Scholars@Duke

• Background
• 

  Education, Training, & Certifications

  • M.B.A., Johns Hopkins University 2012
  • Neurotology and Skull Base Surgery Fellow, Otolaryngology Head & Neck Surgery, Johns Hopkins University School of Medicine 1996 - 1997
  • Otolaryngology-Head & Neck Surgery Resident, Otolaryngology Head & Neck Surgery, Johns Hopkins University School of Medicine 1991 - 1996
  • Surgery Intern, Surgery, Johns Hopkins University School of Medicine 1990 - 1991
  • M.D., Harvard Medical School 1990
• 

  Previous Appointments & Affiliations

  • Instructor in the Department of Surgery, Head and Neck Surgery & Communication Sciences, Section of Surgical Disciplines 2017
• Research
• 

  Selected Grants

  • Evaluation of Unilateral vs Bilateral Hearing Aids for the Treatment of Age-related Hearing Loss awarded by Patient Centered Outcomes Research Institute 2021 - 2025
  • Economic Evaluation and Research Prioritization of Adult Hearing Screening in the US awarded by National Institutes of Health 2021 - 2024
  • Addressing Barriers to Adult Hearing Healthcare awarded by National Institutes of Health 2016 - 2021
• 

  External Relationships

  • Advanced Bionics Corp.(Boston Scientific)
  • Alexander Graham Bell Association for the Deaf and Hard of Hearing
  • Med El Corporation
  • ST. Augustine Hospital Division of ENT
• Publications & Artistic Works
• 

  Selected Publications

  • Academic Articles

    • Munjal, Tina, Cherie-Ann Nathan, Michael J. Brenner, Konstantina M. Stankovic, Howard W. Francis, and Tulio A. Valdez. “Re-engineering the Surgeon-Scientist Pipeline: Advancing Diversity and Equity to Fuel Scientific Innovation.” Laryngoscope 131, no. 10 (October 2021): 2161–63. https://doi.org/10.1002/lary.29800.
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    • Smith, Blaine D., Hannah L. Martin, Howard W. Francis, and Calhoun D. Cunningham. “Vein Graft Tympanoplasty: How a Transiently Used Graft Material Transformed Middle Ear Surgery.” Otolaryngol Head Neck Surg, May 11, 2021, 1945998211012292. https://doi.org/10.1177/01945998211012292.
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    • Ahmadmehrabi, Shadi, Janice L. Farlow, Nneoma S. Wamkpah, Brandon I. Esianor, Michael J. Brenner, Tulio A. Valdez, Sonya Malekzadeh, Carol R. Bradford, and Howard W. Francis. “New Age Mentoring and Disruptive Innovation-Navigating the Uncharted With Vision, Purpose, and Equity.” Jama Otolaryngol Head Neck Surg 147, no. 4 (April 1, 2021): 389–94. https://doi.org/10.1001/jamaoto.2020.5448.
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    • Cooper, M. W., B. K. Ward, J. Sharon, and H. W. Francis. “Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa” 7, no. 2 (April 1, 2021): 82–87. https://doi.org/10.1016/j.wjorl.2021.01.003.
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    • Singh, Anisha, Howard W. Francis, P Brian Smith, Reese H. Clark, and Rachel G. Greenberg. “Association between Hyperbilirubinemia and Hearing Screen Failure in the Neonatal Intensive Care Unit in Infants Born Preterm.” J Pediatr 231 (April 2021): 68–73. https://doi.org/10.1016/j.jpeds.2020.12.059.
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    • Lee, Emerson E., Nicholas S. Andresen, Bryan McKenzie, Jeffrey D. Sharon, Howard W. Francis, and Daniel Q. Sun. “Perigeniculate arachnoid cysts and CSF fistulae of the fallopian canal: Histopathologic correlates of a rare clinical entity.” World J Otorhinolaryngol Head Neck Surg 7, no. 2 (April 2021): 71–81. https://doi.org/10.1016/j.wjorl.2020.12.005.
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    • Brenner, M. J., R. F. Nelson, T. A. Valdez, S. A. Moody-Antonio, C. A. O. Nathan, M. A. St John, and H. W. Francis. “Centralized Otolaryngology Research Efforts: Stepping-stones to Innovation and Equity in Otolaryngology–Head and Neck Surgery.” Otolaryngology  Head and Neck Surgery (United States), January 1, 2021. https://doi.org/10.1177/01945998211065465.
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    • Weinreich, Heather M., Benjamin Ostrander, Seth E. Pross, Raktima Dasgupta, and Howard W. Francis. “Prevalence of Xerostomia Among Cochlear Implant Recipients.” Jama Otolaryngology  Head & Neck Surgery, October 15, 2020. https://doi.org/10.1001/jamaoto.2020.3409.
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    • Buchman, Craig A., René H. Gifford, David S. Haynes, Thomas Lenarz, Gerard O’Donoghue, Oliver Adunka, Allison Biever, et al. “Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss: A Systematic Review and Consensus Statements.” Jama Otolaryngol Head Neck Surg 146, no. 10 (October 1, 2020): 942–53. https://doi.org/10.1001/jamaoto.2020.0998.
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    • Hong, Hyejeong, David W. Dowdy, Kelly E. Dooley, Howard W. Francis, Chakra Budhathoki, Hae-Ra Han, and Jason E. Farley. “Prevalence of Pre-Existing Hearing Loss Among Patients With Drug-Resistant Tuberculosis in South Africa.” Am J Audiol 29, no. 2 (June 8, 2020): 199–205. https://doi.org/10.1044/2020_AJA-19-00103.
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    • Bettger, Janet Prvu, Rowena J. Dolor, David L. Witsell, Judy R. Dubno, Carl F. Pieper, Amy R. Walker, Mina Silberberg, et al. “Comparative implementation-effectiveness of three strategies to perform hearing screening among older adults in primary care clinics: study design and protocol.” Bmc Geriatr 20, no. 1 (May 11, 2020): 170. https://doi.org/10.1186/s12877-020-01576-x.
