Nasal Obstruction Outcomes in Medial Flap Turbinoplasty and Inferior Turbinate Submucous Resection.

Objectives: To compare longitudinal improvement in nasal obstruction quality-of-life outcomes between medial flap turbinoplasty (MFT) and inferior turbinate submucous resection (SMR) concurrently performed with functional septorhinoplasty.

Methods: Retrospective review of a prospectively collected cohort of patients undergoing functional septorhinoplasty between 2015 and 2022 at a tertiary academic center. Outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire preoperatively and over 12 months postoperatively.

Partial Reversal of Anosmia Following Platinum-Based Chemotherapy in a Patient With Colorectal Adenocarcinoma.

Platinum-based chemotherapy is known to cause taste and smell changes (TSCs) via a host of mechanisms, including altered receptor activity, saliva/mucus production, and induction of receptor destruction via mitotic inhibition. In the literature to date, these changes have primarily resulted in worsening of taste and smell. In this case report, we document the first instance of an individual regaining their sense of olfactory detection following treatment with oxaliplatin for colorectal adenocarcinoma.

Surgical Management of Inferior Turbinate Hypertrophy in the Era of Widespread Communicable Disease.

Inferior turbinate reduction procedures have been performed for decades. After significant evolution, turbinoplasty and other mucosal-sparing techniques have become the main method to successfully reduce turbinate hypertrophy. The debate of which technique produces the most effective and durable outcomes is ongoing.

A Comparison of Near-Infrared Imaging and Computerized Tomography Scan for Detecting Maxillary Sinusitis.

Objective: To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize its accuracy compared to computerized tomography (CT) scan.

Methods: In a prospective investigational study, NIR and CT images from 65 patients who presented to a tertiary care rhinology clinic were compared to determine the sensitivity and specificity of NIR as an imaging modality.

Results: The sensitivity and specificity of NIR imaging in distinguishing normal versus maxillary sinus disease was found to be 90% and 84%, normal versus mild maxillary sinus disease to be 76% and 91%, and mild versus severe maxillary sinus disease to be 96% and 81%, respectively.

Rhinology Medicare reimbursements have not been keeping up with inflation.

Background: Studies have suggested that physicians are steadily being paid less per Medicare service over time based on inflation-adjusted dollars. The objective of this study was to determine whether this phenomenon was true for rhinologic procedures.

Methods: This study was a retrospective analysis of the 2000-2021 Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule investigating fees for in-office endoscopies (Current Procedural Terminology [CPT] codes 31231-31238), in-office balloon ostial dilation (CPTs 31295-31298), in-facility low-relative value unit (RVU) surgeries (<10 work RVUs [wRVUs]; CPTs 31239-31288 and 61782), and in-facility high-RVU surgeries (>10 wRVUs; CPTs 31290-31294).

Spontaneous Involution of Juvenile Nasopharyngeal Angiofibromas: Report of a Case.

Juvenile nasopharyngeal angiofibroma (JNA) is a locally aggressive tumor that predominantly affects adolescent males. Surgical resection is generally considered the standard treatment for both primary and recurrent tumors, regardless of staging. The natural history of these tumors, particularly when untreated or in the setting of residual tumor, is not well characterized.

The Effects of Pass/Fail USMLE Step 1 Scoring on the Otolaryngology Residency Application Process.

Objectives: To investigate how the decision to report United States Medical Licensing Examination (USMLE) Step 1 score as pass/fail will influence future otolaryngology residency application and match processes.

Study Design: Survey study.

Methods: An anonymous and voluntary survey approved by the Otolaryngology Program Directors Organization was administered to academic faculty members from April 24, 2020 through May 19, 2020.

Budesonide vs Saline Nasal Irrigation in Allergic Rhinitis: A Randomized Placebo-Controlled Trial.

Objectives: Budesonide nasal irrigation is currently widely used in the treatment of chronic sinusitis typically following endoscopic sinus surgery to improve inflammatory control. Its application in treatment of allergic rhinitis has not been previously studied. This study assesses the subjective and clinical response to budesonide buffered hypertonic saline nasal irrigation and hypertonic saline nasal irrigation in patients with allergic rhinitis.

Telelecture Educational Series in Facial Plastic and Reconstructive Surgery.

We sought to evaluate the usefulness of a monthly telelecture educational series in facial plastic and reconstructive surgery for resident education and to identify potential areas for improvement. A monthly series of facial plastic and reconstructive surgery telelectures were hosted at our institution between 2016 and 2018. A web-based survey was sent to 13 residents and 7 invited faculty presenters.

Vision Outcomes in Early versus Late Surgical Intervention of Pituitary Apoplexy: Meta-Analysis.

Background: Pituitary apoplexy (PA) is defined by hemorrhage and necrosis of the pituitary gland, often acute in onset, and frequently in the setting of an existing pituitary adenoma. Our objective was to conduct a meta-analysis of the available literature on vision outcomes following surgical intervention for PA on the basis of the timing from apoplexy to surgery (ATS).

Methods: A thorough literature search of the published English-language literature was performed in PubMed, Ovid, and Cochrane databases using the key words ("pituitary apoplexy") and ("surgery" or "vision") from database inception to August 2018 was conducted.

Predictors of Short-term Morbidity and Mortality in Open Anterior Skull Base Surgery.

