Ofir Zavdy - Academia.edu (original) (raw)
Papers by Ofir Zavdy
Authorea (Authorea), Jan 31, 2024
The Laryngoscope, Nov 14, 2023
Clinical Otolaryngology, Oct 9, 2023
The Laryngoscope, Nov 14, 2023
Otology & Neurotology, Sep 24, 2020
Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular d... more Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular depth of insertion (aDOI) measurements using plain x-ray scans. Study Design: Retrospective study where three observers independently evaluated and compared intraoperative anterior-posterior and oblique x-ray scans. Setting: A tertiary pediatric medical center. Patients: Included were 50 children (100 ears) who underwent bilateral simultaneous cochlear implantation during 2008 to 2015. Main Outcome Measures: Inter-rater agreement of aDOI measured in plain x-ray scans; effect of head position on measured aDOI; and symmetry of aDOI between patients’ ears in bilateral simultaneous cochlear implantations. Results: Differences in the average aDOI measurements among the three observers ranged between 2 and 7 degrees. There was high inter-rater agreement (R = 0.99, p < 0.01) among all observers, and strong correlations between each pair of observers (0.92–0.99). Head rotation of 45 degrees (between the two views) resulted in a median difference in aDOI of 14 degrees, with excellent correlation among the observers. The rate of asymmetry was high, with a median difference of 39 degrees and up to 220 degrees between ears. Conclusions: Assessment of aDOI using intraoperative plain x-rays is efficient and reliable. The effect of head positioning on measurement is small. Further studies are needed to evaluate the effect of aDOI and insertion symmetry on functional outcomes.
Quality of Life Research, Apr 18, 2023
Journal of The American Academy of Audiology, Jul 1, 2022
Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and... more Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and localizing the direction of sound. Unilateral hearing loss (UHL) affects quality of life in both childhood and adulthood, speech development and academic achievements. Sound amplification using air-conducting hearing aids (HA) is a common option for hearing rehabilitation of UHL. The processing time of digital HA can significantly delay the acoustic stimulation in 3-10 milliseconds, which is far longer than the maximal natural interaural time difference (ITD) of 750 microseconds. This can further impair spatial localization in these patients. Purpose: We sought to assess whether HA effects on ITD and interaural level difference (ILD) impair localization among subjects with unilateral conductive hearing loss (UCHL). Research Design: Normal-hearing participants underwent localization testing in different free field settings. Study Sample: Ten volunteers with normal-hearing thresholds. Intervention: Repeated assessments were compared between normal (binaural) hearing, UCHL induced by insertion of an inactivated HA to the ear canal (conductive HL) and amplification with a HA. Results: In UCHL mode, with HA switched-off, localization was significantly impaired compared to normal hearing (η²=0.151). Localization error was more pronounced when sound was presented from the front and from the side of the occluded ear. When switched-on, amplification with HA significantly improved localization for all participants compared to UCHL. Better localization with HA was seen in high frequencies compared to low frequencies (η²=0.08, 0.03). Even with HA localization did not reach that of normal hearing (η²=0.034). Conclusions: Mild UCHL caused localization to deteriorate. HA significantly improved sound localization, albeit the delay caused by the device processing time. Most of the improvements were seen in high-frequency sounds, representing a beneficial effect of amplification on ILD. Our results have potential clinical value in situations of mild CHL, for instance, otitis media with effusion.
Authorea (Authorea), Apr 3, 2021
This a preprint and has not been peer reviewed. Data may be preliminary.
Cancers
Background: Immunosuppression is strongly associated with an increased risk of developing cutaneo... more Background: Immunosuppression is strongly associated with an increased risk of developing cutaneous squamous cell carcinoma (cSCC). Studies on solid organ transplant recipients (SOTR) and chronic lymphocytic leukemia (CLL) patients have already demonstrated higher rates of aggressive cSCC tumors in these populations compared to immunocompetent controls. Studies on other immunosuppressed patient groups are scarce. This study was aimed at assessing the effects of different immunomodulating conditions on patients diagnosed with cSCC. We sought to compare the clinical features, treatments, and survival rates among the different study groups, as well as outcomes to those of immunocompetent controls with cSCC. Methods: A retrospective analysis of 465 cSCC patients, both immunosuppressed (IS) and immunocompetent controls. Etiologies for immunosuppression included SOTR, CLL, chronic kidney disease (CKD), psoriasis, rheumatoid arthritis (RA) and systemic lupus erythematous (SLE). Results: Co...
