2011 AAO-HNSF new oral research daily highlights

(Press-News.org) San Francisco, CA – The 2011 Annual Meeting & OTO EXPO of the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF), the largest meeting of ear, nose, and throat doctors in the world, will convene September 11-14, 2011, in San Francisco, CA.

Featuring more than 386 scientific research sessions, 468 posters, and several hundred instruction course hours for attendees, the annual meeting is a unique opportunity for journalists from around the world to cover breaking science and medical news. Reporters will have access to the latest research and clinical advances in the field of otolaryngology – head and neck surgery.

Information for the Media The AAO-HNSF Annual Meeting & OTO EXPO Newsroom will be located in the Moscone Convention Center, Room 250. Hours of operation: Saturday, September 10, 12pm to 5pm; Sunday – Tuesday, September 11 – 13, 7:30 am to 5 pm; and Wednesday, September 14, 8:00 am – 2:00 pm. There will also be a Meet & Greet for all press with Richard Rosenfeld, MD, MPH, Editor-in-Chief of Otolaryngology-Head and Neck Surgery, on Sunday, September 11, 2011, from 12:30pm – 1:15pm in the newsroom.

The newsroom serves as a work space for credentialed members of the news media. The newsroom is managed and staffed by the AAO-HNS Communications Unit. Please see the AAO-HNS website for media credentialing requirements for the event.

To register and view advance press releases, log on to the AAO-HNS website at http://tinyurl.com/657a292.

Facial Plastic and Reconstructive Surgery

Anthropometric Study of the Caucasian Nose in the City of Curitiba: Importance of Population Assessment
Presenters: Annelyse C. Ballin (presenter); Bettina Carvalho; Cezar A. Sarraff-Berger; Marcos Mocellin; Renata V. Becker
Date/Time: Tuesday, September 13, 2011; 10:10am

San Francisco, CA – In a presentation at the 2011 Annual Meeting & OTO EXPO in San Francisco, the aesthetic parameters of Caucasian noses of Curitiba, Brazil, were compared with the standard aesthetic ideals from the literature.

Caucasian noses of Curitiba are shorter, with a wider base, and less projected than the aesthetic ideal, showing possible miscegenation of the population and the importance of population studies for evaluation, preoperative counseling, and surgical planning.

General Otolaryngology

Epidemiology and Burden of Recurrent Acute Rhinosinusitis
Presenters: Neil Bhattacharyya, MD (presenter); Jeff Grebner; Noel G. Martinson
Date/Time: Monday, September 12, 2011; 9:30am

San Francisco, CA – Recurrent acute rhinosinusitis (RARS) may affect approximately 1 in 3,000 adults. Despite significant health care costs over $1,000/year per individual patient with RARS, nasal endoscopy and computed tomography are not commonly obtained early after potential diagnosis.

Medical claims data (2003-2008) from a large payer database were analyzed, and adult patients with RARS (defined as at least 4 acute rhinosinusitis [ARS] claims each with a filled oral antibiotic prescription in a 12-month period) were extracted. Diagnostic procedures, surgery rates, and medical costs were determined. The study concluded that RARS is likely an underdiagnosed condition warranting further study.

How Good Is Google? The Quality of Otolaryngology Information on the Internet
Presenters: Max Daniel Pusz, MD (presenter); Scott E. Brietzke, MD, MPH
Date/Time: Tuesday, September 13, 2011; 10:02am

San Francisco, CA – Despite any cautionary warnings from medical providers, searching internet websites is likely to be a patient's (or parent's) first step in obtaining timely information on the treatment of common otolaryngology problems. The quality of the information a patient (parent) may encounter using a Google search for a typical otolaryngology ailment was critically examined.

There is marked variability in the quality of website information for the treatment of common otolaryngologic problems. Searches on more chronic problems resulted in a higher proportion of biased advertisement websites. Larger, comprehensive websites generally provided better information, but were less than perfect in presenting complete information on treatment options.

