Research

UCSF OHNS Introduces Local Anesthesia with IV Conscious Sedation in Cochlear Implantation Surgery

Anonymous — Fri, 14 Jun 2024 19:28:08 +0000

UCSF OHNS Introduces Local Anesthesia with IV Conscious Sedation in Cochlear Implantation Surgery

Anonymous (not verified) Fri, 06/14/2024 - 12:28

Cochlear implantation surgery can restore functional hearing for individuals struggling with severe hearing impairment. Hearing loss is very common in the elderly population, and when conventional hearing aids are no longer adequate, cochlear implants are indicated. Recent studies have found a link between hearing loss and cognitive decline, and restoring hearing in the elderly population is crucial to their ability to communicate and remain socially engaged. However, older patients often have concerns about the risk of surgery, and many would rather avoid surgery even if it may help them hear again.

Song Cheng, MD, of the Department of Otolaryngology-Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS), has initiated an effort to perform cochlear implant surgeries at UCSF using local anesthesia and intravenous sedation, which is commonly referred to as monitored anesthesia care (MAC). During the procedure, patients are comfortable, conscious and monitored by an anesthesiologist throughout the procedure. Dr. Cheng explains that "the adoption of this technique is primarily aimed at elderly patients and patients with other medical comorbidities that put them at an increased risk during general anesthesia."

According to Dr. Cheng, "receiving a cochlear implant can be life-changing for patients who are socially isolated because of hearing loss. Cochlear implant surgery can be performed safely and comfortably without undergoing general anesthesia. We hope that this initiative will help more patients pursue the treatment they need."

Patient selection is key because patients are awake throughout the procedure and need to remain still during the surgery. Dr. Cheng explains, "patients must lie on their back with their head turned to one side for about 1.5 hours during the procedure, which can be challenging for those with neck or spine issues." Patients must also understand that there is a chance of needing to switch to general anesthesia during the procedure if that is deemed to be safer.

Dr. Cheng's initiative to implement cochlear implantation under MAC at UCSF OHNS is built on extensive experience gained under the mentorship of J. Thomas Roland Jr., MD, at NYU Langone Health, who has completed over 450 cochlear implantations under MAC. Motivated by the successful outcomes he has witnessed, Dr. Cheng aims to make this innovative technique available to patients at UCSF, reducing fears associated with general anesthesia. "We have had great feedback from our patients, and I am very excited that we can now offer this option," shares Dr. Cheng.

He expresses gratitude for the collaborative effort and support extended by our anesthesia team and OR staff, affirming a shared commitment to optimizing patient outcomes through innovation. This effort represents a continued evolution of patient-centered care at UCSF OHNS. Grounded in evidence-based practice and driven by a passion for innovation, this initiative embodies the spirit of progress in health care, offering hope to individuals with severe hearing impairment.

UCSF OHNS's Dr. Jennifer Grandis's Article on Gender Disparities Published in Cancer Cell

Anonymous — Tue, 07 May 2024 21:46:23 +0000

UCSF OHNS's Dr. Jennifer Grandis's Article on Gender Disparities Published in Cancer Cell

Research

Anonymous (not verified) Tue, 05/07/2024 - 14:46

Advancing equality for women in medicine has been a staple in Dr. Jennifer Grandis's career at Otolaryngology-Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS). A recent article in Cancer Cell by Dr. Grandis, "Career Trajectories of MD-PhD Physician Scientists: The Loss of Women Investigators," commentated on the gender disparities in academic medicine.

Dr. Grandis, along with her esteemed collaborators, OHNS's Drs. Richard Steinman, Lisa Gandy, Elana Fertig, Amanda Blackford and Ms. Hanfei Qi, comment on the systematic changes that would better sustain equality efforts.

"Poorly defined and inconsistently executed promotion, tenure, and dissemination of start-up funding and space risk gender bias to impact these decisions, impeding women's advancement," Dr. Grandis and the remaining authors write.

"Even while women MD-PhD trainees are as successful as their male counterparts in securing funding as trainees and junior faculty, they are missing from the ranks of NIH-funded established investigators," the authors write. "Women physician scientists are disproportionately leaving the investigator track… The consequences of this loss of talent are likely substantial. The drive to gender equity is taking too long. It is time for institutions and the biomedical enterprise to put octane in the tank," Dr. Grandis and the contributors write in a compelling conclusion.