Context: Toxicity from radiation therapy for laryngeal squamous cell carcinoma includes dysphagia... more Context: Toxicity from radiation therapy for laryngeal squamous cell carcinoma includes dysphagia, mucositis, laryngeal edema, weight loss and pain. Hypofractionation (HF) regimens shorten the overall treatment time to lower the risk for accelerated repopulation of tumor cells following initiation of radiotherapy (RT) demonstrated improved overall survival and locoregional control. Objective: To examine the early toxicity of HF to the larynx, compared with standard fractionated (SF) RT. Methods: Retrospective analysis of 127 laryngeal SCC patients who were treated with RT; Early glottic cancer (50%) received hypofractionation (2.25Gy/fr, 63Gy) only to the glottis while advanced stage disease (50%) received standard fractionation (2Gy/fr, 70Gy) to the glottis and to bilateral neck, with or without concurrent chemotherapy (CRT). Results: Patients in HF group consumed significantly higher dosages of both Fentanyl (15 mg versus 8 mg) and Oxycodone (2.9 mg versus 2.1) due to increased pa...
Applied Sciences
Objectives—Cochlear implantation has been suggested to be associated with an air-bone gap, possib... more Objectives—Cochlear implantation has been suggested to be associated with an air-bone gap, possibly secondary to increased middle- and inner-ear stiffness. To explore the effect of possible changes in mechanics due to cochlear implantation, we measured wideband tympanometry (WBT) in individuals with normal hearing and individuals with severe to profound sensorineural hearing loss who underwent unilateral or bilateral cochlear implantation. Our goal was to characterize differences in WBT patterns associated with severe to profound sensorineural hearing loss and with cochlear implantation. Design—The study participants were 24 individuals with normal hearing (48 ears) and 17 with cochlear implants, of which 15 were unilaterally implanted and two were implanted bilaterally. All the participants had normal otoscopy. In the implanted group, inner-ear anatomy was normal according to preoperative imaging. All participants underwent pure-tone audiometric assessment, standard tympanometry (2...
Journal of the American Academy of Audiology
Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and... more Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and localizing the direction of sound. Unilateral hearing loss (UHL) affects quality of life in both childhood and adulthood, speech development and academic achievements. Sound amplification using air-conducting hearing aids (HA) is a common option for hearing rehabilitation of UHL. The processing time of digital HA can significantly delay the acoustic stimulation in 3-10 milliseconds, which is far longer than the maximal natural interaural time difference (ITD) of 750 microseconds. This can further impair spatial localization in these patients. Purpose: We sought to assess whether HA effects on ITD and interaural level difference (ILD) impair localization among subjects with unilateral conductive hearing loss (UCHL). Research Design: Normal-hearing participants underwent localization testing in different free field settings. Study Sample: Ten volunteers with normal-hearing thresholds. Int...
Otology & Neurotology, 2020
Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular d... more Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular depth of insertion (aDOI) measurements using plain x-ray scans. Study Design: Retrospective study where three observers independently evaluated and compared intraoperative anterior-posterior and oblique x-ray scans. Setting: A tertiary pediatric medical center. Patients: Included were 50 children (100 ears) who underwent bilateral simultaneous cochlear implantation during 2008 to 2015. Main Outcome Measures: Inter-rater agreement of aDOI measured in plain x-ray scans; effect of head position on measured aDOI; and symmetry of aDOI between patients’ ears in bilateral simultaneous cochlear implantations. Results: Differences in the average aDOI measurements among the three observers ranged between 2 and 7 degrees. There was high inter-rater agreement (R = 0.99, p < 0.01) among all observers, and strong correlations between each pair of observers (0.92–0.99). Head rotation of 45 degrees (between the two views) resulted in a median difference in aDOI of 14 degrees, with excellent correlation among the observers. The rate of asymmetry was high, with a median difference of 39 degrees and up to 220 degrees between ears. Conclusions: Assessment of aDOI using intraoperative plain x-rays is efficient and reliable. The effect of head positioning on measurement is small. Further studies are needed to evaluate the effect of aDOI and insertion symmetry on functional outcomes.
