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Inflammatory mechanisms in chronic rhinosinusitis
P32
Otolaryngology-Head and Neck Surgery, Vol 141, No 3S1, September 2009
crucial in this environment. This session explores the performance data you directly drive, in terms of safe practice, as well as equips you with the skills you need to understand the data behind potentially imposed metrics and payer contract models. You will walk away with a practical roadmap to put you in the driver seat for quality initiatives and quality based incentive systems. The ⬃2.5 hour program will begin with a riveting presentation from the Massachusetts Medical Society on their experience with tiering and the payer environment in their state and its impact on Otolaryngologists, moves into practical tips on creating/using metrics in your practice, and ends with presentations and discussion on operative disasters, specifically, operative fires and wrong side surgery (including presentation of the data from the overwhelming member response to the wrong-side / wrong-sinus surgery survey). EDUCATIONAL OBJECTIVES: 1) To learn the skills needed in quality-based incentive programs/contracts to keep your business sound. 2) To provide a template and foundation for responding to payers trying to institute inappropriate measures or grading systems. 3) To provide evidence-based skills or processes to reduce your risk of operating room disasters.
Inflammatory mechanisms in chronic rhinosinusitis Andrew Lane, MD; Noam Cohen, MD, PhD; Martin DesRosiers, MD; Thibaut Van Zele, MD, PhD (presenters) PROGRAM DESCRIPTION: In recent years, basic science research has significantly advanced our understanding of the underlying pathophysiology of chronic rhinosinusitis. Ongoing investigations are providing insight into the immune mechanisms that lead to state of persistent sinus inflammation. Newer concepts de-emphasize a causative role for specific infectious pathogens, instead implicating abnormalities in host sinonasal mucosal immune function. Dysregulation of protective innate and adaptive immune mechanisms in the sinonasal tract have the potential to create permissive conditions for microbial growth and generate chronic inflammatory responses to environmental stimuli. Modulation of such immune responses at the mucosal surface may provide new avenues for therapeutic intervention. This mini-seminar will review the latest research into the etiology of chronic rhinosinusitis. Presentations will describe the normal immune function of the sinonasal tract as well as alterations observed in chronic inflammatory disease. Topics will include mucociliary clearance, mucosal barrier function, epithelial innate immunity, the role of lymphocytes and other adaptive immune cells, and
genetic polymorphisms in chronic rhinosinusitis. The role of putative infectious agents, such as fungi, biofilms, and staphylococci, will be discussed in light of emerging theories about host-pathogen interactions at the mucosal surface. Future opportunities for translating basic science research findings into practical clinical applications will be presented. Finally, predictions will be offered as to emerging areas of research that will impact otolaryngologists’™ management of chronic rhinosinusitis in the future. EDUCATIONAL OBJECTIVES: 1) Review basic science advancements in the understanding of host inflammatory mechanisms underlying chronic rhinosinusitis. 2) Appreciate potential translational medical approaches for the treatment of chronic sinonasal inflammatory disease. 3) Understand active ongoing research with potential clinical impact in the next decade.
Issues in facial transplantation Daniel Alam, MD (moderator); Carmen Paradis, MD, MA PROGRAM DESCRIPTION: Our group at the Cleveland Clinic performed the first combined human face and maxilla transplant on a 46 year old patient who had suffered massive facial injuries from a gunshot wound to the midface. She had undergone 23 major reconstructive procedures by the Department of Plastic Surgery which resulted in suboptimal outcomes and was subsequently referred to a multidisciplinary face transplant team for evaluation for candidacy for allograft transplantation. After thorough evaluation, the patient was approved for this procedure through the institution’s established IRB protocol. We will discuss the ethical basis, the research foundations, and the technical components of this landmark procedure. The rationale and decision making process for patient selection will be described and anatmocial challenges and limitations of allograft transplantation will be examined. The findings from this particular case will be framed within the concept of facial transplantation as a whole. Specific emphasis will be placed on the ethical controversy surrounding this topic. Speakers will include Carmen Paradis MD, the chief ethicist for research innovation at the Cleveland Clinic, who was involved in the evaluation of this patient and the IRB approval process in this case, and Daniel Alam MD, the facial plastic surgeon who authored the specific operative protocol for this surgery and was the primary microvascular surgeon for the procedure. EDUCATIONAL OBJECTIVES: 1) Understand the ethical basis for face transplantation in appropriately selected patients. 2) Understand the technical and anatomical basis of allograft face transplantation and its limitations and scope
Words and degrees that may be missing from abstracts in this program are due to limitations in the submission process. Continuing improvements in that database are still in process, and a serious attempt has been made to correct missing content. For the latest information about the annual meeting, and to access the new Itinerary Planner for your visit, please go to: www.entnet.org/annual_meeting.
