bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and Treatment of Pediatric Rhinosinusitis
Authors: Chun Robert H. , Skinner Margaret L. , Sulman Cecille G. , Wei Julie L. 
Published: August 2013

Program Description:Pediatric chronic rhinosinusitis (PCR) without cystic fibrosis remains one of the most common complaints presenting to otolaryngologists. However, there is no standardized protocol in the work‐up, diagnosis, imaging, and treatment of this disease process. This seminar will focus on diagnostic testing, including when to image and what allergy or immunology tests to order; pre‐operative medical treatment options, including irrigations and diet modification; and review of best evidence for surgical management of PCR, including balloon dilation. We will also discuss the management of complications of acute pediatric rhinosinusitis and discuss our data about long‐term impacts of surgical intervention.Educational Objectives:1) Apply the indications for CT imaging, the role of allergy and immunology testing, and the potential impact of non‐surgical interventions in managing PCR. 2) Evaluate the evidence related to surgical treatment of PCR, including biopsy for primary ciliary dyskinesia, adenoidectomy, functional endoscopic sinus surgery, and balloon dilation. 3) Recognize the acute and long‐term complications seen in pediatric rhinosinusitis and the short‐term and long‐term management of this disease.
Ask the Experts: An Endoscopic Potpourri
Authors: Kennedy David W. , Palmer James N. , Ferguson Berrylin J. , Hwang Peter H. , Stankiewicz James A. , Zinreich S. James 
Published: August 2013

Program Description:Rhinologic diagnostic and treatment problems commonly create dilemmas in practice. This miniseminar provides for interactive discussion of the management options and the decision rationale involved in difficult sinus diagnostic and treatment situations. A case presentation format is used with case presentations from each of the panelists, emphasizing questions with regard to differential diagnosis, evaluation, imagining, and treatment. Cases are representative of those encountered by either a general otolaryngologist or a subspecialty rhinologist, but have critical decision points for discussion. The session focuses on the decision making process, frontal sinus disease, revision surgery, and fungal sinusitis, as well as common tumors.Educational Objectives:1) Review the surgical decision making process in chronic sinus disease. 2) Implement different imaging modalities and improved quality of interpretation for both CT and MRI images. 3) Improve the management of difficult to treat chronic rhinosinusitis.
Evidence‐Based Post‐operative Management of Chronic Rhinosinusitis
Authors: Lee Jivianne T. , Han Joseph , Hwang Peter H. , Stringer Scott P. 
Published: August 2013

Program Description:Endoscopic sinus surgery (ESS) without adequate post‐operative care can lead to unsatisfactory results. Judicious post‐operative management of chronic rhinosinusitis (CRS) is essential to optimize surgical outcomes. Recent years have witnessed significant expansion and innovation with respect to post‐op interventions. The purpose of this miniseminar is to evaluate and discuss the extensive complement of post‐op therapies currently available for CRS from an evidence‐based perspective. A panel of academic leading rhinologists will be conducting this miniseminar using a multimedia case‐based format with audience interactive questions. Clinical cases illustrating implementation of various post‐op regimens will be presented in addition to review of relevant evidence.Educational Objectives:1) Evaluate current post‐op therapies for CRS and appraise their roles in maximizing surgical outcomes. 2) Assess the use of biomaterials, novel adjuvant therapies, and recent innovations in pharmaceutical delivery post‐ESS. 3) Discuss the relevant evidence and proper application of each therapeutic modality in the post‐operative setting.
Innovative Immunomodulatory Therapies in Chronic Sinusitis
Authors: Chandra Rakesh K. , Batra Pete S. , Chiu Alexander G. , Han Joseph , Holbrook Eric H. , Sindwani Raj 
Published: August 2013

