These studies identify that children with CRSwNP or AFRS are vitamin D(3) deficient, which may be linked to increased dendritic cell infiltrate. These results suggest a role for vitamin D(3) as a key player in the immunopathology of pediatric CRSwNP.

Objectives: Describe audiologic outcomes in hearing preservation cochlear implantation (CI) using a precurved electrode array inserted using an external sheath and evaluate association of electrode positioning and preservation of residual hearing. Study Design: Retrospective review.Setting: Tertiary otologic center.Patients: Twenty-four adult patients who underwent hearing preservation CI with precurved electrode array. Interventions: CI, intraoperative computed tomography (CT)Outcome measures: Audiologic measures [Consonant-nucleus-consonant (CNC) words, AzBio sentences, low-frequency pure tone averages (LFPTA)] and electrode location (scalar location, electrode-to-modiolus distance (M -), angular insertion depth).Results: Twenty-four adults with <80dB LFPTA with a precurved electrode array inserted using an external sheath; 16 underwent intraoperative CT. LFPTA was 58.5 dB HL preoperatively, with a 17.3 dB threshold shift at CI activation (p=0.005). CNC word scores improved from 6% preoperatively to 64% at 6 months postoperatively (p<0.0001). There was one scalar translocation and no tip fold-overs. The average angular insertion depth was 388.2 degrees, and the average M across all electrodes was 0.36 mm. Multivariate regression revealed a significant correlation

ObjectiveTo investigate the prevalence and impact of obstructive sleep apnea (OSA) and obesity in lateral skull base cerebrospinal fluid leak repair (LSBR) of various etiologies.MethodsRetrospective case review at a tertiary skull base center was conducted of consecutive adults undergoing LSBR via transmastoid, middle cranial fossa, or combined approach between 2013–2018. The following data were collected: demographics, comorbidities, radiology and intraoperative findings, and surgical outcomes including complications and need for revision surgery or shunt placement. Patients with incomplete data or leaks following skull base surgery, trauma or chronic ear disease were excluded.ResultsNinety‐four patients (67.4% female, mean age 53.5 ± 12.9 years) underwent repair forspontaneous (sCSFL, 44%) and other etiology (nsCSFL) leaks. nsCSFL served as a comparisongroup consisting of leaks status‐post lateral skull base surgery, temporal bone fractures, andchronic ear disease. Class III obesity (P = .02), OSA (P = .03), and imaging findings of empty sella (OR = 3.32, P = .02), and skull base thinning including contralateral tegmen thinning (31%, OR = 4.3, P = .02), arachnoid granulations (26%, OR = 4.35, P = .02), and superior canal dehiscence (15.8%, OR = 8.57, P = .04) were more common in sCSFL. Four patients (4.2%) required surgical revision for recurrence, and another four (4.2%) resolved with shunting. Evidence of elevated intracranial hypertension was present in nine patients with sCSF leaks and was predictive of need for revision or shunt procedures (P < .01).ConclusionObesity, OSA, and imaging consistent with elevated intracranial pressures were more common among patients with sCSFL. Elevated intracranial pressure predicted outcomes following multilayer repair of spontaneous CSF leaksLevel of Evidence4 Laryngoscope, 130:2234–2240, 2020

IMPORTANCE Over two-thirds of the adult population in the United States use Facebook. Despite the high interest in and use of social media by the general public, the presence and accessibility of health care organizations on social media has not yet been fully evaluated. OBJECTIVE To determine the use and popularity of social media among otolaryngology residency programs in the United States. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of the presence of accredited otolaryngology residency programs in the United States in an internet data repository was conducted. Programs were stratified by Doximity Residency Navigator reputation rankings (dividing programs into quartiles) and US News & World Report (comparing programs affiliated with hospitals ranked in the top 50 vs programs affiliated with unranked hospitals). Social media sites and activity for each program were assessed using internet searches. The study was conducted in April 2017. RESULTS Among 101 otolaryngology residency programs, 30 were found to have social media sites (29.7%). Facebook and Twitter were the most commonly used services, with 25 (24.8%) and 14 (13.9%) accounts, respectively. Based on Doximity Residency Navigator rankings, programs in the first quartile were more likely to have Facebook profiles than programs in the fourth quartile (42.3% vs 12.0%; absolute difference, 30%; 95% CI, 2.9% to 52.6%). Firstand second-quartile programs showed increased Facebook activity. There was greater Twitter presence in first-vs fourth-quartile programs (19.2% vs 8.0%; absolute difference, 11.2%; 95% CI, −11.6% to 33.0%). Higher-quartile programs were more active on Twitter and exhibited increased numbers of likes and followers. Analysis of US News & World Report rankings revealed that ranked programs had higher rates of presence, activity, and popularity on both Facebook and Twitter. However, these were smaller differences than seen when comparing Doximity Residency Navigator rankings. Correlation between the 2 ranking systems was indicated (Spearman ρ = 0.59; 95% CI, 0.34 to 0.76). CONCLUSIONS AND RELEVANCE This study suggests that otolaryngology residency programs with higher Doximity Residency Navigator reputation rankings have a stronger presence on social media. Smaller trends were observed for programs in the top 50 US News & World Report rankings. Overall, social media use among otolaryngology programs seems relatively low, and this may present an opportunity to increase communication with the public via these technologies.

Objective: Characterize differences in adult cochlear implant outcomes and programming parameters for a straight (CI422/522) and a precurved (CI532) electrode array. Setting: Cochlear implant (CI) program at a tertiary otologic center. Patients: Fifty-eight adults were included in the study; 29 were implanted with CI422 or CI522 and 29 were implanted with CI532. Each CI532 recipient was matched to a CI422/522 recipient in terms of age and preoperative hearing thresholds for comparison purposes. Main Outcome Measures: Consonant-Nucleus-Consonant (CNC) words, AzBio sentences, residual audiometric thresholds, and Speech Spatial Qualities (SSQ) questionnaire collected 6 months postoperatively were used to characterize outcomes. Pulse duration, maxima, impedances, and overall charge measurements were used to characterize programming parameters. Results: Postoperative unaided low frequency pure-tone average (LFPTA) was significantly better for the CI532 group. CNC scores were significantly better for the CI532 group. Impedances and pulse duration were significantly lower for the CI532 group, but there was no difference in overall charge between the groups. Conclusion: The CI532 group showed either similar or statistically superior results on all measures when compared with the CI422/522 suggesting that the CI532 electrode may be an advantageous substitute for the CI522.

Porcine small intestinal submucosal grafts are effective in the repair of the tympanic membrane. These grafts are an excellent choice in total endoscopic cases as it avoids incisions necessary for allograft harvest.

Controlling for the type of prosthesis, there were no significant differences in hearing outcomes with respect to staged ossicular chain reconstruction or whether the endoscope or microscope was used for visualization. Thus, in this series, endoscopic OCR yields similar audiometric outcomes when compared with microscopic OCR.

For patients using a bimodal hearing configuration with substantial residual hearing in the non-CI ear, bilateral cochlear implantation yields improved audiologic performance and better subjective quality of life, irrespective of the ability to preserve acoustic hearing during the second sided implantation.