Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 2nd International Conference and Exhibition on Rhinology and Otology Dubai, UAE.

Day 1 :

Keynote Forum

Aage R Moller

The University of Texas at Dallas
USA

Keynote: Severe tinnitus has similarities with chronic neuropathic pain

Time : 10:00-10:25

OMICS International Otolaryngology-2015 International Conference Keynote Speaker Aage R Moller photo
Biography:

Aage R Moller completed his Doctor of Medicine from the Karolinska Institute, Stockholm, Sweden, in 1965. He spent 12 years teaching neuroscience research at the same institution after which he immigrated to the USA and became Associate Professor of Otolaryngology at the University of Pittsburgh School of Medicine, later Professor of Neurosurgery at the same institution 1978-1998; 1998-present he is at The University of Texas at Dallas School of Behavioral and Brain Sciences as the Founders Professor and Distinguished Lecture of Cognition and Neuroscience. He is author of 205 articles in refereed journals, 16 single author professional books, co-editor of 9 books, most recently “Textbook of Tinnitus” by Springer 2010.

Abstract:

Tinnitus has many different forms and it seems unlikely that the same treatment will be effective for all different forms of tinnitus. Recent studies of tinnitus in humans and in animal models have reveled many similarities between severe tinnitus and chronic neuropathic pain. Activation of maladaptive neural plasticity plays an important role in creation and maintaining the symptoms in some forms of tinnitus and chronic neuropathic pain. Recent studies using electrical stimulation of the vagus nerve for reversing such “bad” plasticity have shown promising results in treatment of some forms of tinnitus. Transcranial magnetic stimulation (TMS) can activate specific parts of the brain and it has a beneficial effect on some forms of tinnitus, as has deep brain stimulation. Electrical stimulation of the skin behind the ears can reduce some forms of tinnitus. The phantom sound of tinnitus is often accompanied by conditions that affect sleep, the ability to do intellectual work and life in general. Some people experience fear of sounds. These conditions are best described as suffering and they often impair the quality of life to a greater extent than the tinnitus sound. The degree of suffering is not directly related to the strength of the tinnitus sound. New development in neuroscience have shown that strengthen or weakening of connections in the brain play important roles in some forms of tinnitus. These and other recent findings in neuroscience may become important in development of new and more effective treatments of tinnitus.

Keynote Forum

Kumaresh Krishnamoorthy

Dr Kumaresh ENT Clinic
India

Keynote: Head and Neck Surgery

Time : 10:25-10:50

OMICS International Otolaryngology-2015 International Conference Keynote Speaker Kumaresh Krishnamoorthy photo
Biography:

Kumaresh Krishnamoorthy after completing his residency in 1999 pursued advanced clinical fellowship training in the US in both -Head and Neck Surgery and Otology & Neurotology. He is one of the few in India to have a dual fellowship degree. He is an honorary faculty at Bangalore Medical College, India and he started the Cochlear Implant program which was the first in a tertiary teaching Government hospital in Karnataka. He instructs in hands-on workshops on head and neck and Otology courses. He has authored text book chapters and has contributed articles in peer reviewed journals. He is actively involved with cutting edge research in the areas of his specialization. Microbial Robotics (formerly Bacterial Robotics), a life science firm developing microscopic BactoBots™ recently appointed him, as its Director, Clinical Surgery – India, for its soon-to-be-formed medical device subsidiary.

Abstract:

Head and Neck surgery previously was in the domain of the general surgeons and now rightfully is slowly moving to the Otolaryngologists. Unlike the Western Nations, head and neck as a subspeciality is slowly getting recognised in our part of the world. Few National bodies have taken the initiatives in formulating guidelines and in training prospective specialists at various centres. The Otolaryngology 2015 is an opportunity for the young specialists to explore the current opportunities in the field of head and neck surgery. This forum will also help in understanding the current knowledge from the best experts in this field. Head and Neck comprises of vital structures within a critical narrow field and any small mistake is going to have fatal implications for the patient. Unlike yester years where disease removal/cancer free survival was the goal of any treatment the goal now is to achieve better cosmesis. Incisions are planned to achieve aesthetical recovery. Some of the surgeries frequently undertaken by the surgeon are: Thyroid, salivary gland surgeries, airway stenosis correction, carotid body tumours and cancers of the head and neck. In this key note address, the author will describe the various interesting head and neck surgeries undertaken by him.

Keynote Forum

Joep Tan

Sint Lucas Andreas Ziekenhuis
Netherlands

Keynote: Logistics and relevance of drug induced sleep endoscopy

Time : 10:50-11:15

OMICS International Otolaryngology-2015 International Conference Keynote Speaker Joep Tan photo
Biography:

Joep Tan is ENT surgeon and operational manager of the department of ENT at the Sint Lucas Andreas Hospital in Amsterdam, currently the largest in the Netherlands by volume of surgical and non-surgical treatment of obstructive sleep apneu syndrome. After an interruption is his medical study to complete a PhD in the basic sciences of neuroanatomy and neurophysiology at the Erasmus University Rotterdam he decided to continue the clinical part of his medical training, followed by ENT residency at the Academic Medical Centre of the University of Amsterdam, the Netherlands.Next to his clinical and managerial duties he is involved in optimising patient treatment logistics within various sleep clinics.