Mortality after Tracheostomy at a Tertiary Care Hospital
Presenters: Eben L. Rosenthal, MD (presenter); Alexandra E. Kejner, MD; Paul Castellanos, MD
Date/Time: Wednesday, September 14, 2011; 9:04am

San Francisco, CA – Hospitals are increasingly being evaluated for postoperative mortality, which includes intensive care patients who succumb to their medical disease after routine tracheostomy.

High rates of mortality after tracheostomy negatively impact hospital postoperative mortality and hospital ratings. Although there were no surgical deaths, only 57% of tracheostomy patients survived to discharge, illustrating the significant disease burden in this patient population and the need to stratify postoperative mortality.

Using the iPhone for Voice Recordings in Laryngology
Presenters: Jeremy Hornibrook, FRACS (presenter); Emily Lin; Tika Ormond
Date/Time: Wednesday, September 14, 2011; 9:38am

San Francisco, CA – In a presentation at the 2011 AAO-HNSF Annual Meeting & OTO EXPO in San Francisco, CA, researchers evaluated the adequacy of an iPhone for voice recording enabling acoustic measurement of voice quality and demonstrated the usefulness of an iPhone-based acoustic analysis for identifying voice aberration and monitoring voice changes after phonosurgery.

Research results showed relatively high measure-remeasure and acceptable between-system reliabilities for a selection of acoustic measures.

Head and Neck Surgery

Contemporary Morbidity and Mortality in Head and Neck Surgery
Presenters: Harrison W. Lin, MD (presenter); Neil Bhattacharyya, MD
Date/Time: Tuesday, September 13, 2011; 8:56am

San Francisco, CA – Complication rates for inpatient head and neck surgery (HNS) procedures have declined in the past decade, although complications are still associated with longer length of stay (LOS). The presence of a postoperative complication is no longer significantly associated with increased mortality. Enhancements in perioperative medical management of HNS inpatients are likely responsible for these improved results.

In the study, a database specific for patients undergoing inpatient primary head and neck surgical procedures was extracted from the National Hospital Data Survey (2005-2007). The frequency of perioperative complications, mortality, and LOS were quantified. The influence of these medical complications on mortality and LOS were determined with multivariate statistics.

Crawling Wave Sonoelastography of Benign and Malignant Thyroid Nodules
Presenters: Jonathan M. Walsh, MD (presenter); Bradley Mills; Deborah Rubens; Kevin Parker; Liwei An; Matthew Miller, MD; Hah Z, PhD
Date/Time: Sunday, September 11, 2011; 10:38am

San Francisco, CA – In a paper presented at the 2011 AAO-HNSF Annual Meeting & OTO EXPO in San Francisco, researchers discussed the Crawling Wave (CrW) Elastography, a novel sonoelastography technique, which can be utilized to provide quantitative measurements of thyroid tissue shear velocity (a measure of tissue stiffness) and distinguish between benign and malignant thyroid nodules.

The results of the study concluded crawling wave sonoelastography can provide quantitative estimations of shear velocity (SV) depicting the elastic properties of thyroid nodules. The SV with contrast to noise ratios can differentiate between benign thyroid nodules and papillary thyroid carcinoma.

Differences in Head and Neck Cancer Risk Perception between Smoking and Nonsmoking NASCAR Attendees
Presenters: Laura White, RN (presenter); Anthony Chin Quee; Carla Berg; Justin Wise; Edie Hapner, PhD
Date/Time: Monday, September 12, 2011; 8:16am

San Francisco, CA – There is a lack of knowledge regarding the risk of head and neck cancer. Studies have demonstrated a difference in cancer risk perception between smokers and nonsmokers.

Overall, the study findings indicated differences in perception of risk between smokers and non-smokers. Gaining a better understanding of the psychosocial factors related to perceived risk of head and neck cancer, otolaryngologists may better tailor interventions aimed at increasing awareness within the clinic setting.

