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Hearing Disorders: HELP
Articles by David M. Barrs
Based on 11 articles published since 2009
(Why 11 articles?)
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Between 2009 and 2019, David Barrs wrote the following 11 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Guideline Clinical practice guideline: sudden hearing loss. 2012

Stachler, Robert J / Chandrasekhar, Sujana S / Archer, Sanford M / Rosenfeld, Richard M / Schwartz, Seth R / Barrs, David M / Brown, Steven R / Fife, Terry D / Ford, Peg / Ganiats, Theodore G / Hollingsworth, Deena B / Lewandowski, Christopher A / Montano, Joseph J / Saunders, James E / Tucci, Debara L / Valente, Michael / Warren, Barbara E / Yaremchuk, Kathleen L / Robertson, Peter J / Anonymous4970719. ·Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan 48202, USA. rstachl1@hfhs.org ·Otolaryngol Head Neck Surg · Pubmed #22383545.

ABSTRACT: OBJECTIVE: Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL. PURPOSE: The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. RESULTS: The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals, thrombolytics, vasodilators, vasoactive substances, or antioxidants to patients with ISSNHL. The panel made strong recommendations against clinicians (1) ordering computerized tomography of the head/brain in the initial evaluation of a patient with presumptive SSNHL and (2) obtaining routine laboratory tests in patients with ISSNHL.

2 Review What is the best imaging modality for diagnosing a large vestibular aqueduct? 2016

Deep, Nicholas L / Hoxworth, Joseph M / Barrs, David M. ·Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona, U.S.A. · Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona, U.S.A. ·Laryngoscope · Pubmed #26418544.

ABSTRACT: -- No abstract --

3 Clinical Trial Phase 2 study examining magnesium-dependent tinnitus. 2011

Cevette, Michael J / Barrs, David M / Patel, Alpen / Conroy, Kelly P / Sydlowski, Sarah / Noble, Brie N / Nelson, Gregory A / Stepanek, Jan. ·Department of Otolaryngology, Mayo Clinis, Scottsdale, AZ, USA. Cevette.michael@mayo.edu ·Int Tinnitus J · Pubmed #22249877.

ABSTRACT: BACKGROUND: Recent studies in noise-induced and idiopathic sensorineural hearing loss have suggested that magnesium supplementation may lessen both hearing loss and the severity of tinnitus in patients. Further epidemiological evidence indicates that all age groups of Americans fall short of the recommended daily allowance for magnesium by 100 mg daily. PURPOSE: The purpose of this study was to examine any potential benefit in lessening the severity of tinnitus in patients taking supplemental magnesium. RESEARCH DESIGN: The study was a single-arm, open-label, before-and-after study of oral magnesium (532 mg per day) in 26 patients for 3 months. Tinnitus severity was evaluated and recorded daily by the patient using the Tinnitus Distress Rating (TDR) scale of 0 (no tinnitus) to 10 (worst possible tinnitus). The Tinnitus Handicap Inventory (THI) was administered before and at the end of the study, and scores were converted to the grades of the 5-item Tinnitus Severity Scale (TSS). The purpose of this phase 2 study was to investigate whether the treatment was effective at all, and, as such, a placebo control was not performed. All data were collected at Mayo Clinic in Scottsdale, Arizona, between March 6 and December 10, 2008. STUDY SAMPLE: Patients with moderate to very severe tinnitus (TDR score of 3 through 8). INTERVENTION: Daily magnesium supplementation, 532 mg; patient completion of the THI; and daily self-report of TDR. DATA COLLECTION AND ANALYSIS: The main outcome measures were mean TDR scale scores and THI scores as converted to TSS grades. The primary analysis was done on the basis of intention to treat. RESULTS: Twenty-six patients were enrolled; 19 completed the study. The extent of handicap, as measured by THI/TSS, for subjects with slight or greater impairment was significantly decreased (P=.03). Patients who ranked slight or greater on the THI/TSS before intervention showed a significant decrease in the severity of their tinnitus at post-testing (P=.008). CONCLUSION: The results suggest that magnesium may have a beneficial effect on perception of tinnitus-related handicap when scored with the THI.

4 Article Diagnosing Large Vestibular Aqueduct: Radiological Review of High-Resolution CT Versus High-Resolution Volumetric MRI. 2017

Deep, Nicholas L / Carlson, Matthew L / Weindling, Steven M / Barrs, David M / Driscoll, Colin L W / Lohse, Christine M / Lane, John I / Hoxworth, Joseph M. ·*Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona †Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota ‡Neuroradiology Division, Department of Radiology, Mayo Clinic, Jacksonville, Florida §Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota ||Neuroradiology Division, Department of Radiology, Mayo Clinic, Rochester, Minnesota ¶Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona. ·Otol Neurotol · Pubmed #28604576.