Abstract:

Obstructive sleep apnea(OSA) is characterised by collapse of the upper airway. The levels and direction of the collapse can be assessed with drug induced sleep endoscopy (DISE), a sedation technique requiring a balancing act between sleep depth and autonomous pulmonary ventilation. There is increasing evidence that endoscopic findings can predict the outcome of surgical and non surgical treatment of OSA. The presentation will address the current evidence on the diagnostic impact of drug induced sleep endoscopy on the treatment options of obstructive sleep apnea and the organisation of a safe and reliable workflow when confronted with an increasing number of patients.

Break: Coffee Break 11:15-11:30 @ Al Dhiyafah Pre Function Hall
  • Track 1- Anatomy and Physiology of Ear and Nose
    Track 2: Anatomical and Physiological Disorders of Nose
    Track 3- Rhinitis and Rhinosinusitis - Types and Treatment
    Track 4- Sinonasal Disorders and Surgical Treatment
    Track 5- Common Cold- Causes and Treatment Track
    6- Sinusitis- Types and Treatment
Location: Al Diyafah 1-3
Speaker

Chair

Bharat Bhushan

Northwestern Feinberg School of Medicine, USA

Speaker

Co-Chair

Mashudu Tshifularo

University of Pretoria, South Africa

Session Introduction

Nicola Luigi Bragazzi

University of Genoa
Italy

Title: Nano-otorhinolaringology: State of the art and future perspectives

Time : 11:30-11:50

Biography:

Nicola Luigi Bragazzi is currently a MD, MSc, PhD and a resident in Public Health. He got his MD (medical degree) on the 15th of July in 2011 cum laude with a thesis on Personalized Nanomedicine ("Nanomolecular aspects of medicine, at the cutting-edge of the nanobiosciences in the field of health-care") and the joint Italo-Russian MSc (Master of Science) in Nanobiotechnologies at Lomonosov Moscow State University (27th April 2012). He got his PhD in Nanochemistry and Nanobiotechnology at Marburg University, Germany and is currently a resident in Public Health at University of Genoa, Italy, 3rd year. He is author and/or co-author of several publications.

Abstract:

The main objective of this presentation is to offer a comprehensive, updated overview of nano-othorhinolaringology, addressing its main issues, the current solutions and the future perspectives. The introduction of nanobiotechnologies has revolutionized the field of internal medicine, enabling a personalized treatment of the disease instead of the conventional “one-size-fits-all” management. Both ear and nasal cavity have a highly compartmentalized anatomy, which makes drug delivery particularly challenging. Specifically, drug delivery may be limited from a poor absorption from the nose and the ear, which may be further complicated by the pathophysiological condition of the patient. Biotechnologies and genetic engineering as well as bioinformatics are giving encouraging results in the treatment and control of head and neck cancer, by elucidating the pathogenesis at a molecular level and enabling physicians to treat the patient at the nanoscale. Since the pioneering work of Ellis-Behnke and collaborators, who developed a nanobiotechnological-enabled solution to stop bleeding during surgery, which could be for example used in the treatment of epistaxis, nano-otorhinolaringology has much evolved. Novel nanosized drugs are thought to be ideal vehicles that could overcome the above-.mentioned limitations: Nano-objects, such as carbon nanotubes, nanogels, nanodisks, liposomes, polymersomes, lipidicnanocapsules, ethosomes and poly(lactic-co-glycolic acid) (PLGA) or chitosan nanoparticles could provide an efficient means for drug transfer in the ear and nose. These new-generation approaches may increase drug delivery efficiency, since these drugs are more stable and more effective. Moreover, in the ear and in the nose these vector systems are specifically uptaken into highly specialized cells, targeting cell-surface receptors and cell signaling pathways. New formulation of amphotericin B, such as polyene antibiotic amphotericin B (AMB), one of the first nanotherapeutic agents to be approved and commercially released, are showing promising results against chronic Rhinosinusitis. Nanoporous coatings of implants, such as cochlear implants, represent an important solution for topical delivery of drugs, in that they could alleviate post-surgical complications of a particularly invasive surgery, such as infections. Many variables, including formulation and the physiochemical parameters of the drugs, can be finely tuned, in terms of the amount and duration of drug release. Drug release profile could be indeed ad hoc optimized by exploiting mathematical modeling (for example, differential equations and artificial neural networks), or simulations (such as molecular dynamics). Last but not least, biosafety remains an issue to be addressed, since long-term safety of these vectors has not yet been investigated. For this reason, the nanotoxicology calls for continuous caution to monitor, control and prevent any adverse effect in the future.

