Transcutaneous versus percutaneous bone-anchored hearing aids: A quality of life comparison.

PURPOSE: To determine whether patients have improved quality of life outcomes with percutaneous bone conduction implant (p-BCI) versus transcutaneous bone conduction implant (t-BCI). MATERIALS & METHODS: Retrospective chart review of patients who have undergone placement of a BCI in the Ascension St John Providence Health System from 2013 to 2018. Patient satisfaction of t-BCI and p-BCI was measured using a questionnaire that incorporated the Glasgow Benefit Inventory (GBI) and BAHA, aesthetic, hygiene & use (BAHU) survey. Key outcome variables were separated into 2 categories: (1) evaluation of wound healing and implant-associated complications, and (2) quality of life improvements. RESULTS: Comparative analysis of the 27 p-BCI patients and 10 t-BCI patients showed overall positive benefit with no statistically significant difference on quality of life improvement between the two groups. Total complication rates for p-BCI (48.1 %) vs t-BCI (10 %) was marginally significant (p = 0.056). Rate of revision for p-BCI versus t-BCI was 14.8 % vs 0 %, respectively. CONCLUSION: This study provides a much-needed comparative insight in patient's experience with these two devices. Understanding which device is preferable in the patient's view will offer helpful information for guiding proper implant selection.

Straw vs Cup Use in Patients with Symptoms of Oropharyngeal Dysphagia.

CONTEXT: This study aims to determine whether straw or cup use is superior for the control of a single thin liquid bolus in patients with symptoms of oropharyngeal dysphagia to liquids. METHODS: This is a prospective, randomized, single-blinded study. Patients were studied at a Professional Voice and Swallowing Center by a laryngologist between April 2017 and April 2018. Twenty-five patients, 18 years of age or older, who presented with symptoms of oropharyngeal dysphagia the clinic were included in the study. Each patient complained of difficulty with choking on liquids. Informed consent was obtained from each patient. Patients that were unable to follow one to two step commands and patients with dysphagia that lack oral strength or respiratory strength to facilitate straw or cup usage were not included. Patients with dysphagia that are tracheostomy tube dependent were also not included. RESULTS: The average PAS for straw versus cup drinking at 10mL was 1.08 and 1.04 respectively with a p-value of 0.33. For straw versus cup at 20mL, the PAS was 1.04 and 1.26 respectively with a p-value of 0.13. For 30mL, the PAS was 1.0 and 1.4 for straw and cup use respectively with a p-value of 0.16. And for 40mL, the PAS was 1.0 and 1.09 with a p-value of 0.27. CONCLUSIONS: No statistical significant difference was demonstrated in risk of penetration or aspiration of thin liquids between cup and straw usage in patients with mild oropharyngeal dysphagia.

Two Soft Contact Lenses Retained in the Superior Fornix for 15 Years in a Patient With Unique Orbital Anatomy.

A 70-year-old white woman presented to her ophthalmologist with bacterial conjunctivitis resistant to treatment. The relationship between the patient's globe and superior orbital rim prompted high clinical suspicion of an occult foreign body as the cause. The following article describes the office visits preceding the discovery of two adhered soft contact lenses lodged in the superior fornix of the right eye that had been hidden for 15 years. We discuss the role her unique orbital anatomy played in successfully concealing these foreign bodies for over a decade. In addition, we present an algorithm to practice when an occult foreign body is suspected, which includes effective clinical techniques.