HPV and Head and Neck Cancer in Canada: Trends 1992 to 2008
Presenters: Martin Corsten, MD, FRCSC (presenter); Ryan Rourke; Stephanie Elin Johnson; Ted McDonald
Date/Time: Monday, September 12, 2011; 9:04am

San Francisco, CA – The prevalence of HPV-related head and neck cancers in Canada is increasing, while the prevalence of non-HPV-related head and neck cancers is decreasing. This has been accompanied by a decrease in both age at diagnosis and mortality in HPV related head and neck cancers.

Head and Neck cancers were put into three groups: (High (HHPV), ie, oropharynx; Moderate (MHPV), ie, oral cavity; and Low (LHPV), ie, larynx. The study found that HHPV cancers increased in incidence at an average annual rate (AAR) of 1.02% (P = .010); MHPV and LHPV cancers decreased at an AAR of 2.38% (P = .000) and 3.67% (P = .000) respectively. The median age at diagnosis for HHPV cancers decreased by an average of 0.23 years per year.

HPV+ Oral Cancer Patients Do Not Have Better QOL Trajectory
Presenters: Arun Sharma, MD (presenter); David Doody; Eduardo Mendez, MD; John Houck, MD; Pawadee Lohavanichbutr, MD; Neal D. Futran, MD, DMD; Bevan Yueh, MD, MPH
Date/Time: Monday, September 12, 2011; 8:40am

San Francisco, CA – In a paper presented at the 2011 AAO-HNSF Annual Meeting & OTO EXPO in San Francisco, researchers determined the role of human papillomavirus (HPV) status on quality of life (QOL) in patients with oral cavity and oropharyngeal squamous cell carcinoma (OSCC).

Results show re-treatment QOL was higher in patients with high risk HPV tumors compared with patients with HPV negative or low risk HPV (HPV-11, 32, 53, 66) tumors (P = .004). This association remained in multivariate analysis. Patients with high risk HPV tumors had larger decreases in QOL from pre-treatment to immediate post-treatment compared with patients with HPV negative or low risk HPV tumors (P = .032).

Survival Based on Smoking Status in Head and Neck Cancer
Presenters: Kevin S. Emerick, MD (presenter); Bradford Diephuis; James Michaelson; Paul Busse; Sebastian Jara; Daniel G. Deschler, MD; John Clark, MD
Date/Time: Wednesday, September 14, 2011; 11:26am

San Francisco, CA – While a significant focus in head and neck cancer has been on human papillomavirus (HPV) and tumor biomarkers, it is important to recognize smoking as an important factor in survival outcome for head and neck cancer. Both nonsmokers and previous smokers have a survival advantage over current smokers.

Study results show significant overall and disease-specific survival differences were observed between current, previous, and nonsmokers. Current smokers had a lower survival in all subsites except for oral cavity. The biggest differences were observed in the oropharynx subsite. 5-year disease-specific survival for oropharyngeal cancer was: current smokers 57.0%, nonsmokers 86.9%, and previous smokers 81.8%. Similar overall survival differences were observed. Smoking status did not impact on overall or disease-specific survival in oral cavity cancer.

Laryngology/Broncho-Esophagology

The Effect of Singing on Laryngopharyngeal Reflux
Presenters: Daniel Steven Fink, MD (presenter); Sugam Bhatnagar; Phillip Song, MD; Glenn Bunting, MS
Date/Time: Sunday, September 11, 2011; 11:18am

San Francisco, CA – While there has been widespread conjecture regarding the role of laryngopharyngeal reflux in singing, there remain no objective data demonstrating that voice use causes increased reflux.

While singers may have increased reflux complaints, the study's data suggest that the singing itself does not cause an increase in acid exposure to the laryngopharynx.

Otology/Neurotology

Can Computerized Tests Serve as an Objective Measure and Improve Cognitive Abilities in Tinnitus?
Presenters: Dorina Kallogjeri (presenter); Nikta Katta; Andre Wineland, MD; Jay F. Piccirillo, MD
Date/Time: Wednesday, September 14, 2011; 8:56am

San Francisco, CA – Tinnitus affects millions of people on a daily basis; research data presented at the 2011 AAO-HNSF Annual Meeting & OTO EXPO in San Francisco, suggest that the Brain Fitness Program can be a potential aid to patients with severe tinnitus, as it seems to improve attention, memory, and ability to comprehend.