International Journal of Cancer, 2012
Testicular cancer incidence is highest among men of northern European ancestry and lowest among m... more Testicular cancer incidence is highest among men of northern European ancestry and lowest among men of Asian/African descent. We conducted a large-scale migrant cohort study to assess origin and migrant generation as predictors of testicular germ cell tumors (TGCTs), controlling for possible confounders. Data on 1,092,373 Jewish Israeli males, who underwent a general health examination prior to compulsory military service at ages 16-19 between the years 1967-2005, were linked to Israel National Cancer Registry to obtain incident TGCTs up to 2006. Cox proportional hazards was used to model time to event. Overall, 1,001 incident cases (534 seminoma and 467 nonseminoma) were detected during 19.2 million person-years of follow-up. Origin was a strong independent predictor of TGCTs with remarkably low incidence for North African-born (HR = 0.10, 95% CI: 0.04-0.21) and Asian-born (HR = 0.35, 0.20-0.62), while intermediate for Israeli-born of North African origin (HR = 0.48, 0.40-0.58) and Asian origin (HR = 0.56, 0.47-0.66), compared to European origin. A comparison of Israeli born of North African and Asian origin with North African and Asian-born yielded a HR of 2.31 (1.36-3.93). Significant risk factors controlled for were year of birth, years of education and height. Findings persisted when analyses were stratified by histologic subtypes of TGCTs. The findings of lower rates of TGCTs among men born in North Africa and Asia compared to European ancestry, but a steep increase in next generation migrants, particularly among the Israeli-born migrants from North Africa, provide clues to direct further research on the role of modern lifestyle and environment in the etiology of TGCTs.
The Laryngoscope, 2021
Anticoagulant and antiplatelet medications (ACAP) are known to be associated with an increased ri... more Anticoagulant and antiplatelet medications (ACAP) are known to be associated with an increased risk for epistaxis. There are conflicting results regarding the impact of Novel Oral Anticoagulants (NOAC) on epistaxis and its severity.
Authorea (Authorea), Jan 31, 2024
The Laryngoscope, Nov 14, 2023
Clinical Otolaryngology, Oct 9, 2023
The Laryngoscope, Nov 14, 2023
Otology & Neurotology, Sep 24, 2020
Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular d... more Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular depth of insertion (aDOI) measurements using plain x-ray scans. Study Design: Retrospective study where three observers independently evaluated and compared intraoperative anterior-posterior and oblique x-ray scans. Setting: A tertiary pediatric medical center. Patients: Included were 50 children (100 ears) who underwent bilateral simultaneous cochlear implantation during 2008 to 2015. Main Outcome Measures: Inter-rater agreement of aDOI measured in plain x-ray scans; effect of head position on measured aDOI; and symmetry of aDOI between patients’ ears in bilateral simultaneous cochlear implantations. Results: Differences in the average aDOI measurements among the three observers ranged between 2 and 7 degrees. There was high inter-rater agreement (R = 0.99, p < 0.01) among all observers, and strong correlations between each pair of observers (0.92–0.99). Head rotation of 45 degrees (between the two views) resulted in a median difference in aDOI of 14 degrees, with excellent correlation among the observers. The rate of asymmetry was high, with a median difference of 39 degrees and up to 220 degrees between ears. Conclusions: Assessment of aDOI using intraoperative plain x-rays is efficient and reliable. The effect of head positioning on measurement is small. Further studies are needed to evaluate the effect of aDOI and insertion symmetry on functional outcomes.
Quality of Life Research, Apr 18, 2023
Journal of The American Academy of Audiology, Jul 1, 2022
Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and... more Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and localizing the direction of sound. Unilateral hearing loss (UHL) affects quality of life in both childhood and adulthood, speech development and academic achievements. Sound amplification using air-conducting hearing aids (HA) is a common option for hearing rehabilitation of UHL. The processing time of digital HA can significantly delay the acoustic stimulation in 3-10 milliseconds, which is far longer than the maximal natural interaural time difference (ITD) of 750 microseconds. This can further impair spatial localization in these patients. Purpose: We sought to assess whether HA effects on ITD and interaural level difference (ILD) impair localization among subjects with unilateral conductive hearing loss (UCHL). Research Design: Normal-hearing participants underwent localization testing in different free field settings. Study Sample: Ten volunteers with normal-hearing thresholds. Intervention: Repeated assessments were compared between normal (binaural) hearing, UCHL induced by insertion of an inactivated HA to the ear canal (conductive HL) and amplification with a HA. Results: In UCHL mode, with HA switched-off, localization was significantly impaired compared to normal hearing (η²=0.151). Localization error was more pronounced when sound was presented from the front and from the side of the occluded ear. When switched-on, amplification with HA significantly improved localization for all participants compared to UCHL. Better localization with HA was seen in high frequencies compared to low frequencies (η²=0.08, 0.03). Even with HA localization did not reach that of normal hearing (η²=0.034). Conclusions: Mild UCHL caused localization to deteriorate. HA significantly improved sound localization, albeit the delay caused by the device processing time. Most of the improvements were seen in high-frequency sounds, representing a beneficial effect of amplification on ILD. Our results have potential clinical value in situations of mild CHL, for instance, otitis media with effusion.