Bharat Bhushan

Northwestern Feinberg School of Medicine
USA

Title: Metabolic alterations in children with Obstructive sleep apnea

Time : 11:50-12:10

Speaker
Biography:

Bharat Bhushan is currently working as a Research Assistant Professor, Department of Otolaryngology head and Neck Surgery, Northwestern University, Chicago & Postdoctoral Research Associate, Division of Otolaryngology, Department of Surgery, Ann & Robert H Lurie Children’s Hospital of Chicago. He has completed his PhD from Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. His thesis work was on the Genetic, Metabolic and Hormonal Profile in obese Asian Indians with Obstructive Sleep Apnea.

Abstract:

Background & Purpose: Obstructive sleep apnea (OSA) is associated with increased risk for metabolic syndrome in both adults and children. Obesity and metabolic syndrome are rapidly increasing in developed countries. Abnormalities of metabolic variables in severity dependent OSA in children has not been investigated to a significant extent.
Methods: Children evaluated in past two years for OSA were included in the study. Components of the metabolic syndrome; total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholesterol (LDL-c) and blood pressure were collected from subject’s medical records. Body mass index (BMI) was calculated using height and weight. OSA was classified as mild (1 Results: 55 Children were included (33 Male and 22 Female) with a mean age of 10.65±4.7 (Mean±SD) years. Seventeen subjects had mild OSA, 23 had moderate/severe OSA, and 15 had no OSA. The mean AHI for mild and moderate/severe OSA was 2.41±1.0 events/hr. and 18.5±17.8 events/hr. respectively. Total cholesterol was higher in moderate/severe OSA (165.8±40.5)mg/dl when compared with no OSA (143.6±32.3)mg/dl p=0.09. Triglyceride levels were significantly higher in moderate/severe OSA (122.1±62.4)mg/dl compared to no OSA (80.4±3.7)mg/dl p=0.03. Systolic blood pressure was significantly increased in moderate/severe OSA (122.2±26.3) when compared with no OSA (108.7±6.8) p=0.02. There was no significant difference in BMI, HDL-c, LDL-c and fasting blood glucose and diastolic blood pressure.
Conclusion: We found that OSA in children adversely affects several of the components associated with metabolic syndrome.

Mashudu Tshifularo

University of Pretoria
South Africa

Title: Complicated Sinusitis

Time : 12:10-12:30

Speaker
Biography:

Mashudu Tshifularo is among the best ENT specialists in the country well recognised by his peers as such. He is the first and only Black HOD and Professor in ENT in South Africa who has trained more South African Black local specialists ENT than all 8 Universities combined in ten year period. He is the first doctor to have a patented medical device (middle ear and stapes prosthesis registered with patent office) among all ENT specialists in South Africa. He has published more than 30 articles and is currently busy with his PhD studies with the University of Pretoria.

Abstract:

Objectives: An epidemiological review of complicated bacterial sinusitis among our patients.
Study Design: A prospective case series.
Setting: Tertiary referral center, ENT Dept. University of Pretoria.
Subjects: Eight nine (89) inpatients (65) males and (14) females admitted and treated in our hospital with complicated pan-sinusitis between April 2002 and August 2012.
Results: The mean age was 13 years, with a M:F ratio of 7:1. All patients presented with sporadic first episode of sinusitis occurring within 2 weeks of upper airway infection. The affected age group was mainly pediatric of peri-purbetal age. In almost all patients headache and facial (per orbital) swelling were the main presenting symptoms. 85% were initially referred to other departments; 59.3% (45) Ophthalmology, 18.6% (16) Neurosurgery, 6.7% (9) Pediatrics and only 15.2% (14) directly to ENT (Otorhinolaryngology). 46 (61%) of these patients had intra-cranial complications confirmed on Computed Tomography (CT) scan and were managed in consultation with the neurosurgeons and ophthalmologists. There were no major iatrogenic complications reported. Staphylococcus species were the most organisms isolated, 50% of the pus swab had a negative culture. Medical treatment based on culture and sensitivity together with surgical drainage as a multidiscipline approach achieved good outcome.
Conclusion: Complications of bacterial sinusitis is a common problem in the pediatric age group in this community, with males more affected than females. A high index of suspicion of complicated sinusitis in any adolescent with orbital, facial or frontal swelling associated with headache. A high resolution contrasted Computed Tomography (CT) scan is mandatory for exclusion of complicated sinusitis.

Speaker
Biography:

Casale Manuele has completed his PhD at the age of 33 years from Campus Bio-Medico University of Rome, Italy and a fellowship from University of Navarra, School of Medicine, Pamplona, Spain. He is the Assistant Professor of Otolaryngology Department of Campus Bio-Medico University of Rome. He has published more than 65 papers in reputed international journals and serving as an Editorial Board Member of repute.

