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Hearing Disorders: HELP
Articles by David D. Pothier
Based on 7 articles published since 2010
(Why 7 articles?)

Between 2010 and 2020, D. Pothier wrote the following 7 articles about Hearing Disorders.
+ Citations + Abstracts
1 Review Antivirals for idiopathic sudden sensorineural hearing loss. 2012

Awad, Zaid / Huins, Charlie / Pothier, David D. ·Department of Otolaryngology, Head and Neck Surgery, University College London Hospital, London, UK. z.awad@doctors.org.uk. ·Cochrane Database Syst Rev · Pubmed #22895957.

ABSTRACT: BACKGROUND: Idiopathic sudden sensorineural hearing loss (ISSHL) is characterised by sudden loss of hearing of cochlear or retro-cochlear origin without an identifiable cause. Antivirals are commonly prescribed, but there is no consensus on the treatment regimen or their effectiveness. OBJECTIVES: To determine the effectiveness and side effect profile of antivirals in the treatment of ISSHL. SEARCH METHODS: We systematically searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 5), PubMed, EMBASE, CINAHL and other databases to 12 June 2012. We also scanned the reference lists of identified studies for further trials. SELECTION CRITERIA: Randomised controlled trials comparing different antivirals versus placebo (both with or without other treatment). DATA COLLECTION AND ANALYSIS: Two authors independently extracted data, met to resolve disagreements and contacted study authors for further information. We assessed study risk of bias independently. We considered meta-analysis inappropriate and ultimately not possible due to differing treatment protocols of varying dose and duration, together with differing inclusion criteria and outcome measures between studies. The results of each study are reported individually. MAIN RESULTS: We included four randomised trials (257 participants). The overall risk of bias in the included studies was low. Two trials compared the addition of intravenous acyclovir to a steroid (prednisolone). One included 43 participants, the other 70 patients. Neither demonstrated any hearing improvement with ISSHL. Another (84 patients) did not show any statistically significant difference between groups with the addition of valacyclovir to prednisolone (compared to steroid plus placebo) with respect to change in pure-tone audiogram. Comparing the addition of intravenous acyclovir to hydrocortisone with hydrocortisone alone, the final trial did not show any statistically significant difference between groups (60 patients). No trial documented any serious adverse effects related to the use of antiviral treatment. One study reported slight to moderate nausea equally in the acyclovir and placebo groups (one patient in each). Another reported insomnia, nervousness and weight gain with valacyclovir (number not specified). Even though no meta-analysis was possible, evidence from the four RCTs has demonstrated no statistically significant advantage in the use of antivirals in the treatment of ISSHL. AUTHORS' CONCLUSIONS: There is currently no evidence to support the use of antiviral drugs in the treatment of ISSHL. The four trials included in this review were, however, small and with a low risk of bias. Further randomised controlled trials with larger patient populations, using standardised inclusion criteria, antiviral regimes and outcome measures, are needed in order for adequate meta-analysis to be performed to reach definitive conclusions. A uniform definition of ISSHL should also be established, together with what constitutes adequate recovery.

2 Review Chlorhexidine ototoxicity in ear surgery, part 1: review of the literature. 2011

Lai, Philip / Coulson, Chris / Pothier, David D / Rutka, John. ·Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, ON. ·J Otolaryngol Head Neck Surg · Pubmed #22420428.

ABSTRACT: OBJECTIVE: Chlorhexidine is a common antiseptic used to prevent surgical infection. However, its exposure to the middle ear may lead to deafness. The mechanisms of the ototoxicity of chlorhexidine are reviewed. The importance of recognizing its toxicity cannot be overstated in preventing injury to patients undergoing ear surgery. METHODS: A systematic literature search was performed looking at data from human and animal studies. Search engines included MEDLINE, EMBASE, The Cochrane Library, CENTRAL, CINAHL, and Web of Science to November 1, 2010, for relevant studies published in all languages. Two independent reviewers (P.L. and D.D.P.) screened the references from published articles for additional relevant studies. Medical Subject Headings and key words including intervention (chlorhexidine, antiseptic), exposure (myringoplasty, intratympanic), and adverse effects (sensorineural hearing loss, ototoxicity, vestibular toxicity) were used. RESULTS: Twelve studies were identified, two of which were non-English and were excluded. Only 2 articles on human subjects and 12 articles on animal models concerning chlorhexidine ototoxicity were identified. CONCLUSIONS: Chlorhexidine in both human studies and animal models demonstrates ototoxicity if it reaches the inner ear. The toxicity of chlorhexidine appears to be related to its concentration and probable contact time with the round window membrane intraoperatively. It is conceivable that the incidence of chlorhexidine toxicity may be higher than stated if unrecognized or has resulted in subsequent medicolegal actions. From the evidence available, safer preparation solutions are available without clinical risks for ototoxicity should surgeons continue with this practice.