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    • Hong, Hyejeong, David W. Dowdy, Kelly E. Dooley, Howard W. Francis, Chakra Budhathoki, Hae-Ra Han, and Jason E. Farley. “Aminoglycoside-induced Hearing Loss Among Patients Being Treated for Drug-resistant Tuberculosis in South Africa: A Prediction Model.” Clin Infect Dis 70, no. 5 (February 14, 2020): 917–24. https://doi.org/10.1093/cid/ciz289.
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    • Hong, H., D. W. Dowdy, K. E. Dooley, H. W. Francis, C. Budhathoki, H. -. R. Han, and J. E. Farley. “Risk of hearing loss among multidrug-resistant tuberculosis patients according to cumulative aminoglycoside dose.” Int J Tuberc Lung Dis 24, no. 1 (January 1, 2020): 65–72. https://doi.org/10.5588/ijtld.19.0062.
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    • Hong, Hyejeong, Kelly E. Dooley, Laura E. Starbird, Howard W. Francis, and Jason E. Farley. “Adverse outcome pathway for aminoglycoside ototoxicity in drug-resistant tuberculosis treatment.” Arch Toxicol 93, no. 5 (May 2019): 1385–99. https://doi.org/10.1007/s00204-019-02407-8.
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    • Brown, C Scott, Ralph Abi Hachem, Avani Pendse, John F. Madden, and Howard W. Francis. “Low-Grade Papillary Schneiderian Carcinoma of the Sinonasal Cavity and Temporal Bone.” Ann Otol Rhinol Laryngol 127, no. 12 (December 2018): 974–77. https://doi.org/10.1177/0003489418803391.
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    • Pross, Seth E., Bryan K. Ward, Jeffrey D. Sharon, Heather M. Weinreich, Nafi Aygun, and Howard W. Francis. “A Prospective Study of Pain From Magnetic Resonance Imaging With Cochlear Implant Magnets In Situ.” Otol Neurotol 39, no. 2 (February 2018): e80–86. https://doi.org/10.1097/MAO.0000000000001661.
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    • Patel, M. A., A. E. Marciscano, C. Hu, I. Jusué-Torres, R. Garg, A. Rashid, H. W. Francis, et al. “Long-term treatment response and patient outcomes for vestibular schwannoma patients treated with hypofractionated stereotactic radiotherapy.” Frontiers in Oncology 7, no. SEP (September 4, 2017). https://doi.org/10.3389/fonc.2017.00200.
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    • Balkany, Thomas, Kaming Lo, Howard Francis, Simon Angeli, Michael Novak, William Luxford, Rodney Lusk, and Heather Strader. “Development and Validation of the Cochlear Implant Surgical Competency Assessment Instrument.” Otol Neurotol 38, no. 4 (April 2017): 504–9. https://doi.org/10.1097/MAO.0000000000001349.
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    • Li, Lilun, Bryan Ward, Margaret Cocks, Amir Kheradmand, and Howard W. Francis. “IgG4-Related Disease of Bilateral Temporal Bones.” Ann Otol Rhinol Laryngol 126, no. 3 (March 2017): 236–40. https://doi.org/10.1177/0003489416672476.
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    • Nellis, Jason C., Jeff D. Sharon, Seth E. Pross, Lisa E. Ishii, Masaru Ishii, Jacob K. Dey, and Howard W. Francis. “Multifactor Influences of Shared Decision-Making in Acoustic Neuroma Treatment.” Otol Neurotol 38, no. 3 (March 2017): 392–99. https://doi.org/10.1097/MAO.0000000000001292.
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    • Nellis, Jason C., David W. Eisele, Howard W. Francis, Alexander T. Hillel, and Sandra Y. Lin. “Impact of a mentored student clerkship on underrepresented minority diversity in otolaryngology-head and neck surgery.” Laryngoscope 126, no. 12 (December 2016): 2684–88. https://doi.org/10.1002/lary.25992.
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    • Abt, Nicholas B., Douglas D. Reh, David W. Eisele, Howard W. Francis, and Christine G. Gourin. “Does resident participation influence otolaryngology-head and neck surgery morbidity and mortality?” Laryngoscope 126, no. 10 (October 2016): 2263–69. https://doi.org/10.1002/lary.25973.
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    • Sharon, Jeffrey D., Benjamin G. Northcutt, Nafi Aygun, and Howard W. Francis. “Magnetic Resonance Imaging at 1.5 Tesla With a Cochlear Implant Magnet in Place: Image Quality and Usability.” Otol Neurotol 37, no. 9 (October 2016): 1284–90. https://doi.org/10.1097/MAO.0000000000001176.
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    • Emmett, Susan D., Debara L. Tucci, Ricardo F. Bento, Juan M. Garcia, Solaiman Juman, Juan A. Chiossone-Kerdel, Ta J. Liu, et al. “Moving Beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America.” Otol Neurotol 37, no. 8 (September 2016): 1040–48. https://doi.org/10.1097/MAO.0000000000001148.
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    • Sharon, Jeffrey D., Courtney L. Kraus, Matthew Ehrenburg, Heather M. Weinreich, and Howard W. Francis. “Risk Assessment and Prevention of Corneal Complications After Lateral Skull Base Surgery.” Otol Neurotol 37, no. 8 (September 2016): 1148–54. https://doi.org/10.1097/MAO.0000000000001123.
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    • Thomas Roland, J., Craig Buchman, Laurie Eisenberg, Lillian Henderson, Shuman He, Jill Firszt, Howard Francis, et al. “Proceedings of the Annual Symposium of the American Cochlear Implant Alliance.” Cochlear Implants Int 17, no. 5 (September 2016): 211–37. https://doi.org/10.1080/14670100.2016.1225348.
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    • Clark, James H., Allen Feng, Aisha Harun, Glendine Brown, and Howard W. Francis. “Secondary Acquired Cholesteatoma: Presentation and Tympanoplasty Outcomes.” Otol Neurotol 37, no. 7 (August 2016): 902–7. https://doi.org/10.1097/MAO.0000000000001100.
