About

Dr. Richard K. Gurgel is a professor of Neurotology and Skull Base Surgery within the Department of Otolaryngology – Head and Neck Surgery at the University of Utah. His clinical interests include the full spectrum of neurotology, specifically in the care of patients with vestibular schwannomas (acoustic neuromas), glomus tumors, and other skull base lesions. He has an interest in the surgical restoration of both conductive and sensorineural hearing loss and auditory prostheses such as cochlear implants and robotic-assisted cochlear implantation. His research focuses on the impact of hearing loss on cognition in older adults. Dr. Gurgel is the section chief of Otology and Director of the Cochlear Implant Program at the University of Utah, caring for children and adults, and the Salt Lake Veteran’s hospital, caring for veterans. He also serves as the Neurotology Fellowship Director. As an NIH-funded surgeon-scientist, his research emphasizes how cochlear implants can improve cognition and the effects of hearing loss on cognitive health. He has authored two leading books in his field, Otologic Surgery and Imaging in Otolaryngology, along with over 125 peer-reviewed publications and book chapters. Dr. Gurgel completed his residency in Otolaryngology – Head and Neck Surgery at the University of Iowa Hospitals and Clinics and his fellowship in Otology, Neurotology, and Skull Base Surgery at Stanford University. He is recognized for his compassionate, professional, and attentive care, and has received numerous awards, including the Dr. Clark Lowe Rich Distinguished Surgeon & Mentor Award in 2025.

Research topics

• Medicine
• Surgery
• Internal medicine
• Computer Science
• Political Science
• Radiology
• Family medicine
• General surgery
• Demography
• Audiology

Selected publications

• Associations of Baseline Frailty Status and Age With Outcomes in Patients Undergoing Vestibular Schwannoma Resection

  JAMA Otolaryngology–Head & Neck Surgery · 2021 · 40 citations

  • Medicine
  • Demography
  • Surgery

  <h3>Importance</h3> Although numerous studies have evaluated the influence of advanced age on surgical outcomes following vestibular schwannoma (VS) resection, few if any large-scale investigations have assessed the comparative prognostic effects of age and frailty. As the population continues to age, it is imperative to further evaluate treatment and management strategies for older patients. <h3>Objective</h3> To conduct a population-based evaluation of the independent associations of chronological age and frailty (physiological age) with outcomes following VS resection. <h3>Design, Setting, and Participants</h3> In this large-scale, multicenter, cross-sectional analysis, weighted discharge data from the National Inpatient Sample were searched to identify adult patients (≥18 years old) who underwent VS resection from 2002 through 2017 using<i>International Classification of Diseases, Ninth Revision, Clinical Modification</i>and<i>Tenth Revision, Clinical Modification </i>codes. Data collection and analysis took place September to December 2020. <h3>Main Outcomes and Measures</h3> Complex samples regression models and receiver operating characteristic curve analysis were used to evaluate the independent associations of frailty and age (along with demographic confounders) with complications and discharge disposition. Frailty was evaluated using the previously validated 11-point modified frailty index (mFI). <h3>Results</h3> Among the 27 313 patients identified for VS resection, the mean (SEM) age was 50.4 (0.2) years, 15 031 (55.0%) were women, and 4720 (21.0%) were of non-White race/ethnicity, as determined by the National Inpatient Sample data source. Of the included patients, 15 090 (55.2%) were considered robust (mFI score = 0), 8204 (30.0%) were prefrail (mFI score = 1), 3022 (11.1%) were frail (mFI score = 2), and 996 (3.6%) were severely frail (mFI score ≥3). On univariable analysis, increasing frailty was associated with development of postoperative hemorrhagic or ischemic stroke (odds ratio [OR], 2.44 [95% CI, 2.07-2.87]; area under the curve, 0.73), while increasing age was not. Following multivariable analysis, increasing frailty and non-White race/ethnicity were independently associated with both mortality (adjusted OR [aOR], 2.32 [95% CI, 1.70-3.17], and aOR, 3.05 [95% CI, 1.02-9.12], respectively) and extended hospital stays (aOR, 1.54 [95% CI, 1.41-1.67], and aOR, 1.71 [95% CI, 1.42-2.05], respectively), while increasing age was not. Increasing frailty (aOR, 0.61 [95% CI, 0.56-0.67]), age (aOR, 0.98 [95% CI, 0.97-0.99]), and non-White race/ethnicity (aOR, 0.62 [95% CI 0.51-0.75]) were all independently associated with routine discharge. <h3>Conclusions and Relevance</h3> In this cross-sectional study, findings suggest that frailty may be more accurate for predicting outcomes and guiding treatment decisions than advanced patient age alone following VS resection.

