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Tissue eosinophilia in chronic sinusitis
Scientific Posters
complications and were free of all symptoms. The laser compleletly ablated the lingual tonsils removing the obstruction in the airway. P127 Temporal Mandibular Joint Reconstruction Using Vascularized Bone Graft with Alloderm Samir Khariwala, MD (presenter); James Chan, MD; Daniel Alam, MD
Cleveland OH; Cleveland Heights OH; Cleveland OH
Objectives: Vascularized free bone grafts have been used extensively for reconstruction of the mandible. When surgical resection includes the temporal mandibular joint, definitive management remains controversial. We describe a novel technique that involves the use of a fibula free flap with alloderm to reconstruct the lateral hemimandible and temporal mandibular joint capsule. Methods: Retrospective case series at an academic center. Patients undergoing composite resection of the lateral hemimandible including the condyle, or with disruption of the temporal mandibular joint were evaluated in this study. Results: There were 6 patients (5 male, 1 female) with a mean age of 53.7 years. Indications for surgery were carcinoma (n ⫽ 4) and osteoradionecrosis (n ⫽ 2). Mean follow-up was 12 months. All patients reported improved facial symmetry, decreased trismus, adequate jaw opening, and improved occlusion. The majority of patients demonstrated good postoperative speech and swallowing. All but one patient was able to chew and tolerate a normal diet. There were no flap failures, infections, or complications. Conclusion: The lateral hemimandible and temporal mandibular joint can be resected and successfully reconstructed using a fibula free flap with alloderm. Improved cosmesis, decreased trismus, adequate jaw opening, minimal jaw drift, and the ability to chew were achieved in the majority of patients treated in this manner. P128 Alternative Medication and Nutritional Supplement Use in the Otolaryngology Patient Vishvesh M Mehta, MD (presenter); Jessica W Lim, MD Staten Island NY; Brooklyn NY
Objectives: The use of nutritional supplements and herbal medications in the United States is becoming increasingly popular. Otolaryngology patients may not report nutritional supplement or alternative therapy use when asked during the medical history. However, its use may have adverse effects, such as interfering with prescribed medications or causing coagulation abnormalities. The objectives of this study are to make otolaryngologists aware of the potential effects of alternative therapies and nutritional supplements commonly used by patients.
Methods: Surveys were completed by otolaryngology patients in the clinic and private offices. This study was conducted at the University Hospital and its affiliates. Additional case examples were included and a literature review was performed. Results: Numerous nutritional, herbal, and alternative therapies were used. The treatments were usually not considered a “medication” by the patient. The products used were both for health maintenance and treatment of disease. Salicylate derivatives were one of the most common ingredients in nutritional supplement mixtures. Conclusion: Nutritional supplements and alternative therapies may not be elicited in the medical history or reported as medication by the patient. The otolaryngologist needs to be more aware of the use of alternative and complementary medicines to prevent adverse effects of treatment.
P129 Tissue Eosinophilia in Chronic Sinusitis Altan Yildirim, MD (presenter) Sivas Turkey
Objectives: To analyze histopathologically mucosal inflammation and tissue eosinophilia of the osteomeatal complex of the patients with chronic rhinosinusitis and to assess these findings in relation to CT scores. Methods: The mucosa of the osteomeatal complex of 31 consecutive patients obtained during endoscopic sinus surgery were stained by hematoxylin and eosin. Total inflammatory cells and eosinophils were quantified. The preoperative CT scans were scored by staging system of LundMacKay. Results: We have found a significant correlation between the tissue eosinophilia and the total inflammatory cells count of tissue (r ⫽ 0.36; P ⫽ 0.041). But there were no significant correlation either between the tissue eosinophilia and CT scores (r ⫽ 0.34; P ⫽ 0.058) or between the total inflammatory cells count of tissue and CT scores (r ⫽ 0.10; P ⫽ 0.564). Conclusion: Eosinophilic infiltration seems to be the denominator in chronic rhinosinusitis. But CT findings did not correlated with the extent of mucosal inflammation or with the eosinophilic infiltration.