Dr. Grandis's research has received great acclaim, earning an impact factor of 50.3! Other researchers have frequently cited the article, contributing to the strong impact factor score.

UCSF OHNS Team Member Wins 3rd Place in Medical Engineering Competition

Wed, 21 Feb 2024 20:54:45 +0000

UCSF OHNS Team Member Wins 3rd Place in Medical Engineering Competition

Research

esullivan@medi… Wed, 02/21/2024 - 12:54

What if AirPods could be hearing aids? That was what Nicole Jiam, MD (team principal investigator), and her team, Pinnacle, argued during the 2024 iHackHealth Appathon 3.0 competition. Dr. Nicole Jiam, UCSF OHNS faculty member, teamed up with Lourdes Kaufman (UCSF medical student), Amritpal Singh (UCSF medical student), and Dr. Alexandra Bourdillon (UCSF OHNS resident). They were selected as 1 of 10 teams to partner with UC Berkeley engineering and graduate students to create an iOS mobile app prototype to solve a critical unmet need in the healthcare space.

The Pinnacle team's presentation focused on resolving critical pain points that those with hearing loss suffer from, including the high cost of hearing aids and the negative stigmas associated with them. The presentation proposed a pure-tone audiometry app that exports hearing settings to the AirPods to amplify or safeguard hearing. These clinical settings also modify and personalize front-end sound input to improve music enjoyment.

The clinical team collaborated with Apple to use its open-source tool kits to develop the hearing aid technology. The competition's Final Event involved pitching and presenting prototypes to judges from Apple, UC Berkeley, UCSF, members of the digital health industry, and venture capitalists. They won 3^rd place based on the following 5 categories: demonstrated customer need, innovative solution, market readiness, effective use of Apple frameworks, and overall presentation.

As a winning team, Pinnacle won a Fung Institute "Meet and Greet" with CITRIS Foundry and UCSF Innovation Ecosystem. The team was awarded a monetary prize and will be connected with iOS developers at Apple.

Excerpt: During the 2024 iHackHealth Appathon 3.0 competition, Amritpal Singh (UCSF medical student) and Lais Conceicao (UC Berkeley graduate student), representing Pinnacle, presented a solution to use AirPods as hearing aids, addressing issues like cost and stigma, collaborating with Apple and winning awards.

Advancing Gender Equity in Medicine with UCSF OHNS's Jennifer R. Grandis, MD

ohns_admin — Thu, 05 Oct 2023 18:46:37 +0000

Advancing Gender Equity in Medicine with UCSF OHNS's Jennifer R. Grandis, MD

Research

ohns_admin Thu, 10/05/2023 - 11:46

In the world of medicine and science, there is an imperative to ensure that talent knows no gender bias. Recognizing the importance of this issue, the John Conley, MD Lecture on Medical Ethics has chosen to spotlight Jennifer R. Grandis, MD, a distinguished professor of Otolaryngology-Head and Neck Surgery at the University of California, San Francisco (UCSF), as its 2023 Lecturer. Dr. Grandis, a passionate physician-scientist, delivered a powerful lecture titled "Building and Sustaining Careers: A Gender Equity Lens" during the AAO-HNSF Annual Meeting & OTO Experience Opening Ceremony on Sunday, October 1, 2023.

The John Conley, MD Lecture on Medical Ethics

This prestigious award is named in honor of Dr. John Conley, a luminary in the field of head and neck surgery. It reflects Dr. Conley's dedication to the practice of medicine and his profound love for head and neck surgery. This award is not just a recognition of excellence but also a celebration of the ethics and professionalism that Dr. Conley cherished throughout his career.

A Visionary in Medicine

Dr. Grandis is a remarkable figure in the world of medicine and science. Her work in otolaryngology-head and neck surgery, combined with her role in the Developmental Therapeutics Program at UCSF's Helen Diller Family Comprehensive Cancer Center, has made her a true pioneer in her field.

As a physician-scientist, Dr. Grandis's journey in head and neck surgery began with a realization of the suffering endured by head and neck cancer patients. Traditional treatments often came with debilitating side effects and limited curative outcomes. This fueled her passion to discover more precise and effective treatments. Her research led to a significant focus on epidermal growth factor receptor (EGFR) signaling and the development of EGFR-targeted therapies, such as cetuximab. Dr. Grandis and her team identified the activation of the STAT3 pathway as a common mechanism of drug resistance, resulting in the development of a STAT3 inhibitor now undergoing clinical testing. "We discovered that head and neck cancer patients whose tumors harbored genetic alterations that activated the PI3K signaling pathway and were taking NSAIDs (usually baby aspirin) had significantly improved survival."