  DOI

• Assessing Trends in Fellowship Training Among Otolaryngology Residents: A National Survey Study

  Otolaryngology · 2021 · 50 citations

  Senior authorCorresponding
  • Medicine
  • Family medicine
  • General surgery

  OBJECTIVE: To summarize trends in otolaryngology fellowship applications, fellowships selected, and reasons for pursuing a fellowship. STUDY DESIGN: One-page anonymous questionnaire. SETTING: A survey was completed by examinees at the conclusion of their American Board of Otolaryngology-Head and Neck Surgery oral examination from 2011 to 2019. METHODS: Data included age, gender, fellowship type, reasons for doing a fellowship, and type of practice that examinees will enter. Spearman correlation and Pearson chi-square tests were completed. RESULTS: < .001), notably with women selecting pediatric otolaryngology at a higher frequency than men (30.9% vs 15.8%). CONCLUSION: There is a statistically significant increasing trend of otolaryngology residents who choose to undergo further training in fellowship. These data from a large, long-term study will be valuable in planning for training and workforce needs in the future.

  DOI

• Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss

  JAMA Otolaryngology–Head & Neck Surgery · 2020 · 138 citations

  • Computer Science
  • Medicine
  • Political Science

  Importance: Cochlear implants are a treatment option for individuals with severe, profound, or moderate sloping to profound bilateral sensorineural hearing loss (SNHL) who receive little or no benefit from hearing aids; however, cochlear implantation in adults is still not routine. Objective: To develop consensus statements regarding the use of unilateral cochlear implants in adults with severe, profound, or moderate sloping to profound bilateral SNHL. Design, Setting, and Participants: This study was a modified Delphi consensus process that was informed by a systematic review of the literature and clinical expertise. Searches were conducted in the following databases: (1) MEDLINE In-Process & Other Non-Indexed Citations and Ovid MEDLINE, (2) Embase, and (3) the Cochrane Library. Consensus statements on cochlear implantation were developed using the evidence identified. This consensus process was relevant for the use of unilateral cochlear implantation in adults with severe, profound, or moderate sloping to profound bilateral SNHL. The literature searches were conducted on July 18, 2018, and the 3-step Delphi consensus method took place over the subsequent 9-month period up to March 30, 2019. Main Outcomes and Measures: A Delphi consensus panel of 30 international specialists voted on consensus statements about cochlear implantation, informed by an SR of the literature and clinical expertise. This vote resulted in 20 evidence-based consensus statements that are in line with clinical experience. A modified 3-step Delphi consensus method was used to vote on and refine the consensus statements. This method consisted of 2 rounds of email questionnaires and a face-to-face meeting of panel members at the final round. All consensus statements were reviewed, discussed, and finalized at the face-to-face meeting. Results: In total, 6492 articles were identified in the searches of the electronic databases. After removal of duplicate articles, 74 articles fulfilled all of the inclusion criteria and were used to create the 20 evidence-based consensus statements. These 20 consensus statements on the use of unilateral cochlear implantation in adults with SNHL were relevant to the following 7 key areas of interest: level of awareness of cochlear implantation (1 consensus statement); best practice clinical pathway from diagnosis to surgery (3 consensus statements); best practice guidelines for surgery (2 consensus statements); clinical effectiveness of cochlear implantation (4 consensus statements); factors associated with postimplantation outcomes (4 consensus statements); association between hearing loss and depression, cognition, and dementia (5 consensus statements); and cost implications of cochlear implantation (1 consensus statement). Conclusions and Relevance: These consensus statements represent the first step toward the development of international guidelines on best practices for cochlear implantation in adults with SNHL. Further research to develop consensus statements for unilateral cochlear implantation in children, bilateral cochlear implantation, combined electric-acoustic stimulation, unilateral cochlear implantation for single-sided deafness, and asymmetrical hearing loss in children and adults may be beneficial for optimizing hearing and quality of life for these patients.