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    • Fang, Christina H., Sei Yeon Chung, Danielle M. Blake, Alejandro Vazquez, Chengrui Li, John P. Carey, Howard W. Francis, and Robert W. Jyung. “Prevalence of Cochlear-Facial Dehiscence in a Study of 1,020 Temporal Bone Specimens.” Otol Neurotol 37, no. 7 (August 2016): 967–72. https://doi.org/10.1097/MAO.0000000000001057.
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    • Park, EunMi, Patrick K. Ha, David W. Eisele, Howard W. Francis, and Young J. Kim. “Personal characteristics of residents may predict competency improvement.” Laryngoscope 126, no. 8 (August 2016): 1746–52. https://doi.org/10.1002/lary.25744.
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    • Miller, M., M. S. Pearl, E. Wyse, A. Olivi, and H. W. Francis. “Decompression of the Jugular Bulb for Enhanced Infralabyrinthine Access to the Petroclival Region: A Quantitative Analysis.” Journal of Neurological Surgery, Part B: Skull Base 77, no. 3 (June 1, 2016): 249–59. https://doi.org/10.1055/s-0035-1566302.
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    • Lin, Sandra Y., Howard W. Francis, Lloyd B. Minor, and David W. Eisele. “Faculty diversity and inclusion program outcomes at an academic otolaryngology department.” Laryngoscope 126, no. 2 (February 2016): 352–56. https://doi.org/10.1002/lary.25455.
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    • Quittner, Alexandra L., Ivette Cejas, Nae-Yuh Wang, John K. Niparko, and David H. Barker. “Symbolic Play and Novel Noun Learning in Deaf and Hearing Children: Longitudinal Effects of Access to Sound on Early Precursors of Language.” Plos One 11, no. 5 (January 2016): e0155964. https://doi.org/10.1371/journal.pone.0155964.
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    • Francis, Howard W., Ira Papel, Ioan Lina, Wayne Koch, David Tunkel, Paul Fuchs, Sandra Lin, et al. “Otolaryngology-head and neck surgery at Johns Hopkins: The first 100 years (1914-2014).” Laryngoscope 125 Suppl 9 (November 2015): S1-35. https://doi.org/10.1002/lary.25490.
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    • Emmett, Susan D., Debara L. Tucci, Magteld Smith, Isaac M. Macharia, Serah N. Ndegwa, Doreen Nakku, Kaitesi B. Mukara, et al. “GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa.” Otol Neurotol 36, no. 8 (September 2015): 1357–65. https://doi.org/10.1097/MAO.0000000000000823.
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    • Harun, Aisha, James Clark, Yevgeniy R. Semenov, and Howard W. Francis. “The Role of Obliteration in the Achievement of a Dry Mastoid Bowl.” Otol Neurotol 36, no. 9 (September 2015): 1510–17. https://doi.org/10.1097/MAO.0000000000000854.
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    • Da Cruz, M. J., and H. W. Francis. “Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development.” J Laryngol Otol 129 Suppl 3 (July 2015): S23–29. https://doi.org/10.1017/S0022215115001346.
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    • Ahmed, Aadil, Mueen Ahmad, C Matthew Stewart, Howard W. Francis, and Nasir I. Bhatti. “Effect of distractions on operative performance and ability to multitask--a case for deliberate practice.” Laryngoscope 125, no. 4 (April 2015): 837–41. https://doi.org/10.1002/lary.24856.
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    • Emmett, Susan D., and Howard W. Francis. “The socioeconomic impact of hearing loss in U.S. adults.” Otol Neurotol 36, no. 3 (March 2015): 545–50. https://doi.org/10.1097/MAO.0000000000000562.
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    • Francis, Howard W., Jennifer A. Yeagle, and Carol B. Thompson. “Clinical and psychosocial risk factors of hearing outcome in older adults with cochlear implants.” Laryngoscope 125, no. 3 (March 2015): 695–702. https://doi.org/10.1002/lary.24921.
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    • Weinreich, H. M., H. W. Francis, J. K. Niparko, and W. W. Chien. “Techniques in cochlear implantation.” Operative Techniques in Otolaryngology  Head and Neck Surgery 25, no. 4 (December 1, 2014): 312–20. https://doi.org/10.1016/j.otot.2014.09.002.
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    • Sun, Daniel Q., Xin Zhou, Frank R. Lin, Howard W. Francis, John P. Carey, and Wade W. Chien. “Racial difference in cochlear pigmentation is associated with hearing loss risk.” Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology 35, no. 9 (October 2014): 1509–14. https://doi.org/10.1097/mao.0000000000000564.
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    • Emmett, Susan D., and Howard W. Francis. “Bilateral hearing loss is associated with decreased nonverbal intelligence in US children aged 6 to 16 years.” Laryngoscope 124, no. 9 (September 2014): 2176–81. https://doi.org/10.1002/lary.24746.
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    • Meserole, Rachel L., Christine M. Carson, Anne W. Riley, Nae-Yuh Wang, Alexandra L. Quittner, Laurie S. Eisenberg, Emily A. Tobey, Howard W. Francis, and John K. Niparko. “Assessment of health-related quality of life 6 years after childhood cochlear implantation.” Qual Life Res 23, no. 2 (March 2014): 719–31. https://doi.org/10.1007/s11136-013-0509-3.
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    • Starmer, Heather M., Bryan K. Ward, Simon R. A. Best, Christine G. Gourin, Lee M. Akst, Alexander Hillel, Henry Brem, and Howard W. Francis. “Patient-perceived long-term communication and swallow function following cerebellopontine angle surgery.” Laryngoscope 124, no. 2 (February 2014): 476–80. https://doi.org/10.1002/lary.24252.
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    • Hennessey, Patrick T., Howard W. Francis, and Christine G. Gourin. “Is there a "July effect" for head and neck cancer surgery?” Laryngoscope 123, no. 8 (August 2013): 1889–95. https://doi.org/10.1002/lary.23884.
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    • Muniak, Michael A., Alejandro Rivas, Karen L. Montey, Bradford J. May, Howard W. Francis, and David K. Ryugo. “3D model of frequency representation in the cochlear nucleus of the CBA/J mouse.” J Comp Neurol 521, no. 7 (May 1, 2013): 1510–32. https://doi.org/10.1002/cne.23238.
