About

Tiffany Peng Hwa, M.D., is an Assistant Professor of Otorhinolaryngology: Head and Neck Surgery at the Hospital of the University of Pennsylvania. She serves as Co-Director of the Resident Sinus-Oto Clinic and the Temporal Bone Laboratory within the University of Pennsylvania Health System. Dr. Hwa is a core faculty member at the Hearing Sciences Center and the Medical Director of the Center for Adult-Onset Hearing Loss. Her educational background includes a B.A. in Biology from Rutgers University, graduating Summa Cum Laude in 2010, and an M.D. from Weill Cornell Medical College, where she received Honors in Research in 2014. She also completed a certification in Clinical Epidemiology and Biostatistics at the University of Pennsylvania in 2021. Her professional focus encompasses research and clinical care in otorhinolaryngology, with particular expertise in hearing sciences and head and neck surgery.

Research topics

• General surgery
• Surgery
• Medicine
• Audiology

Selected publications

• Non-English Validation of the AzBio Sentence Test: A Systematic Review of Current Applications and Early Adoption Patterns

  Otology & Neurotology · 2025-10-28

  reviewSenior author

  OBJECTIVE: To identify validated non-English versions of the AzBio Sentences and evaluate their development, validation processes, and current use in clinical and research settings. DATABASES REVIEWED: PubMed, Web of Science, and Scopus were systematically searched for studies involving non-English adaptations of the AzBio Sentences. METHODS: A systematic review was conducted. Articles were screened by 2 independent reviewers based on criteria related to test development and clinical application. Studies that cited non-English AzBio versions were also surveyed. Extracted data included development methodology, participant demographics, test structure, and funding sources. The Mixed Methods Appraisal Tool was used to assess study quality and publication bias. RESULTS: Nineteen studies met the inclusion criteria, identifying 4 validated non-English AzBio tests: French (FrBio), Spanish (S-AzBio), Mandarin Chinese (CMnBio), and Hebrew (HeBio). Each test utilized a 2-phase development model, similar to the original AzBio, though differences existed in corpus size, list length, and validation metrics. Despite the validation, clinical adoption remains limited; only 3 studies reported postoperative CI outcomes using HeBio or CMnBio. Linguistic analyses revealed variability in test difficulty within and across languages. Early evidence suggests promising utility, particularly for assessing speech recognition in noise, though usage is often confined to research contexts. CONCLUSION: Non-English AzBio tests represent a critical step toward more inclusive and linguistically appropriate audiologic assessments. However, their limited clinical implementation and variability in linguistic complexity underscore the need for broader cross-linguistic validation and standardized adaptation protocols. These efforts are essential to improving access to effective speech recognition testing for diverse patient populations.

  PublisherDOI

• Impact of Stimulus Delivery Method on Music Enjoyment in Cochlear Implant Users

  Otology & Neurotology · 2025-11-17

  articleSenior author

  OBJECTIVE: Previous work has shown that music re-engineering can enhance music enjoyment in cochlear implant (CI) recipients. In this study, we investigate the impact of the mechanism of stimulus delivery on music enjoyment by comparing direct streaming (DS) with external audio (EA). STUDY DESIGN: Prospective cohort study. SETTING: Academic cochlear implant center. PATIENTS: Eligibility criteria included (1) age 18 years or above, (2) unilateral or bilateral CI, (3) at least 3 months' status post cochlear implantation, and (4) English-speaking. INTERVENTIONS: Patients were assigned to listen to music excerpts through DS or external audio (EA). A retest with the opposite stimulus modality was requested 2 weeks after the initial visit. MAIN OUTCOME MEASURES: Patients rated music excerpts from various genres on 3 metrics: musicality, naturalness, and pleasantness. These scores were combined to create a total enjoyment score. RESULTS: Thirty-six subjects with a mean age of 63 years (SD 16.23, range 20 to 86) participated in the study. Twenty-four returned for retesting with the opposite stimulus delivery. Across all tests, there was a preference for EA over DS (mean difference +0.81, P <0.0001). Within the unilaterally implanted subjects, CI + deaf ear group scored EA significantly lower than both the CI + NH and CI + HA/impaired hearing groups ( P <0.0001). There was no difference between EA and DS in bilaterally implanted users. In total, 83.3% of subjects reported that utilization of the audio mixer increased music enjoyment, and 77.8% of subjects expressed a desire to use it on music of their own choosing. CONCLUSIONS: Subjects with unilateral CI demonstrated a preference for EA over DS, which was consistent after retest with randomization. In CI-only conditions (bilateral CI or CI + deaf), subjects had a slight preference for DS or no difference. EA and DS should not be considered equivalent methods of stimulus delivery in the assessment of music enjoyment in unilateral CI recipients.

