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American Academy of Otolaryngology, Sept. 11-14, 2011

The 115th Annual American Academy of Otolaryngology -- Head and Neck Surgery Foundation Meeting and Otolaryngology Expo

The 115th Annual American Academy of Otolaryngology -- Head and Neck Surgery Foundation Meeting and Otolaryngology Expo was held from Sept. 11 to 14 in San Francisco, and attracted more than 9,400 participants from around the world, including otolaryngologists, medical experts, allied health professionals, and administrators. The conference featured instruction courses, mini-seminars, scientific oral presentations, honorary guest lectures, and numerous scientific posters. Presentations focused on the latest advances in chronic ear infection, sinusitis, snoring and sleep apnea, hearing loss, allergies and hay fever, swallowing disorders, nosebleeds, hoarseness, dizziness, and head and neck cancer.

In one study, Hamid R. Djalilian, M.D., of the University of California in Irvine, and colleagues found that harmonic sound therapy was effective in reducing the loudness and annoyance of tinnitus. The investigators evaluated 32 patients with tinnitus.

"The protocol we developed was an Internet-based protocol in which an individual with tinnitus was evaluated and the tinnitus pitch was determined and other characteristics were taken into consideration. Next, a file was generated based on an algorithm and the sound file was put on an MP3 player. In this study, patients listened to the sound file for an hour and we measured the loudness and annoyance of the ringing before and after the patient listened to the sound file," Djalilian said.

The investigators found that 88 percent of patients had some reduction in ringing. In addition, 72 percent had greater than a 25 percent reduction in loudness and annoyance, while 13 percent experienced complete suppression of the ringing. The duration of residual inhibition varied among patients but the median duration was approximately 33 minutes.

"We have found that harmonic sound therapy is an effective way of temporarily reducing the perception of tinnitus. This sound can be delivered via the Web to the patient and placed on an MP3 player. This allows for a telemedicine approach to the treatment of tinnitus in the future," Djalilian added.


In another study, Kevin S. Emerick, M.D., of Massachusetts General Hospital in Boston, and colleagues found that smoking status impacted the survival of patients with head and neck cancer.

"These data come from a much larger study we are undertaking to better assess a larger number of clinical and pathologic factors [and their] impact on the lethality of head and neck cancer," Emerick said.

The investigators evaluated patients with head and neck cancer who were previous smokers (stopped smoking upon diagnosis), current smokers, and nonsmokers. They compared two- and five-year survival rates among four major subsites of head and neck cancer patients.

"We found that nonsmokers and previous smokers did better than smokers in all subsites except the oral cavity, where outcomes were equivalent. Specifically, in patients with oropharynx tumors, the five-year overall survival was as much as 40 percent better. In patients with larynx and hypopharynx tumors, the five-year survival rate was approximately 15 percent better," Emerick said. "These data show that there was improved survival among nonsmokers and that this impact is different between the subsites of the head and neck."


Alexandra E. Kejner, M.D., of the University of Alabama in Birmingham, and colleagues found that only 57 percent of patients who underwent tracheostomy at a tertiary care hospital survived to discharge, despite no surgical deaths.

The investigators performed 115 tracheostomies and found that 21 percent died within the 30-day postoperative period but no patients died from complications related to tracheostomy, including mediastinitis, hemorrhage, or infection.

"In the patients who did not survive the 30-day postoperative period, there were several significant differences: age, age greater than 70, number of comorbidities (history of stroke, chronic lung disease, etc.), and length of time from admission to tracheostomy. Gender, ethnicity, nor time on ventilator was found to be significant," Kejner said. "High-risk patients were more likely to have a higher mortality. These were patients who were sick. Tracheostomy was not the cause of death in this patient population but, rather, many [patients] succumbed to their premorbid conditions."


Angela Cogburn Paddack, M.D., of the University of Arkansas for Medical Sciences in Little Rock, and colleagues evaluated the link between food hypersensitivity associated with cow's milk protein allergy and common gastrointestinal and upper aerodigestive disorders among children younger than 2 years of age.

The investigators identified a subset of children that had both gastrointestinal and ear, nose, and throat symptoms that did not improve with traditional therapies. The most common upper aerodigestive symptoms were chronic congestion or problems swallowing, which are often blamed on gastrointestinal reflux.

"We found a small subset of children whose gastrointestinal and ear, nose, and throat symptoms were made better by treating them for cow's milk protein allergy. Practicing clinicians should consider cow's milk allergy as a cause in children whose symptoms are refractory to reflux management," Paddack said. "Food hypersensitivity is an increasingly frequent diagnosis in the pediatric population and cow's milk protein allergy should be considered when treatment for other inflammatory conditions fails."


Laura White, M.D., of Emory University in Atlanta, and colleagues found different perceptions about head and neck cancer risk among smokers and nonsmokers.

The investigators found that smokers worried significantly more about head and neck cancer than nonsmokers. In addition, smokers perceived head and neck cancer to be significantly less dangerous than did nonsmokers. There was no significant difference in the perceived head and neck cancer risk reduction due to smoking cessation between smokers with quit attempts and smokers with no quit attempts.

"Although the two groups had significant differences in their perceptions of head and neck cancer worry and perceived danger, neither smokers or nonsmokers worried much about their risk of head and neck cancer despite [the fact] that they perceived head and neck cancer to be dangerous," White said.


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