Factors impacting cerebrospinal fluid leak rates in endoscopic sellar surgery.

Background: In patients undergoing transnasal endoscopic sellar surgery, an analysis of risk factors and predictors of intraoperative and postoperative cerebrospinal fluid leak (CSF) would provide important prognostic information.

Methods: A retrospective review of patients undergoing endoscopic sellar surgery for pituitary adenomas or craniopharyngiomas between 2002 and 2014 at 7 international centers was performed. Demographic, comorbidity, and tumor characteristics were evaluated to determine the associations between intraoperative and postoperative CSF leaks.

Mucous Cytokine Levels in Chronic Rhinosinusitis-Associated Olfactory Loss.

Importance: Olfactory loss is a frequent symptom of patients with chronic rhinosinusitis (CRS), but our understanding of how inflammatory cytokines affect olfaction is limited.

Objectives: To examine whether inflammatory cytokines are present in the olfactory cleft and whether they correlate with objective olfaction.

Design, Setting, And Participants: In this cross-sectional study, patients with CRS underwent quantitative olfactory testing using the Sniffin Sticks test to calculate a composite threshold discrimination identification (TDI) score from October 21, 2013, to November 12, 2015.

The Olfactory Cleft Endoscopy Scale correlates with olfactory metrics in patients with chronic rhinosinusitis.

Background: Olfactory loss affects a majority of patients with chronic rhinosinusitis (CRS). Traditional objective measures of disease severity, including endoscopy scales, focus upon the paranasal sinuses and often have weak correlation to olfaction.

Methods: Adults with CRS were prospectively evaluated by blinded reviewers with a novel Olfactory Cleft Endoscopy Scale (OCES) that evaluated discharge, polyps, edema, crusting, and scarring of the olfactory cleft.

How I Do It: The Sphenoethmoidectomy.

Background: Several techniques for performing the sphenoethmoidectomy have been described. We present a safe, effective, and efficient technique.

Objective: We present text, images, and video to demonstrate our preferred technique for performing a sphenoethmoidectomy.

Predictors of 30-day morbidity and mortality in transnasal microscopic pituitary tumor excision.

Background: There is a lack of population-based, multi-institutional analyses of factors associated with morbidity and mortality following pituitary tumor excision.

Methods: The American College of Surgeons National Surgical Quality Improvement Project files were used to compile information on patients that had undergone transnasal microscopic pituitary tumor resection from 2006 to 2012. Patient demographics, comorbidities, operative characteristics, and morbidity and mortality in the 30 days following surgery were included.

Fibroblast levels are increased in chronic rhinosinusitis with nasal polyps and are associated with worse subjective disease severity.

Background: Fibroblasts are implicated in tissue remodeling and recruitment of inflammatory cells in chronic rhinosinusitis (CRS). Populations of fibroblasts remain unquantified in CRS subtypes. The objectives of this study were to measure fibroblast populations in subtypes of CRS, and to investigate the association between fibroblasts and disease severity.

Multi-institutional study of risk factors for perioperative morbidity following transnasal endoscopic pituitary adenoma surgery.

Background: The goal of this study was to identify preoperative risk factors associated with increased perioperative morbidity after endoscopic pituitary surgery.

Methods: A retrospective review of patients undergoing endoscopic pituitary adenoma surgery between 2002 and 2014 at 6 international centers was performed. Standard demographic and comorbidity data, as well as information regarding tumor extent and treatment were collected.

Superoxide dismutase reduces the inflammatory response to Aspergillus and Alternaria in human sinonasal epithelial cells derived from patients with chronic rhinosinusitis.

Background: Aspergillus fumigatus and Alternaria alternata are ubiquitous environmental fungal allergens that can exacerbate airway inflammation and contribute to the disease process in patients with chronic rhinosinusitis (CRS). These antigens have been shown to induce human sinonasal epithelial cells (HSNECs) to promote a proinflammatory response, but what is unclear is a means by which to reduce these effects. Inhaled pathogens can induce HSNECs to produce reactive oxygen species (ROS) that trigger cytokine production.

