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Oral Abstracts Yield Interesting Research

Scientific Oral Presentations
7:30 – 8:30 am
Room N140

Research into a variety of topics will be presented Monday during “Scientific Oral Presentations: General Otolaryngology.” Following are summaries of four of the six-minute presentations.

Converting Enzyme Inhibitor-Induced Angioedema

Adrienne M. Laury, MD, of San Antonio Military Medical Center, presents an abstract during Sunday’s “Scientific Oral Presentations: Best of Orals.”

A meta-analysis of pharmacologic treatments of angioedema resulting from the use of ACE inhibitors led to a surprising conclusion, said presenter Claire M. Lawlor, MD. The use of “standard therapy” of corticosteroids, antihistamines, and H2-blockers is not substantiated by the literature.

The analysis looked at studies published between 1970 and 2018, resulting in five articles representing 218 cases, three randomized controlled trials, and two prospective case series. One of the two trials of icatibant, a bradykinin B2 receptor agonist, found more rapid improvement of symptoms compared with a control group treated with corticosteroids and antihistimines. One study of C1-inhibitor replacement found no significant benefit over the control group.

More investigation into the pharmacology for ACE inhibitor-induced angioedema is needed, Dr. Lawlor said.

Inhalational Injury and the Larynx: A Review

Burn patients with facial and neck injuries are at risk of airway obstruction from airway edema and inhalation injury, but laryngeal injury is a secondary consideration because of other complications from burns, according to the results of a literature search.

A literature search of several databases found that half of patients with mild to severe burns have abnormal laryngeal findings, and 70 percent remain dysphonic decades after the injury. Healing is prolonged and different from cutaneous burns, said presenter Jennifer F. Ha, MD.

The take-home message, Dr. Ha said, is that multidisciplinary management helps to optimize the short- and long-term morbidity and that burns result in a lasting impact on patient quality of life.

Opioids and the Otolaryngologist: An Ambulatory Assessment

Because the use of opioids has increased greatly, outpatient prescriptions written for otolaryngology patients were analyzed to see if prescribing patterns changed. Data were collected from the National Ambulatory Medical Care Survey for 2006 to 2013.

Among 19.2 million otolaryngology visits annually, 3.8 percent of patients received an opioid prescription. The prescription rate increased from 2.3 percent in 2006-2007 to 4.6 percent in both 2008-2009 and 2010-2011. The rate dropped to 3.5 percent in 2012-2013.

Co-author Neil Bhattacharyya, MD, said that even though those percentages are small, the authors were surprised it reached 4.6 percent. That translates into more than 750,000 otolaryngology office visits that resulted in opioid prescriptions, so continued vigilance in opioid prescribing is needed.

Clinical Utility of Mobile Phone-Recorded Laryngoscopy

The use of smartphone adapters to record laryngoscopic videos yielded positive results in terms of video quality, ease of use, and satisfaction from patients and offsite clinicians.

In the study, 20 adult patients had their larynges examined using a mobile phone adapter and a standard eyepiece. The adapter required less than 30 seconds of setup with no complications reported. The adapter recording was graded sufficient for assessment in 90 percent of cases.

Presenter Theresa Waltina Schwanke, MD, said quality parameters were reduced as a result of the study and that offsite reviewers rated the videos higher than the physicians performing the exams. Researchers concluded that the technology also could help reduce repeat examinations and enhance teaching, and that patients liked watching the videos.

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