Department of Otorhinolaryngology

Otorhinolaryngology

Program Highlights – Previous Programs

The Department of Otorhinolaryngology – Head and Neck Surgery was pleased to present the 1st International TransOral Robot Surgery (TORS) Conference, a CME-accredited activity, on July 24 and 25, 2014 in Philadelphia.  A sold-out crowd of 220 attendees joined the 20 faculty to fill the auditorium.  Registrants from the fields of otolaryngology, head and neck surgery, oral surgery, neuroradiology, medical and surgical oncology, and reconstructive surgery hailed from 25 states around the US, and 37 foreign countries from 6 different continents!

The program was held on the University of Pennsylvania campus. Lectures were presented in the Arthur H. Rubenstein Auditorium at the Smilow Center for Translational Research, with live surgery and demonstration dissections streamed live to the auditorium as well. All presentations were simultaneous projected on the state-of-the-art video wall located adjacent to the auditorium, making excellent use of the latest technology available.  Posters, commercial exhibits and dining were located in Smilow Commons, situated immediately outside the lecture hall.

Gregory S. Weinstein, MD, Professor and Vice Chair, and Bert W. O’Malley, Jr., MD, Professor and Chair, Department of Otorhinolaryngology – Head and Neck Surgery at the University of Pennsylvania served as course directors, with additional Penn faculty from the Departments of Otorhinolaryngology – Head and Neck Surgery, Medicine, and Radiation Oncology. Distinguished guest faculty included both national and international leaders in the field.

The conference was scheduled immediately preceding the 5th World Congress – IFHNOS and Annual Meeting of the AHNS in New York City, allowing registrants to attend both programs since travel from Philadelphia to New York City was fast and easy via Amtrak train from Philly’s 30th Street Station to NYC’s Penn Station.

On Thursday, July 24, after welcome remarks from Dr. O’Malley and Chi Van Dang, MD, PhD, Professor and Director of the Abramson Cancer Center, the program commenced with of a series of sixteen lectures, followed by two cadaver demonstration dissections sessions, first presenting basic cases followed by advanced surgical cases. On Friday, July 25, the day began with an expert panel, followed by live surgery; another expert panel concluded the program.

A highlight of the 2-day meeting in Philadelphia was the presentation of the inaugural Chevalier Jackson Health Care Innovator Medal, established by the University Of Pennsylvania’s Department Of Otorhinolaryngology – Head and Neck Surgery and the Penn Center for Head and Neck Cancer. This annual award honors an individual whose work has resulted in a broad awareness or an innovative solution for a pressing health care issue which, in turn, has had a positive impact on public health.

Chevalier Jackson (1865-1958) is considered the “Father of Endoscopy” and essentially invented the modern science of endoscopy of the upper airway and esophagus in which he developed and perfected novel surgical instruments with integrated lighting. The surgical scopes that he developed transformed the field of endoscopy. His instruments allowed safe removal of objects that were lodged in the throat, lungs and esophagus which had previously resulted in death for large numbers of adults and children. He created and chaired the world’s first Department of Bronchoesophagology at the University of Pennsylvania in 1919. Two traits that made him unique were his passion for sharing his new techniques and teaching worldwide, as well as his dedication to public health.

The first award was presented to Mr. Tony Horton, creator of the P90X fitness programs and an international fitness and nutrition expert recognized for his work in creating a medically-based exercise regime that has helped many reach their diet and fitness goals, at a banquet, held Thursday evening, July 24, at The College of Physicians of Philadelphia. This historic and architecturally unique venue was founded in 1787 and is the oldest professional medical organization in the United States.  Attendees included the conference faculty and many of the participants in additional to Penn faculty and staff, TORS patients and research donors.

Mr. Horton also participated in a Question and Answer session, along with Dr. Weinstein and a TORS patient and cancer survivor, during the conference lunch-hour on Thursday.  University of Pennsylvania medical students, residents and staff were invited to join the Q&A session in Smilow Auditorium, while conference attendees were able to view the session via the video wall during the meal break.  After the session, Mr. Horton had the opportunity to participate in simulation exercises on the da Vince Robot, and graciously provided a photo op for many of his P90X fans.

