American Academy of Otolaryngology, Sept. 10-13
The annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery was held from Sept. 10 to 13 in Chicago and attracted more than 8,000 participants from around the world, including otolaryngologists, medical experts, allied health professionals, and administrators. Presentations focused on the latest advances in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck.
In one study, Patrick J. Antonelli, M.D., of the University of Florida in Gainesville, and colleagues found that ciprofloxacin impaired tympanic membrane healing more than ofloxacin, which can be aggravated by steroids.
"Our study confirms earlier findings from both tissue culture and epidemiological studies that quinolone antibiotics impair tympanic membrane healing, which increases the risk of permanent tympanic membrane perforations. Importantly, this effect differs by the specific quinolone, it is not a class effect. Furthermore, this effect may be aggravated by the addition of a steroid, which is commonly done to promote resolution of inflammation," Antonelli said. "Clinicians need to consider the potential impact of quinolone ear drops when prescribing these agents. In cases where ofloxacin and ciprofloxacin are considered equivalent and a steroid is not needed, ofloxacin holds less risk for long-term tympanic membrane perforation. In cases involving granulation tissue, ciprofloxacin with a steroid may be preferred."
In another study, Daniel R. Clayburgh, M.D., Ph.D., of the Oregon Health & Science University in Portland, and colleagues found that the addition of adjuvant radiation after surgery for oropharynx cancer improved survival; however, this observation does not appear to hold true for human papillomavirus (HPV)-related oropharynx cancer.
"This was a review of data contained in the national cancer database, focusing on patients with oropharynx cancer who underwent surgery and were found to have a single cervical lymph node metastasis," Clayburgh said.
According to Clayburgh, current guidelines recommend either adjuvant radiation therapy or observation, or adjuvant chemoradiation if there are high-risk features.
"When all oropharyngeal cancers are considered together, our data confirm that patients with high-risk features have the best long-term survival if they receive adjuvant chemoradiation. In patients without high-risk features, there appears to be a clear survival benefit for patients treated with adjuvant radiation rather than observation. This is supported by one or two other recent studies examining other large datasets," Clayburgh said. "Our dataset allowed us to extract a subset of patients with known HPV-associated cancers. In these patients, there was no benefit to adjuvant radiation or chemoradiation over observation after surgery."
Adrienne M. Laury, M.D., of the San Antonio Uniformed Services Health Education Consortium in Ft. Sam Houston, Texas, and colleagues found that balloon dilation of sinus ostia and nasal dilation (placebo arm) provided significant and equivalent improvement in sinus and headache symptoms.
"Balloon dilation of sinus ostia and nasal dilation (placebo arm) both provided significant and equivalent improvement in sinonasal symptom scores and headache symptom scores at six months after the intervention," Laury said. "Both balloon dilation of sinus ostia and nasal dilation provided similar decreases in medication utilization over the six-month follow-up."
The investigators found that both Acclarent and Entellus balloon devices provided significant and equivalent improvement in sinonasal symptom scores and headache symptom scores at six months.
"Further study is required looking at the utilization of the balloon dilation device for sinus pressure headache," Laury added. "Based on this small study, balloon dilation of sinus ostia is not currently recommended for the treatment of 'sinus'/barometric pressure headaches. Further studies should include a longer follow-up as well as larger sample size."
AAO-HNSF: Improvement in OSA With Cranial Nerve Stimulation
MONDAY, Sept. 11, 2017 -- For patients with moderate or severe obstructive sleep apnea, cranial nerve XII stimulation is associated with significant clinical improvements at one and five years, according to a study presented at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery, held from Sept. 10 to 13 in Chicago.
AAO-HNSF: New Consensus on Balloon Dilation of Sinuses
THURSDAY, Sept. 14, 2017 -- A clinical consensus statement on balloon dilation of the sinuses has been approved by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Board of Directors and presented at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery, held from Sept. 10 to 13 in Chicago.
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Posted: September 2017