  DOI

• Increasing Frailty, Not Increasing Age, Results in Increased Length of Stay Following Vestibular Schwannoma Surgery

  Otology & Neurotology · 2020 · 31 citations

  • Medicine
  • Surgery
  • Internal medicine

  OBJECTIVE: Understand the frailty of vestibular schwannoma surgical patients and how frailty impacts clinical course. STUDY DESIGN: Retrospective Cohort. SETTING: Single-tertiary academic hospital. PATIENTS: All patients undergoing vestibular schwannoma surgery. INTERVENTION: The modified frailty index (mFI) was calculated for all patients undergoing surgery for vestibular schwannoma between 2011 and 2018. Patient demographics and medical history, perioperative course, and postoperative complications were obtained from the medical record. MAIN OUTCOME MEASURES: The primary endpoint was hospital length of stay (LOS). Secondary endpoint was postoperative complications. Basic statistical analysis was performed including multivariate linear regressions to determine independent predictors of LOS. RESULTS: There were 218 patients included and the mean age was 48.1 ± 0.9 (range 12-77). One-hundred ten patients were male (50.5%). The mean ICU LOS was 1.6 ± 0.1 days while mean total hospital LOS was 4.3 ± 0.2. There were 145 patients (66.5%) who were robust (nonfrail) with an mFI of 0, while 73 (33.5%) had an mFI of ≥1. Frailty (mFI≥2) was associated with longer hospital LOS compared with the prefrail (p = 0.0014) and robust (p = 0.0004) groups, but was not associated with increased complications (OR = 1.3; 95% CI: 0.5-3.7; p = 0.5925) or ICU LOS (p > 0.05). In multivariate analysis, increased mFI, and NOT increased age, was an independent risk factor for increased hospital LOS (p = 0.027). CONCLUSION: Increasing frailty, and not increasing age, is an independent risk factor for longer hospital LOS, but not for increased postoperative complications. Patients' frailty status may be useful preoperatively in counselling patients about postoperative expectations and frail vestibular schwannoma patients may require increased health spending costs given their increased hospital LOS.

  DOI

Recent grants

• Exploring the Cognitive and Quality of Life Impact of Cochlear Implantation in Older Adults

  NIH · $228k · 2017–2020

Frequent coauthors

• Robert K. Jackler

  Stanford University

  82 shared

• Nikolas H. Blevins

  Stanford University

  77 shared

• Marlan R. Hansen

  University of Iowa

  60 shared

• Ashkan Monfared

  George Washington University

  55 shared

• Rick F. Nelson

  University School

  53 shared

• Joe Walter Kutz

  The University of Texas Southwestern Medical Center

  52 shared

• Philip V. Theodosopoulos

  Neurological Surgery

  52 shared

• John S. Oghalai

  University of Southern California

  52 shared

Education

• B.A., Biology

  University of Utah

• M.D.

  University of Utah

• Other, Otolaryngology – Head and Neck Surgery

  University of Iowa Hospitals and Clinics

• Other, Otology, Neurotology, and Skullbase Surgery

  Stanford University

Awards & honors

• Dr. Clark Lowe Rich Distinguished Surgeon & Mentor Award (20…

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