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Scientific Oral Presentations: Surgery Management Methods

Cutting-edge imaging technology to assess disease severity and optimal post-operative medical management will join an impressive line-up of topics featured at the Scientific Oral Presentations: Rhinology/Allergy, Head & Neck Surgery, and Facial Plastic and Reconstructive Surgery from 8:00 am to 9:30 am today in West Level III, Room 301.

“Until recently, no objective measure of successful treatment in disease severity of chronic rhinosinusitis existed,” said lead investigator Micah M. Likness, MD. “We will present two novel objective computerized CT scoring systems and compare them against the most commonly used CT methods of staging sinus disease. We have found that the methods that correlated the best were the two computerized CT methods.”

Dr. Likness was a resident in the Department of Otolaryngology, State University of New York, Buffalo, when he conducted his study, “Computed Tomography (CT) Scans as an Objective Measure of Disease Severity in Chronic Rhinosinusitis.” He is now a private practice otolaryngologist at Ear, Nose and Throat Associates, Yankton, SD.

The subjective Lund-Mackay staging system is the most widely accepted and easy to use of the many methods in existence. The inability to subgrade disease severity prompted Zinreich to modify the scale of this method, thus increasing sensitivity to change. However, both of these methods are subjective. For the study, the Lund-Mackay and Zinreich methods were compared to the objective computerized systems: the 3D Volumetric Scoring System, and the 2D Coronal OMC scoring system; which uses a single coronal slice through the osteomeatal complex. All four methods of scoring were compared for measuring disease severity and sensitivity to change and correlation differences between staging systems tested reflect their sophistication and inclusiveness.

“For those interested in imaging assessment of chronic rhinosinusitis and 3D CT technology, then they will want to hear these results,” Dr. Likness said. “The audience can learn about the four methods of scoring disease severity tested, the strengths and pitfalls of each method, and the methods that correlate best with each other.”

In another presentation scheduled for 8:14 am, “The Role of Postoperative Systemic Corticosteroids when Using a Steroid-Eluting Spacer following Sinus Surgery,” Jonathan F. Dautremont, MD, a medical resident, Department of Otolaryngology-Head and Neck Surgery, University of Calgary, will discuss advantages and disadvantages of two approaches.

Currently, most surgeons give their patients a course of post-operative systemic steroids after endoscopic sinus surgery to promote optimized healing, but these medications are not without side effects, he said. In addition, steroid-eluting spacers have been developed to directly place this medication within the sinus cavity without the systemic side effects.

“There is now some controversy about the best medical management of these patients,” Dr. Dautremont said. “We sought to answer whether the addition of systemic steroids still offers any benefit when steroid-eluting spacers are used.”

From this session, he said he hoped audience members would make up their own minds about the appropriate course of action after hearing the data.

“They will want to consider whether they would still use postoperative systemic steroids if they adopt the use of a steroid-eluting sinus spacer,” Dr. Dautremont said. “Any general otolaryngologist or rhinologist will benefit from hearing results of this research, especially those tracking the emerging evidence for various postoperative care strategies.”