ABSTRACT: OBJECTIVES: To compare the diagnostic yield of high-resolution volumetric T2-weighted MRI (HRT2-MRI) with high-resolution computed tomography (HRCT) for diagnosis of large vestibular aqueduct (LVA). STUDY DESIGN: Three board-certified neuroradiologists performed an independent, blinded radiological review for diagnosing LVA with 2:1 age-matched controls on patients with both HRCT and HRT2-MRI imaging. SETTING: Tertiary referral center. PATIENTS: All patients between 2002 and 2016 with hearing loss who underwent both HRCT and HRT2-MRI and were diagnosed with LVA on either modality. MAIN OUTCOME MEASURES: Concordance rate for LVA between HRCT and HRT2-MRI. RESULTS: Concordance rate for HRCT and HRT2-MRI for diagnosing LVA was 88% (124/141) when assessing both the midpoint and external aperture diameters. Fifteen ears had LVA on computed tomography (CT), but not on magnetic resonance imaging (MRI); in comparison, two ears had LVA on MRI, but not on CT (p = 0.002). Excellent inter-rater reliability among the three radiologists was demonstrated. CONCLUSION: Historically, HRCT has been the imaging modality of choice for diagnosing LVA. Although a higher concordance rate of HRT2-MRI was found compared with previous studies utilizing earlier MRI technology, HRCT still detected a larger number of patients with clinically significant hearing loss compared with MRI. Given the high concordance rate and efficacy of both modalities in diagnosing LVA, the ultimate decision of which modality to choose may depend on other patient-specific and clinical factors.

5 Article Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care. 2016

Kleindienst, Samantha J / Dhar, Sumitrajit / Nielsen, Donald W / Griffith, James W / Lundy, Larry B / Driscoll, Colin / Neff, Brian / Beatty, Charles / Barrs, David / Zapala, David A. ·Mayo Clinic, Scottsdale, AZ. · The Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, ILThe Hugh Knowles Center, Northwestern University, Evanston, IL. · Department of Medical Social Sciences, Northwestern University, Evanston, IL. · Department of Otorhinolaryngology, Mayo Clinic, Jacksonville, FL. · Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN. · Department of Otolaryngology, Mayo Clinic, Phoenix, AZ. ·Am J Audiol · Pubmed #27679840.

ABSTRACT: PURPOSE: The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems. METHOD: Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting. RESULTS: Ratings of adverse health consequences, diagnostic difficulty, and presence of nonotologic symptoms associated with these diseases resulted in the identification of 104 diseases potentially important for detection prior to adult hearing aid fitting. CONCLUSIONS: Current and evolving health care delivery systems, including direct-to-consumer sales, involve inconsistent means of disease detection vigilance prior to device fitting. The first steps in determining the safety of these different delivery methods are to identify and prioritize which diseases present the greatest risk for poor health outcomes and, thus, should be detected in hearing health care delivery systems. Here the authors have developed a novel multidimensional rating system to rank disease importance. The rankings can be used to evaluate the effectiveness of alternative detection methods and to inform public health policy. The authors are currently using this information to validate a consumer questionnaire designed to accurately identify when pre- fitting medical evaluations should be required for hearing aid patients.

6 Article Labyrinthine concussion following gunshot injury: A case report. 2015

Bogle, Jamie M / Barrs, David / Wester, Matthew / Davis, Laurie / Cevette, Michael J. ·a Department of Otolaryngology , Mayo Clinic Arizona , Scottsdale , USA and. · b Department of Audiology , Mayo Clinic Arizona , Scottsdale , USA. ·Int J Audiol · Pubmed #27092730.

ABSTRACT: OBJECTIVE: Labyrinthine concussion due to a postauricular gunshot wound has not been well reported. DESIGN: Retrospective chart review. STUDY SAMPLE: We describe an otherwise healthy 22-year-old male who received a gunshot wound to the left mastoid and subsequently reported hearing loss and rotational vertigo. RESULTS: Audiometric testing demonstrated significant inverted scoop shaped sensorineural hearing loss. Vestibular diagnostic testing indicated a significant uncompensated left peripheral vestibulopathy. Imaging demonstrated no structural changes to the middle ear or labyrinth, suggesting that the auditory and vestibular losses noted on diagnostic examination were likely due to labyrinthine concussion. CONCLUSIONS: Labyrinthine concussion may lead to reduced vestibular reflex pathway following gunshot wounds to the temporal bone. Clinical presentation is likely to vary significantly among cases.

7 Article Cost Effectiveness of Childhood Cochlear Implantation and Deaf Education in Nicaragua: A Disability Adjusted Life Year Model. 2015

Saunders, James E / Barrs, David M / Gong, Wenfeng / Wilson, Blake S / Mojica, Karen / Tucci, Debara L. ·*Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.; †Department of Otolaryngology, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.; ‡Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.; §Duke University, Research Triangle Park, Durham, North Carolina, U.S.A.; ∥Department of Otolaryngology, Hospital Central Managua, Managua, Nicaragua; and ¶Duke University Medical Center, Durham, North Carolina, U.S.A. ·Otol Neurotol · Pubmed #26171672.