Program Description:The purpose of the miniseminar is to systematically review the available immunomodulatory therapies in the management strategy of CRS. The panelists will present clinical scenarios to illustrate potential use of these innovative treatments. The existing literature will also be appraised to elucidate the strength of the existing evidence base. The panel consists of experienced academic rhinologists representing six academic tertiary care centers with extensive experience in treating recalcitrant CRS patients. Audience participation will be encouraged through use of the audience response system. Real‐time texting of questions to the moderator will be used to maximize interaction between the audience and panelists.Educational Objectives:1) Discuss potential immunomodulatory targets for systemic and topical therapy in chronic rhinosinusitis based on current knowledge of the disease pathophysiology. 2) Apply innovative medical therapies in a case‐based approach, including topical/oral steroids, topical/systemic antimicrobials, leukotriene modifiers, aspirin desensitization, monoclonal antibodies, and immunotherapy. 3) Appraise the available literature on these treatment modalities to elucidate the strength of the present evidence base.
Office‐Based Procedures and Surgery in Rhinology
Authors: Benninger Michael S. , Hwang Peter H. , Han Joseph , Atkins James S. , Krespi Yosef P. 
Published: August 2013

Program Description:Office based rhinologic surgical procedures have increased, driven by expansion of procedure technology applicable to the office and improved endoscopic visualization. These procedures are minimally invasive and afford the ability for office management of relatively simple surgical disease and also more complex, chronic disorders, such as chronic rhinosinusitis with polyps. This miniseminar will describe the technology and techniques of office rhinologic procedures. These include injections, laser surgery, polypectomy, turbinectomy, and the use of balloons. The seminar will identify optimal methods of anesthesia, creating a safe and efficient procedure setting, compliance, and legal and coding aspects of establishing office rhinology procedures.Educational Objectives:1) Describe the role of office based nasal and sinus procedures/surgery in the context of patient safety, cost containment, and clinical efficiency. 2) Incorporate processes and procedures that will allow for efficient and safe implementation of office based nasal and sinus procedures/surgery. 3) Analyze the socio‐economic issues related to office based rhinologic procedures and surgery, including medico‐legal issues and billing and reimbursement methods.
Topical Therapies in Chronic Sinonasal Disease
Authors: Harvey Richard J. , Chiu Alexander G. , Schlosser Rodney J. , Cohen Noam A. , Psaltis Alkis , Wormald Peter J. 
Published: August 2013

Program Description:This miniseminar provides an evidence‐based approach to the science behind topical management of sinonasal disease and parallels our greater understanding of the mechanisms in chronic sino‐nasal inflammation. The scientific basis behind delivery systems is presented. Cochrane reviews on topical steroids and antifungals have produced surprising evidence, and current recommendations by treatment guidelines such as EPOS 2012 will be debated. The miniseminar is presented by rhinologists actively involved in the development of topical therapies both clinically and in research. There is direct clinical application of current research and available products to the management of chronic sinonasal disease in general otolaryngology practice.Educational Objectives:1) Define the therapeutic goals of topical therapies and understand the influence of device and surgical state on topical delivery. 2) Review current evidence based guidelines on topical therapies in CRS and learn about the science behind novel topical agents. 3) Identify the inflammatory conditions under which to apply these new topical therapies.
Creating a Comprehensive Sleep Center in an Otolaryngology Practice
Authors: Friedman Michael , Yaremchuk Kathleen L. , Jacobwitz Ofer , Davidson Terence M. 
Published: August 2013

Program Description:With increased demand of patients seeking treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS), diagnosis of OSAHS will become an increasingly significant component of every ENT practice. Surgical treatment will remain an option for selected patients Explain options for attended and unattended polysomnography. Review new techniques and clinical research on OSAHS. Review CPT coding and reimbursement expectations for diagnostic studies, non‐invasive and minimally invasive procedures. Identify patients with mild/moderate disease (continuous positive airway pressure intolerant) who could benefit from minimally‐invasive and non‐invasive techniques. Present non‐invasive treatment options that can be incorporated into an ENT practice.Educational Objectives:1) Incorporate sleep testing into ENT practice, implement coding/reimbursement for diagnostic and treatment, and apply an algorithm for successful treatment of snoring and OSA. 2) Properly identify and treat each anatomic site and identify patients who can be helped by multilevel minimally‐invasive techniques rather than classic surgery. 3) Incorporate custom‐made mandibular advancement devices into an ENT/OSAHS practice and share our experience with Provent therapy.
Current Concepts and Pitfalls in the Management of Obstructive Sleep Apnea
Authors: Pang Kenny P. , Rotenberg Brian , Woodson B. Tucker 
Published: August 2013

