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Otolaryngologic Clinics of North America

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https://read.qxmd.com/read/30770176/totally-implantable-active-middle-ear-implants
#1
REVIEW
Michael D Seidman, Tyler A Janz, Jack A Shohet
The Envoy Esteem and the Carina system are the 2 totally implantable hearing devices. The Esteem is designed for patients with bilateral moderate to severe sensorineural hearing loss who have an unaided speech discrimination score of greater than and equal to 40%. The Carina system is designed for patients with moderate to severe sensorineural hearing loss or those with mixed hearing loss. The Esteem offers a technologically advanced method to provide improvements in hearing and is available in the United States, whereas the Carina system is currently not available in the United States...
February 12, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30765094/special-populations-in-implantable-auditory-devices-developmentally-challenged-and-additional-disabilities
#2
REVIEW
Daniel Jethanamest, Baishakhi Choudhury
Children with hearing loss and additional disabilities can benefit from cochlear implants and other implantable auditory devices. Although each individual child must be evaluated, and families uniquely counseled on goals and realistic expectations, overall many gains and benefits are possible in this population. In this article, an overview of the considerations for this group is discussed and outcomes are reviewed, including auditory and speech measures as well as benefits in other skills and quality of life...
February 11, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30765093/special-populations-in-implantable-auditory-devices-geriatric
#3
REVIEW
Selena E Briggs
Hearing loss is common in the geriatric population. Most hearing loss is associated with presbycusis or age-related hearing loss, impacting one-third of individuals over 65 years and increasing in prevalence with age. Hearing loss impacts quality of life, psychological health, and cognition. Implantable auditory devices are an exceptional option to improve hearing and quality of life. Various implantable auditory devices have been implemented safely with significant improvement in communication and performance on auditory tasks...
February 11, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30765092/future-of-implantable-auditory-devices
#4
REVIEW
Robert M Rhodes, Betty S Tsai Do
The advances in technology leading to rapid developments in implantable auditory devices are constantly evolving. Devices are becoming smaller, less visible, and more efficient. The ability to preserve hearing outcomes with cochlear implantation will continue to evolve as surgical techniques improve with the use of continuous feedback during the procedure as well as with intraoperative delivery of drugs and robot assistance. As engineering methods improve, there may one day be a totally implantable aid that is self-sustaining in hearing-impaired patients making them indistinguishable from patients without hearing loss...
February 11, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30765091/auditory-neuropathy-bridging-the-gap-between-hearing-aids-and-cochlear-implants
#5
REVIEW
Robert J Yawn, Ashley M Nassiri, Alejandro Rivas
Auditory neuropathy spectrum disorder (ANSD) is a complex and heterogeneous disorder associated with altered neural synchrony with respect to auditory stimuli. Patients have characteristic auditory findings including normal otoacoustic emissions in the setting of abnormal auditory brainstem response. Patients with ANSD have a high incidence of comorbid developmental delay that may impact speech outcomes. Treatment options for ANSD include hearing amplification and cochlear implantation. The article highlights issues and controversies with the diagnosis and treatment of this complex disorder...
February 11, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30617011/electroacoustic-stimulation
#6
REVIEW
Carol Li, Megan Kuhlmey, Ana H Kim
Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear...
January 4, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30617010/osseointegrated-auditory-devices-bone-anchored-hearing-aid-and-ponto
#7
REVIEW
Soha N Ghossaini, Pamela C Roehm
Osseointegrated auditory devices (OADs) are hearing devices that use an external receiver/processor that stimulates bone conduction of sound via a titanium prosthesis that is drilled into the bone of the cranium. Since their introduction in 1977, OADs have undergone substantial evolution, including changes in manufacturing of the implant, improvements in the external sound processor, and simplification of implantation techniques. Expansion of criteria for patient candidacy for implantation has occurred corresponding with changes in the implants and processors...
January 4, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30612758/physiology-of-osseointegration
#8
REVIEW
Jennifer Wing Yee Lee, Manohar Lal Bance
"Bone conduction implant devices rely on osseointegration of titanium implants with the underlying skull, characterized by endosseous healing and de-novo bone formation both surrounding and onto the implant surface. The key steps in osseointegration are the initial tissue response to implantation, peri-implant osteogenesis, and peri-implant bone remodeling. There is increasing evidence that osseointegration is primarily an immune-mediated process with the key players being the complement cascade and macrophages, which form part of the host innate immunity...
January 3, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30612757/osseointegrated-auditory-devices-bonebridge
#9
REVIEW
Mia E Miller
Bonebridge is an active bone conduction device that consists of a bone conduction-floating mass transducer (BC-FMT) and magnet internally and an audio processor externally. Surgery for implantation can be performed under local anesthesia but requires surgical planning for adequate bone depth for the BC-FMT well. Bonebridge does not require osseointegration to function, so the device can be activated early. One disadvantage of Bonebridge is the sizable artifact on MRI created by the internal magnet. Studies of Bonebridge implantation demonstrate few complications, and hearing outcomes are audiologically equivalent to other bone conduction devices...
January 3, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30612756/the-vibrant-soundbridge-a-global-overview
#10
REVIEW
Jennifer Maw
The Vibrant Soundbridge is a semi-implantable, active middle ear implant that is a safe and effective treatment for patients with sensorineural hearing loss. Since Food and Drug Administration approval for this indication, many international investigators have expanded its use for conductive and mixed hearing losses. This article reviews the author's experience and the international uses of this versatile device.
