About

Neil S. Patel, MD, is an Associate Professor of Otolaryngology–Head and Neck Surgery and an Adjunct Associate Professor of Neurosurgery at University of Utah Health. He leads a busy otology and lateral skull base practice with primary clinical interests in vestibular schwannoma, paraganglioma, and hearing implants, including auditory brainstem implantation, a program he established at Utah, performing the first ABI in the Intermountain West. Dr. Patel completed his residency in Otolaryngology–Head and Neck Surgery and a fellowship in Otology, Neurotology, and Skull Base Surgery at the Mayo Clinic in Rochester, Minnesota. He earned his undergraduate degree in Biomedical Engineering from Duke University and his medical degree from the University of Illinois, where he was inducted into the Gold Humanism Honor Society and Alpha Omega Alpha Honor Medical Society. Dr. Patel maintains an active research program with over 80 peer-reviewed publications and is a frequent national and international speaker, directing otology and skull base courses across the country. He cares for both children and adults at multiple hospitals and clinics, including the University of Utah Hospitals and Clinics, Intermountain Primary Children’s Hospital, LDS Hospital, and Medical Center, and maintains multistate licensure to expand access to care via telemedicine.

Research topics

• Medicine
• Surgery
• Internal medicine
• Audiology
• Radiology
• Physical medicine and rehabilitation

Selected publications

• Multi‐Frequency Electrocochleography Results in Fewer Drop Alarms During Cochlear Implant Insertion

  The Laryngoscope · 2026-05-05

  articleOpen access

  OBJECTIVE: To evaluate intracochlear electrocochleography (ECochG) amplitude parameters during cochlear implantation (CI) using a novel multi-frequency ECochG algorithm. METHODS: A multi-institutional, prospective cohort study was performed at 18 high-volume CI centers. The inclusion criteria were adults with sensorineural hearing loss and audiometric thresholds of ≤ 90 dB hearing level at 500 Hz undergoing CI with Advanced Bionics (Valencia, CA) Ultra 3D devices between 2024 and 2025. ECochG recordings were performed with simultaneous multi-frequency stimulation of four frequencies between 125 and 4000 Hz during cochlear implant insertion. Concurrent multi-frequency recording allowed extraction of amplitude and phase of each frequency individually. Post hoc analysis was performed to determine the difference in the number of drop alarms between single- and multi-frequency ECochG. An ECochG amplitude drop of 6 dB was defined as a drop alarm. Insertion track patterns were compared between single- and multi-frequency ECochG. RESULTS: One hundred ninety-five ears were included. Mean number of drop alarms for the single-frequency algorithm was 1.72 (95% CI: 1.52, 1.92; median 1) compared to 0.42 (95% CI: 0.31, 0.53; median 0) for multi-frequency; p < 0.001. The number of Type C patterns (rise in amplitude during insertion followed by a drop) decreased with the multi-frequency ECochG algorithm compared to the single-frequency ECochG algorithm. The number of Type D patterns (no-response) decreased, indicating that multi-frequency ECochG generated more responses across the cochlea than single-frequency ECochG. CONCLUSIONS: A novel multi-frequency ECochG algorithm during CI is associated with fewer drop alarms and altered insertion track patterns, which may provide a more accurate assessment of the cochlear microenvironment.

  PublisherDOI

• A Unique Perspective: Intrapatient Comparison of Perimodiolar and Lateral Wall Cochlear Implant Electrodes

  Otology & Neurotology · 2026-02-13

  articleSenior authorCorresponding

  OBJECTIVE: The debate regarding the optimal cochlear implant (CI) electrode array-perimodiolar (PM) versus lateral wall (LW)-has intensified with evolving technology. Comparing electrode designs is challenging due to variability in patient characteristics. This study compares PM versus LW electrodes placed in opposite ears of the same patients. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Individuals undergoing bilateral cochlear implantation with a LW electrode in one ear and a PM in the other from 2003 to 2023. INTERVENTION: Bilateral cochlear implantation with each electrode type. MAIN OUTCOME MEASURES: Demographics and audiologic data (4-frequency pure tone average (PTA), consonant-nucleus-consonant (CNC) scores, and AzBio scores in quiet and noise). Outcomes were compared using Wilcoxon Signed Ranks Test with SPSS version 27. RESULTS: Thirty-two patients met inclusion criteria. Median age at PM and LW implantation was 64.5 (Q1-Q3: 46.8 to 71.9) and 69.6 (50.6 to 76.3) years, respectively. CNC scores were significantly higher in PM arrays: 66% (51 to 71) vs. 42% (26 to 70), P =0.008. AzBio scores in quiet (75% vs. 67%, P =0.082) and noise (59% vs. 63%, P =1.000) showed no significant differences. Battery life was longer in the PM group (33.5 vs. 30 hours), though not statistically significant ( P =0.819). CONCLUSION: PM arrays offer improved CNC word understanding when compared with LW arrays, but do not offer a significant improvement in battery life or AzBio scores. To our knowledge, this is the first study to compare these outcomes using each patient as their own control, thereby controlling for the majority of patient factors that could influence performance.