Study results suggest that BST could serve as the first objective measure of the cognitive impairment associated with tinnitus. These data also suggest that Brain Fitness Program can be a potential aid to patients with severe tinnitus.

Customized Web-Based Sound/Music Therapy for Tinnitus
Presenters: Hamid R. Djalilian, MD (presenter); Kasra Ziai; John McGuire, MD
Date/Time: Wednesday, September 14, 2011; 9:04am

San Francisco, CA – Customized sound therapy can be delivered via the internet. Harmonic sound therapy is effective in reducing the loudness and annoyance of tinnitus in a diverse group of subjects.

Thirty-two subjects were enrolled. The patients matched their tinnitus frequency using a Web-based protocol. A customized harmonic sound therapy file was downloaded by the patient onto an MP3 player. The subjects listened to the sound file for 1 hour using open-ear headphones at a level equal to tinnitus loudness (mixing-point).

Is There a "Biological Gear" in the Human Middle Ear?
Presenters: Sunil Puria, PhD (presenter); Charles Steele; Hongxue Cai; Ryan Jackson
Date/Time: Monday, September 12, 2011; 11:02am

San Francisco, CA – Study authors presented new research at the 2011 AAO-HNSF Annual Meeting & OTO EXPO in San Francisco, CA, that suggests a new "twisting" gear-like motion is necessary for efficient high-frequency sound transmission in larger mammals, due to higher moments of inertia for hinge-like motion in these species.

A mammal's ability to hear high-frequency sound is due to unique structures such as 3 distinct middle-ear (ME) ossicles. In larger mammals such as humans, the ME features a cylindrical malleus cross section, differing eardrum areas on each side of the malleus handle, and a mobile saddle-shaped malleus-incus joint (MIJ). These features favor the existence of the twisting motion of the malleus-incus complex in addition to the classical hinge-like motion.

The Efficacy of Ear Canal Irrigations with Isopropyl Alcohol
Presenters: Herbert Silverstein, MD, FESC (presenter); Mark J. Van Ess, DO; Benjamin Wycherly, MD; Yadiel A. Alameda, MD
Date/Time: Tuesday, September 13, 2011; 10:46am

San Francisco, CA – Weekly irrigation with 70% isopropyl alcohol (IPA) is safe and reduces the accumulation of cerumen in the external auditory canal. Routine use of IPA may decrease the number of patient visits for cerumen related issues.

Forty ears were randomly divided into 2 groups. Group 1 instilled IPA weekly for 2 months, followed by 2 months of no cleaning. Group 2 did the opposite. Cerumen occlusion graded 0 to 4 (0%, 25%, 50%, 75%, 100%) followed by cerumenectomy at 0, 2, and 4 months.

Study results revealed the mean grade at the initial evaluation in Group 1 was 3.1 (range, 2-4) and in Group 2 was 3.3 (range, 3-4) (P = .33). After the first 2 months, there was a significant difference between those who used the IPA (Group 1) vs. those who did not (Group 2) (P < .0002). There was also a significant difference within both groups between using the IPA for 2 months and not cleaning for 2 months (P < .02 Group 1, P < .01 Group 2). All subjects tolerated IPA with no complaints or side effects, and there were no cases of canal irritation.

Pediatric Otolaryngology

A Retrospective Review of Ventilation Tube Removal in Children
Presenters: Faisal Ahmed Arshad (presenter); Showkat Mirza, FRCS; Chee-Yean Eng, MD
Date/Time: Tuesday, September 13, 2011; 8:32am

San Francisco, CA – Ventilation tube insertion is the primary surgical intervention in persistent otitis media with effusion. Around 7% of ventilation tubes require elective removal. The objective of the study was to discover the tympanic membrane healing rate after ventilation tube removal and identify measures that will improve the healing rate.