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    • Ceh, Kristin M., Deborah M. Bervinchak, and Howard W. Francis. “Early literacy gains in children with cochlear implants.” Otol Neurotol 34, no. 3 (April 2013): 416–21. https://doi.org/10.1097/MAO.0b013e31827b4b81.
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    • Harun, Aisha, Yuri Agrawal, Marietta Tan, John K. Niparko, and Howard W. Francis. “Sex and age associations with vestibular schwannoma size and presenting symptoms.” Otol Neurotol 33, no. 9 (December 2012): 1604–10. https://doi.org/10.1097/MAO.0b013e31826dba9e.
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    • Ward, Bryan K., Howard W. Francis, Simon R. Best, Heather M. Starmer, Lee M. Akst, and Christine G. Gourin. “National prevalence and impact of perioperative vagus nerve injury in vestibular schwannoma.” Laryngoscope 122, no. 12 (December 2012): 2824–31. https://doi.org/10.1002/lary.23605.
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    • Lauer, Amanda M., Paul A. Fuchs, David K. Ryugo, and Howard W. Francis. “Efferent synapses return to inner hair cells in the aging cochlea.” Neurobiol Aging 33, no. 12 (December 2012): 2892–2902. https://doi.org/10.1016/j.neurobiolaging.2012.02.007.
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    • Laeeq, Kulsoom, Howard W. Francis, David A Diaz Voss Varela, Mohammad Umair Malik, Charles W. Cummings, and Nasir I. Bhatti. “The timely completion of objective assessment tools for evaluation of technical skills.” Laryngoscope 122, no. 11 (November 2012): 2418–21. https://doi.org/10.1002/lary.23494.
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    • Malik, Mohammad U., Vinciya Pandian, Hamid Masood, David A. Diaz, Voss Varela, Alfredo José Dávalos-Balderas, Martha Parra-Cardenas, Phillip Seo, and Howard W. Francis. “Spectrum of immune-mediated inner ear disease and cochlear implant results.” Laryngoscope 122, no. 11 (November 2012): 2557–62. https://doi.org/10.1002/lary.23604.
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    • Clark, James H., Jennifer Yeagle, Alicia I. Arbaje, Frank R. Lin, John K. Niparko, and Howard W. Francis. “Cochlear implant rehabilitation in older adults: literature review and proposal of a conceptual framework.” J Am Geriatr Soc 60, no. 10 (October 2012): 1936–45. https://doi.org/10.1111/j.1532-5415.2012.04150.x.
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    • Ward, Bryan K., Yuri Agrawal, Elena Nguyen, Charles C. Della Santina, Charles J. Limb, Howard W. Francis, Lloyd B. Minor, and John P. Carey. “Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach.” Otol Neurotol 33, no. 8 (October 2012): 1386–91. https://doi.org/10.1097/MAO.0b013e318268d20d.
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    • Lin, Frank R., Wade W. Chien, Lingsheng Li, Danisa M. Clarrett, John K. Niparko, and Howard W. Francis. “Cochlear implantation in older adults.” Medicine (Baltimore) 91, no. 5 (September 2012): 229–41. https://doi.org/10.1097/MD.0b013e31826b145a.
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    • Best, Simon R., Heather M. Starmer, Yuri Agrawal, Bryan K. Ward, Alexander T. Hillel, Wade W. Chien, Howard W. Francis, Rafael J. Tamargo, and Lee M. Akst. “Risk factors for vagal palsy following cerebellopontine angle surgery.” Otolaryngol Head Neck Surg 147, no. 2 (August 2012): 364–68. https://doi.org/10.1177/0194599812442042.
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    • Clark, James H., Nae-Yuh Wang, Anne W. Riley, Christine M. Carson, Rachel L. Meserole, Frank R. Lin, Laurie S. Eisenberg, et al. “Timing of cochlear implantation and parents' global ratings of children's health and development.” Otol Neurotol 33, no. 4 (June 2012): 545–52. https://doi.org/10.1097/MAO.0b013e3182522906.
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    • Francis, Howard W., Mohammad U. Malik, David A. Diaz Voss Varela, Maxwell A. Barffour, Wade W. Chien, John P. Carey, John K. Niparko, and Nasir I. Bhatti. “Technical skills improve after practice on virtual-reality temporal bone simulator.” Laryngoscope 122, no. 6 (June 2012): 1385–91. https://doi.org/10.1002/lary.22378.
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    • Francis, Howard W., and Daniele Rigamonti. “Letter to the editor in response to German et al. Stereotactic radiosurgery for vestibular schwannomas: a survey of current practice patterns of neurotologists.” Otol Neurotol 33, no. 4 (June 2012): 686–87. https://doi.org/10.1097/MAO.0b013e31825367cb.
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    • Ward, Bryan K., Christine G. Gourin, and Howard W. Francis. “Vestibular schwannoma surgical volume and short-term outcomes in Maryland.” Arch Otolaryngol Head Neck Surg 138, no. 6 (June 2012): 577–83. https://doi.org/10.1001/archoto.2012.877.
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    • Arora, Asit, Sam Khemani, Neil Tolley, Arvind Singh, James Budge, David A Diaz Voss Varela, Howard W. Francis, Ara Darzi, and Nasir I. Bhatti. “Face and content validation of a virtual reality temporal bone simulator.” Otolaryngol Head Neck Surg 146, no. 3 (March 2012): 497–503. https://doi.org/10.1177/0194599811427385.
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    • Starmer, Heather M., Simon R. Best, Yuri Agrawal, Wade W. Chien, Alexander T. Hillel, Howard W. Francis, Rafael J. Tamargo, and Lee M. Akst. “Prevalence, characteristics, and management of swallowing disorders following cerebellopontine angle surgery.” Otolaryngol Head Neck Surg 146, no. 3 (March 2012): 419–25. https://doi.org/10.1177/0194599811429259.