  PublisherDOI

• Current State of Temporal Bone Education: National Survey of U.S. Otolaryngology Residency Programs

  The Laryngoscope · 2026-04-02

  articleOpen access

  OBJECTIVES: To characterize the structure, resources, and educational practices of temporal bone laboratory training across ACGME-accredited U.S. otolaryngology residency programs. METHODS: A national cross-sectional survey was distributed to program directors and faculty responsible for temporal bone education. Survey domains included curriculum structure, training frequency, faculty involvement, assessment practices, and access to laboratory resources. Descriptive statistics and univariable regression analyses were performed to explore associations between program characteristics and neurotology fellowship pursuit. RESULTS: Thirty-seven programs responded (28.2%). Laboratory structure varied widely, including longitudinal (monthly or weekly) and condensed (annual or 2-3 courses/year) formats. Programs with longitudinal sessions reported more annual lab hours than condensed formats (median 42 vs. 16 h/year, p = 0.003). All programs had access to cadaveric temporal bones (mean 2.25 ± 1.13 bones per resident/year), though five reported fewer bones than residents. The mean drill-to-resident ratio was 0.59, with 10.8% reporting a 1:1 ratio. Formal performance evaluation was used by 43.2% of programs. On exploratory univariable analysis, longer otology rotation duration was associated with having at least one neurotology fellow within five years (p = 0.025). Larger resident cohort size (p = 0.048) and older laboratory instruments (p = 0.043) were associated with producing more than one fellow. CONCLUSION: There is substantial variability in temporal bone education across U.S. otolaryngology training programs. Programs differ in curricula, resources, and access to cadaveric and simulation-based training. Standardization of core components may improve educational equity and training consistency. LEVEL OF EVIDENCE: N/A.

  PublisherDOI

• Access to Cochlear Implantation: Trends in Surgeon Volume and Training

  The Laryngoscope · 2025-02-11 · 1 citations

  articleOpen access

  OBJECTIVES: Evaluate the training background of surgeons performing high volumes of cochlear implants (CIs) and estimate the ratio of providers trained in otology/neurotology (O&N) to the number of traditional CI candidates and audiologists. METHODS: A retrospective review of US surgeon registration data from a single CI manufacturer was performed to determine CI volume based on surgeon training. The prevalence of traditional candidates for CIs was estimated from US census population data and compared with the number of O&N providers. The ratio of audiologists to O&N providers was estimated from the Bureau of Labor and Statistics and American Speech-Language-Hearing Association databases. RESULTS: From 2021 to 2023, a mean of 88% of providers performing ≥25 CIs per year and 90% performing ≥40 per year had training in O&N. All surgeons registering ≥100 implants per year were O&N providers. The mean percentage of O&N providers performing ≥25 CIs per year and ≥ 40 per year was higher than the percentage of General and Pediatric Otolaryngology providers performing the same volume: mean difference = 76%, p < 0.001 and mean difference = 79%, p < 0.001, respectively. The mean estimated prevalence of traditional CI candidates per O&N provider is 3,354 with an estimated mean of 32 audiologists (3.5 trained in CIs) per O&N provider. CONCLUSION: 88% of high-volume CI surgeons have fellowship training in O&N. To meet the current state of CI underutilization and anticipated growing population of CI candidates, we propose increasing the surgical capacity of O&N providers and the number of surgeons proficient in CIs. LEVEL OF EVIDENCE: NA Laryngoscope, 135:2146-2153, 2025.