Authorea (Authorea), Apr 3, 2021
This a preprint and has not been peer reviewed. Data may be preliminary.
Cancers
Background: Immunosuppression is strongly associated with an increased risk of developing cutaneo... more Background: Immunosuppression is strongly associated with an increased risk of developing cutaneous squamous cell carcinoma (cSCC). Studies on solid organ transplant recipients (SOTR) and chronic lymphocytic leukemia (CLL) patients have already demonstrated higher rates of aggressive cSCC tumors in these populations compared to immunocompetent controls. Studies on other immunosuppressed patient groups are scarce. This study was aimed at assessing the effects of different immunomodulating conditions on patients diagnosed with cSCC. We sought to compare the clinical features, treatments, and survival rates among the different study groups, as well as outcomes to those of immunocompetent controls with cSCC. Methods: A retrospective analysis of 465 cSCC patients, both immunosuppressed (IS) and immunocompetent controls. Etiologies for immunosuppression included SOTR, CLL, chronic kidney disease (CKD), psoriasis, rheumatoid arthritis (RA) and systemic lupus erythematous (SLE). Results: Co...
Context: Toxicity from radiation therapy for laryngeal squamous cell carcinoma includes dysphagia... more Context: Toxicity from radiation therapy for laryngeal squamous cell carcinoma includes dysphagia, mucositis, laryngeal edema, weight loss and pain. Hypofractionation (HF) regimens shorten the overall treatment time to lower the risk for accelerated repopulation of tumor cells following initiation of radiotherapy (RT) demonstrated improved overall survival and locoregional control. Objective: To examine the early toxicity of HF to the larynx, compared with standard fractionated (SF) RT. Methods: Retrospective analysis of 127 laryngeal SCC patients who were treated with RT; Early glottic cancer (50%) received hypofractionation (2.25Gy/fr, 63Gy) only to the glottis while advanced stage disease (50%) received standard fractionation (2Gy/fr, 70Gy) to the glottis and to bilateral neck, with or without concurrent chemotherapy (CRT). Results: Patients in HF group consumed significantly higher dosages of both Fentanyl (15 mg versus 8 mg) and Oxycodone (2.9 mg versus 2.1) due to increased pa...
Applied Sciences
Objectives—Cochlear implantation has been suggested to be associated with an air-bone gap, possib... more Objectives—Cochlear implantation has been suggested to be associated with an air-bone gap, possibly secondary to increased middle- and inner-ear stiffness. To explore the effect of possible changes in mechanics due to cochlear implantation, we measured wideband tympanometry (WBT) in individuals with normal hearing and individuals with severe to profound sensorineural hearing loss who underwent unilateral or bilateral cochlear implantation. Our goal was to characterize differences in WBT patterns associated with severe to profound sensorineural hearing loss and with cochlear implantation. Design—The study participants were 24 individuals with normal hearing (48 ears) and 17 with cochlear implants, of which 15 were unilaterally implanted and two were implanted bilaterally. All the participants had normal otoscopy. In the implanted group, inner-ear anatomy was normal according to preoperative imaging. All participants underwent pure-tone audiometric assessment, standard tympanometry (2...
Journal of the American Academy of Audiology
Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and... more Background: Binaural hearing is of outmost importance for communicating in noisy surroundings and localizing the direction of sound. Unilateral hearing loss (UHL) affects quality of life in both childhood and adulthood, speech development and academic achievements. Sound amplification using air-conducting hearing aids (HA) is a common option for hearing rehabilitation of UHL. The processing time of digital HA can significantly delay the acoustic stimulation in 3-10 milliseconds, which is far longer than the maximal natural interaural time difference (ITD) of 750 microseconds. This can further impair spatial localization in these patients. Purpose: We sought to assess whether HA effects on ITD and interaural level difference (ILD) impair localization among subjects with unilateral conductive hearing loss (UCHL). Research Design: Normal-hearing participants underwent localization testing in different free field settings. Study Sample: Ten volunteers with normal-hearing thresholds. Int...