ABSTRACT: INTRODUCTION: Cochlear implantation (CI) is a common intervention for severe-to-profound hearing loss in high-income countries, but is not commonly available to children in low resource environments. Owing in part to the device costs, CI has been assumed to be less economical than deaf education for low resource countries. The purpose of this study is to compare the cost effectiveness of the two interventions for children with severe-to-profound sensorineural hearing loss (SNHL) in a model using disability adjusted life years (DALYs). METHODS: Cost estimates were derived from published data, expert opinion, and known costs of services in Nicaragua. Individual costs and lifetime DALY estimates with a 3% discounting rate were applied to both two interventions. Sensitivity analysis was implemented to evaluate the effect on the discounted cost of five key components: implant cost, audiology salary, speech therapy salary, number of children implanted per year, and device failure probability. RESULTS: The costs per DALY averted are $5,898 and $5,529 for CI and deaf education, respectively. Using standards set by the WHO, both interventions are cost effective. Sensitivity analysis shows that when all costs set to maximum estimates, CI is still cost effective. CONCLUSION: Using a conservative DALY analysis, both CI and deaf education are cost-effective treatment alternatives for severe-to-profound SNHL. CI intervention costs are not only influenced by the initial surgery and device costs but also by rehabilitation costs and the lifetime maintenance, device replacement, and battery costs. The major CI cost differences in this low resource setting were increased initial training and infrastructure costs, but lower medical personnel and surgery costs.

8 Article Sudden Sensorineural Hearing Loss Associated With Intralabyrinthine Hemorrhage. 2015

Cervantes, Sergio Santino / Barrs, David M. ·Mayo Clinic Arizona, Phoenix, Arizona, U.S.A. ·Otol Neurotol · Pubmed #24914788.

ABSTRACT: -- No abstract --

9 Article Cochlear implantation in developing countries as humanitarian service: physician attitudes and recommendations for best practice. 2011

Saunders, James / Barrs, David. ·Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. james.saunders@hitchcock.org ·Otolaryngol Head Neck Surg · Pubmed #21493294.

ABSTRACT: OBJECTIVE: To make recommendations concerning cochlear implantation during humanitarian medical trips by exploring the attitudes of US cochlear implant surgeons. STUDY DESIGN: Cross-sectional survey. SETTING: Academic. SUBJECTS AND METHODS: Questionnaires were sent to 405 members of the William House Cochlear Implant Study Group. The 198 respondents (49%), all active cochlear implant surgeons, were divided into 3 groups depending on their level of experience working in a developing country. RESULTS: Eighty-nine percent of respondents supported cochlear implants in these environments, although 42% of these cochlear implant surgeons stated that they would modify their criteria for implantation considering the challenges in developing countries. There was strong support for cochlear implants in postlingual deafened patients and prelingual deafened patients under the age of 3 years, although nearly half of respondents (48%) would not implant prelingual deafened patients after they reached the age of 3 years. Three-quarters of respondents (74%) believed that developing countries should have the same access to current multichannel devices used in developed countries, as opposed to simpler, possibly lower cost devices. A local audiologist was deemed the most important personnel requirement (83%), and limited audiology and rehabilitative resources were the greatest postoperative concern rather than lack of postoperative care or infection. CONCLUSION: . This survey strongly supports the practice of performing cochlear implants during humanitarian trips to developing countries and makes best-practice recommendations to make outcomes successful.

10 Article A healthy woman with dizziness induced by acute noise exposure. 2010

Donald, Carrlene / Barrs, David / Hoxworth, Joseph. ·Mayo Clinic, Phoenix, Arizona, USA. ·JAAPA · Pubmed #20411637.

ABSTRACT: -- No abstract --

11 Article Cochlear implant patients with superficial siderosis. 2009

Sydlowski, Sarah A / Cevette, Michael J / Shallop, Jon / Barrs, David M. ·Mayo Clinic Arizona, Department of Audiology, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. sarah.sydlowski@gallaudet.edu ·J Am Acad Audiol · Pubmed #19594083.

ABSTRACT: BACKGROUND: Considered a rare disorder, superficial siderosis of the central nervous system (SSCN) has become more frequently diagnosed in recent years. As it is characterized by progressive sensorineural hearing loss, patients' needs may surpass the capability of hearing aid technology. Despite the retrocochlear nature of the disorder, patients have undergone cochlear implantation (CI) with varying success. PURPOSE: To summarize the issues surrounding cochlear implant candidates with SSCN as well as highlight trends in performance postimplantation. RESEARCH DESIGN: Retrospective case reports of seven cochlear implant candidates detail the symptoms, typical audiologic presentation, and array of clinical issues for patients with this progressive and potentially fatal disease. RESULTS: Despite the retrocochlear component of a hearing loss caused by SSCN, cochlear implantation may be a viable option. CONCLUSIONS: It is essential that the CI audiologist not only be aware of the disorder but also be well versed in the resulting implications for the cochlear implant process. A more thorough case history, an expanded candidacy test battery, and knowledge of the typical presentation of SSCN are critical. The diagnosis of SSCN will impact expectations for success with the cochlear implant, and counseling should be adjusted accordingly.