  PublisherOA PDFDOI

• Evaluating the Impact of Cochlear Implantation on Cognitive Outcomes in Older Adults: A 5-Year Follow-Up

  Otology & Neurotology · 2025-12-09

  articleOpen access

  OBJECTIVE: To assess the long-term impact of cochlear implantation (CI) on cognitive outcomes in older adults 5 years post-implantation. STUDY DESIGN: Prospective, interventional study. SETTING: Tertiary care center. PATIENTS: Cochlear implant recipients aged 65 or older. INTERVENTIONS: Subjects underwent preoperative cognitive testing with a novel battery of validated neuropsychological tests including those assessing global cognition (Mini-Mental Status Exam), verbally based cognition (Digit span, Stroop, Hopkins Verbal Learning Test-Revised, Hayling Sentence Completion) and comparable visually-based cognition [Spatial span, d2 Test of Attention, Brief Visuospatial Memory Test-Revised (BVMT-R), Trail Making Test Part B]. Testing was repeated 5 years postoperatively. MAIN OUTCOME MEASURES: Cognitive outcomes assessed with cognitive testing battery. RESULTS: After 5.71±1.14 years after CI, 16 subjects (mean age 83±7.22 y, 93.75% male, 87.5% with normal preoperative cognitive status) repeated the cognitive battery. In comparison to preoperative testing, subjects showed stable performance on 4 of 11 cognitive test scores, including those assessing global cognition, auditory attention, verbal learning and memory, and auditory-based executive functioning. Conversely, there was a significant decrease on a verbal test of executive functioning (Stroop Color-Word: Z=-2.557, P =0.011) and all visually based tests of attention (d2 total correct scores Z=-2.667, P =0.008; spatial span total score: Z=-2.388, P =0.017, BVMT-R: total raw score Z=-2.615, P =0.009, BVMT-R delayed raw score Z=-2.829, P =0.005; trails B seconds: Z=-2.158, P =0.031). CONCLUSIONS: In a 5-year follow-up of CI, participants demonstrated stability on a global scale in addition to 3 other verbally based cognitive measures. When contrasted with declines on all visually based analog cognitive tests, these preliminary findings in a small and select sample, suggest a beneficial role of CI in enhancing cognition in older recipients. PROFESSIONAL PRACTICE GAP AND EDUCATIONAL NEED: The long-term effect of CI on cognitive status of older adults who are at risk of dementia associated with hearing loss. LEARNING OBJECTIVE: Learners will better understand the long-term impact of CI on cognition in older adults. DESIRED RESULT: To demonstrate that CI in older adults can improve cognition in certain domains, whereas other domains are unaffected or continue to decline with age. LEVEL OF EVIDENCE: Level III. INDICATE IRB OR IACUC: IRB 00083983, The University of Utah.

  PublisherOA PDFDOI

• Transcanal Cochlear Implantation in X-linked Gusher Syndrome With Novel Technique of Securing the Electrode Lead and Preventing Receiver Stimulator Migration

  Otology & Neurotology · 2025-10-08

  articleSenior authorCorresponding
  PublisherDOI

• Psychosocial Outcomes in Patients with Neurofibromatosis Type 2: A Retrospective Database Analysis

  Journal of Neurological Surgery Part B Skull Base · 2025-02-01

  article
  PublisherDOI

• Optimal Timing of Primary Radiosurgical Treatment of Growing Vestibular Schwannoma: Insights From Salvage Microsurgery Outcomes

  Otolaryngology · 2025-02-10 · 3 citations

  articleOpen access

  OBJECTIVE: Limited evidence guides the optimal timing of treatment after the detection of tumor growth during the observation of sporadic vestibular schwannoma (VS). The current work aimed to inform the timing of radiosurgical intervention based on an analysis of patient outcomes among those who ultimately failed stereotactic radiosurgery (SRS) and underwent salvage microsurgery. STUDY DESIGN: A historical cohort study. SETTING: Seven centers across the United States and Norway. METHODS: Adults with sporadic VS who underwent salvage microsurgery following failed primary SRS were included. The primary outcome of interest was the association between tumor size at the time of primary SRS and the ability to achieve gross total resection (GTR) and maintain postoperative House-Brackmann (HB) facial nerve grade I at the last follow-up after salvage microsurgery. RESULTS: Among 96 patients, the median (interquartile range [IQR]) cerebellopontine angle (CPA) tumor size at primary SRS was 14.5 mm (10.0-19.0). Each 1-mm increase in CPA tumor size at the time of primary SRS was associated with a 13% increased likelihood of near-total/subtotal resection or most recent postoperative HB grade >I (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.21, P = .001), with an optimal tumor size threshold to distinguish this outcome of 12 mm of CPA extension (c-index 0.73). Similarly, for each 1-mm increase in CPA tumor size at the time of primary SRS, a 9% increase in any postoperative complication with salvage microsurgery was observed (OR 1.09, 95% CI 1.02-1.15, P = .009). CONCLUSION: Corroborated by size threshold surveillance data informing the timing of primary microsurgical resection, the current study suggests that VS outcomes are optimized when primary radiosurgical intervention is undertaken on growing tumors when they harbor 10-15 mm of cerebellopontine angle extension or less.