  PublisherDOI

• Cochlear Implants Impair Emotional Responses to Music in Individuals With Single-Sided Deafness

  Otology & Neurotology · 2025-11-17 · 2 citations

  article

  OBJECTIVE: Emotional responses to music are a crucial facet of music listening, but remain inadequately characterized among cochlear implant (CI) users. We aimed to evaluate musical emotion in implantees with single-sided deafness (SSD). STUDY DESIGN: Cross-sectional. SETTING: Tertiary academic center, community hearing loss groups. PATIENTS: CI users with SSD (N=18); adult normal hearing (NH) controls (N=21). EXPOSURES: Participants listened to 10 musical clips and rated valence (happiness vs. sadness) and arousal (excitement vs. calm). MAIN OUTCOME MEASURES: Range-difference between a participant's maximum and minimum rating-and discrepancy-difference from a participant's NH ear ratings for each stimulus-of both valence and arousal. RESULTS: Compared with SSD participants' NH ears, CI-alone listening demonstrated diminished range of valence (4.43 vs. 5.82, P =0.035) and arousal (5.80 vs. 6.41, P =0.033), although binaural listening was not significantly different from the NH ear. Nine of 20 ratings exhibited significant discrepancy between NH and CI ears, compared with only one between NH and binaural conditions; average discrepancy was higher for both valence and arousal in the NH versus CI comparison than NH versus binaural. Binaural listening for SSD individuals did not differ significantly from NH individuals for individual stimulus ratings or for valence and arousal range. CONCLUSIONS: CIs dampen musical emotion, but do not substantially influence the binaural music listening experience for individuals with SSD. Our findings using within-subject controls demonstrate deficits in CI-mediated musical emotion, but the compensation by the NH ear in binaural listening offers encouragement for music lovers with SSD considering implantation. LEVEL OF EVIDENCE: Level III.

  PublisherDOI

• In Response to <i>The Impact of Monoclonal Antibody Usage on Hearing Outcomes: A Systematic Review</i>

  The Laryngoscope · 2025-08-26

  letter1st authorCorresponding

  The authors have nothing to report.

  PublisherDOI

• Trends in Female Authorship at American Academy of Otolaryngology‐HNS Annual Meetings From 2007 to 2022

  Otolaryngology · 2025-06-25

  articleOpen accessSenior author

  OBJECTIVE: This study aims to trends in female authorship in poster and oral presentations at American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) annual meetings. STUDY DESIGN: Retrospective analysis of AAO-HNS annual meeting presentations. SETTING: Abstract data from scientific contributions at AAO-HNS annual meetings. METHODS: ChatGPT 3.5 API was used to predict gender identities of author names extracted from publicly available scientific oral and poster presentation abstracts between 2007 and 2022. Secondary variables included presentation type (oral or poster presentation), presentation topic, and authorship order (first author, presenter, and senior author). Logistic regression models were explored to determine the probability of female author participation as first, presenting, and senior author. RESULTS: Our analysis included 48,877 authors extracted from 11,850 abstracts. For all oral and poster presentations, 29% of authors were female, increasing from 21.2% in 2007 to 37.9% in 2022 (P < .001). Although female authors accounted for 32% of presenters and 31% of first authors, they represented 22% of senior authors. Logistic regression models determined that the probability of female author participation increased by 5% each year; however, there remained a significant gap of 24.2% between male and female author participation in 2022. CONCLUSION: Representation of female authors at annual AAO-HNS meetings has increased from 2007 to 2022 as demonstrated by artificial intelligence (AI)-generated gender identification of authors in this study. These trends reflect the changing demographics of otolaryngology trainees and their mentors. Future studies exploring methods to promote gender diversity are crucial for increasing female representation at all levels within otolaryngology research.

