Vincent Lin

Ten-year health-related quality of life in cochlear implant recipients: prospective SF-36 data with SF-6D conversion.

To evaluate the long‐term impact of cochlear implantation on quality of life measured by the Medical Outcomes Study 36‐Item Short‐Form Health Survey (SF‐36). Scores were also converted to the SF‐6D to derive health utility scores.

Preoperative steroids for hearing preservation cochlear implantation: A review

Preoperative steroids have been shown to be beneficial in reducing the hearing loss associated with cochlear implantation. This review article discusses the mechanism of action, effects of differing routes of administration, and side effects of steroids administered to the inner ear. Studies on the role of preoperative steroids in animal and human studies are also examined and future directions for research in this area are discussed.

Quality of life in cochlear implantees: Comparing utility values obtained through the Medical Outcome Study Short‐Form Survey‐6D and the Health Utility Index Mark 3

To evaluate the changes in health‐related quality of life in unilateral adult cochlear implant patients using the Medical Outcome Study Short‐Form Survey‐36 (SF‐36) and the Health Utility Index Mark 3 (HUI‐3). To do so, a health utility index was obtained by converting the SF‐36 to the Medical Outcome Study Short‐Form Survey‐6D (SF‐6D) to permit comparison with HUI‐3 scores in the context of health preference as measured by quality‐adjusted life years.

Tactile dysgeusia : a new clinical observation of middle ear and skull base surgery

Objective: To describe a new clinical observation of “tactile dysgeusia,” a phenomenon associated with otologic and skull base surgery likely caused by injury to the chorda tympani nerve (CTN) or the nervus intermedius (NI) with subsequent aberrant cross‐innervation with somatosensory fibers in the surgical field.

The addition of a contralateral routing of signals microphone to a unilateral cochlear implant system—A prospective study in speech outcomes†

The purpose of the study was to investigate the potential clinical advantages of incorporating a contralateral routing of signals (CROS) microphone in unilateral cochlear implant (CI) users.

Assessment of the psychosocial impacts of cochlear implants on adult recipients and their partners

Objectives: In the present study we sought to evaluate the psychosocial and quality of life (QOL) impacts of cochlear implant (CI) treatment on both CI recipients and their partners in a Canadian population. Methods: A qualitative cross-sectional contemporary cohort evaluation was conducted by distributing specifically designed questionnaires to both CI recipients and their partners at their follow-up appointments over a month at Sunnybrook Health Sciences Centre. Results: It was found that both CI recipients and their partners demonstrated substantial benefit and improvement in multiple psychosocial domains. Discussion: Musical listening was found to show variable improvements between recipients. Further analysis found a simple correlation where the group of recipients who all had a hearing disability for a longer duration had demonstrated a higher proportion of improvement in musical listening. CI recipients endorsed having improved QOL which was in agreement with proxy observation by partners. Conclusion: Overall, CI use has been shown to have significant benefit to psychosocial well-being of CI recipients. This benefit is also conferred to their caregivers/partners; which in our society concerned about caregiver burden is quite important to recognize.

The Canadian Otolaryngology–Head and Neck Surgery Workforce in the Urban-Rural Continuum: Longitudinal Data from 2002 to 2013:

Objectives To evaluate the proportion of otolaryngology–head and neck surgery (OHNS) providers who are rural versus urban based from 2002 to 2013. Secondary objective was to present perspectives of rural primary care providers on unmet needs for OHNS services. Study Design Mixed methods database analysis and prospective survey. Setting National administrative database. Subjects and Methods The Canadian Medical Association OHNS provider Masterfile and the Statistics Canada postal code file were used to determine provincial, urban, rural, and Aboriginal group care coverage. The Society of Rural Physicians of Canada was surveyed to explore care delivery and unmet needs for OHNS and audiology. Descriptive statistics and linear regression were used to describe results. Results Ontario and Quebec had the largest annual OHNS physician growth (6.38 providers/year; r2 = 0.94) versus stagnant growth in the territories. The clear majority of OHNS providers are in urban centers, and rural OHNS coverage is decreasing annually (–0.33 providers/year, r2 = 0.28). There are no OHNS providers in 485 population centers where Aboriginal groups are located. A survey of 40 rural primary care providers reported that OHNS care is most commonly delivered through seasonal visits to a local facility, with otology (hearing loss, chronic ear disease) and rhinology (nonmalignant nasal or sinus conditions) as the most frequently reported unmet needs. Conclusion From 2002 to 2013, OHNS coverage showed a trend for urban consolidation. Most Aboriginal groups may have decreased access to care, as there are no OHNS providers in 485 population centers where reserves are located. There is an unmet need for specialized OHNS services reported by rural primary care physicians, especially otology and rhinology.

Case of the Month #171: Osteogenesis Imperfecta of the Temporal Bone

A 35-year-old man presented to the Department of Otolaryngology with progressive bilateral hearing loss, worse on the right, over the past 12 years. Audiometry determined the hearing loss to be mixed, both conductive and sensorineural. He had no otalgia, vertigo, or otorrhea. There was no history of otologic surgery, noise exposure, or familial hearing loss. He described remote minor head injury at age 4 years that required stitches, and prior fractures, which generally occurred during hockey matches, of his clavicle, fingers, a toe, and the left tibia and fibula. He was not taking any regular medications. Results of a general physical examination were normal. Results of an otologic examination revealed tortuous external auditory canals bilaterally but normal tympanic membranes. High-resolution computed tomography of the temporal bones was performed (Figures 1 and 2).

Development and face validation of a Virtual Reality Epley Maneuver System (VREMS) for home Epley treatment of benign paroxysmal positional vertigo: A randomized, controlled trial

PURPOSE To develop and validate a smartphone based Virtual Reality Epley Maneuver System (VREMS) for home use. METHODS A smartphone application was designed to produce stereoscopic views of a Virtual Reality (VR) environment, which when viewed after placing a smartphone in a virtual reality headset, allowed the user to be guided step-by-step through the Epley maneuver in a VR environment. Twenty healthy participants were recruited and randomized to undergo either assisted Epleys or self-administered Epleys following reading instructions from an Instructional Handout (IH). All participants were filmed and two expert Otologists reviewed the videos, assigning each participant a score (out of 10) for performance on each step. Participants rated their perceived workload by completing a validated task-load questionnaire (NASA Task Load Index) and averages for both groups were calculated. RESULTS Twenty participants were evaluated with average age 26.4±7.12years old in the VREMS group and 26.1±7.72 in the IH group. The VR assisted group achieved an average score of 7.78±0.99 compared to 6.65±1.72 in the IH group. This result was statistically significant with p=0.0001 and side dominance did not appear to play a factor. Analyzing each step of the Epley maneuver demonstrated that assisted Epleys were done more accurately with statically significant results in steps 2-4. Results of the NASA-TLX scores were variable with no significant findings. CONCLUSION We have developed and demonstrated face validity for VREMS through our randomized controlled trial. The VREMS platform is promising technology, which may improve the accuracy and effectiveness of home Epley treatments. LEVEL OF EVIDENCE N/A.