Abstract:

This study was designed to prospectively evaluate the role of nebulized hyaluronic acid (HA) given for 10 days/mo over 3 months as adjunct treatment to minimize symptoms and preventing exacerbation of chronic rhinosinusitis (CRS). Thirty-nine eligible patients were randomized to receive nebulized 9-mg sodium hyaluronate nasal washes plus saline solution (21 patients) or 5 mL of saline alone (18 patients), according to an open-label, parallel-group design, with blind observer assessment. A questionnaire about main CRS discomfort and nasal endoscopy for mucous discharge and/or mucosal edema of nasal cavities was used to assess primary outcomes of treatments. Secondary outcome measures included side effects and satisfaction. HA significantly improved quality of life in CRS patients according to the CRS questionnaire (16±3.72 versus 11.52±4.28; p<0.001), contrary to saline group scores (18.92±3.09 versus 18.21±3.21; p<0.55). The HA group showed significantly reduced osteomeatal edema (2.42 versus 1.52; p<0.001) and secretions (0.95 versus 0.42; p<0.001), whereas there was no statistically significant difference in the saline group. The compliance to the treatment was similar in both groups and no side effects were recorded. The results of this study suggested that intermittent treatment with topical 9-mg sodium hyaluronate plays a role in minimizing symptoms and could prevent exacerbations of CRS.

Tareq M Al-Ayed

Faisal Specialist Hospital & Research Centre
Kingdom of Saudi Arabia

Title: Minimal exhaled nitric oxide production in the lower respiratory tract of healthy children aged 2-7 years

Time : 12:50-13:10

Speaker
Biography:

Tareq M Al-Ayed obtained his MBBS at King Saud University, Riyadh, in 1992. He did his Pediatric Residency training at King Faisal Specialist Hospital & Research Centre from 1993 to 1997. He then received the Diploma in Child Health from the Royal College of Physicians and Surgeons, Ireland in September 1996. He is certified in both Saudi Board of Pediatrics (February 1998) and American Board of Pediatrics (October 1998). He did his Pediatric Critical Care Medicine Fellowship training at Mcgill University, Canada from 1998 to 2001 and then he became a Consultant Pediatric Intensivist at King Faisal Specialist Hospital & Research Centre – Riyadh. He is also the Head of Saudi Pediatric Intensive Care Society.

Abstract:

Elevated Exhaled Nitric oxide (eNO) has been demonstrated in inflammatory airway conditions e.g. asthma. This study has measured eNO levels in normal preschool children for whom there is little data available and in whom the prevalence of asthma is high. Fifty children, 2-7 years old, undergoing elective surgery, excluding airway procedures, were recruited. Children with known respiratory disease or acute viral infections were excluded. Gas for eNO measurement was collected in a non- diffusion bag: 1) Via the mask after inhalation induction of anesthesia 2) Via endotreacheal tube (ETT) or laryngeal mask airway (LMA). 3) During emergence. Measurement was off-line by chemiluminescent analyzer. Mean eNO level by mask was 10.23 ppb (mean valueSD 8.8-11.1 ppb) after induction and 8.35 ppb (mean value  SD 5.9-10.8 ppb) on emergence. Mean eNO for the intubated group (n=25) was 0.75 ppb (mean valueSD 0.4-1 ppb) (p<0.0001 vs mask); mean eNO for LMA group (n=25) was 2.6 ppb (mean valueSD 2–3.2 ppb), which different from the mask (p<0.0001), and from ETT values (p<0.0001). Most eNO is produced by the upper airway in healthy pre-school children. The lower airway constitutive eNO production is very low. The LMA does not completely isolate the upper airway and current mask collection techniques allow significant contamination of samples by sino-nasal eNO production in young children.

Break: Lunch Break 13:10-13:50 @ Al- Tanour Restaurant

Giselle L Gotamco

University of Santo Tomas Hospital
Philippines

Title: A case of hybrid carcinoma of the nose

Time : 13:50-14:10

Speaker
Biography:

Giselle L Gotamco, MD, has completed her medical education at University of Santo Tomas. She spent her Post-graduate internship at the Chinese General Hospital and Medical Center. She is currently on her first year of residency training in Otorhinolaryngology Head and Neck Surgery at the University of Santo Tomas Hospital.

Abstract:

Hybrid neoplasm is a rare tumor composed of two different tumor entities, each with an exactly defined tumor category and arising from an identical origin within the same area, producing a single mass. It should be distinguished from tumors with more than one growth pattern. Less than 30 cases have been described and represent less than 0.1-0.4% of all registered tumors in the salivary glands. Occurrences in the salivary glands, palate, maxillary sinus, larynx, and lacrimal gland have been reported. There have been no published reports of an intranasal hybrid carcinoma. This is a case report of a 62-year old male presenting with nasal obstruction in a Tertiary Private Hospital. The patient had a 30-year history of nasal obstruction accompanied by a progressively enlarging mass on the nasal bridge, pain, anosmia, and epistaxis. Endoscopy showed flaring of the septum antero-superiorly with intact mucosa. MRI showed ill-defined lytic bone lesions with solid mass component involving nasal bones, hard palate, and alveolar process and a right nasal polypoid nodule. Biopsy showed undifferentiated carcinoma, prompting nasal bone and septum excision through a lateral rhinotomy incision. Histopathology revealed a hybrid tumor composed of adenoid cystic and squamous cell carcinoma, moderately differentiated. The patient underwent 13 cycles of radiation therapy. Hybrid tumors are rare tumor entities. It is important to recognize both components and distinguish the higher histologic type in determining its aggressiveness and in formulating treatment options and prognosis. Diagnosed patients require close and extended follow up and monitoring.