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    • Francis, Howard W., Chadi Makary, Christopher Halpin, Benjamin T. Crane, and Saumil N. Merchant. “Temporal bone findings in a case of Susac's syndrome.” Otol Neurotol 32, no. 8 (October 2011): 1198–1204. https://doi.org/10.1097/MAO.0b013e31822e9665.
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    • Diaz Voss Varela, D. A., M. U. Malik, V. Pandian, H. W. Francis, and N. I. Bhatti. “Virtual reality training for mastoidectomy: What do trainees and faculty think?” Laryngoscope 121, no. SUPPL. 5 (August 29, 2011). https://doi.org/10.1002/lary.22276.
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    • Rivas, Alejandro, Kofi D. Boahene, Héctor Corrada Bravo, Marietta Tan, Rafael J. Tamargo, and Howard W. Francis. “A model for early prediction of facial nerve recovery after vestibular schwannoma surgery.” Otol Neurotol 32, no. 5 (July 2011): 826–33. https://doi.org/10.1097/MAO.0b013e31821b0afd.
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    • Yew, Margaret, Basil Dubbs, Olivia Tong, George T. Nager, John K. Niparko, Arzu Tatlipinar, and Howard W. Francis. “Arachnoid granulations of the temporal bone: a histologic study of dural and osseous penetration.” Otol Neurotol 32, no. 4 (June 2011): 602–9. https://doi.org/10.1097/MAO.0b013e3182129026.
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    • Clark, James H., Frank R. Lin, Safia N. Salaria, C Matthew Stewart, and Howard W. Francis. “Malignant otitis externa caused by Aspergillus fumigatus: a case report.” Otol Neurotol 32, no. 3 (April 2011): e22–23. https://doi.org/10.1097/MAO.0b013e3181e3dec7.
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    • Francis, H. W., A. L. Marlowe, and J. K. Niparko. “Revision cochlear implantation in children.” Operative Techniques in Otolaryngology  Head and Neck Surgery 21, no. 4 (December 1, 2010): 233–38. https://doi.org/10.1016/j.otot.2010.05.002.
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    • Yeagle, J. D., K. M. Ceh, and H. W. Francis. “Geriatric cochlear implantation.” Operative Techniques in Otolaryngology  Head and Neck Surgery 21, no. 4 (December 1, 2010): 266–71. https://doi.org/10.1016/j.otot.2010.03.003.
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    • Stewart, C Matthew, Hamid Masood, Vinciya Pandian, Kulsoom Laeeq, Lee Akst, Howard W. Francis, and Nasir I. Bhatti. “Development and pilot testing of an objective structured clinical examination (OSCE) on hoarseness.” Laryngoscope 120, no. 11 (November 2010): 2177–82. https://doi.org/10.1002/lary.21095.
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    • Francis, Howard W., Hamid Masood, Kashif N. Chaudhry, Kulsoom Laeeq, John P. Carey, Charles C. Della Santina, Charles J. Limb, John K. Niparko, and Nasir I. Bhatti. “Objective assessment of mastoidectomy skills in the operating room.” Otol Neurotol 31, no. 5 (July 2010): 759–65. https://doi.org/10.1097/MAO.0b013e3181e3d385.
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    • Francis, Howard W., Hamid Masood, Kulsoom Laeeq, and Nasir I. Bhatti. “Defining milestones toward competency in mastoidectomy using a skills assessment paradigm.” Laryngoscope 120, no. 7 (July 2010): 1417–21. https://doi.org/10.1002/lary.20953.
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    • Agrawal, Yuri, James H. Clark, Charles J. Limb, John K. Niparko, and Howard W. Francis. “Predictors of vestibular schwannoma growth and clinical implications.” Otol Neurotol 31, no. 5 (July 2010): 807–12. https://doi.org/10.1097/MAO.0b013e3181de46ae.
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    • Marlowe, Andrea L., Jill E. Chinnici, Alejandro Rivas, John K. Niparko, and Howard W. Francis. “Revision cochlear implant surgery in children: the Johns Hopkins experience.” Otol Neurotol 31, no. 1 (January 2010): 74–82. https://doi.org/10.1097/MAO.0b013e3181c29fad.
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    • Tan, Marietta, Oluwaseun A. Myrie, Frank R. Lin, John K. Niparko, Lloyd B. Minor, Rafael J. Tamargo, and Howard W. Francis. “Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007.” Laryngoscope 120, no. 1 (January 2010): 144–49. https://doi.org/10.1002/lary.20672.
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    • Laeeq, Kulsoom, Nasir I. Bhatti, John P. Carey, Charles C. Della Santina, Charles J. Limb, John K. Niparko, Lloyd B. Minor, and Howard W. Francis. “Pilot testing of an assessment tool for competency in mastoidectomy.” Laryngoscope 119, no. 12 (December 2009): 2402–10. https://doi.org/10.1002/lary.20678.
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    • Barker, David H., Alexandra L. Quittner, Nancy E. Fink, Laurie S. Eisenberg, Emily A. Tobey, John K. Niparko, and John K. CDaCI Investigative Team. “Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication.” Dev Psychopathol 21, no. 2 (2009): 373–92. https://doi.org/10.1017/S0954579409000212.
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    • Rivas, Alejandro, Andrea L. Marlowe, Jill E. Chinnici, John K. Niparko, and Howard W. Francis. “Revision cochlear implantation surgery in adults: indications and results.” Otol Neurotol 29, no. 5 (August 2008): 639–48. https://doi.org/10.1097/MAO.0b013e31817e5d31.
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    • Francis, Howard W., Craig A. Buchman, Jiovani M. Visaya, Nae-Yuh Wang, Teresa A. Zwolan, Nancy E. Fink, John K. Niparko, and John K. CDaCI Investigative Team. “Surgical factors in pediatric cochlear implantation and their early effects on electrode activation and functional outcomes.” Otol Neurotol 29, no. 4 (June 2008): 502–8. https://doi.org/10.1097/MAO.0b013e318170b60b.
