Scholars@Duke
David Latham Witsell

David Latham Witsell

Professor Emeritus of Head and Neck Surgery & Communication Sciences
Head and Neck Surgery & Communication Sciences
david.witsell@duke.edu
DUMC Box 3805, Durham, NC 27710
Box 3805, Durham, NC 27705

Selected Publications

A Pragmatic Clinical Trial of Hearing Screening in Primary Care Clinics: Effect of Setting and Provider Encouragement.

Journal Article Ear Hear · January 2024 OBJECTIVES: The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonethe ... Full text Link to item Cite

Screening for Eustachian Tube Dysfunction in Clinical Practice Using the Eustachian Tube Dysfunction Questionnaire-7.

Journal Article Laryngoscope · November 2022 OBJECTIVES/HYPOTHESIS: To evaluate the ability of the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) to discriminate between patients with Eustachian tube dysfunction (ETD) and Non-ETD diagnoses, and identify symptom information to improve ability to ... Full text Link to item Cite

A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening.

Journal Article Cost Eff Resour Alloc · June 25, 2022 BACKGROUND: Hearing loss is a high prevalence condition among older adults, is associated with higher-than-average risk for poor health outcomes and quality of life, and is a public health concern to individuals, families, communities, professionals, gover ... Full text Link to item Cite

The Association Between Hearing Loss and Surgical Complications in Older Adults.

Journal Article Ear Hear · 2022 OBJECTIVES: In this study, we sought to evaluate whether older patients with hearing loss who underwent surgery were at greater risk of postsurgical complications, increased inpatient length-of-stay (LOS), and hospital readmission. DESIGN: This was a retro ... Full text Link to item Cite

A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study.

Journal Article BMC Oral Health · May 17, 2021 BACKGROUND: To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. METHODS: Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 ... Full text Link to item Cite

The use of balloon dilation in revision sinus surgery.

Journal Article Int Forum Allergy Rhinol · October 2020 BACKGROUND: Recent studies have demonstrated a dramatic increase in the use of balloon sinus dilation (BSD) in the United States. However, the use of BSD specifically in revision sinus surgery has not been investigated. This study addresses the question of ... Full text Link to item Cite

Comparative implementation-effectiveness of three strategies to perform hearing screening among older adults in primary care clinics: study design and protocol.

Journal Article BMC Geriatr · May 11, 2020 BACKGROUND: The burden of hearing loss among older adults could be mitigated with appropriate care. This study compares implementation of three hearing screening strategies in primary care, and examines the reliability and validity of patient self-assessme ... Full text Link to item Cite

Using Google Trends to Predict Pediatric Respiratory Syncytial Virus Encounters at a Major Health Care System.

Journal Article J Med Syst · January 30, 2020 To assess whether Google search activity predicts lead-time for pediatric respiratory syncytial virus (RSV) encounters within a major health care system. Internet user search and health system encounter database analysis. Pediatric RSV encounter volumes ac ... Full text Link to item Cite

The effect of lateral neck dissection on complication rate for total thyroidectomy.

Journal Article Am J Otolaryngol · 2020 PURPOSE: To determine the complication profile for total thyroidectomy with and without concomitant lateral neck dissection using a large administrative database. MATERIALS AND METHODS: The IBM MarketScan® Commercial Database (2010-2014) analytic cohort wa ... Full text Link to item Cite

A pathway to value-based care of chronic rhinosinusitis using a claims database.

Journal Article Laryngoscope Investig Otolaryngol · February 2019 OBJECTIVE: To construct a comprehensive picture of the typical chronic rhinosinusitis (CRS) patient in the United States including the demographics, comorbidities, and geographic prevalence. The study will also identify the diagnostic and treatment regimen ... Full text Link to item Cite

Balloon Catheter Dilation of the Sinuses: A 2011-2014 MarketScan Analysis.

