Meredith E Adams

University of Minnesota Twin Cities | UMN · Department of Otolaryngology

Objective To examine the prevalence of cerumen impaction in a nationally representative sample of the US population and the association of cerumen impaction with sociodemographic factors, hearing loss, and tinnitus. Methods The cohort included 14,230 individuals aged ≥12 years who completed otoscopy and audiometry in NHANES (2005–2016). Cerumen im...

This study investigated management practices for Meniere's disease (MD) and their temporal trends from 2008 to 2022 within the TriNetX network database. Study cohort included adult patients (≥18 years) with the diagnosis of MD from TriNetX's multi‐institutional medical records (n = 77,493). MD diagnosis and management were queried based on the inte...

Objective The impact of poor sleep on tinnitus has been mainly attributed to central processes. There is an association between sleep disorders and hearing loss, but whether hearing levels mediate the association between sleep disorders and tinnitus is unknown. This study investigates the association between sleep characteristics, tinnitus, and hea...

Importance Dizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown. Objective To examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-spe...

Cochlear implants are among the most successful neural prosthetic devices to date but exhibit poor frequency selectivity and the inability to consistently activate apical (low frequency) spiral ganglion neurons. These issues can limit hearing performance in many cochlear implant patients, especially for understanding speech in noisy environments an...

Background Hearing loss has been identified as an independent risk factor for negative health outcomes and mortality. However, whether rehabilitation with hearing aid use is associated with lower mortality is currently unknown. This study aimed to examine the associations of hearing loss, hearing aid use, and mortality in the USA. Methods In this...

Importance Among adults who present for clinical evaluation of dizziness, there is a critical need to identify interventions, such as physical therapy (PT), to mitigate the risk of falls over time. Objective The primary objective was to examine the association between receipt of PT and falls requiring medical care within 12 months of presentation...

Objective: There is increased confusion regarding MRI-compatible CIs and BAHAs. This report describes two cases when patients underwent MRIs with non-MRI compatible devices. Results: One patient with bilateral Cochlear Osias experienced dislocation of both internal magnets after 1.5 Tesla MRI. Both magnets were outside the silastic sheath, with...

Decision-making in management of sporadic vestibular schwannoma aims to identify the most appropriate options based on tumor characteristics, symptoms, health, and goals for each patient. Advances in knowledge of tumor natural history, improvements in radiation techniques, and achievements in neurologic preservation with microsurgery have shifted e...

Computerized dynamic posturography (CDP) provides multisensory assessment of balance. Consensus is lacking regarding CDP utility and coverage determinations vary. To inform best practices and policy, this cross-sectional study quantifies provider use of CDP among Medicare beneficiaries over time (2012-2017), by geographic region (hospital referral...

Objective: The workforce of neurotology has changed with increasing numbers of accredited programs and diverse representation among trainees over the past several decades. This study aims to describe the characteristics, density, and geographic variation of the current neurotology workforce in the United States. Study design: Cross-sectional stu...

This quality improvement study examines the accuracy of the automated audiogram image recognition on the Apple iPhone using a large sample of audiogram reports representing various degrees of hearing loss.

Subjective tinnitus is an auditory phantom perceptual disorder without an objective biomarker. Fast and efficient diagnostic tools will advance clinical practice by detecting or confirming the condition, tracking change in severity, and monitoring treatment response. Motivated by evidence of subtle anatomical, morphological, or functional informati...

This cross-sectional study aims to quantify the association between having a prior hearing test and awareness of hearing loss and hearing aid use in older US adults.

Importance: Overuse of costly neuroimaging technology is associated with low-value care for the prevalent symptom of dizziness. Although quality improvement initiatives have focused on the overuse of computed tomography (CT) scans in emergency departments (EDs), most patients with dizziness present to outpatient clinics. To inform practice and pol...

Neuromodulation treatment effect size for bothersome tinnitus may be larger and more predictable by adopting a target selection approach guided by personalized striatal networks or functional connectivity maps. Several corticostriatal mechanisms are likely to play a role in tinnitus, including the dorsal/ventral striatum and the putamen. We examine...

While the majority of vestibular disorders may be diagnosed solely on clinical grounds, a variety of clinical scenarios exist in which objective functional assessment of the vestibular system provides data that facilitate diagnosis and treatment decisions. There exists a veritable armamentarium of sophisticated vestibular test modalities, including...