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    • Nahas, Zayna, Arzu Tatlipinar, Charles J. Limb, and Howard W. Francis. “Spontaneous meningoencephalocele of the temporal bone: clinical spectrum and presentation.” Arch Otolaryngol Head Neck Surg 134, no. 5 (May 2008): 509–18. https://doi.org/10.1001/archotol.134.5.509.
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    • Stamataki, Sofia, Howard W. Francis, Michael Holliday, and Edward McCarthy. “Histological features of osteofibrous hemangioma of the maxillofacial and skull base regions.” Otolaryngol Head Neck Surg 138, no. 5 (May 2008): 587–93. https://doi.org/10.1016/j.otohns.2008.01.002.
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    • Chang, Steven S., Marc Halushka, Joseph Vander Meer, Martin Goins, and Howard W. Francis. “Nasopharyngeal hairy polyp with recurrence in the middle ear.” Int J Pediatr Otorhinolaryngol 72, no. 2 (February 2008): 261–64. https://doi.org/10.1016/j.ijporl.2007.10.003.
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    • Zwolan, Teresa A., Mary Beth O’Sullivan, Nancy E. Fink, John K. Niparko, and John K. CDACI Investigative Team. “Electric charge requirements of pediatric cochlear implant recipients enrolled in the Childhood Development After Cochlear Implantation study.” Otol Neurotol 29, no. 2 (February 2008): 143–48. https://doi.org/10.1097/MAO.0b013e318161aac7.
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    • Wang, Nae-Yuh, Laurie S. Eisenberg, Karen C. Johnson, Nancy E. Fink, Emily A. Tobey, Alexandra L. Quittner, John K. Niparko, and John K. CDaCI Investigative Team. “Tracking development of speech recognition: longitudinal data from hierarchical assessments in the Childhood Development after Cochlear Implantation Study.” Otol Neurotol 29, no. 2 (February 2008): 240–45. https://doi.org/10.1097/MAO.0b013e3181627a37.
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    • Quittner, A. L., D. H. Barker, C. Snell, I. Cruz, L. G. Mcdonald, M. E. Grimley, M. Botteri, et al. “Improvements in visual attention in deaf infants and toddlers after cochlear implantation.” Audiological Medicine 5, no. 4 (November 15, 2007): 242–49. https://doi.org/10.1080/16513860701745401.
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    • Baird, Clinton J., Alia Hdeib, Ian Suk, Howard W. Francis, Michael J. Holliday, Rafael J. Tamargo, Henry Brem, and Donlin M. Long. “Reduction of cerebrospinal fluid rhinorrhea after vestibular schwannoma surgery by reconstruction of the drilled porus acusticus with hydroxyapatite bone cement.” J Neurosurg 107, no. 2 (August 2007): 347–51. https://doi.org/10.3171/JNS-07/08/0347.
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    • Stamataki, Sofia, Howard W. Francis, Mohamed Lehar, Bradford J. May, and David K. Ryugo. “Synaptic alterations at inner hair cells precede spiral ganglion cell loss in aging C57BL/6J mice.” Hear Res 221, no. 1–2 (November 2006): 104–18. https://doi.org/10.1016/j.heares.2006.07.014.
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    • Agwu, Allison George, Ryan Pasternak, Mary Joyner, Courtney L. Carver, Howard W. Francis, and George K. Siberry. “Nontypeable Haemophilus influenzae meningitis complicated by hearing loss in a 9-year-old HIV-infected boy.” Aids Patient Care Stds 20, no. 8 (August 2006): 531–35. https://doi.org/10.1089/apc.2006.20.531.
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    • Lustig, Lawrence R., Jennifer Yeagle, Colin L. W. Driscoll, Nikolas Blevins, Howard Francis, and John K. Niparko. “Cochlear implantation in patients with neurofibromatosis type 2 and bilateral vestibular schwannoma.” Otol Neurotol 27, no. 4 (June 2006): 512–18. https://doi.org/10.1097/01.mao.0000217351.86925.51.
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    • Leung, Janice, Nae-Yuh Wang, Jennifer D. Yeagle, Jill Chinnici, Stephen Bowditch, Howard W. Francis, and John K. Niparko. “Predictive models for cochlear implantation in elderly candidates.” Arch Otolaryngol Head Neck Surg 131, no. 12 (December 2005): 1049–54. https://doi.org/10.1001/archotol.131.12.1049.
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    • Limb, C. J., H. F. Francis, L. R. Lustig, J. K. Niparko, and H. Jammal. “Benign positional vertigo after cochlear implantation.” Otolaryngol Head Neck Surg 132, no. 5 (May 2005): 741–45. https://doi.org/10.1016/j.otohns.2005.01.004.
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    • Rivas, Alejandro, and Howard W. Francis. “Inner ear abnormalities in a Kcnq1 (Kvlqt1) knockout mouse: a model of Jervell and Lange-Nielsen syndrome.” Otol Neurotol 26, no. 3 (May 2005): 415–24. https://doi.org/10.1097/01.mao.0000169764.00798.84.
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    • Francis, Howard W., Jennifer D. Yeagle, Toni Brightwell, and Holly Venick. “Central effects of residual hearing: implications for choice of ear for cochlear implantation.” Laryngoscope 114, no. 10 (October 2004): 1747–52. https://doi.org/10.1097/00005537-200410000-00013.
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    • Francis, Howard W., Alejandro Rivas, Mohamed Lehar, and David K. Ryugo. “Two types of afferent terminals innervate cochlear inner hair cells in C57BL/6J mice.” Brain Res 1016, no. 2 (August 6, 2004): 182–94. https://doi.org/10.1016/j.brainres.2004.05.016.
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    • Ohlrogge, Matthias, and Howard W. Francis. “Temporal bone fracture.” Otol Neurotol 25, no. 2 (March 2004): 195–96. https://doi.org/10.1097/00129492-200403000-00021.
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    • Francis, Howard W., David K. Ryugo, Melissa J. Gorelikow, Cynthia A. Prosen, and Bradford J. May. “The functional age of hearing loss in a mouse model of presbycusis. II. Neuroanatomical correlates.” Hear Res 183, no. 1–2 (September 2003): 29–36. https://doi.org/10.1016/s0378-5955(03)00212-0.