1st International TransOral Robot Surgery (TORS) Conference Faculty Photo

 

 

 

 

 

 

 

 

 

 

Mr. Tony Horton Accepts the

Chevalier Jackson Health Care Innovator Award

 

 

 

 

 

 

 

 

 

L to R: Gregory Weinstein, MD, Tony Horton, Bert W. O’Malley, Jr., MD

Tony Horton gets a demonstration of the da Vinci Robot in the exhibit hall in Smilow Center for Translation Research

 

 

 

 

 

 

 

 

 

 

 

On March 8 - 9, 2014, 51 otolaryngologists, facial plastic and reconstructive surgeons, dermatologic surgeons, oral and maxillofacial surgeons, dental surgeons and general practitioners travelled from around the world to participate in the CME-accredited PENN Rhinoplasty Course, presented by the Department of Otorhinolaryngology – Head and Neck Surgery.  Attendees hailed from 7 foreign countries from North America, South America, Asia and the Middle East, as well as 14 U.S. states.  The program was offered immediately following the annual PENN International Rhinology and Skull Base Course, affording the opportunity for participants to take advantage of both program offerings.

 

Course Director Oren Friedman, MD and co-directors Ara A. Chalian, MD and Daniel G. Becker, MD assembled a distinguished faculty, all experts in their field.  On Saturday, a full day of didactic presentations and case-based panel discussions at Smilow Center for Translational Research on the campus of the University of Pennsylvania focused on evaluation and analysis of the nose; basic and advanced nasal anatomy; functional and aesthetic nasal surgery; nasal valve surgical techniques; treatment of surgical failures; pre-operative planning for safe airway and cosmetic facial plastic surgery; maximizing success in nasal airway surgery; tips and pearls for rhinoplasty and other facial plastic procedures; prevention and management of rhinoplasty complications; and understanding terms and uses of grafts in rhinoplasty. Lectures and panel discussions, including a lunchtime session on nasal analysis and surgical approaches, were live-streamed to the video wall located in Smilow Commons.

On Sunday morning, course registrants were also offered the opportunity to participate in a hands-on cadaver dissection lab at the Perelman School of Medicine at the University of Pennsylvania.  During the lab session a number of pro-sections were performed by the distinguished lab faculty at a demonstration station within the laboratory and projected to monitors throughout the lab space, taking full advantage of the high-tech capabilities of the Human Tissue Lab.

The video wall located outside of Smilow Auditorium, allows for live streaming of lectures to Smilow Commons at this state-of-the-art venue.

 

 

On March 6 - 8, 2014, the Department of Otorhinolaryngology – Head and Neck Surgery, in cooperation with the Department of Neurosurgery, presented the annual CME-accredited PENN International Rhinology and Skull Base Course.  There were a total of 116 registrants from the fields of otolaryngology and neurosurgery hailing from 23 states around the US, and 10 foreign countries from North America, South America, Europe, Asia, and the Middle East.

This was the first year that the entire program was held on the University of Pennsylvania campus. Lectures were presented in the Smilow Auditorium at the Smilow Center for Translational Research Center located, with exhibits and dining located in Smilow Commons.  The highlight of the new venue was the capability to stream the lectures live to the amazing video wall located in Smilow Commons, using the most state-of-the-art technology.

Course directors included Nithin Adappa, MD, Assistant Professor, Noam A. Cohen, MD, PhD, Associate Professor, David. W. Kennedy, MD, Rhinology Professor, Jason G. Newman, MD,  Assistant Professor, Bert W. O'Malley, Jr., MD, Professor and Chairman, and James N. Palmer, MD, Associate Professor and Director of the Division of Rhinology, from the Department of ORL-HNS, as well as M. Sean Grady, MD, Professor and Chairman and John Y.K. Lee, Assistant Professor from Penn’s Department of Neurosurgery. Distinguished faculty from the University of Pennsylvania as well as other renowned universities throughout the United States and Canada, as well international guest speakers Richard Harvey, MD and Raymond Sacks, MD from Sydney, Australia took part in the course.