Heitham Gheriani

St Paul’s hospital and University of British Columbia
Canada

Title: A comparison of two sphenoidotomy approaches using a novel computerized tomography grading system

Time : 14:10-14:30

Speaker
Biography:

Gheriani H is a Rhinologist currently based at St Paul’s Hospital in Vancouver British Columbia in Canada and affiliated to the University of British Columbia. He has obtained his MBChB degree with honours from Benghazi University and completed his otolaryngology residency training program in Ireland based at the Royal College of Surgeons in Ireland. He then moved to Vancouver, BC Canada to join St Paul’s Hospital Sinus Center for fellowship training under Dr. Amin Javer and subsequently joined the faculty staff team at University of British Columbia. His main field of interest is rhinology, endoscopic sinus and skull base surgery.

Abstract:

Introduction: Endoscopic management of sphenoid sinus disease has great potential for surgical complications. A variety of endoscopic surgical techniques have been described for entering the sphenoid sinus. The utility of these surgical techniques is based on the position of the superior turbinate attachment to the sphenoid face (Parson's ridge). A novel computerized tomography (CT) grading system is introduced for the attachment of the superior turbinate to the sphenoid face. Using this new grading system, we recommend a safer systematic approach for entry into the sphenoid sinus.
Methods: A grading based on the attachment of the superior turbinate to the sphenoid face at the level of the natural sphenoid ostium was developed. A total of 53 patients were enrolled. Types A, B, and C refer to the superior turbinate attachment at the medial, middle, or lateral third of the anterior sphenoid face, respectively, and type D refers to orbital attachment of the superior turbinate. The surgical approach used (superior turbinate intact [STI] or superior turbinate resection [STR]) was recorded and correlated to the type of superior turbinate attachment.
Results: The overall incidence of the various superior turbinate attachments were 40% (41) for type A, 41% (42) for type B, 18% (19) for type C, and 1% (1) for type D. STR was used in 38 sides (44%) and STI was used in 48 sides (56%). Spearman correlation study showed that the closer the superior turbinate attachment was to the orbit the more likely STR was used as the choice of entry into the sphenoid (p<0.001).
Conclusion: To perform a safe sphenoid entry it is pertinent to evaluate the superior turbinate attachment to the sphenoid face before making a decision on the method of entry.

Omar Ahmad Abu Suliman

King Abdullah Medical City
Kingdom of Saudi Arabia

Title: Diagnostic and therapeutic challenges in IgG4-related disease in the Sphenoid sinus

Time : 14:30-14:50

Speaker
Biography:

Omar Ahmad Abu Suliman is a Senior Registrar at the Department of Otolaryngology-Head and Neck Surgery at King Abdullah Medical City in Makkah, Saudi Arabia. He obtained his MBBS at Umm Al Qura University in Makkah, in 2008. He completed his Residency in the Western Region Program of the Saudi Board of Otolaryngology Head & Neck Surgery in Dec 2014. His fields of interest are Rhinology & Endoscopic Skull Base Surgery.

Abstract:

Immunoglobulin G4 (IgG4) related disease is a newly recognized fibroinflammatory condition characterized by tumefactive lesions, a dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, storiform fibrosis, and, often but not always, elevated serum IgG4 concentrations. We present a 38 years old female complaining of headache which was progressive and unilateral resistant to analgesics. Diagnosed as a case of migraine started anti migraine treatment with no benefit, it was further complicated by 3rd, 4th and 6th Cranial Palsy. Radiological finding of opacification of left sphenoid sinus with extension to the left cavernous sinus along with bone erosion was noted. The biopsy from the sphenoid sinus mass showed a moderately dense lymphoplasmacytic infiltration accompanied with fibrosis. Immunostaining for IgG4 show significant increase in IgG4-positive plasma cells with IgG4-IgG ratio >40% and >100% IgG4 positive plasma cells per High Field Focus (HPF), giving the diagnosis of IgG4 sinusitis. This is a rare case of IgG4 related disease in the sphenoid sinus. Clinical, radiological and therapeutic challenges are discussed.