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    • Francis, Howard W., and John K. Niparko. “Cochlear implantation update.” Pediatr Clin North Am 50, no. 2 (April 2003): 341–viii. https://doi.org/10.1016/s0031-3955(03)00034-8.
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    • Rothbaum, Daniel L., Jaydeep Roy, Gregory D. Hager, Russell H. Taylor, Louis L. Whitcomb, Howard W. Francis, and John K. Niparko. “Task performance in stapedotomy: comparison between surgeons of different experience levels.” Otolaryngol Head Neck Surg 128, no. 1 (January 2003): 71–77. https://doi.org/10.1067/mhn.2003.13.
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    • Rothbaum, Daniel L., Jaydeep Roy, Dan Stoianovici, Peter Berkelman, Gregory D. Hager, Russell H. Taylor, Louis L. Whitcomb, Howard W. Francis, and John K. Niparko. “Robot-assisted stapedotomy: micropick fenestration of the stapes footplate.” Otolaryngol Head Neck Surg 127, no. 5 (November 2002): 417–26. https://doi.org/10.1067/mhn.2002.129729.
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    • Francis, Howard W., John C. Scott, and Paul B. Manis. “Protein kinase C mediates potentiation of synaptic transmission by phorbol ester at parallel fibers in the dorsal cochlear nucleus.” Brain Res 951, no. 1 (September 27, 2002): 9–22. https://doi.org/10.1016/s0006-8993(02)03095-0.
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    • Francis, Howard W., Nelson Chee, Jennifer Yeagle, Andre Cheng, and John K. Niparko. “Impact of cochlear implants on the functional health status of older adults.” Laryngoscope 112, no. 8 Pt 1 (August 2002): 1482–88. https://doi.org/10.1097/00005537-200208000-00028.
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    • Lustig, L. R., H. A. Arts, D. E. Brackmann, H. F. Francis, T. Molony, C. A. Megerian, G. F. Moore, et al. “Hearing rehabilitation using the BAHA bone-anchored hearing aid: results in 40 patients.” Otol Neurotol 22, no. 3 (May 2001): 328–34. https://doi.org/10.1097/00129492-200105000-00010.
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    • Lee, M. P., J. D. Ravenel, R. J. Hu, L. R. Lustig, G. Tomaselli, R. D. Berger, S. A. Brandenburg, et al. “Targeted disruption of the Kvlqt1 gene causes deafness and gastric hyperplasia in mice.” J Clin Invest 106, no. 12 (December 2000): 1447–55. https://doi.org/10.1172/JCI10897.
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    • Francis, H. W., and P. B. Manis. “Effects of deafferentation on the electrophysiology of ventral cochlear nucleus neurons.” Hear Res 149, no. 1–2 (November 2000): 91–105. https://doi.org/10.1016/s0378-5955(00)00165-9.
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    • Hirvonen, T. P., and A. Piilonen. “Imaging quiz case 2. Cavernous hemangioma.” Arch Otolaryngol Head Neck Surg 126, no. 10 (October 2000): 1267–71.
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    • Mabrie, D. C., H. W. Francis, S. J. Zinreich, J. Sciubba, and G. H. Yoo. “Imaging quiz case 4. Dentigerous cyst.” Arch Otolaryngol Head Neck Surg 126, no. 10 (October 2000): 1269–73.
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    • Cheng, A. K., H. R. Rubin, N. R. Powe, N. K. Mellon, H. W. Francis, and J. K. Niparko. “Cost-utility analysis of the cochlear implant in children.” Jama 284, no. 7 (August 16, 2000): 850–56. https://doi.org/10.1001/jama.284.7.850.
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    • Jiang, W., S. Mishra, and H. W. Francis. “Pathology forum: quiz case 4. Diagnosis: synovial chondromatosis of the TMJ.” Arch Otolaryngol Head Neck Surg 126, no. 7 (July 2000): 903–8.
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    • Stone, J. H., and H. W. Francis. “Immune-mediated inner ear disease.” Curr Opin Rheumatol 12, no. 1 (January 2000): 32–40. https://doi.org/10.1097/00002281-200001000-00006.
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    • Francis, H. W., M. E. Koch, J. R. Wyatt, and J. K. Niparko. “Trends in educational placement and cost-benefit considerations in children with cochlear implants.” Arch Otolaryngol Head Neck Surg 125, no. 5 (May 1999): 499–505. https://doi.org/10.1001/archotol.125.5.499.
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    • Gillespie, M. B., B. W. O’Malley, and H. W. Francis. “An approach to fulminant invasive fungal rhinosinusitis in the immunocompromised host.” Arch Otolaryngol Head Neck Surg 124, no. 5 (May 1998): 520–26. https://doi.org/10.1001/archotol.124.5.520.
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    • Francis, H. W., G. T. Nager, M. J. Holliday, and D. M. Long. “Association of heterotopic neuroglial tissue with an arachnoid cyst in the internal auditory canal.” Skull Base Surgery 5, no. 1 (January 1, 1995): 37–49. https://doi.org/10.1055/s-2008-1058949.
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    • McDowell, P. R., P. B. Gaudin, T. C. Wu, and H. Francis. “Pathologic quiz case. Adenovirus infection of the adenoids.” Arch Otolaryngol Head Neck Surg 120, no. 6 (June 1994): 668–71.
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    • Francis, H. W., and J. B. Nadol. “Patterns of innervation of outer hair cells in a chimpanzee: II. Efferent endings.” Hear Res 64, no. 2 (January 1993): 217–21. https://doi.org/10.1016/0378-5955(93)90009-p.
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    • Francis, H. W., and J. B. Nadol. “Patterns of innervation of outer hair cells in a chimpanzee: I. Afferent and reciprocal synapses.” Hear Res 64, no. 2 (January 1993): 184–90. https://doi.org/10.1016/0378-5955(93)90004-k.
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    • Yoo, G. H., H. W. Francis, and S. J. Zinreich. “Imaging quiz case. Noninvasive Aspergillus sinusitis.” Arch Otolaryngol Head Neck Surg 119, no. 1 (January 1993): 123–24.