On Thursday morning the program began with didactic lectures and case panel in Smilow Auditorium.  After lunch attendees walked across the indoor bridges between buildings to the Flyers/Sixers Surgical Theater on the ground floor of the Hospital of the University of Pennsylvania (HUP) for a presentation of live surgery being performed by Dr. David Kennedy and Dr. James Palmer. Following live surgery all returned to Smilow Auditorium to resume lectures and panel discussions.

 

On Thursday evening attendees and faculty were invited to the course reception and casino night at The University of Pennsylvania Museum of Archaeology and Anthropology.  The Chinese Rotunda, one of the largest unsupported masonry domes in the World, housing a collection of Chinese monumental art that spans thousands of years, provided a unique setting for this social event.  Guests were free to wonder all of the galleries on the Museum’s third floor, adjacent to the Rotunda, including the Canaan and Israel Exhibition, the Buddhist Asia and Japan Galleries, and the Egypt Gallery featuring human and animal mummies, tomb artifacts, and funerary objects and materials used in the mummification process.

 

Friday morning began, again, with didactics and as panel discussion.  Mid-morning attendees were led to Reunion Auditorium in the John Morgan Building at the Perelman School of Medicine at the University of Pennsylvania to observer demonstration cadaveric dissections presented by international visiting faculty Drs. Harvey and Sacks. Participants returned to the Smilow Center on Friday afternoon for a series of skull base lectures, capped off at the end of the day by the Penn Distinguished Skull Base Professorship by honored guests Dr. Ricardo Carrau, Professor of Otolaryngology – Head & Neck Surgery from The Ohio State University, and Dr. Marvin Bergsneider, Professor in Residence, Department of Neurosurgery, UCLA Medical School.

 

On Saturday morning course attendees returned to Reunion Auditorium  to view a another demonstration cadaver dissection conducted by Dr. Carrau, using state-of-the-art powered instrumentation and image-guidance systems.

 

Course registrants were also offered the opportunity to participate in hands-on cadaver dissection labs at the School of Medicine on Friday and Saturday at the new Human Tissue Lab, a recently constructed, modern laboratory facility.

Penn International Rhinology and Skull Base Course 2014 Faculty Photo
 

2014 PENN Distinguished Skull Base Professors receive commemorative plaques and pose with department chairs.

(L to R: Bert O’Malley, Ricardo Carrau, Marvin Bergsneider, Sean Grady)
 
Course Directors, Faculty, and Honored Guests

(L ro R: John Lee, Nithin Adappa, Jason Newman, Jim Palmer, Bert O’Malley,

Ric Carrau, Marvin Bergsneider, Jay Storm, Sean Grady, David Kennedy)

Course participant? Click here to download a pdf copy of the slide presentations from this course.
The unlock password should have been emailed to you, if you did not recieve the email you must contact Cathy.Lafferty@uphs.upenn.edu


On Friday and Saturday, May 3 – 4, 2013 the Department of Otorhinolaryngology – Head and Surgery presented the CME-accredited Advanced Topics in Thyroid and Parathyroid Surgery at The Hub CityView conference center in center city Philadelphia.  A total of 41 registrants and 24 faculty members participated from the fields of otorhinolaryngology, head and neck surgery, endocrinology, pathology, radiation oncology, radiology, surgery and medicine.

 

Jason G. Newman, MD, Assistant Professor and Director, Head and Neck Cancer Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, Pennsylvania Hospital, University of Pennsylvania, Robert L. Ferris, MD, PhD, FACS, UPMC Endowed Professor of Head and Neck Surgery, Vice-Chair for Clinical Operations, Chief, Division of Head and Neck Surgery, University of Pittsburgh, and David Goldenberg, MD, FACS, Professor of Surgery and Oncology, Director of Head and Neck Surgery, Associate Director of Surgical Services Penn State Hershey Cancer Institute Division of Otolaryngology–Head and Neck Surgery, The Pennsylvania State University served as course directors.  Distinguished faculty hailed from numerous regional academic institutions including Temple University, Thomas Jefferson University, Penn State University, The University of Pittsburgh and The University of Pennsylvania.