  PublisherOA PDFDOI

• Upper extremity transvenous access in neurointerventional procedures: Insights from the largest single-center experience

  Journal of Clinical Neuroscience · 2025-05-13

  articleOpen access

  BACKGROUND: The transfemoral approach has traditionally been the primary access site for catheter-guided venography. Recently, upper extremity transvenous access (UETV) has emerged as a promising alternative for neurointerventional procedures, offering potential advantages such as reduced bleeding risk, improved ergonomics, faster recovery, shorter procedure and fluoroscopy times, and a lower likelihood of inadvertent arterial puncture. This study reports on a single-center experience of UETV for neurointerventional venous therapy. METHODS: A total of 158 diagnostic venograms and venous interventions were performed by a single operator between 2020 and 2024 at a single center, with primary intent to use the upper extremity veins for venous access. Data on patient demographics, procedural details, radiographic findings, and outcomes were collected and analyzed. RESULTS: Out of 158 procedures, successful upper extremity catheterization was achieved in 155 cases (98.1%), with 149 (94.3%) completed successfully. Conversion to a femoral approach was necessary in 3 cases (1.9%), all of which were completed successfully. Six interventions (3.8%) were aborted due to challenges in navigating the intracranial veins and venous sinuses that were unrelated to peripheral access. Minor complications occurred in 8 patients (5.1%); no major complications were observed. CONCLUSIONS: This single-center study demonstrates the feasibility and safety of upper extremity-only transvenous access for neurointerventional procedures in the management of complex cerebrovascular diseases. The cephalic and basilic veins of the antecubital fossa veins are recommended as primary access sites. These findings represent the largest case series to date using an upper extremity-first transvenous approach for neurointerventional therapy.

  PublisherDOI

• Music Enjoyment and Listening Time in Cochlear Implant Recipients: The Role of Audiometric Performance

  Otolaryngology · 2025-10-31

  article

  OBJECTIVE: Cochlear implants (CIs) provide remarkable speech rehabilitation in individuals with severe to profound sensorineural hearing loss. In this study, we investigate if speech outcomes are associated with music enjoyment and listening habits. STUDY DESIGN: Cross-sectional. SETTING: Tertiary academic center and community. METHODS: Implantees were recruited from a tertiary academic medical center and via community outreach. CI-aided audiograms and word recognition scores (WRSs) were obtained. Participants completed an online survey rating music enjoyment and time spent listening to music on 10-point Likert scales. Multiple linear regression was performed to assess the relationship between pure-tone average (PTA) and WRS in the implanted or non-implanted ear and self-rated music enjoyment and music listening habits. RESULTS: Seventy-two implantees participated, including 25 bilateral users, 27 bimodal users (one CI and one hearing aid), and 20 unilateral implantees with no contralateral device. Participants had on average 29.9 years since their hearing loss diagnosis, and 7.5 years of implant experience. Neither PTA nor WRS of either ear was significantly associated with self-rated music enjoyment. In contrast, both PTA (β = -.13, P = .0075) and WRS (β = .034, P = .037) of the CI-aided ear were significantly correlated with time spent listening to music; there was no similar association with hearing ability of the non-implanted ear. CONCLUSION: CI-aided hearing ability, but not hearing in the non-implanted ear, significantly influences music listening habits for CI users. Thus, optimizing hearing and speech outcomes is important for both communication and music listening.

  PublisherDOI

• Optimizing Dizziness Management: Impact of Audiology Triage on Care Efficiency

  The Laryngoscope · 2025-12-06

  articleOpen accessSenior authorCorresponding

  OBJECTIVES: To evaluate the impact of a vestibular audiology-driven triage system on care efficiency for patients presenting with dizziness. METHODS: We conducted a retrospective review of all patients who underwent comprehensive Balance Function Testing (BFT) at the University of Pennsylvania vestibular clinic between September 2019 and June 2023. The new vestibular triage model was implemented in early 2021. Data collection comprised patient demographics, initial audiology diagnoses, referral destinations, final medical diagnoses, and time to specialty visit. Linear regression models were employed to assess temporal trends in referral patterns and wait times. RESULTS: Three-thousand three hundred and five patients (mean age 55.9 ± 16.5 years; 34.6% male) were included for analysis. Referrals to neurotology significantly decreased over time (p < 0.0001), while neurology referrals significantly increased (p < 0.0001); ENT referrals showed a non-significant decline (p = 0.14). Time from BFT to neurology (p = 0.0012) evaluation significantly decreased over the course of the study period, while neurotology (p = 0.18) and ENT (p = 0.16) wait times showed non-significant downward trends. CONCLUSION: Vestibular audiology-driven triage represents a promising approach for managing patients with dizziness, resulting in significant changes to referral patterns and potentially improving the efficiency of specialty resource allocation. Future research should explore patient-centered outcomes to further assess its clinical impact.

