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International Forum of Allergy & Rhinology

Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
Mohemmed N Khan, Neeraja Konuthula, Arjun Parasher, Eric M Genden, Brett A Miles, Satish Govindaraj, Alfred M Iloreta
BACKGROUND: Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive malignancy of unknown etiology with a poor overall prognosis. Its relative rarity has made it difficult to determine the impact of different treatment modalities on survival. METHODS: Retrospective study of cases in the National Cancer Data Base (NCDB). NCDB cases that were diagnosed as having SNUC between January 1, 2004, and December 31, 2013 were included in the analysis. Outcomes of patients treated with surgery followed adjuvant chemoradiotherapy were compared with definitive chemoradiotherapy...
October 7, 2016: International Forum of Allergy & Rhinology
Dan Yaniv, Tuvia Hadar, Roe Hod, Roee Lansberg, Ilan Koren, Eitan Yaniv
BACKGROUND: Repair of caudal septal deviation using currently described methods is challenging technically. The aim of this work is to describe a novel and simple technique for the treatment of caudal septal deviations that protects the nasal tip, by fixating of cartilage to the columella. METHODS: All patients with caudal septal deviation operated on between June 2008 to November 2013 in 2 major medical centers were operated using the "fishing line technique." Patient satisfaction was recorded by a standard questionnaire (16-item Sino-Nasal Outcome Test [SNOT-16]), before and after surgery...
October 5, 2016: International Forum of Allergy & Rhinology
Gaurav S Ajmani, Kristen E Wroblewski, Fuad M Baroody, Robert M Naclerio, Jayant M Pinto
BACKGROUND: Little is known about the use of allergy and asthma medications in older adults. This study aimed to assess the prevalence of use of these medications in older adults and evaluate predictors of their use. METHODS: Cross-sectional study using data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of community-dwelling, U.S. adults 57 to 85 years (n = 2976) collected in 2005-2006. We determined prevalence of medication use and used logistic regression to evaluate sociodemographic and health factors associated with their use...
October 3, 2016: International Forum of Allergy & Rhinology
Giovanni Salzano, Mario Turri-Zanoni, Apostolos Karligkiotis, Jacopo Zocchi, Giovanni Dell'Aversana Orabona, Luigi Califano, Paolo Battaglia, Paolo Castelnuovo
BACKGROUND: The infraorbital nerve (ION) is a terminal branch of the maxillary nerve (V2) providing sensory innervation to the malar skin. It is sometimes necessary to sacrifice the ION and its branches to obtain adequate maxillary sinus exposure for radical resection of sinonasal tumors. Consequently, patients suffer temporary or permanent paresthesia, hypoestesthia, and neuralgia of the face. We describe an innovative technique used for preservation of the ION while removing the anterior, superior, and lateral walls of the maxillary sinus through a medial endoscopic transnasal maxillectomy...
September 28, 2016: International Forum of Allergy & Rhinology
Jeremiah A Alt, Vijay R Ramakrishnan, Michael P Platt, Preeti Kohli, Kristina A Storck, Rodney J Schlosser, Zachary M Soler
BACKGROUND: Endoscopic sinus surgery (ESS) has been shown to improve sleep in patients with chronic rhinosinusitis (CRS). However, it is unknown how this improvement compares with non-CRS control subjects' sleep, and medically treated CRS patients. METHODS: Patients meeting diagnostic criteria for CRS and controls from the same reference population were recruited from 4 academic centers. Patients chose either medical or surgical treatment. The Pittsburgh Sleep Quality Index (PSQI) was administered to patients before treatment and after 6 months, whereas controls received the PSQI at enrollment...
September 27, 2016: International Forum of Allergy & Rhinology
Davi Sousa Garcia, Mengfei Chen, Amy K Smith, Paulo Roberto Lazarini, Andrew P Lane
BACKGROUND: To understand mechanisms of human olfactory dysfunction in chronic rhinosinusitis, an inducible olfactory inflammation (IOI) model has been utilized to chronically express inflammatory cytokines locally, resulting in neuronal loss, diminished odorant responses, and repressed olfactory regeneration. Knockout of the minor tumor necrosis factor α receptor 2 (TNFR2) was previously shown to partially rescue these olfactory changes. The purpose of current study was to investigate the role of the major TNF receptor, TNFR1, in chronic olfactory inflammation...