Program Description:There are many different ways and surgical techniques available to treat OSA, causing a lot of confusion and disparity in managing these OSA patients. There is a need to standardize diagnosis, treatment, and prognosis. Concepts will be discussed and pitfalls will be highlighted. This miniseminar will address these latest current concepts in airway evaluation, clinical diagnosis, polysomnographic diagnosis, and various surgical management (from nose, palate, and tongue surgery). The miniseminar will also highlight the pitfalls that should be avoided in the management of OSA.Educational Objectives:1) Recognize the basic concepts of airway evaluation and diagnosis and surgical management of OSA. 2) Confidently diagnose, evaluate, and treat patients with OSA.
Palate Surgery in Obstructive Sleep Apnea: How to Choose among the Options
Authors: Kezirian Eric J. , Weaver Edward M. , Rotenberg Brian , Pang Kenny P. , Cahali Michel B. , Friedman Michael , Woodson B. Tucker 
Published: August 2013

Program Description:Palate surgery is the primary surgical approach for treatment of OSA. Although uvulopalatopharyngoplasty (UPPP) was described 30 years ago, the past 10‐15 years have witnessed the development of alternative palatoplasty techniques. This miniseminar draws from leading surgeons who have developed these procedures and/or performed clinical trials related to them. Findings from published studies will enable attendees to learn more about selection from among the procedures for their patients.Educational Objectives:1) Interpret evidence regarding the range of palatoplasty techniques: UPPP, palate stiffening, modified expansion sphincter pharyngoplasty, relocation pharyngoplasty, lateral pharyngoplasty, Z‐palatoplasty, and palatal advancement. 2) Differentiate between the various palatoplasty techniques for different types of patients.
Pediatric Obstructive Sleep Apnea Syndrome: Guidelines, Evidence, and Nuance
Authors: Maturo Stephen C. , Brietzke Scott E. , Ishman Stacey L. , Mitchell Ron B. 
Published: August 2013

Program Description:Pediatric obstructive sleep apnea syndrome (OSAS) is one of the most common referrals for otolaryngologists. Over the past three years, clinical practice guidelines have been published by the AAO‐HNS, American Academy of Pediatrics, and American Academy of Sleep Medicine regarding the diagnosis and management of OSAS. This presentation will begin with a comparison of these guidelines and the evidence used to reach the recommendations. Panelists, through case examples and examination of current literature, will then discuss nuanced issues of pediatric OSA to include short‐ and long‐term perioperative management, obese children with sleep apnea, and subtleties of formal polysomnography in children.Educational Objectives:1) Compare similarities and differences in the practice guidelines by the various subspecialties involved in the management of children with OSAS and the evidence used to make these recommendations. 2) Evaluate the evidence supporting current perioperative management strategies in children undergoing surgical treatment for OSAS. 3) Improve management of OSAS in obese children and the growing evidence that suggests these children carry increased perioperative risk.
Reducing Surgical Risk: Perioperative Management of Obstructive Sleep Apnea
Authors: Soose Ryan J. , Coutras Steven W. , Ishman Stacey L. , Rotenberg Brian , Stierer Tracey L. 
Published: August 2013

Program Description:OSA is common in surgical populations. Recent studies suggest higher risk of respiratory failure, reintubation, ICU transfer, and longer length of stay in OSA patients. This miniseminar will examine these risks from medical, surgical, and anesthesia perspectives, including an overview of the pathophysiology of this increased risk. Sleep‐certified specialists will discuss anesthesia and patient factors contributing to perioperative risk, measures to reduce this risk, and considerations unique to the pediatric population. Finally, the miniseminar will provide practical information for developing a system‐wide preoperative screening protocol and implementing clinical pathways to evaluate and manage OSA patients in the perioperative period.Educational Objectives:1) Explain the specific surgical and anesthesia risks in patients with OSA and the pathophysiology of the increased risk. 2) Review preoperative, intraoperative, and postoperative strategies that can be employed to reduce complications in patients with OSA. 3) Compare available preoperative screening questionnaires and discuss the development of clinical pathways to screen for and manage OSA patients in the perioperative period.
Coding and Precertification Strategies for Nasal Surgery
Authors: Rhee John S. , Tollefson Travis T. , Ward Preston D. , Patel Krishna G. 
Published: August 2013