Journal Article Otolaryngol Head Neck Surg · December 2018 OBJECTIVE: This study uses a large national claims-based database to analyze recent practice patterns related to balloon catheter dilation (BCD) of the sinuses. STUDY DESIGN: Retrospective study. SETTING: Academic. SUBJECTS AND METHODS: Patients with chron ... Full text Link to item Cite

Steroid Use for Sudden Sensorineural Hearing Loss: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · November 2018 OBJECTIVE: The objective of this study was to describe patterns of corticosteroid treatment for sudden sensorineural hearing loss and to evaluate effectiveness based on delivery mode (oral vs intratympanic vs both). STUDY DESIGN: Cross-sectional repeated m ... Full text Link to item Cite

Idiopathic Sudden Sensorineural Hearing Loss Is Not a Sentinel Event for Acute Myocardial Infarction.

Journal Article Otol Neurotol · August 2018 OBJECTIVE: Given ongoing debate about the suggested association, the primary objective was to determine if idiopathic sudden sensorineural hearing loss (ISSNHL) was a sentinel event for acute myocardial infarction (AMI) in adults. STUDY DESIGN: Case-contro ... Full text Link to item Cite

Patterns of Migraine Disease in Otolaryngology: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · July 2018 Objective To evaluate the prevalence of migraine disease in an otolaryngologic cohort and migraine-related otologic and sinonasal symptoms in this population. Study Design Cross-sectional study utilizing the CHEER (Creating Healthcare Excellence through Ed ... Full text Link to item Cite

Investigating the effects of laryngotracheal stenosis on upper airway aerodynamics.

Journal Article Laryngoscope · April 2018 OBJECTIVE: Very little is known about the impact of laryngotracheal stenosis (LTS) on inspiratory airflow and resistance, especially in air hunger states. This study investigates the effect of LTS on airway resistance and volumetric flow across three diffe ... Full text Link to item Cite

Payer database and geospatial analysis to evaluate practice patterns in treating allergy in North Carolina.

Journal Article Am J Otolaryngol · 2018 OBJECTIVE: The objective of this study was to characterize the delivery of allergy care in North Carolina using a large payer charge database and visualization techniques. STUDY DESIGN: Geospatial database analysis. SETTING: North Carolina State claims dat ... Full text Link to item Cite

CHEER National Study of Chronic Rhinosinusitis Practice Patterns: Disease Comorbidities and Factors Associated with Surgery.

Journal Article Otolaryngol Head Neck Surg · April 2017 Objectives (1) Describe national patterns of chronic rhinosinusitis (CRS) care across academic and community practices. (2) Determine the prevalence of comorbid disorders in CRS patients, including nasal polyposis, allergic rhinitis, asthma, and cystic fib ... Full text Link to item Cite

Nonadherence to Guideline Recommendations for Tympanostomy Tube Insertion in Children Based on Mega-database Claims Analysis.

Journal Article Otolaryngol Head Neck Surg · January 2017 Objective To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3-year period before release of the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideli ... Full text Link to item Cite

Burden of Hearing Loss on Communication Partners and Its Influence on Pursuit of Hearing Evaluation.

Journal Article Ear Hear · 2017 OBJECTIVE: Describe how the burden on the communication partner (CP) from the patient's hearing loss, as perceived by both the patient and their CP, influences a patient's pursuit of hearing evaluation. DESIGN: Cross-sectional design. Demographics, percept ... Full text Link to item Cite

Factors influencing pursuit of hearing evaluation: Enhancing the health belief model with perceived burden from hearing loss on communication partners.

