Otolaryngology Referrals

Our interdisciplinary treatment teams, including audiologists, speech pathologists, physical therapists, and Certified Otolaryngology Nurses, work in a world–class facility housing 28 exam rooms, a surgical–center, and audiology sound booths. We balance clinical work, training, and research to provide compassionate care that includes the most refined treatment protocols in medicine.

Featuring a multidisciplinary team of audiologists, speech pathologists, Certified Otolaryngology Nurses (CORLN), 13 physicians and two academic faculty, the department offers comprehensive services including otology/neurotology, head and neck oncology, laryngology, rhinology, facial plastic and reconstructive surgery, and pediatric otolaryngology.

Surgery Is Best Option to Preserve Hearing

Microsurgery to remove vestibular schwannomas is the best option for long-term hearing preservation, a recent University of Iowa case review found. The study, published in the journal Otology & Neurotology (Sept.2010, pp. 1144-1152), documented hearing outcomes for 49 patients who received surgical treatment for schwannoma at the University of Iowa. Most maintained their postoperative hearing scores in tests up to 13 years after treatment.

The Iowa team’s results compared favorably with other approaches to treating vestibular schwannomas—specifically, observation and radiation therapy. “Microsurgery is thus the only treatment modality that has been shown to maintain stable hearing long after treatment,” the study authors concluded. The finding runs counter to current trends that favor observation and radiation therapy over microsurgery.

The paper presents the Iowa Vestibular Schwannoma Management Algorithm. The formula outlines optimal treatment for patients with schwannomas based on their age and hearing and on the position, size, and growth of the tumor. Indications for middle cranial fossa microsurgery include a patient who is younger than 65 with a tumor that’s not touching the brain stem and a Word Recognition Score in category I, II, or III.

Learn more about the UI’s otology and neurotology services.

Learn more about the UI’s full range of otolaryngology–head and neck surgery services.

Clinical Focus

The Iowa team was first to provide bilateral cochlear implantation and to date, 131 patients have received bilateral implants. 60 adults and 26 children have received simultaneous (both sides done during same surgery) cochlear implants. In addition, 18 adults and 27 children have received sequential implants where surgery is performed on the other side at a later date.

Our skull base surgery team specializes in minimally invasive approaches to lesions of the anterior and lateral skull base. The team manages skull base disorders and includes neurotologists, rhinologists, neurosurgeons, neurophthalmologists, and neuro– and interventional radiologists. We have extensive experience with hearing preservation strategies for acoustic neuroma and cranial nerve sparing procedures for other skull base neoplasm's.

Trans-Oral Robotic Surgery

Trans-oral robotic surgery (TORS) is a recent minimally invasive technique to remove tumors of the throat. Our head and neck surgeons use the da Vinci robotic surgery system to access tumors that formerly required traditional surgery, often involving splitting the jaw. The technique shortens patients' hospital stays and leads to faster recovery and fewer complications.

We welcome the opportunity to consult with you about patients who might benefit from this new approach. Contact Dr. Rodrigo Bayon at rodrigo-bayon@uiowa.edu, or call our physicians-only UI Consult line, 1-800-322-8442.

Research

As a leading NIH-funded cochlear implant research program, we have 26 years of continuous funding that exceeds $60 million dollars. Annually our department receives $5 million in NIH grants to pursue our other research goals. Our clinical research centers include a Balance Disorders Center, a Cochlear Implant Center, and a Voice and Swallowing Center.

Cochlear Implant Research

In cochlear implants, large performance variations still exist among patients. In an attempt to better understand cochlear implant performance levels, the Iowa cochlear implant team has proposed innovative research protocols that have led to many research milestones, including:

• Becoming the first center to provide bilateral implantation to adult patients
• Implementing combined electric and acoustic stimulation
• Using high-rate stimulation to better replicate the normal cochlea
• Developing technology to measure the action potential of the auditory nerve

In addition, the Iowa team has one of the largest longitudinal databases tracking the listening, speaking, and language development in children and adults and has been expanded to include:

• A music perception project that focuses on investigating novel signal-processing schemes to determine if music perception and appreciation can be enhanced
• An infant–toddler perception project that investigates how children under the age of 18 months with a cochlear implant perceive sounds

Tinnitus Research

Our center received the largest clinical–trial grant to study tinnitus in the history of the National Institutes of Health. UI researchers are comparing different versions of treatments that have been reported to help 80 percent of those with tinnitus. The study examines the effectiveness of approaches that combine low–level background sounds, including music, with a new, extensive counseling protocol.
Molecular Otolaryngology and Renal Research Laboratory

Genetic Research

The Molecular Otolaryngology Laboratory has discovered the largest number of genes associated with hearing loss. A clinical laboratory service offers the most extensive gene mapping for identifying causes of hearing loss and deafness in the United States.

The Iowa Center for Auditory Regeneration

The Center is designed to create and develop new therapeutic regimens to treat persons with hearing loss. The Center brings together investigators in the Departments of Otolaryngology–Head and Neck Surgery, Anatomy and Cell Biology, Speech Pathology and Audiology, Biology, Physiology and Biophysics, Neurosurgery, Radiology, and the College of Engineering. This multidisciplinary team of investigators with similar research interests will search for significant advancements in the treatment of neurosensory hearing loss.

UI Offers Faster, Cheaper Genetic Screening

A new method developed by UI researchers cuts the time and expense required to screen for the cause of inherited deafness. The UI's Molecular Otolaryngology and Renal Research Laboratory will offer the new screening beginning this spring.

Previously, identifying the specific cause of a child’s hearing impairment meant sequencing one gene at a time. The new test, called OtoSCOPE, can screen for all known deafness-causing genes in a single pass. Knowing the gene responsible for a child’s hearing impairment can speed treatment and help families. To learn more, contact Dr. Richard Smith at richard-smith@uiowa.edu, or call UI Consult at 1-800-322-8442.

Education

Our multilingual online "Iowa Protocols": serves as a reference for the management of diseases and disorders of the head and neck including instrumentation, step–by–step clinical protocols, and nursing instructions. The department also offers several courses and conferences each year with eligible continuing medical education credit. Recent topics include head and neck cancer and sinus endoscopy.

Iowa Head and Neck Protocols

To you help you make clinical decisions, our department offers online reference management protocols to help you with strategies for diseases and disorders of the head and neck. The Iowa Head and Neck Protocols offers a multilingual reference for:

• Instrumentation
• Step-by-step clinical protocols
• Nursing instructions