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a neck abscess requiring incision and drainage. Sociodemographic information including zip code of residence was extracted and analyzed with Chi-square, Fishers exact test, and multivariate logistic regression. RESULTS The average age of patients with a neck abscess in this study was 3.4 years old, 53.8% were female, 54.6% were Hispanic, and 82.5% had public health insurance. 79% of patients had an abscess located in the superficial neck, and 10.1% had an abscess located in the retropharyngeal space. There were no significant differences in gender, race, type of health insurance, or income between patients that lived within 10 miles of CHLA versus those that lived farther than 10 miles. On multivariate analysis, zip codes with a high volume of neck abscesses were more likely to be lower income neighborhoods. Gender, race, type of health insurance, and distance from CHLA were not associated with zip codes with a high volume of neck abscesses. CONCLUSION Geographic areas in the greater Los Angeles community with a high volume of neck abscesses requiring incision and drainage at our institution were associated with lower income neighborhoods. LEVEL OF EVIDENCE IV.

Epistaxis health disparities in the United States pediatric population

OBJECTIVE Despite epistaxis occurring in up to 60% of the population, few studies have investigated health status disparities in the pediatric epistaxis population. The aim of this study was to evaluate sociodemographic risk factors associated with epistaxis visits for pediatric patients. METHODS Data were extracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey Outpatient Department from 2001 to 2010. Outpatient visits of children less than 18 years who received a primary, secondary, or tertiary diagnosis of epistaxis (ICD-9CM code 784.7X) were included. Bivariate and stepwise multivariate regressions were conducted to develop a final model for epistaxis visits described by sociodemographics. RESULTS Epistaxis visits accounted for 5 ± 0.6 million visits in children less than 18 years. 51% and 33% of children presenting with epistaxis had private insurance and Medicaid, respectively (p = 0.001). 69% of epistaxis visits were evaluated at a pediatric clinic, 18% at an ENT/surgery clinic, and 13% at a general/family medicine clinic (p < 0.0001). After multivariate adjustment, epistaxis visits were associated with older age (p = 0.006). Black children were more likely to present with epistaxis (95% CI 1.3-4.1, p = 0.005) compared to white children. Allergic rhinitis, present in 11% of epistaxis visits, was a significant comorbidity associated with visits (95%CI 1.3-4.6, p = 0.008). Patients were also more likely to present to an ENT/surgery clinic (95% CI 4.5-16.5, p < 0.0001) compared to a general/family medicine clinic. CONCLUSIONS Epistaxis visits by children are associated with age, race, and specialty. Targeted interventions to help reduce this common presentation should be developed.

Olfactory dysfunction and cognition among older adults in the United States: Olfactory dysfunction and cognition

In this work we assess the association between olfactory dysfunction and cognition in a nationally representative sample of older adults in the United States.

Impact of sinonasal disease on depression, sleep duration, and productivity among adults in the United States

Examine the relationship between depression symptoms and sinonasal inflammatory diseases, and investigate health disparities associated with allergic rhinitis (AR) and sinusitis in the United States.