Recent advances in diagnostic and therapeutic approaches to thyroid and parathyroid disorders, particularly for neoplastic disease, have yielded a change in traditional management paradigms. This one-and-a-half day course provided the practitioner an array of contemporary management elements with which to treat patients with endocrine disorders of the head and neck.  On Friday didactic lectures and case-based panel discussions addressed topics in thyroid surgery concerning preoperative assessment, operative management and recurrent and reoperative disease. 

On Saturday morning, thyroid lectures continued addressing postoperative management/surveillance, followed by presentations and panel discussion focusing on treatment of the parathyroid.  The morning concluded with a presentation on Basic Concepts of Sonographic Instrumentation and a hands-on Ultrasound mini-course, with ultrasound equipment made available from three equipment vendors.

The meeting venue, The Hub CityView on the 14th floor of the United Plaza Building at 17th and Chestnut Streets in the heart of the city, provided spectacular views as a backdrop for the program. The contemporary pre-function space offered an exceptional setting for exhibitors, and for all participants to gather for breaks and meals with catering exclusively by Stephen Starr Events.

Penn’s Ara Chalian presents “Reoperation of the Neck - When and How?” with the Philadelphia skyline in the background.
Breakout space is set for hands-on
ultrasound lab.
Pre-function space offers a unique setting for exhibits and refreshment breaks.

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On March 8 - 9, 2013, 52 otolaryngologists, facial plastic and reconstructive surgeons, dermatologic surgeons, general practitioners, and other allied health care professional travelled from around the world to participate in the CME-accredited PENN Rhinoplasty Course, presented by the Department of Otorhinolaryngology – Head and Neck Surgery.  Attendees hailed from 8 foreign countries and 10 U.S. states.  The program was offered immediately following the annual PENN International Rhinology and Skull Base Course, affording the opportunity for participants to take advantage of both program offerings.

Course Director Oren Friedman, MD and co-directors Ara A. Chalian, MD and Daniel G. Becker, MD assembled a distinguished faculty, all experts in their field.  On Saturday, a full day of didactic presentations and case-based panel discussions at the Westin Philadelphia Hotel focused on evaluation and analysis of the nose; basic and advanced nasal anatomy; functional and aesthetic nasal surgery; nasal valve surgical techniques; treatment of surgical failures; pre-operative planning for safe airway and cosmetic facial plastic surgery; maximizing success in nasal airway surgery; tips and pearls for rhinoplasty and other facial plastic procedures; prevention and management of rhinoplasty complications; and understanding terms and uses of grafts in rhinoplasty.

Course registrants were also offered the opportunity on Sunday morning to participate in a hands-on cadaver dissection lab at the Perelman School of Medicine at the University of Pennsylvania.  During the lab session a number of pro-sections were performed by the distinguished lab faculty at a demonstration station within the laboratory and projected to monitors throughout the lab space, taking full advantage of the high-tech capabilities of the newly constructed Human Tissue Lab.

 

 

 

 

 

 

 

 

 

 

A view of the Human Tissue Lab in Stemmler Hall at the Perelman School of Medicine at the University of Pennsylvania, before set up for the Rhinoplasty hands-on laboratory.

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rhinology header

On March 7 - 9, 2013, the Department of Otorhinolaryngology – Head and Neck Surgery, in cooperation with the Department of Neurosurgery, presented the annual CME-accredited PENN International Rhinology and Skull Base Course.  There were a total of 141 registrants from the fields of otolaryngology, head and neck surgery, neurosurgery, neurology and pediatrics. Attendees traveled from 20 states from around the US, and 15 foreign countries from South America, Europe, Asia, and the Middle East.

Course directors included Nithin Adappa, MD, Assistant Professor, Noam A. Cohen, MD, PhD, Associate Professor, David. W. Kennedy, MD, Rhinology Professor, Jason G. Newman, MD,  Assistant Professor, Bert W. O'Malley, Jr., MD, Professor and Chairman, and James N. Palmer, MD, Associate Professor and Director of the Division of Rhinology, from the Department of ORL-HNS, as well as M. Sean Grady, MD, Professor and Chairman and John Y.K. Lee, Assistant Professor from Penn’s Department of Neurosurgery. Distinguished faculty from the University of Pennsylvania as well as other renowned universities throughout the United States, Canada and Europe took part in the course.