P130 Tissue Model and Preliminary Analysis of Microdebriders Used in Endoscopic Sinus Surgery Sandeep Dave, MD (presenter); Roy R Casiano, MD Miami Beach FL; Miami FL
Objectives: In 1999, Ferguson reported the first and only quantitative analysis of microdebriders used in ESS. The purpose of our study was to establish a standardized in vitro
POSTERS
P282
Otolaryngology– Head and Neck Surgery August 2004
complications and were free of all symptoms. The laser compleletly ablated the lingual tonsils removing the obstruction in the airway. P127 Temporal Mandibular Joint Reconstruction Using Vascularized Bone Graft with Alloderm Samir Khariwala, MD (presenter); James Chan, MD; Daniel Alam, MD
Cleveland OH; Cleveland Heights OH; Cleveland OH
Objectives: Vascularized free bone grafts have been used extensively for reconstruction of the mandible. When surgical resection includes the temporal mandibular joint, definitive management remains controversial. We describe a novel technique that involves the use of a fibula free flap with alloderm to reconstruct the lateral hemimandible and temporal mandibular joint capsule. Methods: Retrospective case series at an academic center. Patients undergoing composite resection of the lateral hemimandible including the condyle, or with disruption of the temporal mandibular joint were evaluated in this study. Results: There were 6 patients (5 male, 1 female) with a mean age of 53.7 years. Indications for surgery were carcinoma (n ⫽ 4) and osteoradionecrosis (n ⫽ 2). Mean follow-up was 12 months. All patients reported improved facial symmetry, decreased trismus, adequate jaw opening, and improved occlusion. The majority of patients demonstrated good postoperative speech and swallowing. All but one patient was able to chew and tolerate a normal diet. There were no flap failures, infections, or complications. Conclusion: The lateral hemimandible and temporal mandibular joint can be resected and successfully reconstructed using a fibula free flap with alloderm. Improved cosmesis, decreased trismus, adequate jaw opening, minimal jaw drift, and the ability to chew were achieved in the majority of patients treated in this manner. P128 Alternative Medication and Nutritional Supplement Use in the Otolaryngology Patient Vishvesh M Mehta, MD (presenter); Jessica W Lim, MD Staten Island NY; Brooklyn NY
Objectives: The use of nutritional supplements and herbal medications in the United States is becoming increasingly popular. Otolaryngology patients may not report nutritional supplement or alternative therapy use when asked during the medical history. However, its use may have adverse effects, such as interfering with prescribed medications or causing coagulation abnormalities. The objectives of this study are to make otolaryngologists aware of the potential effects of alternative therapies and nutritional supplements commonly used by patients.
Methods: Surveys were completed by otolaryngology patients in the clinic and private offices. This study was conducted at the University Hospital and its affiliates. Additional case examples were included and a literature review was performed. Results: Numerous nutritional, herbal, and alternative therapies were used. The treatments were usually not considered a “medication” by the patient. The products used were both for health maintenance and treatment of disease. Salicylate derivatives were one of the most common ingredients in nutritional supplement mixtures. Conclusion: Nutritional supplements and alternative therapies may not be elicited in the medical history or reported as medication by the patient. The otolaryngologist needs to be more aware of the use of alternative and complementary medicines to prevent adverse effects of treatment.
P129 Tissue Eosinophilia in Chronic Sinusitis Altan Yildirim, MD (presenter) Sivas Turkey
Objectives: To analyze histopathologically mucosal inflammation and tissue eosinophilia of the osteomeatal complex of the patients with chronic rhinosinusitis and to assess these findings in relation to CT scores. Methods: The mucosa of the osteomeatal complex of 31 consecutive patients obtained during endoscopic sinus surgery were stained by hematoxylin and eosin. Total inflammatory cells and eosinophils were quantified. The preoperative CT scans were scored by staging system of LundMacKay. Results: We have found a significant correlation between the tissue eosinophilia and the total inflammatory cells count of tissue (r ⫽ 0.36; P ⫽ 0.041). But there were no significant correlation either between the tissue eosinophilia and CT scores (r ⫽ 0.34; P ⫽ 0.058) or between the total inflammatory cells count of tissue and CT scores (r ⫽ 0.10; P ⫽ 0.564). Conclusion: Eosinophilic infiltration seems to be the denominator in chronic rhinosinusitis. But CT findings did not correlated with the extent of mucosal inflammation or with the eosinophilic infiltration.
P130 Tissue Model and Preliminary Analysis of Microdebriders Used in Endoscopic Sinus Surgery Sandeep Dave, MD (presenter); Roy R Casiano, MD Miami Beach FL; Miami FL
Objectives: In 1999, Ferguson reported the first and only quantitative analysis of microdebriders used in ESS. The purpose of our study was to establish a standardized in vitro
POSTERS
P282
Otolaryngology– Head and Neck Surgery August 2004