Journal Article Int J Audiol · July 2016 OBJECTIVE: There is limited application of health behavior-based theoretical models in hearing healthcare, yet other fields utilizing these models have shown their value in affecting behavior change. The health belief model (HBM) has demonstrated appropria ... Full text Link to item Cite

Does an Otolaryngology-Specific Database Have Added Value? A Comparative Feasibility Analysis.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVES: There are multiple nationally representative databases that support epidemiologic and outcomes research, and it is unknown whether an otolaryngology-specific resource would prove indispensable or superfluous. Therefore, our objective was to det ... Full text Link to item Cite

Tonsillectomy Bleed Rates across the CHEER Practice Research Network: Pursuing Guideline Adherence and Quality Improvement.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVES: (1) Compare postoperative bleeding in the CHEER network (Creating Healthcare Excellence through Education and Research) among age groups, diagnoses, and practice types. (2) Report the incidence of bleeding by individual CHEER practice site base ... Full text Link to item Cite

Variation in the Use of Vestibular Diagnostic Testing for Patients Presenting to Otolaryngology Clinics with Dizziness.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVE: We used a national otolaryngology practice-based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder. STUDY DESIGN: Database review. SETTING: ... Full text Link to item Cite

Thyroid Disease and Surgery in CHEER: The Nation's Otolaryngology-Head and Neck Surgery Practice-Based Network.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVES: (1) Describe thyroid-related diagnoses and procedures in Creating Healthcare Excellence through Education and Research (CHEER) across academic and community sites. (2) Compare management of malignant thyroid disease across these sites. (3) Prov ... Full text Link to item Cite

Ménière's Disease: A CHEER Database Study of Local and Regional Patient Encounter and Procedure Patterns.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVE: (1) Integrate practice-based patient encounters using the Dartmouth Atlas Medicare database to understand practice treatments for Ménière's disease (MD). (2) Describe differences in the practice patterns between academic and community providers ... Full text Link to item Cite

Evaluation of Compliance for Treatment of Sudden Hearing Loss: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVE: The objective of this study is to describe the presentation and management of sudden sensorineural hearing loss for patients seen in academic and community-based practices within the context of the American Academy of Otolaryngology-Head and Nec ... Full text Link to item Cite

Assessment of the Clinical Utility of Cervical and Ocular Vestibular Evoked Myogenic Potential Testing in Elderly Patients.

Journal Article Otol Neurotol · August 2015 OBJECTIVES: To assess whether patient age or sex was predictive of a bilaterally absent cervical or ocular vestibular evoked myogenic potential (cVEMP or oVEMP). STUDY DESIGN: Retrospective case review. SETTING: Tertiary center. PATIENTS: Patients presenti ... Full text Link to item Cite

Changes in aerodynamics during vocal cord dysfunction.

Journal Article Comput Biol Med · February 2015 BACKGROUND: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a ... Full text Link to item Cite

Impact of Otitis Media Severity on Children's Quality of Life.

Journal Article Otolaryngol Head Neck Surg · August 2014 OBJECTIVE: Children with otitis media (OM) suffer sleep disturbances, loss of appetite, earache, and behavioral problems. Our objective was to quantitate the average burden of OM and to compare the associated impact of tympanostomy tubes on infant health r ... Full text Link to item Cite

Caregiver Quality of Life Is Related to Severity of Otitis Media in Children.

Journal Article Otolaryngol Head Neck Surg · August 2014 OBJECTIVE: Otitis media (OM) in children is the most frequent reason for physician visits in developed countries and burdens caregivers, society, and the child. Our objective was to describe the impact of OM severity on parent/caregiver quality of life (Qo ... Full text Link to item Cite

An analysis of registered clinical trials in otolaryngology from 2007 to 2010: ClinicalTrials.gov.

Journal Article Otolaryngol Head Neck Surg · November 2013 OBJECTIVE: To describe the conditions studied, interventions used, study characteristics, and funding sources of otolaryngology clinical trials from the ClinicalTrials.gov database; compare this otolaryngology cohort of interventional studies to clinical v ... Full text Link to item Cite

Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.

Journal Article Med Educ Online · October 29, 2013 INTRODUCTION: Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of ... Full text Link to item Cite

Consumer assessment of healthcare providers and systems surgical care survey: benefits and challenges.