This year the curriculum was separated into otorhinolaryngology and neurosurgery tracks. The otorhinolaryngology track encompassed specific emphasis on advanced endoscopic procedures as well as medical and surgical focus on the frontal sinus, emerging technologies, and endoscopic skull base surgery. The 3-day OTO program began with a full day of didactic presentations and case-based panel discussions at the Westin Philadelphia Hotel.

On Thursday evening attendees and faculty were invited to the course reception held in the Westin’s Georgian room, affording them the opportunity to interact in a more casual setting.

On Friday morning attendees were transported to the Hospital of the University of Pennsylvania to observe live surgery in the Flyer’s/76ers’ Surgical Theater, as performed by Dr. David Kennedy and Dr. James Palmer.  Following live surgery participants walked to Reunion Auditorium at the Perelman School of Medicine to observer demonstration cadaveric dissections presented by visiting faculty Dr. Michael Sillers, University of Alabama at Birmingham, Dr. Anshul Sama, Nottingham Unnivesrity Hospital, United Kingdom, and Dr. Daniel Simmen, Hirslanden Clinic, Zurich, Switzerland.

On Friday afternoon those in the otorhinolaryngology track returned to the Westin to join the neurosurgeons for additional lectures spotlighting skull base surgery. The highlight of the afternoon was the PENN Distinguished Skull Base Professorship; 2013 honored guests were Carl H. Snyderman, MD, MBA, Professor of Otolaryngology and Neurological Surgery, University of Pittsburgh and Peter Nakaji, MD, Director, Minimally Invasive Neurosurgery, Barrow Neurosurgical Associates, Phoenix, Arizona.

On Saturday morning course attendees were conveyed back to the Perelman School of Medicine at the University of Pennsylvania to view a another demonstration cadaver dissection conducted by Dr. Snyderman, using state-of-the-art powered instrumentation and image-guidance systems.

Course registrants were also offered the opportunity to participate in hands-on cadaver dissection labs at the School of Medicine on Friday and Saturday at the new Human Tissue Lab, a recently constructed, modern laboratory facility.

Penn International Rhinology and Skull Base Course 2013 Faculty Photo


2013 PENN Distinguished Skull Base Professors receive commemorative plaques and pose with some of the course directors.

(L to R: John Lee, Sean Grady, Peter Nakaji, Carl Snyderman, Bert O’Malley, James Palmer, Nithin Adappa)

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19th Annual Advances in Diagnosis and Treatment of

Sleep Apnea and Snoring 2013

Over Presidents’ Day Weekend, February 15 – 17, 2013, Penn’s Department of Otorhinolaryngology – Head and Neck Surgery and Department of Medicine, Division of Sleep Medicine, in cooperation with the University of California, San Francisco Department of Otolaryngology – Head and Neck Surgery, presented the CME-accredited course 19th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring.  A total of 175 participants from the fields of Otorhinolaryngology, Pulmonary Medicine, Sleep Medicine, Neurology, Internal Medicine, Cardiology, Pediatrics, OMFS, Dentistry,  Psychiatry and other related medical specialties participated in the conference.  Attendees hailed from 12 foreign countries and 33 U.S. states.

Richard J. Schwab, MD, Professor, Division of Sleep Medicine in the Department of Medicine at the University of Pennsylvania, along with Andrew N. Goldberg, MD, MSCE, Professor and Eric J. Kezirian, Associate Professor, Department of Otolaryngology – Head and Neck Surgery at UCSF, served as course directors.  Distinguished faculty from the University of Pennsylvania and other prominent US institutions were onsite; Dr. Peter Cistulli of the University of Sydney participated from Australia and Dr. Samuel Kuna from the University of Pennsylvania participated from Philadelphia via teleconference.

The 2 ½-day program, held at the Disney Boardwalk Inn Resort in Orlando, Florida, provided a comprehensive review and update on recent advances in sleep apnea and snoring, highlighting new approaches and controversies in the management of patients with sleep-disordered breathing.  Didactic lectures were presented throughout the curriculum, and breakout sessions were offered to include panel discussions focusing on treatment of insomnia, Sleep Board review, and medical guidelines for managing a fiscally sound sleep lab and home sleep study programs.  A case presentation session was also provided, spotlighting complex surgical cases. 

The highlight of the social program was the remarkable Illuminations Fireworks and Dessert Reception held on Friday evening at EPCOT’s French Island.  The event included a private dessert buffet and spectacular fireworks display and laser show.

Course Director Dr. Richard Schwab presents the latest data on the treatment of sleep apnea to a packed house.

Faculty, staff, course participants, family and friends enjoy the Illuminations Fireworks & Dessert Reception at Epcot’s French Island.

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 On December 4 – 7, 2012, the Department of Otorhinolaryngology – Head and Neck Surgery presented the CME-accredited 6th International Update Course: Otolaryngology Underwater on the island of Cayman Brac, a British Overseas Territory located 480 miles south of Miami in the Western Caribbean.

This exceptional program provided the opportunity for practicing Otolaryngologists to review and update their knowledge of recent advances in a broad spectrum of topics in their field: rhinology, head and neck cancer, pediatric otolaryngology, otology/neurology, laryngology, rhinoplasty, facial plastic surgery, imaging, allergy, obstructive sleep apnea, and the otolaryngologic effects of scuba diving.   The curriculum also utilized thought-provoking panel discussions on difficult cases and controversies in rhinology, management of the thyroid, workforce issues and training, and what is new and exciting in otolaryngology.

A total of 32 attendees participated from 18 different states representing all US regions, as well as from Canada.  In addition to the attendees, 14 faculty members took an active part in the presentations and panel discussions. The distinguished faculty hailed from across the US including Washington University in St. Louis, Northwestern University in Chicago, Emory University in Atlanta, both MD Anderson Cancer Center and the University of Texas Health Science Center in Houston, Georgetown University in Washington, DC, Mayo Clinic in Rochester, Minnesota, and the University of Pennsylvania, Children’s Hospital of Philadelphia, and Temple University in Philadelphia. International faculty traveled from the Hospital Angeles de las Lomas in Huixquilucan, México, Brazilian National Cancer Institute in Rio de Janeiro, Brazil, and Medioxygen Hyperbaric Center and Helsinki University Finnish Institute of Occupational Health in Finnland.

When not participating in the formal lecture sessions, faculty and participants were able to take advantage of the unparalleled splendor of Cayman Island diving.  One of the world’s premier scuba diving destinations, it is home to hundreds of varieties of fish, corals, and marine life.  The pristine beauty of the warm Caribbean Sea provides a spectacular marine environment for reef, wall and wreck diving.

Course participants attend superb presentations on the latest advances in otolaryngology.
Here attendees don special glasses to view video filmed
in the latest 3-D technology.
The AquaHut dive master instructs several course participants in the Brac Reef Beach Resort pool, preparing them for dive certification.
The natural beauty of Cayman Brac can be seen in the abundant tropical flora and fauna.
Divers check their tanks as the boat prepares to launch. (Photo by G. Rodden)
These spectacular photos highlight the beauty and splendor of the undersea world! (Photos by R. Chole)

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PENN Rhinoplasty Course 2012
Highlights

After a 4-year hiatus, 2012 saw the return of the Penn Rhinoplasty Course to Philadelphia. On March 10 and 11, 2012, 72 otolaryngologists, oral maxillofacial surgeons and other allied health care professional travelled from around the world to participate in the CME-accredited Penn Rhinoplasty Course, presented by the Department of Otorhinolaryngology – Head and Neck Surgery. Attendees hailed from 10 different countries and 16 U.S. states. The program was offered immediately following the annual Penn International Rhinology and Skull Base Course, affording the opportunity for participants to take advantage of both program offerings.