Objective Ensuring that patients with dizziness present to the most appropriate level of care and provider are key goals of quality and cost improvement efforts. Using a symptom-defined cohort of adults presenting for dizziness evaluations, we aimed to identify patient factors associated with ambulatory clinic vs emergency department (ED) presentat...

Objective: Clinical practice guidelines recommend canalith repositioning procedures (CRPs) for the management of benign paroxysmal positional vertigo (BPPV). As only 10 to 20% of affected individuals receive CRPs, there is concern for guideline adherence and knowledge dissemination to relevant medical specialties. This study aimed to characterize...

This article reviews the use of human neuroimaging for chronic subjective tinnitus. Evidence-based guidance on the clinical use of imaging to identify relevant auditory lesions when evaluating tinnitus patients is given. After introducing the anatomy and imaging modalities most pertinent to the neuroscience of tinnitus, the article reviews tinnitus...

Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, o...

Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, o...

Importance Variations in diagnostic test use may indicate that there are opportunities for quality improvement in vestibular health care. To date, the extent to which clinician acquisition of tests varies nationwide by region and specialty of the clinician is unknown. Objective To quantify variation in clinician use and payments for audiograms and...

Objective: To characterize patient tolerance and nonmonetary cost burdens of vestibular testing. Rigorously acquired data are essential for patient counseling and to determine if proposed additions/modifications to current protocols improve quality, experience, and efficiencies of care. Study design: Prospective observational study. Setting: T...

Objective: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. Study design: Case series with chart review. Setting: Tertiary referral center. Subjects and methods: Seventeen consecutive pat...

Objective (1) To determine the diagnostic accuracy of tuning fork tests (TFTs; Weber and Rinne) for assessment of hearing loss as compared with standard audiometry. (2) To identify the audiometric threshold at which TFTs transition from normal to abnormal, thus indicating the presence of hearing loss. Data Sources PubMed, Ovid Medline, EMBASE, Web...

OPN770417_Supplemental_Material_CLN – Supplemental material for Randomized Controlled Pilot Study of Video Self-assessment for Resident Mastoidectomy Training

A prospective randomized controlled pilot study was performed to determine if video self-assessment improves competency in mastoidectomy and to assess interrater agreement between expert and resident evaluations of recorded mastoidectomy. Sixteen otolaryngology residents were recorded while performing cadaveric mastoidectomy and randomized into vid...

Objective There is a lack of consensus regarding the indications for vestibular testing in the evaluation of dizziness and balance disorders. Geographic variation in health services utilization is associated with lack of consensus. To understand the variation in current practice, we investigated the patterns of use of vestibular testing and diagnos...

Hypothesis: This study aimed to determine if there are quantitative differences in the neuroepithelium and microvasculature of the saccule between subjects with and without diabetes mellitus (DM). Background: Histopathologic changes that may underlie the association between DM and vestibular dysfunction have not been characterized in humans. Me...

This pilot study aimed to identify candidate proteins for future study that are differentially expressed in vestibular schwannoma (VS) cerebrospinal fluid (CSF) and to compare such proteins with those previously identified in perilymph and specimen secretions. CSF was collected intraoperatively prior to removal of untreated sporadic VS (3 translaby...

Objective: To minimize discomfort, time, and costs, vestibular laboratories may perform monothermal caloric irrigations and discontinue testing if responses are symmetric. This systematic review aimed to determine the diagnostic accuracy of the monothermal caloric screening test (MCST) for unilateral vestibular dysfunction compared with bithermal...

Dizziness associated with vestibular schwannoma is usually ascribed to retrolabyrinthine mechanisms. The goal of this study was to determine if quantitative peripheral vestibular (labyrinthine) otopathology was present in a series of patients with vestibular schwannoma. Comparative human temporal bone study. Otopathology laboratory. Temporal bones...

The "Cochrane Corner" is a section in the journal that highlights systematic reviews relevant to otolaryngology-head and neck surgery, with invited commentary to aid clinical decision making. This installment features the Cochrane review "Interventions to Improve Hearing Aid Use in Adult Auditory Rehabilitation," which identified 32 randomized cont...

Program Description The “dizzy” patient can be a diagnostic challenge. Symptoms can be nonspecific and result from numerous etiologies. While most otolaryngologists realize that a complete and accurate history provides the basis for the diagnosis and management of balance disorders, the use and diagnostic significance of balance tests can be unclea...

To discuss the differential diagnosis of petrous ridge lesions based on a rare case of metastatic pituitary carcinoma. A 41-year-old man with a past medical history of pituitary adenoma and hypopituitarism presented with imbalance and vertigo. Imaging showed a mass eroding the left posterior petrous face. Transtemporal, transmastoid approach for co...