Speaker
Biography:

Mohamed Hamdy Ibrahim graduated from Faculty of Medicine, Ain Shams University, Cairo, Egypt. He joined the neuropsychiatry residency at Ain Shams University Cairo, Egypt from 2001 till 2003. He finished his MD in Neurology and got his Doctorate by 2008. He has been assigned as Lecturer of Neurology and his main concern was in the field of Neurovascular Interventional Radiology. He finished his fellowship in interventional neurology at Zurich University, Switzerland as F.I.N.R. by 2013. Currently he is an Assistant Clinical Professor of Neurology, GMU University, Ajman, United Arab of Emirates (UAE) since 2010. He has published many journals as Open Journal of Medical Imaging (OJMI), The Egyptian Journal of Radiology and Nuclear Medicine, The European Journal of Neurology, Neurology of India. In addition he is now a member of World Federation of Interventional and therapeutic Neuroradiology (WFITN), Member of ESMINT (European Society of Minimal Invasive Neurological Therapy) & Member of European Society of Neuroradiology Diagnostic and Interventional (ESNR)

Abstract:

Objectives: To study the prevalence of intracranial venous stenosis in pseudotumor cerebri patients.
Patients & Methods: Thirty patients were diagnosed having PTC according to Dandy criteria. All underwent general and neurological assessment. Radiological assessment included CT scan brain ±MRI brain without contrast, MRV. All underwent digital subtraction angiography (DSA) (venous phase) to confirm the validity of filling gaps seen at the level of MRV.
Results: MRV brain showed that 24 patients (80%) showed filling gaps. Digital subtraction cerebral angiography (venous phase) showed 9 patients (30%) had stenosis in their dural sinuses. MRV showed to be a good screening tool since it had 100% sensitivity and negative predictive value. However, since it has a moderate specificity (62%) with a positive predictive value (PPV) of only 35%, then lesions detected should be confirmed with digital subtraction cerebral angiography (venous phase) particularly those involving the transverse and sigmoid sinus.
Conclusion: Studying the intracranial venous system in patients with PTC is an important step in understanding the pathophysiology of the disease. Detection of venous sinus stenosis opens the way to a novel therapeutic option for refractory patients like venous sinus stenting.

Andrzej Sieskiewicz

Medical University of Bialystok
Poland

Title: Endoscopic treatment of orbital pathologies

Time : 15:10-15:30

Biography:

Andrzej Sieskiewicz received PhD from the Medical Academy of Bialystok upon the presentation of Doctoral dissertation in 2000. He is a member of Polish Society of Otolaryngologists Head and Neck Surgeons, Polish Society of Skull Base Surgeons, Polish Rhinologic Society. He is author of over 70 publications in medical journals. He is an invited lecturer on polish and international conferences and teaching courses on endoscopic surgery of the nose, paranasal sinuses, skull base and orbit. He is the head of many scientific and research projects sponsored by Medical University of Bialystok and Polish Ministry of Science and Education focused mainly on endoscopic surgery and interdisciplinary cooperation during skull base pathology treatment.

Abstract:


Development of surgical technology, improvement of operative technique, increased anatomical knowledge during the last two decades enabled the endoscopic surgeons to go far beyond paranasal sinuses. One of the regions that still remain very difficult to explore with purely endoscopic technique is the orbit. We aim at presentation of the advantages and limitations of endoscopic surgery of this region. Basing on our own clinical experience endoscopic surgical approaches to various types of orbital pathologies including inflammatory (abscesses), posttraumatic (hematomas, foreign bodies) and tumors will be discussed. Stress will be on proper tailoring the endoscopic technique to lesions of different types and locations. The endoscopic transnasal, transseptal, transmaxillar and external approach to the orbit will be presented. The application of neuronavigation system and intraoperative ultrasonography during these procedures will also be discussed. Both our own experience and data from the relevant literature indicate that intraorbital inflammatory lesions can be effectively treated by means of endoscopy whereas purely endoscopic removal of intraorbital tumor still remains rarity because is technically demanding and requires high experience in this type of surgery. In case of malignancies endoscopy may be used for diagnostic purposes and/or as a method supporting conventional external surgical approaches.

Thorsten Zehlicke

Fresenius University
Germany

Title: Acute sinusitis - Treatment and management with mucolytic agents

Time : 15:30-15:50

Speaker
Biography:

Thorsten Zehlicke received his Medical degree from Hamburg University, School of Medicine in l998, followed by residency training in ENT at Armed Forces Hospital Hamburg. He served in the Bundeswehr medical service from 1994 till now, attaining a rank of commander.
He served on the Faculty 
of Rostock University School of Medicine as Assistant Professor (2004-2009). In 2014 he became Professor at the Fresenenius Business School in Hamburg, teaching students in health economics. His research and clinical 
interests 
include 
the function of the Eustachian tube, auditory implants and the treatment of the paranasal sinuses. Since 2009 he is chair of the hearing center, Armed Forces Hospital Hamburg.