A total of 113 cases were included in the study. The average age at grommet insertion and removal was 5.8 years old and 8.3 years old, respectively. After ventilation tube removal the perforation edges were freshened in all cases. The majority of patients (84.1%) subsequently had an intact tympanic membrane. Additional procedures were performed on 19 ears, 6 with insertion of overlay absorbable material and 14 with a fat plug. Closure rate in these patients was 100%. The results showed Shah and Sheperd grommets had a significantly lower residual tympanic membrane perforation rate compared to T-Tube and Titanium grommets.

Food Hypersensitivity and Ear, Nose, and Throat Pathology in Children Less than 2 Years of Age
Presenters: Angela Cogburn Paddack (presenter); Chandra Smith; Gresham T. Richter, MD; Troy Gibbons, MD
Day/Time: Tuesday, September 13, 2011; 10:38am

San Francisco, CA – In a presentation at the 2011 AA0-HNSF Annual Meeting & OTO Expo in San Francisco, study authors explored the relationship between food hypersensitivity associated with cow's milk protein allergy (CMPA) and common gastrointestinal and upper aerodigestive disorders found in children less than two years of age.

Of 191 children reviewed with CMPA, 141 demonstrated upper gastrointestinal (GI) complaints. Twenty-five (18%) of these children had otolaryngologic (ENT) conditions refractory to standard therapy with the majority being chronic otitis media (70%) and oropharyngeal dysphagia (80%). In contrast, only 2% of patients in a GI control group demonstrated ENT disease. Dairy elimination improved GI symptoms in 92 patients, and ENT disease improved in 60%. ENT conditions improved in the control group via standard therapy.

The study suggests a relationship between CMPA and ENT concerns in children less than 2 years old, whereby food hypersensitivity can be associated with recalcitrant otits media and oropharyngeal dysphagia. Elimination diets can improve both GI and ENT conditions refractory to GERD therapy in patients with CMPA.

Long-Term Quality of Life Outcomes in Children Undergoing Adenotonsillectomy for Obstructive Sleep Apnea
Presenters: Premjit Singh Randhawa (presenter); Geoffrey Chilvers; Raul Cetto; Antony A. P. Narula, MA, FRCS
Day/Time: Monday, September 12, 2011; 8:56am

San Francisco, CA – The objective of the study was to assess a cohort of patients who underwent adenotonsillectomy for obstructive sleep apnea 4 years post-surgery for continued and long-term improvement in quality of life using the Child Health Questionnaire Physical Function, version 28. The children were compared to a healthy group of children in the United Kingdom.

Quality of life data is an important measure when deciding on a particular intervention. In the short term, quality of life measures have been shown to improve over a number of years. This study demonstrated that the benefits of surgery are still persistent, and children continue to improve in the long term.

Socioeconomic Factors in Pediatric Neck Abscesses
Presenters: Romaine F. Johnson, MD, MPH (presenter); Zi Yang Jiang, MD
Day/Time: Tuesday, September 13, 2011; 11:18am

San Francisco, CA – Socioeconomic status has been associated with increased risk of developing some infectious diseases. Researchers studied the relationship of socioeconomic status in children with neck abscesses to see if potentially a similar relationship exists.

The authors studied a population of children with neck abscesses at a tertiary care pediatric hospital in Dallas, Texas. The patients' demographic, clinical, and economic data were analyzed to see if socioeconomic status was different when compared to Texas and US averages. Controls for population and hospital averages were instituted.

The results showed 200 children with cervical neck abscesses were analyzed. The median household income of the cohort was calculated to be less than US and Texas averages based on US census data. Forty-eight percent were enrolled in Medicaid at the time of presentation. Twenty-one percent were uninsured or self-payers.

The study concluded children with neck abscesses in this cohort tended to live in areas with lower household incomes. The payer mix was different when compared with the US and Texas but not the study hospital. Insurance status did differ in initial medical care choice (PCP vs. ER) but not overall outcomes.