: Bell's palsy is hypothesized to result from virally mediated neural edema. Ischemia occurs as the nerve swells in its bony canal, blocking neural blood supply. Because viral infection is relatively common and Bell's palsy relatively uncommon, it is reasonable to hypothesize that there are anatomic differences in facial canal (FC) that predispose...

To determine the electrocochleographic characteristics of ears with superior semicircular canal dehiscence (SSCD) and to examine its use for intraoperative monitoring in canal occlusion procedures. Case series. Academic medical center. Thirty-three patients (45 ears) had clinical and computed tomographic evidence of SSCD; 8 patients underwent intra...

Superior canal dehiscence syndrome is a recently described vestibular and hearing condition caused by an absence of bone over the arc of the superior semicircular canal. Patients with the condition present with a variety of perplexing symptoms including conductive hearing loss, hyperacusis, vertigo, autophony, and eye movement in response to sound....

Heterozygous mutations in the gene encoding chromodomain-DNA-binding-protein 7 (CHD7) cause CHARGE syndrome, a multiple anomaly condition which includes vestibular dysfunction and hearing loss. Mice with heterozygous Chd7 mutations exhibit semicircular canal dysgenesis and abnormal inner ear neurogenesis, and are an excellent model of CHARGE syndro...

We report a case of capillary hemangioma of the tympanic membrane in a 51-year-old man with conductive hearing loss, otalgia, and otorrhea. On examination, the external auditory canal was obstructed with a hard, dark red tumor, and purulent discharge was observed. The infection was controlled with antibiotics, but hearing loss persisted. Therefore,...

In this article, the present state of the art with respect to audiovestibular testing for Meniere's disease (MD) is reviewed. There is no gold standard for MD diagnosis, and the classic dictum is that even the "best" tests yield positive results in only two-thirds of patients with MD. Still, we advocate the use and further investigation of advanced...

Thyroidectomy can be a diagnostic and therapeutic procedure for thyroid nodules carrying a risk of thyroid cancer or causing local symptoms, or for hyperfunction. The technical approach for a safe conventional thyroidectomy is a replicable procedure guided by some basic principles and anatomic understanding. One safe approach is detailed here.

Electrocochleography (ECoG) is often used in the evaluation of episodic vertigo, and abnormal findings are commonly thought to be due to endolymphatic hydrops. We have observed that a number of patients with abnormal ECoG were ultimately found to have superior semicircular canal dehiscence (SSCD). Therefore, we examined the electrocochleographic fi...

To assess tumor markers in advanced laryngeal cancer. Marker expression and clinical outcome. Pretreatment tumor biopsy specimens were analyzed from patients enrolled in the Department of Veterans Affairs Laryngeal Cancer Study. Expression of p53 (OMIM TP53) and Bcl-xL (OMIM 600039) in pretreatment biopsy specimens was assessed for correlation with...

To determine if isotonic sodium chloride (hereinafter "saline") nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays at improving quality of life and decreasing medication use. A prospective, randomized controlled trial. Community. A total of 127 adults with chronic nasal and s...

CHD7 is a chromodomain gene mutated in CHARGE syndrome, a multiple anomaly condition characterized by ocular coloboma, heart defects, atresia of the choanae, retarded growth and development, genital hypoplasia, and ear defects including deafness and semicircular canal dysgenesis. Mice with heterozygous Chd7 deficiency have circling behavior and sem...

CHD7 is a novel chromodomain gene mutated in 60%-80% of humans with CHARGE syndrome, a multiple congenital anomaly condition characterized by ocular coloboma, heart defects, atresia of the choanae, retarded growth and development, genital hypoplasia, and characteristic ear abnormalities including deafness. Phenotypic features of CHARGE are highly v...

Objective To assess tumor markers in advanced laryngeal cancer. Design Marker expression and clinical outcome. Setting Laboratory. Patients Tissues from 112 patients of the Veterans Affairs laryngeal cancer trial were analyzed: 42 from the chemotherapy arm and 70 from the surgical arm of the study. Main Outcome Measures p53 and Bcl-xL expressio...

Treatment strategies for squamous cell carcinoma of the head and neck (SCCHN) are based on the TNM classification. Biological markers that can predict the response to therapy have so far not been introduced. The objective of this study was to investigate cyclin D1 deregulation relative to sensitivity to cisplatin. This was a laboratory study of 23...