Objectives/hypothesis: To describe rates of complications and mortality within 30 days of open anterior skull base surgery using a large, multi-institutional outcomes database.

Study Design: Retrospective cohort study.

Methods: The study included patients who underwent open anterior skull base surgery as listed in the American College of Surgeons National Surgical Quality Improvement Project database from 2007 through 2014.

Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery.

Importance: Postoperative packing in nasal surgery often results in nasal obstruction and discomfort. Commercially available silicone intranasal airways (IAs) serve as dual-nasal airway tubes aimed at alleviating this process, but the safety and efficacy of these devices are unknown.

Objective: To evaluate the safety and efficacy of an intraoperatively placed IA device in rhinoplasty and nasal surgery.

Inefficiencies in Computed Tomography Sinus Imaging for Management of Sinonasal Disease.

Objective A subset of patients with sinonasal disease who obtain a diagnostic computed tomography (CT) sinus scan may require repeat preoperative CT due to the inadequacy of diagnostic CT for image-guided sinus surgery (IGSS). This leads to increased CT utilization, health care costs, and patient exposure to ionizing radiation. The objective of this study is to determine the frequencies of diagnostic CT sinus studies that were inadequate for IGSS and repeat CT studies for purposes of IGSS.

Near-Infrared Optical Imaging for Diagnosis of Maxillary Sinusitis.

Computed tomography (CT) is the current gold standard imaging for chronic rhinosinusitis (CRS) but is limited by cost, risk of radiation, and difficulty of being performed in the typical outpatient primary care setting. We describe the novel use of a low-cost, handheld technology to deliver an intraoral near-infrared (NIR) wavelength light to optically image the maxillary sinuses. Digital images were collected for subjects presenting with sinus disease using an intraoral NIR light source for transillumination of the maxillary sinuses, captured by a modified digital single-lens reflex camera.

Monte Carlo modeling of light propagation in the human head for applications in sinus imaging.

Sinus blockages are a common reason for physician visits, affecting one out of seven people in the United States, and often require medical treatment. Diagnosis in the primary care setting is challenging because symptom criteria (via detailed clinical history) plus objective imaging [computed tomography (CT) or endoscopy] are recommended. Unfortunately, neither option is routinely available in primary care.

The role of antibiotics in endoscopic sinus surgery.

Purpose Of Review: To review and discuss recent literature regarding the use of antibiotics in relation to endoscopic sinus surgery (ESS), including perioperative antibiotics, postoperative antibiotics, and antibiotic usage in the setting of postoperative packing.

Recent Findings: Perioperative antibiotics are not recommended by the American Society of Health-System Pharmacists. The necessity of antibiotics following ESS is a heavily debated topic.

Trends of ambulatory sinus surgery for chronic rhinosinusitis.

Background: We sought to examine the trends in rates and demographics of ambulatory endoscopic and open sinus surgery for chronic sinusitis over a 7-year period in the state of California.

Methods: Patient records with Current Procedural Terminology (CPT) codes for endoscopic or open sinus surgery, and diagnosis codes for chronic rhinosinusitis were extracted from the California Ambulatory Surgery Datasets from 2005 to 2011. Population-adjusted surgery rates were calculated as the number of surgeries per 100,000 California residents.

Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident.

Objectives/hypothesis: To identify the prevalence and management of problematic residents. Additionally, we hope to identify the factors associated with successful remediation of unsuccessful otolaryngology residents.

Study Design: Self-reported Internet and paper-based survey.

Comparison of electrosurgical plasma coagulation and potassium-titanyl-phosphate laser photocoagulation for treatment of hereditary hemorrhagic telangiectasia-related epistaxis.

Background: Potassium-titanyl-phosphate (KTP) laser photocoagulation is commonly used for treatment of hereditary hemorrhagic telangiectasia-related epistaxis (HHT-RE). Electrosurgical plasma coagulation (EPC), also known as coblation, has not been rigorously evaluated for HHT-RE.

Methods: Patients seeking treatment for HHT-RE between September 2010 and September 2012 were prospectively randomized (1:1) to KTP or EPC in a single blind prospective cohort study.

Bilateral juvenile nasopharyngeal angiofibroma: report of a case.

Background: Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA.

Osteitis in chronic rhinosinusitis: a review of the literature.

Background: The role of osteitis, or inflammation involving bone, is 1 potential reason for disease recalcitrance in chronic rhinosinusitis (CRS) and is not extensively studied. This review article will discuss osteitis in CRS, including pathophysiology, diagnostic methods, clinical significance, and treatment modalities.

Methods: A systematic review of the literature was performed using PubMed search terms osteitis, osteomyelitis, bone involvement, hyperostosis, neo-osteogenesis, osteoneogenesis, remodeling, single positron emission computed tomography (SPECT), and nuclear scintigraphy, with each term cross-referenced with chronic rhinosinusitis.

The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis.

Background: The significance of osteitis in the management of recalcitrant chronic rhinosinusitis (CRS) has yet to be clearly understood and clinical outcomes data for these patients is lacking. Osteitis has been characterized by inflammatory infiltrate, osteoneogenesis, and bony sclerosis with remodeling. In this study we sought to determine if osteitis negatively impacts quality-of-life (QOL) or clinical outcomes following endoscopic sinus surgery (ESS).

Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis.

Background: Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis(RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less wellknown.

Objective: We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS.