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To FESS or not to FESS: Decisions in pediatric sinusitis
P130
Otolaryngology Head and Neck Surgery May 1995
instruction Courses-- Tuesday
COURSE 3623-1 One-period course ($20)
Room NOCC-85 1:45-2:45
To FESS or Not to FESS: Decisions in Pediatric Sinusitis MARGARETA. KENNA,MD, RICHARD M. ROSENFELD,MD, MPH, and JAMES S. REILLY,MD Pittsburgh, Pa., Brooklyn, N.Y., and Wilmington, Del.
Educational objectives: To accurately diagnose pediatric sinus and associated medical conditions that may influence treatment outcome and to provide a decision tree in the choice of appropriate surgical candidates.
The course will detail an orderly approach to diagnosis and both surgical and medical management; in this way, the children who will benefit the most from surgical intervention will be properly identified. Special emphasis will be placed on the bacteriology of both acute and chronic sinus disease. The diagnostic evaluation will include physical examination, imaging studies, and workup for allergy, immotile cilia, immunologic abnormalities, and other systemic abnormalities that may be associated with sinusitis. Decision-making in the treatment of pediatric sinusitis will be outlined. The indications for surgery and which procedure to use will be discussed in depth. Much attention has been focused on the use of functional endoscopic sinus surgery (FESS) in children. However, the indications for FESS in this age group are not well defined. New evidence suggests that additional medical therapy, including intravenous antimicrobials or adenoidectomy, may be able to achieve outcomes similar to those of FESS. In addition, historically, many other surgical procedures have been advocated, including maxillary sinus aspiration or irrigation, all of which may be useful in certain situations. The importance of matching the right patient to the most effective treatment and procedure will be emphasized.
COURSE 3624-1 One-period course ($20)
therapeutic regimens involved in the management of patients with all types of apneas will be reviewed. The course will discuss both pediatric and adult apnea, with similarities and differences in these groups. Complications of untreated as well as treated apnea will be reviewed, as will surgical techniques. Finally, the potential pitfalls of both medical and surgical therapy will be presented. Specific pathologic conditions will be presented to illustrate examples of obstructive apnea. These cases will include nasal, oropharyngeal, hypopharyngeal, laryngeal, and tracheal abnormalities, as well as vascular lesions.
COURSE 3625-1 One-period course ($20)
Room NOCC-87 1:45-2:45
Positron Emission fomography in Head and Neck Oncology w. FREDERICKMcGUIRT, MD Winston-Salem and Forsyth, N.C.
Educational objectives: To understand the principles and technique of positron emission tomography (PET) scanning and to know when PET scans will be beneficial in the evaluation of patietns with head and neck cancer.
Positron emission tomography is a relatively new imaging modality that uses a glucose-labeled radioisotope that is preferentially taken up by tissues of high metabolic rate, such as neoplastic tissue. This modality has been used by the authors in an investigative fashion in more than 100 patients with head and neck neoplastic disease. This course will provide a summary update of the physics and physiology of positron emission tomography, discuss the general areas of applicability of the test in head and neck oncology, and present illustrative case studies with radiologic comparison to simultaneous CT or MRI scans of the same patients.
Room NOCC-86 1:45-2:45
Sleep Apnea--Current Concepts
COURSE 3626-2 Two-period course ($40)
CHARLES F. KOOPMANN, JR., MD Ann Arbor, Mich.
Clinical Applications of Electronystagmography
Educational objective: To improve the knowledge of evalu-
ALFREDC. COATS, MD Houston, Texas
ation o f apneic patients and nonsurgical and surgical therapeutic options for patients with sleep apnea.
In recent years there has been an increased interest in the evaluation of sleep apnea. This interest is based on an appreciation of the significance of the disorder and its possible sequelae. Also, the number and complexity of patients with symptoms of central, obstructive, and mixed sleep apnea have expanded. This course will present an overview of these types of apnea in order that the participants will be able to recognize and appreciate the possible confusion between types. The signs, symptoms, diagnostic modalities, and various
Room NOCC-88 1:45-4:00
Educational objectives: To understand the principles underlying the techniques and procedures of the ENG examination and the clinical interpretation of the ENG examination.
