Long-term role of zileuton in the treatment of chronic rhinosinusitis in aspirin exacerbated respiratory disease.

Background: Chronic rhinosinusitis (CRS) in the setting of Aspirin Exacerbated Respiratory Disease (AERD) have high rate of treatment failure and disease recurrence.

Objective: Evaluate the long-term effect of zileuton on sinonasal outcomes in patients with AERD.

Methods: AERD patients were reviewed and divided into two cohorts, depending if they were treated with zileuton during their clinical course.

Disease involvement in the central compartment in eosinophilic chronic rhinosinusitis.

Objective: To evaluate disease presence in the central compartment (CC) in patients with eosinophilic chronic rhinosinusitis (CRS).

Methods: Patients with eosinophilic CRS were divided into three endotypes: aspirin-exacerbated respiratory disease (AERD), allergic fungal rhinosinusitis (AFRS), and eosinophilic CRS with nasal polyps (eCRSwNP). CT scans were reviewed for CC involvement, defined as the area between the superior nasal septum (SNS) and middle turbinate (MT).

Sinonasal Anatomic Variants in Allergic Fungal Rhinosinusitis.

Background: The pathophysiology of allergic fungal rhinosinusitis (AFRS) is not well understood.

Objectives: To study the incidence of sinonasal anatomic variants (AVs) in AFRS.

Methods: Retrospective cohort study.

Symptoms and Clinical Findings in Primary Headache Syndrome Versus Chronic Rhinosinusitis.

Background: Primary headache syndrome (PHS) patients frequently present to otolaryngologists with sinonasal complaints and diagnosis of chronic rhinosinusitis (CRS) due to symptomatic overlap. In this study, we compare demographic, subjective, and objective clinical findings of patients with PHS versus CRS.

Methods: We retrospectively reviewed a database of patients presenting to a single tertiary care Rhinology clinic from December 2011-July 2017.

Eosinophilic Mucin: A Predictor for Disease Severity in Chronic Rhinosinusitis.

Objective: The presence of tissue eosinophilia is a determinate of disease severity in patients with chronic rhinosinusitis (CRS). The impact of eosinophilic mucin (EM) as an independent variable has not yet been elucidated.

Study Design: Retrospective review.

How Does Age Impact Presentation and Outcomes in Chronic Rhinosinusitis?

Objectives/hypothesis: The presence of eosinophilia and nasal polyps are well-established prognostic indicators of chronic rhinosinusitis (CRS). The importance of demographic background, such as age, as independent variables has not been elucidated while taking these factors into account.

Study Design: Respective review.

Subjective and Objective Measurements of Sinonasal Manifestations in Patients With Autoimmune Disorders.

Objectives/hypothesis: A number of autoimmune disorders (ADs) are associated with a spectrum of sinonasal manifestations comparable to chronic rhinosinusitis (CRS). Our objective was to study the subjective and objective measurements of sinonasal manifestations of ADs.

Study Design: Retrospective cohort study.

Implementation of an interdisciplinary tracheostomy care protocol to decrease rates of tracheostomy-related pressure ulcers and injuries.

Objectives: Tracheostomy-related pressure injuries (TRPI) have been demonstrated to occur in approximately 10% of tracheostomy patients. In this study, we present TRPI outcomes after implementation of a standardized tracheostomy care protocol.

Methods: A tracheostomy care protocol was developed by an interdisciplinary quality improvement program and implemented on July 1, 2016.

Use of mucosal eosinophil count as a guide in the management of chronic rhinosinusitis.

Background: Chronic rhinosinusitis (CRS) is a local inflammatory process driven by eosinophils. Mucosal eosinophil count (MEC) has previously been demonstrated to be a reliable indicator of disease severity. We aim to evaluate use of MEC in guiding medical management of CRS after functional endoscopic sinus surgery (FESS).

Endoscopic repair of cribriform plate cerebrospinal fluid leaks: An easy and reproducible technique sparing the middle turbinate.

Objective: The purpose of this study was to evaluate the outcomes of patients with cribriform cerebrospinal fluid leaks undergoing endoscopic repair with an easy and reproducible middle turbinate-sparing technique.

Material And Methods: Date was obtained by retrospective chart review and includes a description of the technique with technical pearls and contraindications to the approach.

Results: We report 17 patients who underwent repair of cribriform cerebrospinal fluid leaks with a middle turbinate-sparing technique with 100% success rate at a mean follow up of 38 months.

Salivary Gland Cancers of the Nasopharynx: A Population-Based Analysis of 383 Cases.

Objectives/hypothesis: Salivary gland nasopharynx cancers (SGNPCs) are rare malignancies with few cases discussed in the literature. This study represents the largest cohort of SGNPC to date.

Study Design: Retrospective population-based analysis.