What sets Dr. Grandis apart is her commitment to bridging the gap between the laboratory and the clinic. Her research not only yields new findings but also generates relevant preclinical models that help unravel the underlying mechanisms of clinical observations. This holistic approach is essential for translating scientific discoveries into practical, life-saving treatments.

Collaboration and Mentorship

Dr. Grandis has excelled in her research and played a pivotal role in fostering collaboration between clinicians and investigators. "We need to find common values and goals and create spaces to foster interactions. The rewards can be extraordinary," adds Dr. Grandis. This collaboration has paved the way for robust clinical and translational cancer studies. Her dedication to building a strong research infrastructure at both the University of Pittsburgh and UCSF has been instrumental in advancing cancer research.

However, Dr. Grandis's impact extends beyond her research and institutional roles. She has dedicated significant time and effort to mentoring and supporting her peers. Dr. Grandis advises, "Know what makes you happy and enrich your life with these activities. Clinical medicine and teaching are immensely satisfying, time-consuming and often inflexible. Create space for your loved ones and self-care on a regular (daily) basis. Research has the potential to change the world beyond our clinical practice, but it is often challenging." Her exceptional mentorship has been recognized with prestigious awards, including the University of Pittsburgh Provost's Award for Excellence in Mentoring and the William E. Brown Outstanding MSTP Mentor Award from the Medical Scientist Training Program. Dr. Grandis's commitment to nurturing the next generation of scientists and physicians embodies her belief in gender equity and diversity in the field.

An Advocate

Dr. Jennifer R. Grandis's influence reaches far beyond her immediate circle. She is an elected member of esteemed organizations such as the American Society for Clinical Investigation, the Association of American Physicians and the National Academy of Medicine. Her involvement in these organizations demonstrates her dedication to advancing the practice of medicine and science on a global scale.

"I am honored to have been welcomed into these national societies and sincerely hope that we can increase the number of otolaryngologists elected. These organizations unite academic physicians and physician-scientists in all medical disciplines who mobilize to collectively solve hard problems (like gender equity) and advance biomedical knowledge," shares Dr. Grandis.

Commitment to Gender Equity

Dr. Grandis's commitment to gender equity in science and medicine is deeply personal and driven by the need for change. "In 2018, I was harassed and realized that if it could happen to me, it could happen to anyone." She highlights the gender pay gap and discrimination faced by women in medicine and has conducted research to better understand and address these issues. "I was surprised then to find that women otolaryngologists earned 20% less than men for the same work." During a time when women scientists and physicians continue to be underrepresented in leadership roles, face discrimination and harassment, and receive unequal compensation compared to their male counterparts, her lecture serves as a beacon of hope and a roadmap for change.

Through her lecture, Dr. Grandis aims to facilitate open discussions on these uncomfortable topics and inspire collaborative efforts toward achieving gender equity. "I hope to help people find the language to talk about topics that are often uncomfortable and work collaboratively towards solving hard problems. Medicine is a healing profession and harming our own hurts all of us, especially the patients who could benefit from the talents of women physicians and scientists."

Dr. Grandis's lecture, "Building and Sustaining Careers: A Gender Equity Lens," is an exploration of the challenges and opportunities faced by women in science and medicine. Her lecture synthesizes the experiences and perspectives of both women at various career stages. It is a call to action, a powerful reminder that gender equity is not just an aspiration but an urgent necessity in medicine and science.

Dr. Grandis's lecture serves as a reminder that the path to gender equity in medicine and science is not just a moral imperative but a vital step toward harnessing the full potential of our diverse and talented workforce. Dr. Grandis's tireless efforts and innovative work exemplify the spirit of Dr. John Conley's legacy, which continues to inspire us all in our pursuit of excellence and ethics in the practice of medicine.

Stay connected and follow Dr. Grandis on social media for updates, insights and valuable content.

