Publications by authors named "Lawrence R Lustig"

101 Publications

Impact of COVID-19 on Otolaryngology Literature.

Laryngoscope 2021 Oct 8. Epub 2021 Oct 8.

Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A.

Objectives/hypothesis: To understand the effect of the COVID-19 pandemic on the volume, quality, and impact of otolaryngology publications.

Study Design: Retrospective analysis.

Methods: Fifteen of the top peer-reviewed otolaryngology journals were queried on PubMed for COVID and non-COVID-related articles from April 1, 2020 to March 31, 2021 (pandemic period) and pre-COVID articles from the year prior. Information on total number of submissions and rate of acceptance were collected from seven top-ranked journals.

Results: Our PubMed query returned 759 COVID articles, 4,885 non-COVID articles, and 4,200 pre-COVID articles, corresponding to a 34% increase in otolaryngology publications during the pandemic period. Meta-analysis/reviews and miscellaneous publication types made up a larger portion of COVID publications than that of non-COVID and pre-COVID publications. Compared to pre-COVID articles, citations per article 120 days after publication and Altmetric Attention Score were higher in both COVID articles (citations/article: 2.75 ± 0.45, P < .001; Altmetric Attention Score: 2.05 ± 0.60, P = .001) and non-COVID articles (citations/article: 0.03 ± 0.01, P = .002; Altmetric Attention Score: 0.67 ± 0.28, P = .016). COVID manuscripts were associated with a 1.65 times higher acceptance rate compared to non-COVID articles (P < .001).

Conclusions: COVID-19 was associated with an increase in volume, citations, and attention for both COVID and non-COVID articles compared to pre-COVID articles. However, COVID articles were associated with lower evidence levels than non-COVID and pre-COVID articles.

Level Of Evidence: Level 3 Laryngoscope, 2021.
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http://dx.doi.org/10.1002/lary.29902DOI Listing
October 2021

Generating a Social Media Ontology for Otology and Neurotology.

Otol Neurotol 2021 06;42(5):635-637

Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, JBSA-Fort Sam Houston, Texas.

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http://dx.doi.org/10.1097/MAO.0000000000003170DOI Listing
June 2021

Comparison of Cochlear Implant Device Fixation-Well Drilling Versus Subperiosteal Pocket. A Cost Effectiveness, Case-Control Study.

Otol Neurotol 2021 04;42(4):517-523

Department of Otolaryngology-Head and Neck Surgery, Cornell Medical College, New York, New York.

Objective: To compare surgical characteristics and complications between well drilling (WD) and subperiosteal pocket techniques (SPT) for receiver/stimulator (R/S) fixation of cochlear implant (CI), and conduct cost-effectiveness analysis.

Study Design: Retrospective clinical study, decision-analysis model.

Setting: Tertiary referral center.

Patients: Three-hundred and eighty-eight CI recipients with a minimum of 6-months follow-up.

Interventions: CI surgery using either WD or SPT for R/S fixation. A decision-analysis model was designed using data from a systematic literature review.

Main Outcome Measures: Surgical operation time, rates of major and minor long-term complications were compared. Incremental cost-effectiveness was also estimated, comparing the two methods of fixation.

Results: We compared 179 WD with 209 SPT. Surgery time was significantly shorter in SPT (148 versus 169 min, p = 0.001) and remained significant after adjustment for possible confounders. Higher rates of major complications requiring surgical intervention were found with SPT (10.5% versus 4.5%, p = 0.042), however, the difference was not significant after adjusting for follow-up time (47.8 versus 32.5 months for SPT, WD respectively; p < 0.001). The incremental cost-effectiveness ratio for WD (compared with SPT) was $48,795 per major complication avoided, which was higher than the willingness-to-pay threshold of $47,700 (average cost of 2 h revision surgery).

Conclusions: SPT was found to be faster but potentially risks more complications, particularly relating to device failure. Further long-term studies are required to validate these differences. Based on data from the current literature, neither of the methods is compellingly cost-effective over the other, and surgeons can base their choice on personal preference, comfort, and previous training.
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http://dx.doi.org/10.1097/MAO.0000000000002954DOI Listing
April 2021

The Risks of Being Otologist, an Ergonomic and Occupational Hazard Review.

Otol Neurotol 2020 10;41(9):1182-1189

Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York.

Objective: To review occupational ergonomic risks for the Otologist and Neurotologist.

Data Sources: MEDLINE, OVID, PubMed, and Google Scholar.

Study Selection: A search was conducted to identify all studies in the English language that involve ergonomic-related risks for surgeons.

Results: Occupational hazards, particularly musculoskeletal disorders (MSDs), are common in the surgical community in general and among Otolaryngologists in particular. Very few studies have been conducted assessing MSDs specific to Otologists and Neurotologists. However, extrapolating from other surgical professions with similar ergonomic postures in the operation room and office, one can infer that cervical and lumbar pain are related to prolonged static sitting and neck flexion when working with a microscope and begins early in training. Early institution of correct ergonomic training is feasible and may be effective. Improved ergonomic habits include upright sitting, avoidance of neck flexion, initiating short breaks, and the use of chairs with arm and back support. Future technologies incorporated into otologic surgery should have improved ergonomic design.