Conversion to Chronic Invasive Fungal Sinusitis From Allergic Fungal Sinusitis in Immunocompetence.

A review of the treatment of allergic and invasive fungal sinusitis, as well as a presentation of the first recorded case of a conversion from allergic fungal sinusitis (AFS) to chronic granulomatous invasive sinusitis and the fourth case of invasive fungal sinusitis associated with Curvularia. This immunocompetent patient suffering from chronic AFS converted after repeated high-dose steroid tapers and noncompliance. AFS may present atypically and should be suspected even in immunocompetent patients with sinus disease who report new onset pain and neurologic symptoms.

Doctor Google: Correlating internet search trends for epistaxis with metropolitan climates.

Objective: Variation in weather patterns is often cited as a risk factor for epistaxis although robust studies investigating specific climate factors are lacking. As society is increasingly utilizing the Internet to learn more about their medical conditions, we explore whether Internet search activity related to epistaxis is influenced by fluctuations in climate.

Methods: Internet search activity for epistaxis-related search terms during 2012-2017 were extracted from Google Trends and localized to six highly populated cities in the US: New York, New York; Los Angeles, California; Chicago, Illinois; Houston, Texas; Philadelphia, Pennsylvania; and Atlanta, Georgia.

Reliability of the supraorbital ethmoid cell vs Keros classification in predicting the course of the anterior ethmoid artery.

Background: We previously showed that the supraorbital ethmoid cell (SOEC) is a reliable landmark for identifying the anterior ethmoid artery (AEA). Recent data have suggested that Keros classification is also a dependable predictor. We aim to characterize the location of the AEA and its relation to the skull base in patients with and without SOEC using the Keros classification.

Basaloid nasopharyngeal carcinoma: A population-based analysis of a rare tumor.

Objectives: Basaloid nasopharyngeal carcinoma (BNPC) is an extremely rare malignancy with a paucity of cases reported in the literature. This analysis represents the largest cohort of BNPC to date.

Study Design: Retrospective population-based analysis.

In vitro analysis of growth patterns of invasive fungal species on commonly used endonasal hemostatic agents.

Objective: Previous studies have not examined the potential role of endonasal hemostatic agents in facilitating growth of fungal species. We aim to determine the possibility of these to serve as a nutrient source for fungal growth.

Methods: Cultures of Aspergillus, Fusarium, and Mucor were harvested and placed in solution in sterile saline at standardized high and low concentrations.

Body Mass Index and Olfactory Fossa Depth in Patients with and without Spontaneous Cerebrospinal Fluid Leaks.

Background/aims: Spontaneous cerebrospinal fluid (SCSF) leaks are associated with a high body mass index (BMI) and an expanded skull base. The purpose of this study is to determine if a correlation exists between BMI and olfactory fossa depth (OFD) in patients with SCSF leaks and those without.

Methods: This is a cross-sectional study evaluating the correlation between OFD and BMI in patients with and without SCSF leaks.

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis.

Background: The body of knowledge regarding rhinosinusitis(RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS).

Methods: Evidence-based reviews with recommendations(EBRRs) were developed for scores of topics, using previously reported methodology.

Why sinonasal disease spares the inferior turbinate: An immunohistochemical analysis.

Objectives/hypothesis: Clinically, inflammatory polyps are found in the middle turbinate (MT) in patients with chronic rhinosinusitis (CRS) but not in the inferior turbinate (IT). The purpose of this study was to investigate differences in protein expression between IT and MT tissue in patients with CRS.

Study Design: Prospective cohort.

Product comparison model in otolaryngology: Equivalency analysis of absorbable hemostatic agents after endoscopic sinus surgery.

Objectives/hypothesis: Evidence-based medicine in otolaryngology literature continues to be lacking, especially with regard to new products brought to market. The marketing of products often includes statements of benefit that have limited objective support in research or literature. To address this, and to adequately determine product equivalency/superiority, careful evaluation must be made.

Bony erosion patterns in patients with allergic fungal sinusitis.

Objective: To investigate bony erosion patterns in allergic fungal sinusitis (AFS) and to determine whether the extent of erosion correlates with demographics and preoperative clinical parameters.

Study Design: Retrospective review of prospectively collected data.

Methods: Seventy-four patients with a histopathologic diagnosis of AFS were identified.

Comorbidities in patients with all-positive symptoms on sinonasal outcomes test quality-of-life instrument.

Objectives/hypothesis: The Sinonasal Outcomes Test-20 (SNOT-20) is a validated tool to assess treatment outcomes in patients with chronic rhinosinusitis (CRS). In the clinic, we observed that patients who responded with a positive score on all 20 items of the SNOT-20 questionnaire (pan-positive patients) often did not have evidence of CRS upon workup. Many of these patients had other underlying diseases contributing to their complaints.