Abstract:

The most common etiology of acute rhinosinusitis is a viral infection associated with the common cold. Viral rhinosinusitis is complicated by acute bacterial infection in only 0.5 to 2.0 percent of episodes. The primary goals of management of acute sinusitis are to eradicate the infection, decrease the severity and duration of symptoms, and prevent complications. These goals are achieved through the provision of adequate drainage and appropriate systemic treatment of the likely bacterial pathogens. Several studies and meta-analyses have addressed the efficacy of systemic antibiotics in the treatment of acute rhinosinusitis. Given the difficulty in distinguishing viral from bacterial infection, these studies are complicated by heterogeneity in patient symptoms, underlying etiology, and outcomes of treatment. So the value of antibiotics in the treatment of acute rhinosinusitis is not clear. Mucolytic agents (eg, GeloMyrtol) have the benefit of thinning mucous secretions and improving drainage. They are not, however, commonly used in clinical practice in the treatment of acute sinusitis. We present our differentiated therapy of acute rhinosinusitis which depends on mucolytic agents, topical glucocorticoids and topical decongestants that corresponds to patient needs and avoids antibiotic administration.

Speaker
Biography:

Casale Manuele has completed his PhD at the age of 33 years from Campus Bio-Medico University of Rome, Italy and a fellowship from University of Navarra, School of Medicine, Pamplona, Spain. He is the Assistant Professor of Otolaryngology Department of Campus Bio-Medico University of Rome. He has published more than 65 papers in reputed international journals and serving as an Editorial Board Member of repute.

Abstract:

This study was designed to prospectively evaluate the role of nebulized hyaluronic acid (HA) given for 10 days/mo over 3 months as adjunct treatment to minimize symptoms and preventing exacerbation of chronic rhinosinusitis (CRS). Thirty-nine eligible patients were randomized to receive nebulized 9-mg sodium hyaluronate nasal washes plus saline solution (21 patients) or 5 mL of saline alone (18 patients), according to an open-label, parallel-group design, with blind observer assessment. A questionnaire about main CRS discomfort and nasal endoscopy for mucous discharge and/or mucosal edema of nasal cavities was used to assess primary outcomes of treatments. Secondary outcome measures included side effects and satisfaction. HA significantly improved quality of life in CRS patients according to the CRS questionnaire (16±3.72 versus 11.52±4.28; p<0.001), contrary to saline group scores (18.92±3.09 versus 18.21±3.21; p<0.55). The HA group showed significantly reduced osteomeatal edema (2.42 versus 1.52; p<0.001) and secretions (0.95 versus 0.42; p<0.001), whereas there was no statistically significant difference in the saline group. The compliance to the treatment was similar in both groups and no side effects were recorded. The results of this study suggested that intermittent treatment with topical 9-mg sodium hyaluronate plays a role in minimizing symptoms and could prevent exacerbations of CRS.

Break: Coffee Break 16:10-16:25 @ Al Dhiyafah Pre Function Hall
Speaker
Biography:

Andrew Imogu completed his medical training at the prestigious Medical School, University of Ibadan, Nigeria (University College Hospital, Ibadan) at the age of 23 years. He specialized in Otolaryngology with the fellowship of the West African College of Surgeons (FWACS), National Postgraduate Medical College of Nigeria (FMCORL) and International College of Surgeons (FICS). He is the immediate past President Otolaryngological Society of Nigeria (ORLSON). Currently he is the secretary, faculty board member, examiner and member of senate- faculty of ORL National Postgraduate Medical College of Nigeria and West African College of Surgeons. He is a Chief Consultant National Hospital, Abuja and Chief Medical Director- Hifi Hospital, Abuja, Nigeria.

Abstract:

External frontoethmoidectomy is an open procedure for removal of disease from the fronto-ethmoidal sinuses complex. The success of this operation can be limited by the common problem of maintaining fronto- nasal duct patency. This paper looks at the relevance of this procedure as a veritable option in contemporary management of sinus disease and the different techniques for maintenance of duct patency to ensure success.

Peter Catalano

St. Elizabeth’s Medical Center/ Tufts University School of Medicine
USA

Title: Nasal Surgery for Rhinogenic Headache

Time : 16:45-17:05

Speaker
Biography:

Peter Catalano, MD is Doctor of Medicine from Mount Sinai School of Medicine in NY. He is currently Professor of Otolaryngology at the Tufts University School of Medicine, Chief of Otolaryngology at St. Elizabeth’s Medical Center. He has published over 74 publications in reputed journals; written over 21 book chapters; been invited to over 175 lectures; completed 80 presentations.