Course Director Oren Friedman, MD and co-directors Ara A. Chalian, MD and Daniel G. Becker, MD assembled a distinguished faculty, all experts in their field. On Saturday, a full day of didactic presentations at the Westin Philadelphia Hotel focused on evaluation and analysis of the nose; basic and advanced nasal anatomy; functional and aesthetic nasal surgery; nasal valve surgical techniques; treatment of surgical failures; pre-operative planning for safe airway and cosmetic facial plastic surgery; maximizing success in nasal airway surgery and functional septorhinoplasty; complications in airway, and facial plastic surgery; tips and pearls for rhinoplasty and other facial plastic procedures; prevention and management of rhinoplasty complications; and, understanding terms and uses of grafts in rhinoplasty.

Course registrants were also offered the opportunity on Sunday morning to participate in a hands-on cadaver dissection lab at the Perelman School of Medicine at the University of Pennsylvania. During the lab session a number of pro-sections were performed by the distinguished Penn lab faculty at a demonstration station within the laboratory and projected to monitors throughout the lab space, taking full advantage of the high-tech capabilities of the newly constructed Human Tissue Lab.

Penn ORL-HNS residents Steven Sperry (l.) and Arnaud Bewley (r.) attend the Rhinoplasty lectures at the Westin Philadelphia Hotel.

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PENN International Rhinology and Skull Base Course 2012
Highlights

On March 8 - 10, 2012, 154 otolaryngologists, neurosurgeons and allied health care professional gathered in Philadelphia to take part in the CME-accredited Penn International Rhinology and Skull Base Course. Participants traveled from 22 foreign countries and 23 U.S. states, representing all regions of the globe. The annual course was presented by the Department of Otorhinolaryngology – Head and Neck Surgery, in cooperation with the Department of Neurosurgery.


James N. Palmer, MD, the Director of the Division of Rhinology in the Department of ORL-HNS, served as Executive Course Director. Co-directors included Bert W. O'Malley, Jr., MD, Professor and Chairman, David. W. Kennedy, MD, Rhinology Professor, Noam A. Cohen, MD, PhD, Assistant Professor and Nithin Adappa, MD, Assistant Professor from the Department of ORL-HNS, as well as M. Sean Grady, MD, Professor and Chairman and John Y.K. Lee, Assistant Professor from Penn’s Department of Neurosurgery. Distinguished faculty from the University of Pennsylvania as well as other renowned universities throughout the United States, Canada and Europe took part in the course.


The 3-day program began with a full day of didactic presentations at the Westin Philadelphia Hotel, focusing on the medical and surgical advances in the management of sino-nasal disease and skull base disorders. The morning offered topics of interest to all attendees, such as sinus and skull base anatomy, endoscopic surgical procedures, management of complications, and various approaches to the skull base. The afternoon was devoted to breakout sessions to highlight topics of specific interest in either otolaryngology or neurosurgery, employing lecture format as well as panel discussion and case presentations.

On Thursday evening attendees and faculty were invited to the course reception held in the Westin’s Georgian room, affording them the opportunity to interact in a more casual setting.

Live surgical cases were presented on Friday morning; participants were transported to the Hospital of the University of Pennsylvania to observe live surgery in the Flyer’s/76ers’ Surgical Theater. This was the first year that combined otolaryngology/neurosurgery cases were included in the agenda, as performed by the O’Malley/Grady and Palmer/Lee multidisciplinary teams. Endoscopic sinus surgery was also demonstrated by Dr. Kennedy. Friday afternoon consisted of additional lectures at the Westin, spotlighting the Penn Distinguished Skull Base Professorship; the 2012 honored guests were Dr. Piero Nicolai, Professor and Chairman of the Department of Otorhinolaryngology at the University of Brescia and Dr. Paolo Cappabianca, Professor and Chairman of the Department of Neurological Surgery at the University of Naples Federico II, both from Italy. On Saturday morning course attendees were conveyed to the Perelman School of Medicine at the University of Pennsylvania to view live demonstration cadaver dissections conducted by Dr. Nicolai and Dr. Cappabianca, using state-of-the-art powered instrumentation and image-guidance systems.

Course registrants were also offered the opportunity to participate in hands-on cadaver dissection labs at the School of Medicine on Friday and Saturday. Over the course of these two days, over 100 lab slots were filled in the new Human Tissue Lab, a recently constructed, modern laboratory facility.