Conclusions: Otologists and Neurotologists are exposed to MSDs directly related to their work demands. Incorporating healthy ergonomics into surgical training as well adopting correct posture and the use equipment designed for back support may help mitigate the long-terms risks of MSD.
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http://dx.doi.org/10.1097/MAO.0000000000002769DOI Listing
October 2020

American Neurotology Society, American Otological Society, and American Academy of Otolaryngology - Head and Neck Foundation Guide to Enhance Otologic and Neurotologic Care During the COVID-19 Pandemic.

Otol Neurotol 2020 10;41(9):1163-1174

Department of Otolaryngology, Harvard Medical School.

: This combined American Neurotology Society, American Otological Society, and American Academy of Otolaryngology - Head and Neck Surgery Foundation document aims to provide guidance during the coronavirus disease of 2019 (COVID-19) on 1) "priority" of care for otologic and neurotologic patients in the office and operating room, and 2) optimal utilization of personal protective equipment. Given the paucity of evidence to inform otologic and neurotologic best practices during COVID-19, the recommendations herein are based on relevant peer-reviewed articles, the Centers for Disease Control and Prevention COVID-19 guidelines, United States and international hospital policies, and expert opinion. The suggestions presented here are not meant to be definitive, and best practices will undoubtedly change with increasing knowledge and high-quality data related to COVID-19. Interpretation of this guidance document is dependent on local factors including prevalence of COVID-19 in the surgeons' local community. This is not intended to set a standard of care, and should not supersede the clinician's best judgement when managing specific clinical concerns and/or regional conditions.Access to otologic and neurotologic care during and after the COVID-19 pandemic is dependent upon adequate protection of physicians, audiologists, and ancillary support staff. Otolaryngologists and associated staff are at high risk for COVID-19 disease transmission based on close contact with mucosal surfaces of the upper aerodigestive tract during diagnostic evaluation and therapeutic procedures. While many otologic and neurotologic conditions are not imminently life threatening, they have a major impact on communication, daily functioning, and quality of life. In addition, progression of disease and delay in treatment can result in cranial nerve deficits, intracranial and life-threatening complications, and/or irreversible consequences. In this regard, many otologic and neurotologic conditions should rightfully be considered "urgent," and almost all require timely attention to permit optimal outcomes. It is reasonable to proceed with otologic and neurotologic clinic visits and operative cases based on input from expert opinion of otologic care providers, clinic/hospital administration, infection prevention and control specialists, and local and state public health leaders. Significant regional variations in COVID-19 prevalence exist; therefore, physicians working with local municipalities are best suited to make determinations on the appropriateness and timing of otologic and neurotologic care.
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http://dx.doi.org/10.1097/MAO.0000000000002868DOI Listing
October 2020

Otology and Neurotology in a Post-COVID-19 World.

Otol Neurotol 2020 10;41(9):1159

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http://dx.doi.org/10.1097/MAO.0000000000002901DOI Listing
October 2020

Impact of Underlying Diagnosis on Speech and Quality of Life Outcomes After Cochlear Implantation for Single-Sided Deafness.

Otol Neurotol 2020 04;41(4):e432-e440

Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York.

Objective: Our objective was to compare outcomes in speech and quality of life in those undergoing cochlear implantation for single-sided deafness (SSD), with the aim to characterize the clinical impact of underlying diagnosis in the affected ear and pre-operative hearing status.

Study Design: Prospective case series.

Setting: Academic Cochlear Implant Center.

Patients: 42 adult patients implanted with the diagnosis of SSD.

Interventions: Patients were evaluated at 3-, 6-, and 12-months post-operatively using AZBio sentence and speech, and consonant-nucleus-consonant (CNC) depending on appropriate testing level. Our previously validated Comprehensive Cochlear Implant Quality of Life (CCIQ) questionnaire was administered.

Main Outcome Measures: Speech perception, quality of life.

Results: Subjects were stratified by the underlying diagnosis: Meniere's Disease (MD; n = 10), sudden sensorineural hearing loss (SSNHL; n = 13), and Other (eg TBI, acoustic neuroma, progressive, noise-induced; n = 19). Mean preoperative PTA of the implanted ear was 82dB ± 17; that of the nonimplanted ear was 32dB ± 17. SSNHL and MD demonstrated the highest speech perception score at 3 months (93 and 95%), and "Other" demonstrated the lowest scores at 88%. All 3 groups demonstrated nadir in speech scores at 6 months before improving at 12 months, but the "Other" diagnoses maintained the lowest speech testing across all time points. All 3 groups reported improved quality of life on CCIQ.

Conclusions: Subjects with SSNHL and MD demonstrate excellent speech perception and quality of life outcomes after cochlear implantation for SSD. Subjects with "Other" diagnoses underlying their SSD demonstrated lower scores on speech testing but nonetheless reported improved quality of life.
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http://dx.doi.org/10.1097/MAO.0000000000002578DOI Listing
April 2020

Inaugural Otology and Neurotology "Video Report".

Otol Neurotol 2020 04;41(4):429-430

Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York.

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http://dx.doi.org/10.1097/MAO.0000000000002560DOI Listing
April 2020
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