January 3, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30612755/extended-wear-hearing-technology-the-nonimplantables
#11
REVIEW
Neil M Sperling, Scott E Yerdon, Marc D'Aprile
A new category of hearing technology has emerged that comprises devices inserted deep into the ear canal. Although not implanted, they represent an extension of what is expected of a traditional hearing aid. There are advantages to these devices, but they are not suited for all individuals with hearing loss. This category consists of 2 devices currently available in the United States: Lyric (Phonak AG, Stafa, Switzerland) and Earlens (Earlens, Menlo Park, CA, USA).
January 3, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30612754/limitations-of-conventional-hearing-aids-examining-common-complaints-and-issues-that-can-and-cannot-be-remedied
#12
REVIEW
Sara Lerner
This article examines and evaluates methods, from an audiologist's perspective, of reducing common complaints with conventional hearing aids and issues such as the occlusion effect, acoustic feedback, discomfort, and insufficient gain. Although often successful, reducing one problem may have the tradeoff of causing another issue. This article is meant to provide information to the reader regarding modern conventional hearing aids, the means to alleviate common problems in the clinic, and when middle ear implants and osseointegrated implants can be beneficial...
January 3, 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30390737/patient-engagement-in-otolaryngology
#13
REVIEW
Marisa A Ryan, Emily F Boss
Patient engagement, which involves incorporating the patient and family as partners in their care, is a growing focus in otolaryngology and surgery. Attention to patient and family centeredness, shared decision making, and patient experience together improves the overall tenor of patient engagement. Patient engagement promotes safety through improving quality of electronic health record data, error detection, and treatment decisions and adherence. In this article, we review specific areas of importance for patient engagement in otolaryngology as well as areas needing more research and development...
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30390736/clinical-indices-to-drive-quality-improvement-in-otolaryngology
#14
REVIEW
Christine L Barron, Charles A Elmaraghy, Stephanie Lemle, Wallace Crandall, Richard J Brilli, Kris R Jatana
A Pediatric Tracheostomy Care Index (PTCI) was developed by the authors to standardize care and drive quality improvement efforts at their institution. The PTCI comprises 9 elements deemed essential for safe care of children with a tracheostomy tube. Based on the PTCI scores, the number of missed opportunities per patient was tracked, and interventions through a "Plan-Do-Study-Act" approach were performed. The establishment of the PTCI has been successful at standardizing, quantifying, and monitoring the consistency and documentation of care provided at the authors' institution...
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30309675/button-battery-safety-industry-and-academic-partnerships-to-drive-change
#15
REVIEW
Kris R Jatana, Silas Chao, Ian N Jacobs, Toby Litovitz
The pediatric button battery (BB) hazard has been recognized for several decades. In 2012, the National Button Battery Task Force was established, and most manufacturers have improved warning labels, more secure packaging, and made BB compartments in products are more secure. Tissue neutralization before BB removal (ie, honey or sucralfate/Carafate®) is an effective way to reduce the rate of BB injury. In absence of visible perforation, 0.25% sterile acetic acid esophageal tissue irrigation at time of BB removal is recommended as a neutralization strategy to mitigate injury progression...
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30297183/multidisciplinary-tracheostomy-care-how-collaboratives-drive-quality-improvement
#16
REVIEW
Joshua R Bedwell, Vinciya Pandian, David W Roberson, Brendan A McGrath, Tanis S Cameron, Michael J Brenner
There have been reports of successful quality-improvement initiatives surrounding tracheostomy care for more than a decade, but widespread adoption of best practices has not been universal. Five key drivers have been found to improve the quality of care for tracheostomy patients: multidisciplinary synchronous ward rounds, standardization of care protocols, appropriate interdisciplinary education and staff allocation, patient and family involvement, and use of data to drive improvement. The Global Tracheostomy Collaborative is a quality-improvement collaborative dedicated to improving the care of tracheostomy patients worldwide through communication, dissemination, and implementation of proven strategies based on these 5 key drivers...
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30297182/rethinking-morbidity-and-mortality-conference
#17
REVIEW
Brian Nussenbaum, Richard A Chole
This article will discuss the importance of an effective morbidity and mortality (M&M) conference toward supporting a proactive and preventative approach to patient safety and quality improvement (PSQI). Key characteristics will be discussed that enhance this process for being a mechanism for driving positive PSQI culture change that permeates the department. The focus of this article will be on how to approach the structure and process of this conference for maximal benefit.
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30297181/delivering-otolaryngologic-care-safely-and-successfully
#18
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30297180/publicly-available-databases-in-otolaryngology-quality-improvement
#19
REVIEW
Alexander L Schneider, Jennifer M Lavin
The historical context for quality improvement is provided. Important differences are described between the two overarching types of databases: clinical registries and administrative databases. The pros and cons of each are provided as are examples of their utilization in otolaryngology-head and neck surgery.
February 2019: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/30287065/patient-safety-in-audiology
#20
REVIEW
Tommie L Robinson, Tracey Ambrose, Lyuba Gitman, Lemmietta G McNeilly
There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided.
February 2019: Otolaryngologic Clinics of North America
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