Blast-related otologic injuries constitute a major source of ongoing morbidity after the Boston Marathon bombings. Continued follow-up and care of this patient population are warranted.

Our study highlights the efficacy and utility of simulation in assessing personnel team dynamics and confidence levels and knowledge of emergency airway scenarios. Practitioners in all fields and level of experience benefit in EART training and simulation. We hope that with this information, we will be able to conduct future studies on reduction of patient morbidity and mortality.

Objectives/Hypothesis To evaluate the usefulness of Elastic Scattering Spectroscopy (ESS) as a diagnostic adjunct to frozen section analysis in patients with diagnosed squamous cell carcinoma of the oral cavity. Study Type /Design Prospective, analytic study Methods Subjects for this single institution, IRB-approved study were recruited from among patients undergoing surgical resection for squamous cell cancer of the oral cavity. A portable, Elastic Scattering Spectroscopy (ESS) device with a contact fiberoptic probe was used to obtain spectral signals. Four to ten spectral readings were obtained on each subject from various sites including gross tumor and normal appearing mucosa in the surgical margin. Each reading was correlated with the histopathologic findings of biopsies taken from the exact location of the spectral readings. A diagnostic algorithm based on multidimensional pattern-recognition/machine-learning was developed. Sensitivity and specificity, error rate, and area under the curve (AUC) were used as performance metrics for tests involving classification between disease and non-disease classes. Results Thirty-four (34) subjects were enrolled in the study. One hundred seventy six (176) spectral data-point/biopsy-specimen pairs were available for analysis. ESS distinguished normal from abnormal tissue with a sensitivity ranging from 84% to 100% and specificity ranging from 71% to 89%., depending on how the cutoff between normal and abnormal tissue was defined (i.e., mild, moderate or severe dysplasia). There were statistically significant differences in malignancy scores between histologically normal tissue and invasive cancer and between non-inflamed tissue and inflamed tissue. Conclusions This is the first study to evaluate the effectiveness of ESS in guiding mucosal resection margins in oral cavity cancer. ESS provides fast, real-time assessment of tissue without the need for pathology expertise. ESS appears to be effective in distinguishing between normal mucosa and invasive cancer and between “normal” tissue (histologically normal and mild dysplasia) and “abnormal” tissue (severe dysplasia and carcinoma-in-situ) that might require further margin resection. Further studies, however, are needed with a larger sample size to validate these findings and to determine the effectiveness of ESS in distinguishing visibly and histologically normal tissue from visibly normal but histologically abnormal tissue.

Objectives/Hypothesis: To identify and characterize potential correlations between the SLC26A4 (PDS) genotype and longitudinal hearing loss in a cohort of patients with enlarged vestibular aqueduct (EVA) with or without additional inner ear anomalies. Study Design:Retrospective chart review at a tertiary care children's hospital.Methods: 53 individuals, aged 2 to 30 years with EVA in at least one ear were studied (84 affected ears). All subjects underwent genetic testing for SLC26A4. Statistical correlation between hearing loss, as measured by four-frequency pure tone average (500, 1000, 2000, and 4000 Hz), number of mutant SLC26A4 alleles and presence of inner ear anomalies detected by computed tomography or magnetic resonance imaging was undertaken. The median follow-up time was 18 months with a standard deviation of 14 months.Results: There were 18 males (34%) and 35 females (66%). 5 subjects (9.4%) had two pathogenic SLC26A4 mutations, 8 (15.1%) had one pathogenic mutation, and 40 had no mutations (75.5%). GEE model showed that biallelic SLC26A4 mutations were significantly correlated with a higher number of additional inner ear abnormalities (mean=3.1) compared to patients with one (mean=1.5) or no mutations (mean=1.63) (P=0.01). There was no correlation between the number of mutations and progression of hearing loss (P=0.28). Fluctuating hearing loss was not correlated with the presence of additional inner ear abnormalities (P=0.80) or the number of mutant alleles of SLC26A4 (P=0.43). Conclusions:The number of mutant alleles of SLC26A4 is significantly associated with the presence of additional inner ear anomalies but not with changes in hearing.