3 Article Long-Term Late Toxicity, Quality of Life, and Emotional Distress in Patients With Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy. 2018

McDowell, Lachlan J / Rock, Kathy / Xu, Wei / Chan, Biu / Waldron, John / Lu, Lin / Ezzat, Shereen / Pothier, David / Bernstein, Lori J / So, Nathaniel / Huang, Shao Hui / Giuliani, Meredith / Hope, Andrew / O'Sullivan, Brian / Bratman, Scott V / Cho, John / Kim, John / Jang, Raymond / Bayley, Andrew / Ringash, Jolie. ·Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. · Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. · Department of Biostatistics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. · Department of Endocrine Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. · Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. · Department of Supportive Care, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. · Division of Medical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. · Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. Electronic address: jolie.ringash@rmp.uhn.ca. ·Int J Radiat Oncol Biol Phys · Pubmed #30191868.

ABSTRACT: PURPOSE: To report long-term (>4 years) toxicity and quality of life (QoL) among patients with nasopharyngeal carcinoma (NPC) treated with intensity modulated radiation therapy (IMRT) in a nonendemic center. METHODS AND MATERIALS: A cross-sectional cohort study enrolled patients with NPC who were disease-free and ≥4 years after IMRT ± chemotherapy. Physician-reported adverse events (Common Terminology Criteria for Adverse Events, version 4.03) and patient-reported QoL (Functional Assessment of Cancer Therapy-Head and Neck, Functional Assessment of Chronic Illness Therapy-Fatigue), utilities (EuroQOL-5D), head and neck symptoms (MD Anderson Symptom Inventory-Head and Neck), and emotional distress (Hospital Anxiety and Depression Scale) were collected. Consenting patients also underwent endocrine screening and audiometry. RESULTS: Among 107 patients enrolled, median age at enrollment and time since treatment were 57 (32-81) and 7.5 years (4.2-11.1), respectively. Most patients (99%) received 70 Gy in 35 fractions; the majority (93%) received concurrent chemotherapy. Mean scores for the Functional Assessment of Cancer Therapy-Head and Neck, Functional Assessment of Chronic Illness Therapy-Fatigue, and EuroQOL-5D were 105.0 (46-148), 116.6 (44-160), and 0.85 (0.29-1.00), respectively. Dry mouth, mucus, swallowing/chewing, memory, and teeth/gum problems were scored highest on the MD Anderson Symptom Inventory-Head and Neck; mean symptom severity and symptom interference scores were 2.3 and 2.4, respectively. Grade 3 or higher physician-reported adverse events were noted in 50 patients (47%), most frequently hearing problems (46, 43%). Audiometry revealed significant bilateral hearing loss (grade ≥3) in 68 patients (72%). Depression (25%), anxiety (37%), and fatigue (28%) were common and strongly correlated with QoL. Most patients (69%) developed hypothyroidism; 1 patient (1%) developed pituitary dysfunction requiring hormone replacement. V50 >90 and V45 >99 to the thyroid correlated with significantly higher rates of hypothyroidism. CONCLUSIONS: Despite the implementation of IMRT, survivors of NPC still experience many physical symptoms that affect long-term QoL many years after treatment. Depression, anxiety, and fatigue remain common in long-term survivors and are highly correlated with QoL.

4 Article Olfactory and cochleovestibular dysfunction after head injury in the workplace: an updated series. 2016

Ilan, O / Syed, M I / Aziza, E / Pothier, D D / Rutka, J A. ·Otology/Neurotology, University Health Network, Toronto, ON, Canada. ·Clin Otolaryngol · Pubmed #26506217.