Program Description:In the setting of decreased reimbursements and increased insurance denials, wading through the world of current procedural terminology (CPT) coding for nasal surgery can be challenging. This interactive miniseminar will discuss appropriate coding for nasal surgeries, clarifying the differences between rhinoplasty, vestibular stenosis repair, septoplasty, and turbinate surgery, and discuss indications for precertification. Individual speakers, well versed in the world of nasal surgery, will share strategies in documentation, patient counseling, and navigating appeals. The main goal of the miniseminar is to provide an algorithm for proper and accurate coding and helpful strategies to support these coding choices.Educational Objectives:1) Maximize coding for nasal surgeries involving functional rhinoplasty, septoplasty, and treatment of inferior turbinates. 2) Recognize clinical indications that impact coverage of rhinoplasty by insurance companies. 3) Improve efficiency when interacting with insurance companies in the management of rhinoplasty coding.
Comparison of Tolerance and Cost‐Effectiveness of Two Nasal Anesthesia Techniques for Trans‐nasal Flexible Laryngoscopy (TFL)
Authors: Young VyVy N. , Rosen Clark A. , Smith Libby J. 
Published: August 2013

Objectives:1) Compare tolerance of aerosolized spray vs. syringe administration of topical anesthesia for TFL. 2) Analyze cost‐effectiveness of both techniques.Methods:Prospective, blinded, randomized trial. 108 patients underwent TFL over a 3‐month period. Patients were randomized to receive equivalent dose of 1:1 neosynephrine/4% plain lidocaine mixture via either aerosolized spray (“spray”) or application with 1‐cc syringe (“syringe”). Patients and physicians independently rated comfort of TFL on a 5‐point scale (1=not at all comfortable to 5=very comfortable). Data was collected on patient and endoscopist experience with TFL as well as reasons for poor tolerance of laryngoscopy. Cost analyses of disposable spray tips and syringes were calculated.Results:Both patients and physicians reported very high tolerance of TFL. There was no difference in patient tolerance between spray‐ vs. syringe‐administered anesthesia (P = 0.89). Poor tolerance of laryngoscopy was reported in 6.5% with comparable distribution between anesthetic methods (P = 0.93). There was no impact of patient prior experience with TFL (P = 0.280), and there was no difference between anesthetic methods for TFL performed by the resident, fellow, or attending. The difference between costs of the disposable spray tip vs. syringe was $1.30 per unit.Conclusions:Use of a 1‐cc syringe is an effective method to provide topical nasal anesthesia for TFL and saves $1.30 per unit compared to disposable spray tips. In our practice, transition to syringe‐administered nasal anesthesia is projected to save $1,300 per 1,000 patients, or an anticipated $3,000 per year, with continued excellent patient tolerance of TFL.
The Two‐Week Wait Head and Neck Clinic: Do We Know What Our Patients Think?
Authors: Glore Raad J. , Kundra Amrit , Conboy Peter J. , Moir Andrew , Alun‐Jones Tom 
Published: August 2013

Objectives:Explore patients’ views on hospital communication when patients are referred to the two‐week wait head and neck clinic (2WWHNC).Methods:A prospective qualitative study in the form of questionnaire handed to new patients attending the 2WWHNC. The study ran for six weeks (October ‐ November 2011) and included 104 patients.Results:25.9% of patients said the hospital information letter provoked anxiety. 29.8% of patients said they were not informed by their general practitioners (GPs) that they would require further specialist assessment and investigations.Conclusions:A significant minority of patients were unaware they were attending the 2WWHNC to investigate the possibility of an underlying head and neck cancer. Although patients recognized that hospital communication was informative, perhaps reconsideration of the wording of the information letter as well as providing clearer information by the GPs may help to reduce the level of anxiety.
Incidence and Survival Trends of Sinonasal Adenocarcinoma from 1973 to 2009
Authors: Patel Neal , Patel Shail M. , Sanghvi Saurin , Patel Nicolas R. , Baredes Soly , Eloy Jean A. 
Published: August 2013