Learn About SPIT – a Patient-Centered Tool for Evaluating Chronic Sialadenitis

ohns_admin — Tue, 29 Aug 2023 23:43:15 +0000

Learn About SPIT – a Patient-Centered Tool for Evaluating Chronic Sialadenitis

Research

ohns_admin Tue, 08/29/2023 - 16:43

Chronic sialadenitis is the most common benign salivary gland disorder, characterized by enlargement and inflammation of one or more of the major salivary glands on the cheek or under the jaw. Symptoms can impair daily functions including eating, mood and talking, which in turn lowers a patient's quality of life. This condition is treated by otolaryngologists who work to improve evaluation and treatment.

Jolie Chang, MD and William Ryan, MD, faculty members in the Department of Otolaryngology – Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) had previously developed the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire to quantify sialadenitis symptom severity and assess response to sialendoscopy-assisted salivary duct surgery.

"The significance of this questionnaire was that it was the first patient-reported outcome measure (PROM) designed to specifically characterize obstructive sialadenitis symptoms," says Dr. Chang. Since then, other disease-specific instruments have been developed for salivary gland disorders, and these PROMs have helped physicians assess and quantify patient symptomatology and monitor longitudinal changes following treatment. "However, chronic sialadenitis PROMs are limited in their reliance on physician consensus alone in identifying items for inclusion. Symptoms of importance to patients in pursuing treatment may not align with those of providers," Dr. Chang explains.

With this in mind, Drs. Chang and collaborators set out to develop an inclusive instrument to obtain both patient and provider input in identifying key domains during development. Their study incorporated feedback from patients regarding the prior COSS questionnaire which suggested that this survey was sometimes difficult for patients to complete. The team then worked to validate the survey for use in clinical practice.

"Thanks to work from collaborators, including first-author Arushi Gulati, BS, and expert colleagues from across the U.S., novel obstructive Salivary Problem Impact Test (SPIT) score is now a reality," says Dr. Chang, the senior author. "This new standardized measure of sialadenitis-associated symptoms was assessed for internal consistency, construct validity and test–retest stability."

Study results were presented earlier this year at the Triological Society 2022 Combined Sections Meeting, and the report was recently published in The Laryngoscope. Further work by investigators will assess longitudinal changes with treatment.

UCSF and HMS Team Present Data and Updated Screening Recommendations for Ototoxic Drugs in World Health Organization Journal

ohns_admin — Tue, 04 Apr 2023 23:40:45 +0000

UCSF and HMS Team Present Data and Updated Screening Recommendations for Ototoxic Drugs in World Health Organization Journal

Research

ohns_admin Tue, 04/04/2023 - 16:40

Each year, more than 500,000 cases of hearing loss around the world can be attributed to the use of ototoxic medications. Researchers from the Department of Otolaryngology and Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) and Harvard Medical School (HMS) recently addressed the use of these drugs and management of resulting hearing loss, in the unfortunate event of ototoxicity.

The team authored "Prevention and management of hearing loss in patients receiving ototoxic medications," published in the Bulletin of the World Health Organization (WHO). In the article, the investigators review ototoxic drugs; propose a new framework for early detection, management and treatment; and identify areas for future research, especially in low-resource areas.

The article comes as a response to updated WHO guidelines for the treatment of multidrug-resistant tuberculosis, which advised against the use of drugs that can cause hearing loss. Those updates "reaffirmed patients' right to hearing," note the authors.

"There remain significant gaps in our understanding about optimal screening and treatment of ototoxic hearing loss," write the authors, led by first author Michael Lindeborg, MD, a third-year resident at UCSF OHNS. In the article, the investigators "aim to inspire future international guidelines to address gaps in ototoxicity care and establish research agendas for eliminating ototoxic medications."

In a table, the authors delineate various ototoxic drugs, the mechanism of ototoxicity and the type — irreversible or reversible — and provide guidelines for monitoring hearing loss for each type. The authors also provide a case study and an infographic to offer additional insights and information to providers. Their work aims to improve screening and treatment for ototoxic hearing loss across multiple healthcare settings, including those in low- and middle-income countries.

"New treatment options and revised guidelines will protect millions of people from unnecessary exposure to drugs that cause irreversible hearing loss," write Lindeborg et al. "When agents that result in irreversible hearing loss are the only option, evaluation and adoption of internationally recognized guidelines are needed, alongside additional research, to prevent, manage and treat this unfortunate adverse event."