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    • Tang, Liyang, Carol B. Thompson, James H. Clark, Kristin M. Ceh, Jennifer D. Yeagle, and Howard W. Francis. “Rehabilitation and Psychosocial Determinants of Cochlear Implant Outcomes in Older Adults.” Ear Hear 38, no. 6 (n.d.): 663–71. https://doi.org/10.1097/AUD.0000000000000445.
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  • Book Sections

    • Emmett, S. D., D. Pinder, D. G. Bervinchak, S. Juman, and H. W. Francis. “Establishing Hearing Implant Programs in Low Resource Settings: Practical and Economic Considerations.” In Implantable Hearing Devices, edited by C. de Souza, P. Roland, and D. Tucci, 261–75, 2017.
    • Lin, F. R., J. K. Niparko, and H. W. Francis. “Outcomes in cochlear implantation: Assessment of quality-of-life impact and economic evaluation of the benefits of the cochlear implant in relation to costs.” In Cochlear Implants: Principles and Practices, 229–44, 2012.
    • Niparko, J. K., S. Love-Schlessman, and H. W. Francis. “Hearing loss and associated problems.” In Principles of Ambulatory Medicine: Seventh Edition, 1833–48, 2012.
    • Chien, W. W., H. Francis, and J. K. Niparko. “Hearing Prosthetics: Surgical Techniques.” In Schmidek and Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results: Sixth Edition, 1:588–96, 2012. https://doi.org/10.1016/B978-1-4160-6839-6.10049-8.
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    • Agrawal, Y., and H. W. Francis. “Immune-mediated inner ear disease.” In A Clinician’s Pearls and Myths in Rheumatology, 385–92, 2009. https://doi.org/10.1007/978-1-84800-934-9_39.
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  • Conference Papers

    • Nieman, Carrie L., Heather M. Weinreich, Jeffrey D. Sharon, Wade W. Chien, and Howard W. Francis. “Use of Pericranial Flap Coverage in Cochlear Implantation of the Radical Cavity: Rationale, Technique, and Experience.” In Otolaryngol Head Neck Surg, 155:533–37, 2016. https://doi.org/10.1177/0194599816635642.
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    • Erbele, Isaac D., Frank R. Lin, Yuri Agrawal, Howard W. Francis, John P. Carey, and Wade W. Chien. “Racial Differences of Pigmentation in the Human Vestibular Organs.” In Otolaryngology  Head and Neck Surgery : Official Journal of American Academy of Otolaryngology Head and Neck Surgery, 155:479–84, 2016. https://doi.org/10.1177/0194599816645764.
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    • Saunders, James E., Howard W. Francis, and Piotr H. Skarzynski. “Measuring Success: Cost-Effectiveness and Expanding Access to Cochlear Implantation.” In Otol Neurotol, 37:e135–40, 2016. https://doi.org/10.1097/MAO.0000000000000942.
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    • Malik, Mohammad U., David A Diaz Voss Varela, EunMi Park, Hamid Masood, Kulsoom Laeeq, Nasir I. Bhatti, and Howard W. Francis. “Determinants of resident competence in mastoidectomy: role of interest and deliberate practice.” In Laryngoscope, 123:3162–67, 2013. https://doi.org/10.1002/lary.24179.
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    • Malik, M. U., D. A. Diaz Voss Varela, H. Masood, G. Yenokyan, H. W. Francis, V. Pandian, J. K. Niparko, C. W. Cummings, and N. I. Bhatti. “A comparison of mastoidectomy learning curves in otolaryngology-head and neck surgery residents.” In Laryngoscope, 121:S191, 2011. https://doi.org/10.1002/lary.22073.
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    • Malik, M. U., D. A. Diaz Voss Varela, H. W. Francis, V. Pandian, W. W. Chien, Y. Agrawal, J. K. Niparko, and N. I. Bhatti. “Using a virtual reality temporal bone simulator to enhance surgical competency in procedural tasks: A pilot study.” In Laryngoscope, 121:S186, 2011. https://doi.org/10.1002/lary.22068.
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    • Carpenter, Ryan M., Charles J. Limb, Howard W. Francis, Barbara Gottschalk, and John K. Niparko. “Programmatic challenges in obtaining and confirming the pneumococcal vaccination status of cochlear implant recipients.” In Otol Neurotol, 31:1334–36, 2010. https://doi.org/10.1097/MAO.0b013e3181f395c0.
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    • Francis, Howard W., Alejandro Rivas, Mohamed Lehar, Yu Saito, Peter R. Mouton, and David K. Ryugo. “Efficient quantification of afferent cochlear ultrastructure using design-based stereology.” In J Neurosci Methods, 150:150–58, 2006. https://doi.org/10.1016/j.jneumeth.2005.06.020.
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    • Francis, Howard W., Jennifer D. Yeagle, Stephen Bowditch, and John K. Niparko. “Cochlear implant outcome is not influenced by the choice of ear.” In Ear Hear, 26:7S-16S, 2005. https://doi.org/10.1097/00003446-200508001-00003.
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    • Francis, Howard W., Margaret B. Pulsifer, Jill Chinnici, Robert Nutt, Holly S. Venick, Jennifer D. Yeagle, and John K. Niparko. “Effects of central nervous system residua on cochlear implant results in children deafened by meningitis.” In Arch Otolaryngol Head Neck Surg, 130:604–11, 2004. https://doi.org/10.1001/archotol.130.5.604.
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    • Gillespie, M. B., H. W. Francis, N. Chee, and D. W. Eisele. “Squamous cell carcinoma of the temporal bone: a radiographic-pathologic correlation.” In Arch Otolaryngol Head Neck Surg, 127:803–7, 2001.
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    • Koch, M. E., J. R. Wyatt, H. W. Francis, and J. K. Niparko. “A model of educational resource use by children with cochlear implants.” In Otolaryngol Head Neck Surg, 117:174–79, 1997. https://doi.org/10.1016/s0194-5998(97)70171-2.
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