Journal Article Otolaryngol Head Neck Surg · October 2012 OBJECTIVE: To describe the feasibility and initial results of the implementation of a continuous quality improvement project using the newly available Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS), in a small cohort ... Full text Link to item Cite

Practice-Based Research in Your Practice.

Conference Otolaryngol Head Neck Surg · August 2012 Full text Link to item Cite

CT-guided hookwire placement: a technical innovation for preoperative localization of nonpalpable cervical lymph nodes.

Journal Article AJNR Am J Neuroradiol · August 2012 The aim is to describe the technique of preoperative CT-guided hookwire localization of small, but suspicious, cervical lymph nodes. We present 3 patients who underwent the procedure for nonpalpable cervical nodes detected on PET/CT prior to complete surgi ... Full text Link to item Cite

Effectiveness of cevimeline to improve oral health in patients with postradiation xerostomia.

Journal Article Head Neck · August 2012 BACKGROUND: We assessed the effectiveness of cevimeline 30 mg 3 times daily in patient-reported oral health (Oral Health Impact Profile [OHIP-49]) and quality of life (QOL) in patients with xerostomia. METHODS: In our investigator-initiated, multicenter, r ... Full text Link to item Cite

Treatment-induced changes in vocal cord mobility and subsequent local recurrence after organ preservation therapy for laryngeal carcinoma.

Journal Article Head Neck · June 2012 BACKGROUND: As multidisciplinary cancer treatment evolves, strategies to identify patients needing early resection/salvage are necessary. Some have suggested that vocal cord function after organ-preservation treatment may be an indicator. METHODS: A retros ... Full text Link to item Cite

The Otology Data Collection project: report from the CHEER network.

Journal Article Otolaryngol Head Neck Surg · October 2011 OBJECTIVE: To describe and communicate data collected in the CHEER (Creating Healthcare Excellence through Education and Research) infrastructure proof-of-concept study to facilitate understanding of the potential capabilities of practice-based research ne ... Full text Link to item Cite

Implementation and testing of research infrastructure for practice-based research in hearing and communication disorders.

Journal Article Otolaryngol Head Neck Surg · October 2011 OBJECTIVE: To describe site capability and experience of the CHEER network (Creating Healthcare Excellence through Education and Research) to rapidly collect descriptive data on patients with tinnitus and dizziness visiting participating CHEER sites. STUDY ... Full text Link to item Cite

Studying Life Effects & Effectiveness of Palatopharyngoplasty (SLEEP) study: subjective outcomes of isolated uvulopalatopharyngoplasty.

Journal Article Otolaryngol Head Neck Surg · April 2011 OBJECTIVE: To test the hypothesis that uvulopalatopharyngoplasty (UPPP) improves sleep apnea-related quality of life (measured on the Functional Outcomes of Sleep Questionnaire [FOSQ]) at 3-month follow-up. Secondary objectives were to test (1) the stabili ... Full text Link to item Cite

Building a national research network for clinical investigations in otology and neurotology.

Journal Article Otol Neurotol · February 2010 BACKGROUND: Practice-based research networks (PBRNs) are the preferred research setting for descriptive/epidemiologic studies and studies that explore the effectiveness of treatments for disease that are managed in community settings, away from the rubric ... Full text Link to item Cite

Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices.

Journal Article Otolaryngol Head Neck Surg · October 2008 OBJECTIVE: To evaluate the acute otitis externa and otitis media with effusion performance measure sets in a clinical setting and provide preliminary data on measure compliance. STUDY DESIGN AND SETTING: Quality improvement study. SUBJECTS AND METHODS: Con ... Full text Link to item Cite

Reply to "Quality of life after tonsillectomy in children with recurrent tonsillitis"

Other Otolaryngology - Head and Neck Surgery · October 1, 2008 Full text Cite

Treatment responsiveness of the Singing Voice Handicap Index.