September 27, 2016: International Forum of Allergy & Rhinology
Alberto Schreiber, Davide Mattavelli, Marco Ferrari, Vittorio Rampinelli, Davide Lancini, Francesco Belotti, Luigi Fabrizio Rodella, Piero Nicolai
BACKGROUND: Over the past decade, the treatment of complex intradural and extradural pathologies via expanded endonasal approaches has been made possible by progresses and refinements in skull base reconstruction techniques. The aim of this anatomic study is to describe a novel endonasal flap, the turbinal flap (TF), based on the middle and superior turbinate mucosa and pedicled on the ethmoidal arteries system. METHODS: Three fresh-frozen (6 sides) cadaver heads previously injected with colored silicone were dissected...
September 21, 2016: International Forum of Allergy & Rhinology
Elizabeth E Cottrill, Bei Chen, Nithin D Adappa, James N Palmer, David W Kennedy, Robert J Lee, Noam A Cohen
BACKGROUND: Antimicrobial peptides (AMPs) produced by the epithelium are important for innate immune defense. In 2001, a novel AMP dermcidin (DCD) was described with no homology to other AMPs and an expression pattern restricted to eccrine sweat glands. In contrast to other AMPs, DCD expression has not been shown to be induced under inflammatory conditions in the skin. After identifying DCD by mass spectrometry in a protein sample isolated from human nasal secretions, we sought to determine the role of DCD in innate defense of the sinonasal airway...
September 21, 2016: International Forum of Allergy & Rhinology
Ravi Jain, Michael Hoggard, Kristi Biswas, Melissa Zoing, Yannan Jiang, Richard Douglas
BACKGROUND: Endoscopic sinus surgery (ESS) improves symptoms for many chronic rhinosinusitis (CRS) patients by enlarging the size of sinus ostia, improving mucociliary clearance, and facilitating access for topical therapies. However, the effect of surgery on the sinonasal microbiota remains poorly understood. This study examined changes in bacterial communities in CRS patients before and after surgery. METHODS: Swab samples were taken from the middle meatus of 23 patients undergoing ESS...
September 19, 2016: International Forum of Allergy & Rhinology
Neeraja Konuthula, Mohemmed N Khan, Arjun Parasher, Anthony Del Signore, Eric M Genden, Satish Govindaraj, Alfred M Iloreta
BACKGROUND: Most data on sinonasal mucosal melanoma come from small institutional studies, and therefore optimal treatment methods are not well understood. The purpose of this study was to analyze the association between treatment and survival in sinonasal mucosal melanoma. METHODS: Six hundred ninety-five patients diagnosed with sinonasal mucosal melanoma between 2004 and 2010 were identified from the National Cancer Data Base. Treatment modalities and overall survival rates were determined...
September 14, 2016: International Forum of Allergy & Rhinology
Austin S Adams, David O Francis, Paul T Russell
BACKGROUND: Endoscopic repair of anterior skull-base defects has become the gold standard for management of cerebrospinal fluid (CSF) rhinorrhea. Both improved techniques and adjuvant therapies have led to accepted success rates of greater than 90%. As management has evolved, shorter hospitalizations have been required and the goal of this study is to analyze the outcomes of patients repaired on an outpatient basis vs those managed as inpatients postoperatively. METHODS: Patients undergoing endoscopic repair of CSF rhinorrhea between 2004 and 2014 were identified by review of medical records...
September 14, 2016: International Forum of Allergy & Rhinology
Vijay R Ramakrishnan, Sarah Gitomer, Jennifer M Kofonow, Charles E Robertson, Daniel N Frank
BACKGROUND: Chronic rhinosinusitis (CRS) is a multifactorial inflammatory airway disorder in which bacteria are implicated in the initiation and/or sustenance of disease in some patients. The sinuses are colonized by bacteria even in health, and the potential for sinus-specific niches harboring unique microbial consortia raises questions for clinical and research investigation. The objective was to determine the degree to which resident upper airways microbiota differ between individuals and anatomic sites, in order to determine the optimal site of microbial sampling for study in CRS...
September 14, 2016: International Forum of Allergy & Rhinology
Curtis Hanba, Peter F Svider, Mahdi A Shkoukani, Anthony Sheyn, Jeffrey T Jacob, Jean Anderson Eloy, Adam J Folbe
BACKGROUND: Although there has been extensive study evaluating adult pituitary surgery, there has been scant analysis among children. Our objective was to evaluate a population-based resource to characterize nationwide trends in surgical approach, hospital stay, and complications among children undergoing pituitary surgery. METHODS: The Kids' Inpatient-Database (KID) files (2009/2012) were evaluated for pituitary gland excisions. Procedure, patient demographics, length of inpatient stay, inpatient costs, hospital setting, and surgical complications were analyzed...