ABSTRACT: OBJECTIVES: The objective of this study was to determine the incidence of olfactory dysfunction in workers following head injury in the work place, to define its relationship to the site, severity of injury and direction of force. The demographics of head injured workers were also assessed to determine whether those with olfactory loss were more likely to have sustained a cochleovestibular injury. DESIGN: Retrospective case analysis. SETTING: Tertiary referral university hospital in Toronto, Ontario. PARTICIPANTS: A total of 3438 consecutive patients referred from the Workplace Safety and Insurance Board (WSIB) in the province of Ontario who sustained a work-related head injury were assessed between 1987 and 2014. MAIN OUTCOME MEASURES: Olfactory and cochleovestibular dysfunction assessed by history, clinical examination and subjective and objective tests. RESULTS: Olfactory dysfunction (OD) was identified in 413 of 3438 patients (12.0%) of which 321 were diagnosed with anosmia and 92 with hyposmia. In our series, injuries from a fall were the commonest cause for OD and a frontal or mid-face impact was more likely to result in OD than other regions (P = 0.0002). A loss of consciousness (LOC) of any duration correlated with OD. In those with olfactory dysfunction, an associated skull fracture occurred in 37.1% of patients and a CSF leak in 4.1%, which was significantly higher compared with those without OD(<0.0001). Patients with OD had a higher incidence of cochlear and vestibular loss (19.9% and 20.6%, respectively) compared with those without OD (14.3% and 17.1%, respectively). CONCLUSIONS: Post-traumatic olfactory dysfunction is more likely to occur in patients who experienced a moderate to severe head injury, LOC and more likely to result from a frontal or mid-face blow to the skull. Cochleovestibular dysfunction is likely to occur concurrently with olfactory dysfunction.

5 Article Providing auditory cues to improve stability in children who are deaf. 2012

Cushing, Sharon L / Pothier, David / Hughes, Cian / Hubbard, Bradley J / Gordon, Karen A / Papsin, Blake C. ·Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada. s.cushing@utoronto.ca ·Laryngoscope · Pubmed #23254598.

ABSTRACT: -- No abstract --

6 Article Chlorhexidine ototoxicity in ear surgery part II: survey of preparation solution used by otolaryngologists in Canada: is there a cause for concern? 2011

Lai, Philip / Coulson, Chris / Pothier, David / Rutka, John. ·Department of Otolaryngology-Head and Neck Surgery, University of Toronto. ·J Otolaryngol Head Neck Surg · Pubmed #22420429.

ABSTRACT: OBJECTIVE: To conduct a survey of the antiseptic preparations used for ear surgeries among otolaryngologists in Canada. METHODS: An electronic survey was sent to active members of the Canadian Society of Otolaryngology-Head and Neck Surgery via e-mail. Questions included the use of antiseptic, choice of preparation solution, duration of preparation, use of a barrier method, and compliance with hospital protocol changes. RESULTS: The e-mail was received by 253 otolaryngologists, and 85 completed the survey. Four of 85 respondents did not perform tympanoplasty surgery and were not included in the analysis. Of those who performed tympanoplasty (n  =  81), 78 of the 81 respondents (96%) used an antiseptic preparation solution at surgery, whereas 3 respondents (4%) did not. Sixty-six of the 77 respondents (86%) used aqueous povidone-iodine, 4 (5%) used a chlorhexidine-based preparation, 3 (4%) used an alcohol-based solution, 3 (4%) used others, and 1 answered "I don't know." Thirty-eight of 75 (29%) respondents used a barrier method, 23 (31%) answered "always," 18 (24%) answered "sometimes," and 5 (7%) answered "I don't know." When asked if they would comply with a hypothetical hospital policy to use chlorhexidine in ear surgery, 15 of 79 (19%) respondents agreed, whereas 64 (81%) disagreed. Among the aqueous povidone-iodine users (n  =  66), 7 (11%) agreed to change to chlorhexidine. CONCLUSIONS: There is a wide variation in practice in the use of surgical preparation solution among otolaryngologists performing ear surgery. Surgeons must be vigilant to avoid ototoxicity. A national society consensus on appropriate preparation solutions for ear surgery would minimize patients' risk and minimize future medicolegal actions.

7 Minor Lidocaine in the middle ear may not be without risk. 2012

Pothier, David D / Coulson, Chris J / Rutka, John A. · ·J Otolaryngol Head Neck Surg · Pubmed #22498273.

ABSTRACT: -- No abstract --