Otolaryngology-Head and Neck Surgery, Vol 141, No 3S1, September 2009
crucial in this environment. This session explores the performance data you directly drive, in terms of safe practice, as well as equips you with the skills you need to understand the data behind potentially imposed metrics and payer contract models. You will walk away with a practical roadmap to put you in the driver seat for quality initiatives and quality based incentive systems. The ⬃2.5 hour program will begin with a riveting presentation from the Massachusetts Medical Society on their experience with tiering and the payer environment in their state and its impact on Otolaryngologists, moves into practical tips on creating/using metrics in your practice, and ends with presentations and discussion on operative disasters, specifically, operative fires and wrong side surgery (including presentation of the data from the overwhelming member response to the wrong-side / wrong-sinus surgery survey). EDUCATIONAL OBJECTIVES: 1) To learn the skills needed in quality-based incentive programs/contracts to keep your business sound. 2) To provide a template and foundation for responding to payers trying to institute inappropriate measures or grading systems. 3) To provide evidence-based skills or processes to reduce your risk of operating room disasters.
Inflammatory mechanisms in chronic rhinosinusitis Andrew Lane, MD; Noam Cohen, MD, PhD; Martin DesRosiers, MD; Thibaut Van Zele, MD, PhD (presenters) PROGRAM DESCRIPTION: In recent years, basic science research has significantly advanced our understanding of the underlying pathophysiology of chronic rhinosinusitis. Ongoing investigations are providing insight into the immune mechanisms that lead to state of persistent sinus inflammation. Newer concepts de-emphasize a causative role for specific infectious pathogens, instead implicating abnormalities in host sinonasal mucosal immune function. Dysregulation of protective innate and adaptive immune mechanisms in the sinonasal tract have the potential to create permissive conditions for microbial growth and generate chronic inflammatory responses to environmental stimuli. Modulation of such immune responses at the mucosal surface may provide new avenues for therapeutic intervention. This mini-seminar will review the latest research into the etiology of chronic rhinosinusitis. Presentations will describe the normal immune function of the sinonasal tract as well as alterations observed in chronic inflammatory disease. Topics will include mucociliary clearance, mucosal barrier function, epithelial innate immunity, the role of lymphocytes and other adaptive immune cells, and
genetic polymorphisms in chronic rhinosinusitis. The role of putative infectious agents, such as fungi, biofilms, and staphylococci, will be discussed in light of emerging theories about host-pathogen interactions at the mucosal surface. Future opportunities for translating basic science research findings into practical clinical applications will be presented. Finally, predictions will be offered as to emerging areas of research that will impact otolaryngologists’™ management of chronic rhinosinusitis in the future. EDUCATIONAL OBJECTIVES: 1) Review basic science advancements in the understanding of host inflammatory mechanisms underlying chronic rhinosinusitis. 2) Appreciate potential translational medical approaches for the treatment of chronic sinonasal inflammatory disease. 3) Understand active ongoing research with potential clinical impact in the next decade.
Issues in facial transplantation Daniel Alam, MD (moderator); Carmen Paradis, MD, MA PROGRAM DESCRIPTION: Our group at the Cleveland Clinic performed the first combined human face and maxilla transplant on a 46 year old patient who had suffered massive facial injuries from a gunshot wound to the midface. She had undergone 23 major reconstructive procedures by the Department of Plastic Surgery which resulted in suboptimal outcomes and was subsequently referred to a multidisciplinary face transplant team for evaluation for candidacy for allograft transplantation. After thorough evaluation, the patient was approved for this procedure through the institution’s established IRB protocol. We will discuss the ethical basis, the research foundations, and the technical components of this landmark procedure. The rationale and decision making process for patient selection will be described and anatmocial challenges and limitations of allograft transplantation will be examined. The findings from this particular case will be framed within the concept of facial transplantation as a whole. Specific emphasis will be placed on the ethical controversy surrounding this topic. Speakers will include Carmen Paradis MD, the chief ethicist for research innovation at the Cleveland Clinic, who was involved in the evaluation of this patient and the IRB approval process in this case, and Daniel Alam MD, the facial plastic surgeon who authored the specific operative protocol for this surgery and was the primary microvascular surgeon for the procedure. EDUCATIONAL OBJECTIVES: 1) Understand the ethical basis for face transplantation in appropriately selected patients. 2) Understand the technical and anatomical basis of allograft face transplantation and its limitations and scope
Words and degrees that may be missing from abstracts in this program are due to limitations in the submission process. Continuing improvements in that database are still in process, and a serious attempt has been made to correct missing content. For the latest information about the annual meeting, and to access the new Itinerary Planner for your visit, please go to: www.entnet.org/annual_meeting.