Treatment of Pediatric Obstructive Sleep Apnea beyond Tonsillectomy and Adenoidectomy
Presenters: Michael Friedman, MD (presenter); Alex Maley; David Taylor; Kanwar Kelley; Kristine Pearson-Chauhan; Colleen Hoehne
Date/Time: Monday, September 12, 2011; 8:00am

San Francisco, CA – In a presentation at the 2011 AAO-HNSF Annual Meeting & OTO EXPO in San Francisco, study authors compared the efficacy of adenotonsillectomy with pharyngoplasty vs. adenotonsillectomy alone in the treatment of pediatric OSAHS and the morbidity of adenotonsillectomy with pharyngoplasty vs. adenotonsillectomy alone.

Randomized single-blind controlled study of 60 pediatric patients who were treated from January 2009 to January 2010 at a tertiary care center. Patients were randomized into 2 groups: adenotonsillectomy alone (group I) and adenotonsillectomy with pharyngoplasty (group II). Endpoints included: pre- and postsurgical AHI, number of cures, pain levels, and change in OSA-18.

Study authors concluded with short-term follow-up, the addition of pillar closure to traditional adenotonsillectomy did not significantly improve sleep parameters as measured by polysomnogram or quality of life as measured using the OSA-18. It is unknown if pharyngoplasty will have long-term benefits in preventing progression of OSA.

Rhinology/Allergy

CFTR Modulation by the Tobacco Smoke Toxin Acrolein
Presenters: Nathan S. Alexander, MD (presenter); Daniel Skinner; Eric Sorscher; Shaoyan Zhang; Bradford A. Woodworth, MD
Date/Time: Monday, September 12, 2011; 8:48am

San Francisco, CA – Decreased mucociliary (MCC) is a major contributing feature to chronic rhinosinusitis. The present study demonstrated that acrolein has complex but direct interactions with CFTR. Robust inhibition of Cl-transport at higher concentrations indicates the potential contribution of this toxin to decreased MCC in individuals with chronic tobacco smoke exposure.

Do Nasal Muscles Really Work during Nasal Breathing?
Presenters: Silvio Bettega, MD (presenter); Marcelo Bettega
Date/Time: Wednesday, September 14, 2011; 11:18am

San Francisco, CA – The decrease in electromyographic activities of nasal muscles after removal of an obstructive factor as septum deviation, correlates with the hypothesis that nasal muscles are important during nasal breathing.

Forty-five patients were divided into 2 groups: Group A (n = 16), with no septum deviation and no nasal obstruction; Group B (n = 29), with both. Electromyographic (EMG) activities of nasal muscles were evaluated. Group A was the control, and Group B underwent surgery. Patients were evaluated before and after surgery.

Results show no abnormal finding was found in any of the nasal muscles of the control group. There was less EMG activity during normal breathing compared with forced breathing in both groups. In group B, there was a decrease in EMG activity 30 days after surgery (33.17% on normal breathing and 49.04% on forced breathing) as well as 90 days after surgery (27.21% on normal breathing and 36.14% on forced breathing).

Effects of Anatomy and Particle Size on Nasal Sprays
Presenters: Dennis Frank, PhD (presenter); Sachin Pawar, MD; John S. Rhee, MD, MPH; Julia S. Kimbell, PhD
Date/Time: Tuesday, September 13, 2011; 8:00am

San Francisco, CA – In the presence of a septal deviation, sprays containing 10 um particles may have better penetration past the nasal valve (NV). Additionally, increasing spray speed (above 3m/s) appears to limit spray penetration, suggesting that patients should be discouraged from spraying medications forcefully, as this could limit penetration of the drug.

Symptoms and Signs from the Nose and Sinuses in Asthmatics
Presenters: Wenche Moe Thorstensen (presenter); Nils P. W. Fossland; Malcom Sue-Chu, MBChB, PhD; Vegard Bugten, MD; Sverre K. Steinsvaag, MD, PhD
Date/Time: Wednesday, September 14, 2011; 10:54am

San Francisco, CA – The United Airways Disease hypothesis suggests a link between upper and lower airways in asthmatics. However, there is a need to know more about nose and sinus related quality of life, sinonasal symptoms, and objective nasal air flow in asthmatics compared with healthy individuals.