  PublisherOA PDFDOI

• Limited Utility of Existing Hearing Loss Panels in the Assessment of Early‐Onset, Bilateral Meniere's Disease

  OTO Open · 2025-10-01

  articleOpen accessSenior author

  Abstract Objective While the etiology of Meniere's disease (MD) is likely multifactorial, genetics are thought to play a role. Several previous studies have yielded inconclusive results, potentially due to phenotypic uncertainty and variable diagnostic criteria. To explore potential genetic bases in a more rigorous context, we assessed the clinical predictors and diagnostic yield of current hearing loss panels in a highly curated cohort of patients with bilateral and/or early‐onset MD. Study Design Retrospective cohort study. Setting Multidisciplinary tertiary care hearing loss genetics clinic. Methods Data from clinical notes, audiograms, and genetic reports of adult patients diagnosed with bilateral and/or early‐onset (&lt;40 years) MD from October 2019 to June 2025 were analyzed with logistic regression and summary statistics to determine predictive factors and diagnostic yields of existing genetic panels. Results Of the 37 patients analyzed (mean age 47.7 + 14.5 years, 54% male), 24 (64.8%) had early‐onset MD, 22 (59.5%) had bilateral MD, and 9 (24.3%) had both. Moderately severe to profound hearing loss prior to 65 was significantly associated with pathogenic or likely pathogenic variants (PLPV) (OR 8.98 [1.17, 101]; P = .046). No significant predictors were found for definitive diagnosis, plausible diagnosis, or negative panels. Eight (22%) patients had a PLPV detected on their hearing loss panel, with 0 definitive diagnoses, 3 (8.1%) plausible diagnoses ( MYO15A , SLC17A8 , P2RX2 ), and 6 (16%) completely negative panels. Conclusions Current hearing loss panels show limited diagnostic utility for MD. Future research should prioritize whole genome sequencing to identify novel MD‐associated loci and provide guidance to patients.

  PublisherOA PDFDOI

• Exploring Gender Differences: Training, Practice, and Family Dynamics Among Fellowship‐Trained Neurotologists

  Otolaryngology · 2025-05-14

  articleOpen accessSenior authorCorresponding

  OBJECTIVE: To characterize and examine gender differences in training paths, practice patterns, family dynamics, and career trajectories in the field of neurotology. STUDY DESIGN: Cross-sectional survey. SETTING: Research Electronic Data Capture (RedCap) Framework. METHODS: A survey was created and distributed electronically to fellowship-trained neurotologists in the United States who were identified via publicly available information. Descriptive, univariate, and multivariate statistics were performed. RESULTS: Of the 223 neurotologists invited, 80 (35.8%) responded. Most participants were male (77.5%, n = 62), white (77.5%, n = 62), and aged 41 years or older (81.2%, n = 65). Training and practice patterns showed no significant gender differences. However, women were more likely to have a physician spouse (55.6% vs 25.8%, P = .02), have their first child post-fellowship (55.6% vs 24.2%, P = .007), rely on professional childcare (47.1% vs 22.6%, P = .05), and reduce work hours due to childcare needs (22.2% vs 6.45%, P = .05). Men were more likely to rely on their spouse as the primary caretaker (48.4% vs 5.9%, P = .001). Having a physician spouse was associated with post-fellowship childbearing (48.1% vs 28.9%, P = .041) and increased use of professional childcare (44.3% vs 30.1%, P = .05), regardless of gender. CONCLUSION: Although training and practice patterns were similar across genders, significant differences in family structure, childbearing, and caretaking roles suggest that women in neurotology may face unique challenges that could influence their career progression.

  PublisherOA PDFDOI

Frequent coauthors

• Aaron N. Pearlman

  Cornell University

  46 shared

• Jason A. Brant

  University of Pennsylvania

  41 shared

• Michael J. Ruckenstein

  University of Pennsylvania

  29 shared

• Alexander Chern

  Johns Hopkins University

  26 shared

• Elizabeth K. Weidman

  NewYork–Presbyterian Hospital

  25 shared

• Joshua Lantos

  Cornell University

  25 shared

• Kristen T. Leeman

  Boston Children's Hospital

  25 shared

• Kathryn E. Dean

  Cornell University

  25 shared

Labs

• Temporal Bone LaboratoryPI

Education

• MD

  Weill Cornell Medicine