Journal Article Laryngoscope · September 2008 OBJECTIVES/HYPOTHESIS: To examine the responsiveness of the previously validated Singing Voice Handicap Index (SVHI) to treatment related changes in patients' singing voice. STUDY DESIGN: Prospective. METHODS: Thirty singing patients at a tertiary voice cl ... Full text Link to item Cite

Treatment of tinnitus with gabapentin: a pilot study.

Journal Article Otol Neurotol · January 2007 OBJECTIVE: To evaluate the effectiveness of gabapentin (Neurontin) improve the disease-specific quality of life in patients with moderate tinnitus. STUDY DESIGN: Randomized, double blind, placebo-controlled clinical trial. SETTING: Single-center academic o ... Full text Link to item Cite

Quality of life of patients with otitis media and caregivers: a multicenter study.

Journal Article Laryngoscope · October 2006 OBJECTIVE: The objective of this study was to determine the quality of life of otitis media (OM) patients and their caregivers. STUDY DESIGN: A cross-sectional study was conducted at 11 otolaryngology and five pediatric clinics in the United States between ... Full text Link to item Cite

Clinical practice guideline: acute otitis externa.

Journal Article Otolaryngol Head Neck Surg · April 2006 OBJECTIVE: This guideline provides evidence-based recommendations to manage diffuse acute otitis externa (AOE), defined as generalized inflammation of the external ear canal, which may also involve the pinna or tympanic membrane. The primary purpose is to ... Full text Link to item Cite

The Cooperative Outcomes Group for ENT: a multicenter prospective cohort study on the effectiveness of medical and surgical treatment for patients with chronic rhinosinusitis.

Journal Article Otolaryngol Head Neck Surg · February 2005 OBJECTIVE: To assess outcomes for patients with chronic rhinosinusitis. STUDY DESIGN AND SETTING: Prospective, multicenter study; 31 otolaryngologists enrolled 276 adult patients with chronic rhinosinusitis; patients completed surveys at 3-month intervals, ... Full text Link to item Cite

The Cooperative Outcomes Group for ENT: a multicenter prospective cohort study on the outcomes of tympanostomy tubes for children with otitis media.

Journal Article Otolaryngol Head Neck Surg · February 2005 OBJECTIVE: Outcomes for patients with otitis media were assessed in this prospective, multicenter study. STUDY DESIGN AND SETTING: Thirty-one otolaryngologists enrolled 272 pediatric patients with otitis media; caregivers completed surveys at 3-month inter ... Full text Link to item Cite

Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study.

Journal Article Otolaryngol Head Neck Surg · March 2004 OBJECTIVE: Our goal was to assess disease-specific quality of life outcomes after nasal septoplasty in adults with nasal obstruction. DESIGN, SETTINGS, AND PATIENTS: We conducted a prospective observational outcomes multicenter study with 14 sites and 16 i ... Full text Link to item Cite

Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale.

Journal Article Otolaryngol Head Neck Surg · February 2004 OBJECTIVE: The study goal was to validate a disease-specific health status instrument for use in patients with nasal obstruction.Design, settings, and patients The study consisted of a prospective instrument validation conducted at 4 academic medical cente ... Full text Link to item Cite

Laryngeal dystonia causing inspiratory stridor in children with cerebral palsy.

Journal Article Laryngoscope · December 2003 OBJECTIVE To present three cases of inspiratory stridor caused by laryngeal dystonia (LD) in children with cerebral palsy (CP), one of whom is being treated by periodic botulinum toxin type A (BTX) injection into a vocalis muscle, thereby avoiding tracheos ... Full text Link to item Cite

Management of allergic rhinitis in the working-age population.

Journal Article Evid Rep Technol Assess (Summ) · January 2003 Link to item Cite

Treatment of sudden sensorineural hearing loss with systemic steroids and valacyclovir.