September 14, 2016: International Forum of Allergy & Rhinology
Dara R Adams, Gaurav S Ajmani, Vivian C Pun, Kristen E Wroblewski, David W Kern, L Philip Schumm, Martha K McClintock, Helen H Suh, Jayant M Pinto
BACKGROUND: Olfactory dysfunction has profound effects on quality of life, physical and social function, and mortality itself. Nitrogen dioxide (NO2 ) is a pervasive air pollutant that is associated with respiratory diseases. Given the olfactory nerve's anatomic exposure to airborne pollutants, we investigated the relationship between NO2 exposure and olfactory dysfunction. METHODS: The ability to identify odors was evaluated using a validated test in respondents from the National Social Life, Health, and Aging Project (NSHAP), a representative probability sample of home-dwelling, older U...
September 13, 2016: International Forum of Allergy & Rhinology
Jenna M Christensen, Jasmine Cheng, Peter Earls, Jenny Gunton, William Sewell, Raymond Sacks, Richard J Harvey
BACKGROUND: Vitamin D deficiency is associated with many inflammatory respiratory disease states. However, serum vitamin D concentrations may not reflect tissue-specific availability. In this study we sought to assess the local expression of genes essential in vitamin D regulation in chronic rhinosinusitis (CRS). METHODS: A cross-sectional study of adult patients undergoing endoscopic sinus surgery was performed. Patients were defined as having CRS with polyps (CRSwNP) or without polyps (CRSsNP), or normal sinus mucosa...
September 12, 2016: International Forum of Allergy & Rhinology
Henrique Augusto Cantareira Sabino, Fabiana Cardoso Pereira Valera, Davi Casale Aragon, Marina Zilio Fantucci, Carolina Carneiro Titoneli, Roberto Martinez, Wilma T Anselmo-Lima, Edwin Tamashiro
BACKGROUND: The management of acute exacerbation of chronic rhinosinusitis (AECRS) is still under debate, especially because there are no adequate studies to support a best-evidence treatment for this condition. Antibiotic use for AECRS has been recommended based on extrapolation of data from acute rhinosinusitis (ARS) or non-placebo-controlled studies. This study aimed to evaluate whether antibiotic therapy modifies the course of AECRS in a randomized, placebo-controlled study. METHODS: Patients with AECRS were randomized in a double-blinded manner (2:1 ratio) to receive either amoxicillin-clavulanate 875 mg/125 mg twice daily (BID) (AMX-CLAV, n = 21) or placebo capsules (n = 11) during 14 days...
September 9, 2016: International Forum of Allergy & Rhinology
Emily K Cope, Andrew N Goldberg, Steven D Pletcher, Susan V Lynch
BACKGROUND: Diverse microbial communities colonize healthy sinus mucosa and specific species within these communities are capable of protecting the host from pathogenic infection. However, little is known of the dynamics of upper airway infection and the role of the sinus mucosal microbiome in short- and longer-term outcomes using clinical isolates from patients with chronic rhinosinusitis. METHODS: We examine microbiome and immune dynamics after murine sinus infection with Pseudomonas aeruginosa EC1, isolated previously from a chronic rhinosinusitis patient...
September 6, 2016: International Forum of Allergy & Rhinology
Chang Hoon Bae, Yoon Seok Choi, Si-Youn Song, Yoon-Keun Kim, Yong-Dae Kim
BACKGROUND: Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) release extracellular vesicles (EVs). E. coli-derived and S. aureus-derived EVs are associated with neutrophilic respiratory inflammation. In neutrophilic respiratory inflammation of human, expression of mucin is increased in airway epithelial cells and is associated with increased morbidity and mortality of the affected patients. However, no study on the effects of EVs on expression of mucin genes has been reported in airway epithelial cells...
September 5, 2016: International Forum of Allergy & Rhinology
Anuj Tharakan, Ashleigh A Halderman, Andrew P Lane, Shyam Biswal, Murugappan Ramanathan
BACKGROUND: Environmental factors such as inhaled pollutants like cigarette smoke may play a significant role in diseases of the upper airway including chronic rhinosinusitis (CRS). Recent studies have shown that cigarette smoke causes impaired airway epithelial cell barrier function likely through environmental oxidative stress related pathways. The purpose of this study is to explore whether enhancing nuclear factor erythroid 2 [NF-E2]-related factor 2 [Nrf2], the body's master antioxidant system, can ameliorate cigarette smoke-induced sinonasal epithelial cell (SNEC) barrier dysfunction...
August 31, 2016: International Forum of Allergy & Rhinology
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