  PublisherOA PDFDOI

• Hearing Benefits of Cochlear Implantation in Older Adults With Asymmetric Hearing Loss

  Otology & Neurotology · 2025-03-11 · 4 citations

  articleCorresponding

  OBJECTIVE: To examine the benefit of cochlear implantation (CI) in older adults with single-sided deafness (SSD) and asymmetric hearing loss (AHL). STUDY DESIGN: Retrospective chart review. SETTING: Veterans Affairs Medical Center and tertiary referral center, 2019-2023. PATIENTS: Adults ≥60 years with either SSD or AHL who underwent unilateral CI. INTERVENTIONS: Cochlear implantation. MAIN OUTCOME MEASURES: Audiometric testing (preoperative and postoperative pure-tone averages [PTA], sentence and word recognition), presence of hearing-related symptoms, CI utilization. RESULTS: Twelve subjects were identified who underwent CI for SSD or AHL after being determined to obtain limited benefit from an appropriately fitted unilateral hearing aid (mean age 72.6 yr, 91.7% male, 100% White). Mean duration of hearing loss was 13.7 years, and the most common etiology was idiopathic (25%). Subjects were followed for a median length of 9.1 months after implantation. Mean daily CI use was 9.3 hours per day.Preoperatively, median unaided PTAs of the implanted and contralateral ear were 103.1 and 41.3 dB, respectively; median aided AZBio sentence recognition values in quiet were 0.0 and 81.5%, respectively. In the implanted ear with the CI in use, median PTA improved from 103.1 to 28.1 dB ( p = 0.002), CNC word scores improved from 0.0 to 42.0% ( p = 0.027), CNC phoneme scores improved from 0.0 to 60.0% ( p = 0.043), and AZBio improved from 0.0 to 48.0% ( p = 0.012). Seventy-five percent preoperatively, compared to 33.3% postoperatively, experienced dizziness ( p = 0.063), whereas 83.3 and 33.3% experienced tinnitus ( p = 0.375). CONCLUSIONS: In this group of older adults with SSD or AHL, CI demonstrated significant benefits in hearing thresholds and speech recognition in the implanted ear. Moreover, the average of 9.3 hours of daily use suggests that patients' CI is tolerated and beneficial in this population.

  PublisherDOI

• Implementation of point-of-care genetic testing for head and neck paragangliomas: early experience and future directions

  Oral Oncology · 2025-08-12 · 3 citations

  articleOpen access

  • POC testing increased completion from 71% to 93% compared to traditional referral. • 20% of patients tested via POC had a pathogenic germline variant. • Age distributions differed significantly between POC and traditional cohorts. • Variant-positive patients were significantly younger than variant-negative peers. • Middle ear and jugular PGLs were more often treated than carotid body tumors. This study evaluates the success of a point-of-care genetic testing system for patients with head and neck paragangliomas. We subsequently compare our findings with traditional referral-based testing pathways. We conducted a retrospective cohort study of 293 patients with HNPGLs evaluated at a tertiary referral center between 2015 and 2024. We compared uptake, detection rates, and age distributions between patients tested via traditional referral and those tested via point-of-care. The point-of-care model embeds panel testing into routine otolaryngology clinic visits. Testing completion was significantly higher in the POC cohort (93 %) compared to the traditional cohort (71 %). Pathogenic germline variants were identified in 20 % of POC-tested patients. Variant-positive individuals were significantly younger than variant-negative individuals across both cohorts. Patients who declined testing were significantly older than those who completed testing. Age distributions between POC and traditional cohorts differed significantly (p = 0.0023). POC genetic testing for HNPGLs increases testing rates and allows for earlier risk identification for patients with head and neck paragangliomas. Our data support institutional integration of point-of-care models into routine care.

  PublisherDOI

Frequent coauthors

• Matthew L. Carlson

  60 shared

• George B. Wanna

  The Mount

  33 shared

• Jacob B. Hunter

  Thomas Jefferson University

  32 shared

• Brendan P. O’Connell

  Charlotte Eye Ear Nose & Throat Associates

  30 shared

• Richard K. Gurgel

  University of Utah

  20 shared

• Brian A. Neff

  Mayo Clinic

  15 shared

• Colin L. W. Driscoll

  Mayo Clinic

  14 shared

• Mana Espahbodi

  University of Utah

  12 shared

Education

• B.S., Biomedical Engineering

  Duke University

• M.D.

  University of Illinois

• Other, Otolaryngology, Neurotology, and Skull Base Surgery

  Mayo Clinic

• Other, Otolaryngology-Head and Neck Surgery

  Mayo Clinic

Awards & honors

• Gold Humanism Honor Society
• Alpha Omega Alpha Honor Medical Society