The senior author of the paper is Carole Mitnick of the Department of Global Health and Social Medicine at HMS. Co-authors of the paper include David Jung, MD, PhD, of the HMS Department of Otolaryngology and Dylan Chan, MD, PhD, an associate professor in residence at UCSF OHNS and the director of the Children's Communication Center.

International Consensus Statement on Obstructive Sleep Apnea: A Collaborative Effort to Advance Evidence-Based Care

ohns_admin — Mon, 13 Mar 2023 22:46:27 +0000

International Consensus Statement on Obstructive Sleep Apnea: A Collaborative Effort to Advance Evidence-Based Care

Research

ohns_admin Mon, 03/13/2023 - 15:46

We are proud to announce the publication of the International Consensus Statement on Obstructive Sleep Apnea (ICS:OSA), a multi-collaborative effort led by co-editors Jolie Chang, MD, Andrew Goldberg, MD, MS, and Ilene Rosen, MD, MSCE. Drs. Chang and Goldberg are faculty at the Department of Otolaryngology and Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) and Dr. Rosen works at the University of Pennsylvania.

The comprehensive document summarizes the best available evidence on focal topics related to adult OSA, highlights current understanding and identifies gaps in knowledge that require further research. This monumental effort involved contributions from over 130 international experts in various specialties, including neurology, pulmonology, sleep medicine, otolaryngology, oral-maxillofacial surgery, dentistry, anesthesiology, psychiatry, cardiology and sleep physiology, which reflects the multidisciplinary approach needed to understand and treat OSA.

"The ICS:OSA brings together diverse expertise to provide a comprehensive resource for understanding and treating OSA, enabling clinicians to make evidence-based decisions for their patients," says Dr. Chang, the lead author and co-editor.

The consensus statement was developed using previously defined methodology, assigning focal topics in OSA to formats such as literature review, evidence-based review or evidence-based review. Each topic incorporated available and relevant evidence, which was then summarized and graded based on study quality. The entire document underwent iterative review, with all authors contributing to the consensus.

"This is a truly landmark consensus statement on obstructive sleep apnea with an international cohort of clinicians from all specialties that evaluate and treat sleep disorders," says Dr. Goldberg, co-author and co-editor of the statement and vice chair of UCSF OHNS.

The ICS:OSA covers a wide range of topics, including OSA syndrome definitions, pathophysiology, epidemiology, risk factors for the disease, screening methods, diagnostic testing types, multiple treatment modalities and the effects of OSA treatment on various OSA-associated comorbidities. It also provides a specific focus on health outcomes with positive airway pressure and surgical therapies.

"By summarizing the best available evidence and identifying gaps in knowledge, we aim to inspire new research and improve patient care," says Dr. Goldberg. "With an organized and linked table of contents and over 150 short individual sections, the information in this document is highly accessible and easy to digest."

The ICS:OSA is an invaluable resource for clinicians, researchers, and policy-makers working in the field of obstructive sleep apnea, fostering new research and contributing to improved health outcomes. Read the statement here.

Phone-Only Telehealth: An Accessible Option for an Underserved Patient Population

ohns_admin — Tue, 07 Mar 2023 00:36:07 +0000

Phone-Only Telehealth: An Accessible Option for an Underserved Patient Population

Research

ohns_admin Mon, 03/06/2023 - 16:36

Telephone-based telehealth can provide patients with an even more accessible and equitable option than video-based care, but is it effective? That's the question recently answered by researchers from the University of California, San Francisco (UCSF), including faculty from the Department of Otolaryngology – Head and Neck Surgery (OHNS) — a question that was particularly important during the COVID-19 pandemic.

The team share their findings in "Utility of telephone visits at an urban safety-net hospital during 2020: A retrospective review." The work was published in Laryngoscope Investigative Otolaryngology.

During the COVID-19 pandemic, UCSF OHNS clinicians were among the many providers globally that took advantage of telehealth (when possible) to continuing providing care while minimizing the risk of contagion. But for many of the patients at the Zuckerberg San Francisco General Hospital, traditional telehealth with video wasn't an option due to limited resources, prompting the authors to research the efficacy of phone-only care.

"We wanted to investigate whether or not telephone-based telehealth would provide good care in a disadvantaged patient population," says UCSF OHNS's Jeffrey Sharon, MD, the senior author on the paper.