Journal Article Otol Neurotol · May 2002 Featured Publication OBJECTIVE: To determine if the addition of an antiviral medication to systemic steroids improves recovery in the treatment of idiopathic sudden sensorineural hearing loss. STUDY DESIGN: Randomized, double-blind, placebo-controlled prospective multicenter c ... Full text Link to item Cite

Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. The CAFFS Trial: a randomized controlled trial.

Journal Article JAMA · December 26, 2001 Featured Publication CONTEXT: It is not known whether intranasal corticosteroids are beneficial to treat acute rhinosinusitis in patients with a history of chronic or recurrent sinus symptoms. OBJECTIVE: To assess whether the addition of an intranasal corticosteroid to antibio ... Full text Link to item Cite

Exploring health-related quality of life in patients with diseases of the ear, nose, and throat: a multicenter observational study.

Journal Article Otolaryngol Head Neck Surg · October 2001 Featured Publication OBJECTIVES: This study was undertaken to explore which diseases of the ear, nose, and throat impact daily functioning of patients in an outpatient setting and to observe how specific demographic variables affect health-related quality of life (HRQOL) in th ... Full text Link to item Cite

Use of ototopical antibiotics in treating 3 common ear diseases.

Journal Article Otolaryngol Head Neck Surg · June 2000 Prompted by rising rates of antibiotic resistance, lack of standardized treatment regimens, and new treatment alternatives, the American Academy of Otolaryngology-Head and Neck Surgery convened an expert consensus panel to consider recommendations for the ... Full text Link to item Cite

Diagnosis and treatment of acute otitis externa an interdisciplinary update: Introduction

Other Annals of Otology, Rhinology and Laryngology · February 23, 1999 Cite

Unilateral supraglottitis in adults: fact or fiction.

Journal Article J Otolaryngol · August 1995 Featured Publication Supraglottitis and epiglottitis have been described for many years by various authors. Haemophilus influenzae type b is the primary cause of childhood epiglottitis, which classically appears between the ages of 2 and 4 years. Onset is usually acute and the ... Link to item Cite

Effect of Lactobacillus acidophilus on antibiotic-associated gastrointestinal morbidity: a prospective randomized trial.

Journal Article J Otolaryngol · August 1995 Featured Publication Oral antibiotic therapy can alter the gastrointestinal microflora and result in troublesome gastrointestinal complaints. Patients who have experience with broad-spectrum antibiotics may be reluctant to start or to comply with antibiotic therapy due to the ... Link to item Cite

Regulation of lipoprotein lipase activity and mRNA in the mammary gland of the lactating mouse.

Journal Article Biochem J · March 1, 1994 Featured Publication We examined the effects of reproductive stage and fasting on lipoprotein lipase (LPL) activity and mRNA in the mouse mammary gland. Heparin-releasable and cell-associated LPL activity rose immediately after birth, followed 1-2 days later by an increase in ... Full text Link to item Cite

Unique chromosomal rearrangement and mucin production in a novel salivary myoepithelial cell strain.

Journal Article Arch Otolaryngol Head Neck Surg · October 1993 Featured Publication Pleomorphic adenoma is the most frequently occurring benign neoplasm of the salivary glands. We describe the culture characteristics, biochemical properties, immunohistochemical staining, and genetic rearrangements found in a novel cell strain (UNC4) estab ... Full text Link to item Cite

METABOLIC-REGULATION OF MAMMARY LIPOPROTEIN-LIPASE

Conference FASEB JOURNAL · March 15, 1991 Link to item Cite

Divalent cation activation of galactosyltransferase in native mammary Golgi vesicles.

Journal Article J Biol Chem · September 15, 1990 Featured Publication Millimolar concentrations of manganese are required for maximal activation of purified galactosyltransferase (lactose synthase, EC 2.4.1.22), the enzyme that catalyzes addition of galactosyl groups to proteins and, in lactose synthesis, to glucose. To exam ... Link to item Cite