Identifying Patient Characteristics That Predict Drug-Induced Sleep Endoscopy Anatomy.

OBJECTIVE: To examine if age, sex, body mass index (BMI), neck circumference, or apnea-hypopnea index can predict whether a patient will demonstrate velopharyngeal complete circumferential (CC) collapse on drug-induced sleep endoscopy (DISE). STUDY DESIGN: Single-center retrospective review at The Ohio State Wexner Medical Center of 289 patients between March 2014 and June 2020. SETTING: Quaternary care hospital. METHODS: Patient characteristic and DISE information was extracted from charts and summarized with mean and standard deviation for continuous variables and count and percentage for categorical. CC collapse and patient characteristic associations were explored: 2-sample t test for continuous and chi-square test for categorical. Classification and regression tree (CART) analysis with 3-fold cross-validation was employed to search for the best CC collapse predictors. RESULTS: Male and female BMI and female neck circumference were correlated to velopharyngeal CC collapse, with BMI more strongly correlated. CART analysis for males showed that a BMI ≤34.8 kg/m2 is associated with an 89.4% chance of not demonstrating velopharyngeal CC collapse vs 48% for BMI >34.8 (area under the curve [AUC] = 0.705; AUC >0.7 is acceptable). For females, the CART analysis showed that a BMI ≤36.4 is associated with a 98.4% of not demonstrating velopharyngeal CC collapse vs 30.8% for BMI >36.4 (AUC = 0.73). For females, a neck circumference ≤38.05 cm is associated with a 100% chance of not demonstrating velopharyngeal CC collapse vs 18.4% for >38.05 cm (AUC = 0.72). CONCLUSION: The BMI values for males and females and the female neck circumference values established by the CART model may accurately predict DISE anatomy and possible candidacy for hypoglossal nerve stimulation.

Can a Self-report Measure Be Used to Assess Cognitive Skills in Adults With Hearing Loss?

HYPOTHESES: Adult cochlear implant candidates would self-report their executive functioning abilities as poorer than normal-hearing peers. These executive function abilities would correlate with laboratory-based cognitive tests. Lastly, executive functioning (EF) abilities would be associated with hearing-related quality of life. BACKGROUND: Executive function refers to cognitive abilities involved in behavioral regulation during goal-directed activity. Pediatric and adult users have demonstrated delays and deficits in executive function skills compared with normal-hearing peers. This study aimed to compare self-report executive function in adult cochlear implant candidates and normal-hearing peers and to relate executive function skills to laboratory-based cognitive testing and hearing-related quality of life. METHODS: Twenty-four postlingually deaf adult cochlear implant candidates were enrolled, along with 42 normal-hearing age-matched peers. Participants completed self-reports of executive function using the Behavior Rating Inventory of Executive Function- Adult (BRIEF-A). Participants were also tested using laboratory-based cognitive measures, as well as assessment of hearing-related quality of life on the Nijmegen Cochlear Implant Questionnaire. Groups were compared on BRIEF-A scores, and relations between BRIEF-A and lab-based cognitive measures as well as Nijmegen Cochlear Implant Questionnaire scores were examined. RESULTS: Self-report executive function on the BRIEF-A was not significantly different between groups. Consistent relations of self-report executive function and nonverbal reasoning were identified. Strong relations were not found between self-report executive function and hearing-related quality of life. CONCLUSIONS: Executive function as measured by BRIEF-A demonstrates some relation with a laboratory-based metric of nonverbal reasoning, but not other cognitive measures. Hearing-impaired individuals did not report poorer EF than normal-hearing controls. EF additionally did not correlate with quality of life. Our findings provide preliminary, partial validation of the BRIEF-A instrument in the preoperative evaluation of adult cochlear implant candidates.