Intranasal steroid injections and blindness: our personal experience and a review of the past 60 years.

Objectives/hypothesis: To assess for the safety of intranasal steroid injections.

Study Design: Retrospective chart review and review of the medical literature.

Methods: Seventy-eight patients with chronic rhinitis or sinusitis underwent 237 intraturbinate or intrapolyp triamcinolone acetonide injections between April 2008 and June 2013 at a single, private, outpatient otolaryngology clinic.

The effect of anterior palatine blocks on bleeding in hereditary hemorrhagic telangiectasia nasal surgery.

Objectives/hypothesis: When combined with local sphenopalatine (SP) injection and moderate hypotension, transoral or transcutaneous local injection of the anterior palatine (AP) vessels reduces intraoperative bleeding in hereditary hemorrhagic telangiectasia (HHT) patients undergoing nasal surgery.

Study Design: Retrospective chart review of 55 consecutive HHT patients undergoing a bevacizumab injection for recalcitrant epistaxis. Nineteen patients received local injections to only the SP vasculature, and 36 patients received AP and SP injections.

Treatment of hereditary hemorrhagic telangiectasia with submucosal and topical bevacizumab therapy.

Objective/hypothesis: Bevacizumab delivered as a submucosal and topical intranasal therapy effectively controls hereditary hemorrhagic telangiectasia (HHT)-associated epistaxis.

Study Design: Prospective institutional review board-approved study.

Methods: Between December 2009 and December 2010, 19 patients with HHT-associated epistaxis were treated with 100 mg of intranasal submucosal bevacizumab.

Safety of intranasal Bevacizumab (Avastin) treatment in patients with hereditary hemorrhagic telangiectasia-associated epistaxis.

Objectives/hypothesis: Assess for complications of intranasal Bevacizumab application in patients with hereditary hemorrhagic telangiectasia (HHT)-associated epistaxis.

Study Design: Retrospective chart review.

Methods: In 58 patients presenting with recurrent HHT epistaxis, Bevacizumab was applied intranasally either as a submucosal injection or as a topical spray between October 2006 and June 2010.

Efficacy of intranasal Bevacizumab (Avastin) treatment in patients with hereditary hemorrhagic telangiectasia-associated epistaxis.

Objectives/ Hypothesis: Intranasal Bevacizumab is an effective therapy for epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT).

Study Design: Retrospective chart review.

Methods: In 32 successive patients presenting with recurrent HHT epistaxis 25-100 mg of Bevacizumab was applied intranasally either as a submucosal injection or as a topical spray between November 2008 and May 2010.

The association between interferon regulatory factor 6 (IRF6) and nonsyndromic cleft lip with or without cleft palate in a Honduran population.

Objectives/hypothesis: Interferon regulatory factor 6 (IRF6), the gene that causes van der Woude syndrome (VWS), is a candidate gene for nonsyndromic cleft lip with or without cleft palate (NSCLP) because a number of studies have supported an association between NSCLP and single nucleotide polymorphisms (SNPs) in IRF6 in several populations. This project investigated the contribution of IRF6 to NSCLP in the Honduran population, a previously unstudied group with a high prevalence of NSCLP.

Study Design: Family-based joint linkage and association study.

Antimicrobial resistance among isolates causing invasive pneumococcal disease before and after licensure of heptavalent conjugate pneumococcal vaccine.

Background: The impact of the pneumococcal conjugate vaccine (PCV-7) on antibiotic resistance among pneumococcal strains causing invasive pneumococcal disease (IPD) has varied in different locales in the United States. We assessed trends in IPD including trends for IPD caused by penicillin non-susceptible strains before and after licensure of PCV-7 and the impact of the 2008 susceptibility breakpoints for penicillin on the epidemiology of resistance.

Methodology/principal Findings: We performed a retrospective review of IPD cases at Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center.