Objectives:Study the incidence and survival of patients with sinonasal adenocarcinoma (SNA) between 1973 and 2009 using the Surveillance, Epidemiology, and End Result (SEER) database.Methods:A retrospective cohort study using the United States National Cancer Institute's SEER registry was analyzed to study the incidence and survival for SNA from 1973‐2009. Analysis was conducted based on race and gender.Results:In total, 885 cases of SNA were reported. Males accounted for 50.17%, while females accounted for 49.83%, amounting to a 1.01:1.00 male to female ratio. Analysis of incidence trends revealed a statistically significant decline in incidence of overall population, females, blacks, and “others” (P < 0.05). Overall 20‐year survival for SNA over the past 30 years was 30.25%. Survival data were additionally analyzed by gender revealing females to have a slightly better survival than males (P > 0.05). When survival was stratified by race, “others” had the best survival, followed by whites and blacks, respectively, although this was not statistically significant.Conclusions:The overall incidence of SNA has significantly declined over the past 30 years. The highest decrease in incidence was observed in “others,” when compared to whites and blacks. Moreover, while the female incidence significantly declined, the male incidence rate has stayed stable over the past 30 years. Overall long‐term survival has increased over the last 30 years. No significant difference in survival was noted for gender and race.
Incidence and Treatment Trends in Young Patients with Oropharyngeal Cancer: The SEER Analysis
Authors: Gayar Omar , Ghanem Tamer A.H. , Hall Francis T. , Cote Michele , Ruterbusch Julie , Elshaikh Mohamed , Siddiqui Farzan 
Published: August 2013

Objectives:1) Assess the incidence of oropharyngeal squamous cell carcinoma (OPCa) in patients <45 years. 2) Assess treatments and outcomes.Methods:The SEER 9 database was queried (1973‐2009) for OPCa patients <45 years of age.Results:There were 1603 patients who met the study criteria. The incidence in patients between 36‐45 years increased from 0.79 to 1.39 (per 100,000). In the same time period, there was an increase in rate from 0.20 to 0.42 in whites and a decrease in rate in black patients from 0.67 to 0.32. Surgery was performed alone in 220 (13.72%) and in combination with radiation therapy in 734 (45.79%). Five‐year survival for the study cohort is 54%. Compared to white patients, black patients had worse survival (P < 0.0001). Patients who had surgery as part of their treatment, either alone (localized stage patients) or in combination with radiation had the highest 5‐year survival, followed by radiation.Conclusions:There was an increase in OPCa in patients within the last 4 decades, particularly in the 36‐44 age range. Interestingly, the incidence increased in whites and decreased in blacks. It is important to note that the majority of these patients were treated with surgery, either alone or with radiotherapy. The rising incidence within recent decades is thought to be related to HPV transmission and changes in sexual practices.
An Innovative Computerized Control System in Transoral Laser Surgery of the Larynx
Authors: Guastini Luca , De Matos Leonardo , Caldwell Darwin , Peretti Giorgio 
Published: August 2013

Objectives:1) Describe a new computerized system in transoral laser surgery of the larynx based on a tablet stylus interface. The mechanical joystick interface currently used is the major limiting factor for surgical precision, quality, and safety, requiring extensive surgeon practice. 2) Analyze the statistical reduction of absolute and root‐mean‐square error (RMS error) with the stylus interface in path‐follow trials.Methods:A new robotic system for transoral laser surgery has been created to improve the surgeon's control. It offers a more ergonomic, intuitive, and programmable laser control device: a touch interface with dynamic intraoperative planning capabilities. The system is based on a large‐range laser scanner fully controlled by a stylus on a tactile sensor. It aims the laser in real‐time over the whole surgical field and allows path memorization, providing accurate repetitions of surgeon‐defined laser paths. This enables pre‐execution surgical action tracking and unmatched control for long cuts. Paths of any shape and length are dynamically planned too with the plain stylus device.Results:Trials on ex‐vivo pig larynges and artificial targets performed by experienced and non‐experienced surgeons demonstrate a drop of 80% in max absolute error and about 50% in RMS error with the stylus interface in path‐follow trials. Dynamic planning has also demonstrated its benefits. No error was observed in trials, getting only. 03 mm mean RMS error under a 40× microscope magnification.Conclusions:Trials so far have assessed the new system as highly intuitive and effective. It improves surgical precision, quality, and safety.