Abstract:

The aim of this study was to evaluate the role of targeted nasal and sinus surgery in patients presenting with the primary complaint of headache, with or without sinus symptoms. The study conducted was a prospective non-controlled study. The targeted audience came from a busy metropolitan otolaryngology practice. The subjects were patients presenting with headache, with or without other rhinogenic complaints. A prospective, non-controlled study of 50 consecutive patients presented within a 12 month period for evaluation of headache as a primary symptom, with or without other rhinogenic complaints. Each patient underwent a full history, examination, pre-operative sinus CT (scored by the Lund Mackay system) and Headache Impact Test Score (HIT-6) questionnaire, followed by targeted nasal and sinus surgery. Post-operative HIT-6 was also recorded at 3 and 6 months, and the results analyzed statistically Targeted nasal and sinus surgery statistically reduced the mean HIT-6 score postoperatively, from a mean of 61.9 preoperatively to 45.5 postoperatively (p<0.05) (a HIT-6 score >60 indicates a severe impact on quality of life, while a score <49 implies a minor impact on quality of life). Patients with a lower Lund Mackay score had a larger drop in HIT-6 than those with a higher score. This study demonstrates a role for targeted and limited nasal and sinus surgery as a valid therapeutic option for patients with headache having the clinical and radiographic features described herein, and who are either not candidates for, refractory to, or not willing to use medications for control of headache symptoms.

Speaker
Biography:

S M Rathnasiri Bandara is waiting to complete his PhD in 2017 at Faculty of Medicine, University of Peradeniya in Sri Lanka on the topic of paranasal nitric oxide and migraine and working as second in charge in youth friendly clinic at teaching hospital Kandy, Sri Lanka. He has published 2 papers on hypoxic nitric oxide theory (SHNOT) for migraine and psychiatric disorders in a reputed journal. That was related to a new hypothesis connected to paranasal sinus nitric oxide and neuropsychiatric dis orders. He also has served as the President of Human Protection Foundation in Sri Lanka since 2005.

Abstract:

Migraine is an extremely common disorder and has co morbidity with many neurological illnesses. After reviewing the neurophysiological and biochemical basis of the research findings and hypotheses of migraine and other neurological disorders we present to the best of our knowledge the first paranasal sinus nitric oxide mediated neuro-biophysiological explanation for many neurological disorders. The etiology of neurological illnesses is mainly due to neurotransmitter imbalance, neurodegenerative changes acute and chronic inflammation, effects of hypo and hyper endothelial and neuronal NO levels and genetic predisposition. According to this paranasal sinus nitric oxide based description those effects are mainly brought on by the sinorhinogenic impulse distribution of the central nervous system except genetic predisposition. Moreover, avoidance of the central neuronal influence and stress to the brain in early childhood or young age caused by migraine would help to prevent the progression or aggravation of the neurological illnesses. Indeed, this article explains a new pathophysiological initiation between sinorhinogenic nitric oxide effects and neurological disorders and provides an etiologically important neuro vascular impulse generating pathway to cause or aggravate neurological disorders. Therefore the patients who are clinically suspected of having migraine headache and neurological disorders or along with susceptible neurological disorders should receive comprehensive sinorhinological examination and evaluation based on the sinus hypoxic nitric oxide phenomena. A standard surgical and medical management of migraine that is linked with the sinus hypoxic nitric oxide theory are suggested to be used for even neurological disorder as a new treatment of neurological illnesses and to prevent the dysfunction of central specific neural circuits.

Min Xiong

Guangzhou General Hospital of Guangzhou Military Command
China

Title: Quadrupedal head position enhances recovery from chronic maxillary sinusitis

Time : 17:25-17:45

Speaker
Biography:

Min Xiong is currently an Associate Chief Doctor in the Department of ENT, Guangzhou General Hospital of Guangzhou Military Command. His basic focus is on endoscopic sinus surgery and Otomicrosurgery. His basic research focus is on the pathological mechanism of noise induced hearing loss.

Abstract:

Objectives: The position of human maxillary ostia is high on their superomedial walls, which may be suboptimal for natural drainage. Human maxillary sinuses exhibit better passive drainage through their ostia when tilted anteriorly to mimic a quadrupedal head position. We all know that sufficient drainage is very important for the treatment of chronic rhinosinusitis (CRS). Chronic maxillary sinusitis (CMS) is the high incidence of CRS. The aim of this study was to investigate the efficacy of quadrupedal head position in patients with CMS.
Methods: One hundred six patients diagnosed with CMS were enrolled. Patients were randomized to quadrupedal head position group and non-quadrupedal head position group for 6 weeks of treatment. Treatment outcomes were measured using 1) Lund-Mackay scoring system of pre-and post-treatment computer tomography (CT); and 2) Sinonasal Quality-of-Life (QoL) Survey completed at baseline and 6 weeks of therapy.
Results: There were statistically significant differences in QoL scores and CT scores between quadrupedal head position group and non-quadrupedal head position group. The quadrupedal head position group had much more improvements in QoL scores and CT scores than that of non-quadrupedal head position group. One patient in the quadrupedal head position group required functional endoscopic sinus surgery (ESS) due to persistent symptoms, and nine patients in non-quadrupedal head position group needed ESS. There were fewer patients that required ESS in the quadrupedal head position group than in the non-quadrupedal head position group.
Conclusions: The improvements of QoL scores and CT scores were significantly better in the quadrupedal head position group than that in the non-quadrupedal head position group. Quadrupedal head position can be valuable adjuvant therapy for patients with CMS.