The authors' objective was twofold: determining the efficacy for telephone-only audio visits for underserved patients seeking otolaryngological care and identifying the patient factors associated with phone visit attendance. The results showed that telephone visits are accessible to patients and be used for several different aspects of otolaryngological patient care. The authors did not find any patient demographic factors that were significantly associated with missing telephone appointments.

The findings indicate the potential of telehealth to improve health equity by increasing the accessibility of medical care, particularly in areas of low physician density and for underserved patient populations.

"Despite limited diagnostic capabilities, telephone audio visits can be an effective and accessible tool for providing continuity and advancing care in socially disadvantaged patients," write the authors, led by first author Eric Kim, a medical student at the UCSF School of Medicine.

The researchers conducted a retrospective review of all adult telephone visits in 2020, a total of 318 telehealth appointments completed by 254 patients, 72.8% of whom were of racial or ethnic minority; 76.3% had low-income, need-based insurance; and 43.7% had limited English proficiency.

"Our retrospective review reveals that telephone visits may be limited diagnostically but can be instrumental in providing continuity and advancing patient care through care coordination, counseling and managing pharmacotherapy," writes the team. "By elucidating the patterns of the applications of telephone visits, we hope to identify how to best optimize our telehealth delivery and inform our improvement and education efforts to best benefit socially disadvantaged patients."

Co-authors of the paper included UCSF OHNS's Shauna Brodie, RN, MS, FNP, UCSF School of Medicine student Joseph Kidane and Delphine Tuot, MD, of the UCSF Division of Nephrology and the Center for Vulnerable Populations at the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital.

#1 Most Read 2022 Facial Plastics Article is Facial Analysis in Gender Affirming Surgery

ohns_admin — Sat, 14 Jan 2023 00:26:47 +0000

#1 Most Read 2022 Facial Plastics Article is Facial Analysis in Gender Affirming Surgery

Research

ohns_admin Fri, 01/13/2023 - 16:26

A team including researchers from the Department of Otolaryngology – Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) have been recognized by the journal Facial Plastic Surgery & Aesthetic Medicine as having the most-read article for 2022. UCSF team members include senior author Dr. Rahul Seth, Dr. P. Daniel Knott, and Dr. Hailey Juszczak (SOM '21).

The article aims to validate surgical decisions for gender affirming surgery by quantifying the effect of sex on adult facial size and shape through an analysis of three-dimensional (3D) facial surface images.

The article is available for free through January 26, 2023.

Hearing Health Education Programs and Smartphone Apps to Promote Hearing Conservation in Teenagers

ohns_admin — Wed, 11 Jan 2023 00:23:16 +0000

Hearing Health Education Programs and Smartphone Apps to Promote Hearing Conservation in Teenagers

Research

ohns_admin Tue, 01/10/2023 - 16:23

A team including researchers from the Department of Otolaryngology – Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) assess the impact of a video-based hearing health education program in high school students. They developed a smartphone application to monitor daily noise doses from headphone use.

The team, led by first author Jolie Chang, MD, of UCSF OHNS, share their findings in "A smartphone application and education program for hearing health promotion in high school teenagers." The work was published in The Laryngoscope.

The authors assessed knowledge retention and measured headphone listening behavior change after 76 teenagers participated in the video-based hearing health education and hearing screening sessions. Of the participants, 83% identified as a racial or ethnic minority and 66% were of low-income socioeconomic status from two public high schools in San Francisco.

The results showed that hearing health knowledge was retained in students and was improved in their parents.

"Video-based hearing health education with knowledge question reinforcement was associated with knowledge retention in students and improved parental attitudes and knowledge about hearing conservation," write the authors.

Over the six weeks of the study, 12 of the students also used a novel smartphone application that measured daily noise exposure via headphones and displayed alerts when cumulative daily doses of noise neared the maximum. The smartphone app offered a real-time display of noise exposure dose and identified at-risk students. Users of the app significantly reduced average daily headphone noise doses with reduced time spent at the highest volume settings.

"The integration of hearing health education, hearing screening and digital health tools has promise to promote positive behavior changes for long-term hearing conservation," concluded Dr. Chang et al.

Dr. Chang is an Associate Professor and the Chief of the Division of Sleep Surgery and General Otolaryngology at UCSF OHNS. Additional researchers from the department include senior author Steven Cheung, MD, and Jennifer Henderson Sabes, AuD, Camille Huwyler, MD, and Norimasa Yoshida, MEng.