Study results show asthmatics (male/female 41/59; mean age, 44.1 years; range, 19-64 years) reported significantly more symptoms of nasal obstruction [mean VAS 38mm (SD 26) vs 9 mm (SD 12), P < .001] than controls (male/female 43/53; mean age, 41 years; range, 20-65 years). PNIF was significantly lower in asthmatics than controls [mean PNIF 85 l/min (SD 24) vs 102 l/min (SD 19), P < .001].

This study provides further evidence of the clinical importance of the upper airway in the diagnostic and therapeutic management of asthmatic patients.

Sleep Medicine

Analysis of the Correlation between Sleep Hygiene and Clinical Symptoms in Obstructive Sleep Apnea Patients
Presenters: Joonseok Lee (presenter); Kunhee Lee; Seungyoup Shin; Sungwan Kim; Su Young Jung
Date/Time: Wednesday, September 14, 2011; 10:30am

San Francisco, CA – If patients who complain of sleep apnea symptoms were to control side effects, it could be possible to hope for an improvement in daytime symptoms; patients would see an increase in sleep quantity and satisfaction.

The objective of the study was to conduct a survey on obstructive sleep apnea patients. This study tried to analyze the relationship between the various subjects relating to sleep hygiene and clinical symptoms.

A total of 197 patients completed the survey. The survey was composed of 4 categories; daytime symptoms, nighttime symptoms, the Epworth Sleepiness Scale, and sleep hygiene. The daytime and nighttime symptoms were graded by the 10 point Visual Analogue Scale, and sleep hygiene by the 3 Point scale, the higher points indicating severity.

The result of figuring out the correlation between the 9 categories of sleep hygiene and the 3 categories of the symptoms showed that in cases of inappropriate temperature and humidity, the 3 symptom categories were more severe (nighttime symptoms r = 0.565, daytime symptoms r = 0.379, ESS r = 0.318). Drinking before sleep (nighttime symptoms r = 0.647, daytime symptoms r = 0.455, ESS r = 0.297) and emotional excitement or arousal (nighttime symptoms r = 0.542, daytime symptoms r = 0.392, ESS r = 0.336) caused higher severity results in each symptom category.

Influence of Intranasal Corticosteroids on Sleep Parameters and Airway Inflammation
Presenters: François Lavigne (presenter); Basil J. Petrof; Normand Dubé; Philippe Lavigne; Qutayba Hamid, MD, PhD; Andrea Benedetti, PhD
Date/Time: Monday, September 12, 2011; 10:02am

San Francisco, CA – Fatigue is associated with obstructive sleep apnea (OSA). Increased inflammation in the pharyngeal tissues of OSA patients may further exacerbate the disease. This study evaluates the effects of intranasal corticosteroid (INCS) treatment on sleep parameters and airway inflammation in AR vs. non-AR OSA patients.

Results show there were no differences in age, sex, BMI, or apneahypopnea index (mean AHI = 28.4 vs 27.7/h) at baseline. After treatment, AR group showed significant improvements in: 1) supine AHI (55.85 vs 39.7/h), 2) oxygen saturation nadir (86.42 vs. 88.8%), and 3) Epworth scores. This improvement was associated with reduction of eosinophils (P < .0001), and to lesser extent CD4 positive cells (P < .05) in the tissue obtained from the 3 sites, CD68 decreased at the uvula. Allergic subjects had a higher nasal symptoms score before treatment, which was not statistically significant. There was no evidence that change over time differed by allergy status.

The study confirmed the implication of inflammation in sleep apnea and showed that controlling inflammation in the upper airways is very useful in improving clinical symptoms associated with this disease.

### About the AAO-HNS The American Academy of Otolaryngology – Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents more than 11,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization's vision: "Empowering otolaryngologist-head and neck surgeons to deliver the best patient care."