Otology & Neurotology, 2020
Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular d... more Objective: To evaluate in cochlear implant patients, the feasibility and reliability of angular depth of insertion (aDOI) measurements using plain x-ray scans. Study Design: Retrospective study where three observers independently evaluated and compared intraoperative anterior-posterior and oblique x-ray scans. Setting: A tertiary pediatric medical center. Patients: Included were 50 children (100 ears) who underwent bilateral simultaneous cochlear implantation during 2008 to 2015. Main Outcome Measures: Inter-rater agreement of aDOI measured in plain x-ray scans; effect of head position on measured aDOI; and symmetry of aDOI between patients’ ears in bilateral simultaneous cochlear implantations. Results: Differences in the average aDOI measurements among the three observers ranged between 2 and 7 degrees. There was high inter-rater agreement (R = 0.99, p < 0.01) among all observers, and strong correlations between each pair of observers (0.92–0.99). Head rotation of 45 degrees (between the two views) resulted in a median difference in aDOI of 14 degrees, with excellent correlation among the observers. The rate of asymmetry was high, with a median difference of 39 degrees and up to 220 degrees between ears. Conclusions: Assessment of aDOI using intraoperative plain x-rays is efficient and reliable. The effect of head positioning on measurement is small. Further studies are needed to evaluate the effect of aDOI and insertion symmetry on functional outcomes.
International Journal of Cancer, 2012
Testicular cancer incidence is highest among men of northern European ancestry and lowest among m... more Testicular cancer incidence is highest among men of northern European ancestry and lowest among men of Asian/African descent. We conducted a large-scale migrant cohort study to assess origin and migrant generation as predictors of testicular germ cell tumors (TGCTs), controlling for possible confounders. Data on 1,092,373 Jewish Israeli males, who underwent a general health examination prior to compulsory military service at ages 16-19 between the years 1967-2005, were linked to Israel National Cancer Registry to obtain incident TGCTs up to 2006. Cox proportional hazards was used to model time to event. Overall, 1,001 incident cases (534 seminoma and 467 nonseminoma) were detected during 19.2 million person-years of follow-up. Origin was a strong independent predictor of TGCTs with remarkably low incidence for North African-born (HR = 0.10, 95% CI: 0.04-0.21) and Asian-born (HR = 0.35, 0.20-0.62), while intermediate for Israeli-born of North African origin (HR = 0.48, 0.40-0.58) and Asian origin (HR = 0.56, 0.47-0.66), compared to European origin. A comparison of Israeli born of North African and Asian origin with North African and Asian-born yielded a HR of 2.31 (1.36-3.93). Significant risk factors controlled for were year of birth, years of education and height. Findings persisted when analyses were stratified by histologic subtypes of TGCTs. The findings of lower rates of TGCTs among men born in North Africa and Asia compared to European ancestry, but a steep increase in next generation migrants, particularly among the Israeli-born migrants from North Africa, provide clues to direct further research on the role of modern lifestyle and environment in the etiology of TGCTs.
The Laryngoscope, 2021
Anticoagulant and antiplatelet medications (ACAP) are known to be associated with an increased ri... more Anticoagulant and antiplatelet medications (ACAP) are known to be associated with an increased risk for epistaxis. There are conflicting results regarding the impact of Novel Oral Anticoagulants (NOAC) on epistaxis and its severity.
The efficacy of replacing generic running with Taekwondo (TKD) specific technical skills during i... more The efficacy of replacing generic running with Taekwondo (TKD) specific technical skills during interval training at an intensity corresponding to 90-95% of maximum heart rate (HRmax) has not yet been demonstrated. Therefore, the purpose of this study was to compare the HR responses and perceived exertion between controlled running and highintensity TKD technical interval training in adolescent TKD athletes. Eighteen adolescent, male TKD athletes performed short-duration interval running and TKD specific technical skills (i.e. 10-20 [10-s of exercise interspersed with 20 s of passive recovery]) in a counterbalanced design. In both training methods, HR was measured and expressed as the percentage of HR reserve (%HRres). Rating of perceived exertion (RPE, Borg's category rating-10 scale), Banister's training impulse (TRIMP) and Edwards' training load (TL) were used to quantify the internal training load. Recorded cardiovascular responses expressed in %HRres in the two training methods were not significantly different (p > 0.05). Furthermore, the two training methods induced similar training loads as calculated by Banister and Edwards' methods. Perceived exertion ranged between "hard" and "very hard" during all interval training sessions. These findings showed that performing repeated TKD specific skills increased HR to the same level, and were perceived as producing the same training intensity as did short-duration interval running in adolescent TKD athletes. Therefore, using specific TKD kicking exercises in high-intensity interval training can be applied to bring more variety during training, mixing physical and technical aspects of the sport, while reaching the same intensity as interval running.