The electronystagmography (ENG) examination is a battery of vestibular and oculomotor tests, drawn from the neurologic and neurootologic examinations, in which eye movements are recorded electrooculographically. The main clinical application of ENG is its use in separating vestibular and oculomotor deficits of the central nervous system from deficits of the peripheral vestibular system. In addi-
Otolaryngology Head and Neck Surgery May 1995
instruction Courses-- Tuesday
COURSE 3623-1 One-period course ($20)
Room NOCC-85 1:45-2:45
To FESS or Not to FESS: Decisions in Pediatric Sinusitis MARGARETA. KENNA,MD, RICHARD M. ROSENFELD,MD, MPH, and JAMES S. REILLY,MD Pittsburgh, Pa., Brooklyn, N.Y., and Wilmington, Del.
Educational objectives: To accurately diagnose pediatric sinus and associated medical conditions that may influence treatment outcome and to provide a decision tree in the choice of appropriate surgical candidates.
The course will detail an orderly approach to diagnosis and both surgical and medical management; in this way, the children who will benefit the most from surgical intervention will be properly identified. Special emphasis will be placed on the bacteriology of both acute and chronic sinus disease. The diagnostic evaluation will include physical examination, imaging studies, and workup for allergy, immotile cilia, immunologic abnormalities, and other systemic abnormalities that may be associated with sinusitis. Decision-making in the treatment of pediatric sinusitis will be outlined. The indications for surgery and which procedure to use will be discussed in depth. Much attention has been focused on the use of functional endoscopic sinus surgery (FESS) in children. However, the indications for FESS in this age group are not well defined. New evidence suggests that additional medical therapy, including intravenous antimicrobials or adenoidectomy, may be able to achieve outcomes similar to those of FESS. In addition, historically, many other surgical procedures have been advocated, including maxillary sinus aspiration or irrigation, all of which may be useful in certain situations. The importance of matching the right patient to the most effective treatment and procedure will be emphasized.
COURSE 3624-1 One-period course ($20)
therapeutic regimens involved in the management of patients with all types of apneas will be reviewed. The course will discuss both pediatric and adult apnea, with similarities and differences in these groups. Complications of untreated as well as treated apnea will be reviewed, as will surgical techniques. Finally, the potential pitfalls of both medical and surgical therapy will be presented. Specific pathologic conditions will be presented to illustrate examples of obstructive apnea. These cases will include nasal, oropharyngeal, hypopharyngeal, laryngeal, and tracheal abnormalities, as well as vascular lesions.
COURSE 3625-1 One-period course ($20)
Room NOCC-87 1:45-2:45
Positron Emission fomography in Head and Neck Oncology w. FREDERICKMcGUIRT, MD Winston-Salem and Forsyth, N.C.
Educational objectives: To understand the principles and technique of positron emission tomography (PET) scanning and to know when PET scans will be beneficial in the evaluation of patietns with head and neck cancer.
Positron emission tomography is a relatively new imaging modality that uses a glucose-labeled radioisotope that is preferentially taken up by tissues of high metabolic rate, such as neoplastic tissue. This modality has been used by the authors in an investigative fashion in more than 100 patients with head and neck neoplastic disease. This course will provide a summary update of the physics and physiology of positron emission tomography, discuss the general areas of applicability of the test in head and neck oncology, and present illustrative case studies with radiologic comparison to simultaneous CT or MRI scans of the same patients.
Room NOCC-86 1:45-2:45
Sleep Apnea--Current Concepts
COURSE 3626-2 Two-period course ($40)
CHARLES F. KOOPMANN, JR., MD Ann Arbor, Mich.
Clinical Applications of Electronystagmography
Educational objective: To improve the knowledge of evalu-
ALFREDC. COATS, MD Houston, Texas
ation o f apneic patients and nonsurgical and surgical therapeutic options for patients with sleep apnea.
In recent years there has been an increased interest in the evaluation of sleep apnea. This interest is based on an appreciation of the significance of the disorder and its possible sequelae. Also, the number and complexity of patients with symptoms of central, obstructive, and mixed sleep apnea have expanded. This course will present an overview of these types of apnea in order that the participants will be able to recognize and appreciate the possible confusion between types. The signs, symptoms, diagnostic modalities, and various
Room NOCC-88 1:45-4:00
Educational objectives: To understand the principles underlying the techniques and procedures of the ENG examination and the clinical interpretation of the ENG examination.
The electronystagmography (ENG) examination is a battery of vestibular and oculomotor tests, drawn from the neurologic and neurootologic examinations, in which eye movements are recorded electrooculographically. The main clinical application of ENG is its use in separating vestibular and oculomotor deficits of the central nervous system from deficits of the peripheral vestibular system. In addi-