Penn International Rhinology and Skull Base Course 2012 Faculty Photo

L to R: N. Cohen, J. Lee, S. Grady, P. Cappabianca (Skull Base Professor, NSG),
P. Nicolai (Skull Base Professor, ORL), B. O’Malley, J. Palmer, D. Kennedy, N. Adappa.

Penn ORL-HNS Chief Resident Marcelo Antunes (second
from left) poses with course
directors Noam Cohen (left),
Jim Palmer (third from left)
and Nithin Adappa (right).

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17th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring 2011
Highlights

Over Presidents’ Day Weekend, February 18 – 20, 2011, Penn’s Department of Otorhinolaryngology – Head and Neck Surgery and Department of Medicine, Division of Sleep Medicine, in cooperation with the University of California, San Francisco Department of Otolaryngology – Head and Neck Surgery, presented the CME-accredited course 17th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring.  A total of 161 participants from the fields of Otorhinolaryngology, Internal Medicine, Sleep Medicine, Neurology, Pulmonology, Psychiatry and other related medical specialties participated in the conference.  Attendees hailed from 10 foreign countries and more than 30 different U.S. states.

Richard J. Schwab, MD, Professor, Division of Sleep Medicine in the Department of Medicine at the University of Pennsylvania, along with Andrew N. Goldberg, MD, MSCE, Professor and Eric J. Kezirian, MD, MPH, Associate Professor, Department of Otolaryngology – Head and Neck Surgery at UCSF, served as course directors.  Distinguished faculty from the University of Pennsylvania and other prominent US institutions were onsite, and Dr. Peter Cistulli of the University of Sydney participated from Australia via teleconference.

The 2 ½-day program, held at the Disney Boardwalk Inn Resort in Orlando, Florida, provided a comprehensive review and update on recent advances in sleep apnea and snoring, highlighting new approaches and controversies in the management of patients with sleep-disordered breathing.  Didactic lectures were presented throughout the curriculum, and breakout sessions were offered to include panel discussions focusing on Sleep Board review and medical guidelines for managing a fiscally sound sleep lab and portable sleep studies.  A case presentation session was also provided, spotlighting controversial surgical cases.  In addition, a surgical lab was available allowing participants to gain hands-on expertise with newer surgical techniques such as palatal implants, radiofrequency, and tongue suspension, for snoring and OSA, using such animal tissue as pig tongue.

The highlight of the social program was the remarkable Illuminations Fireworks and Dessert Reception held on Friday evening at EPCOT’s French Island.  The event included a private dessert buffet and spectacular fireworks display and laser show.

Course participants enjoy the Illuminations Fireworks & Dessert Reception at Epcot’s French Island.

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Penn Rhinology and Skull Base Dissection Courses 2011
Highlights

On March 10 - 12, 2011, the Department of Otorhinolaryngology – Head and Neck Surgery, in cooperation with the Department of Neurosurgery, presented the CME-accredited Penn International Rhinology and Skull Base Dissection Course to 143 otolaryngologists and neurosurgeons from around the globe. Participants hailed from 21 countries and 19 different states from all regions in the U.S.

James N. Palmer, MD, the Director of the Division of Rhinology in the Department of ORL-HNS, served as Executive Course Director. Co-directors included Bert W. O'Malley, Jr., MD, Professor and Chairman, David. W. Kennedy, MD, Rhinology Professor, and Noam A. Cohen, MD, PhD, Assistant Professor from the Department of ORL-HNS, as well as M. Sean Grady, MD, Professor and Chairman and John Y.K. Lee, Assistant Professor from Penn’s  Department of Neurosurgery. Distinguished faculty from the University of Pennsylvania as well as other renowned universities throughout the United States, Canada and Europe took part in the course.

The 3 ½-day program began with a full day of didactic presentations at the Westin Philadelphia Hotel, focusing on the medical and surgical advances in the management of sino-nasal disease and skull base disorders. The morning offered topics of interest to all attendees, such as basic sinus anatomy, endoscopic surgical procedures, and various approaches to the skull base, while the afternoon was devoted to breakout sessions spotlighting either otolaryngology or neurosurgery, utilizing lectures as well as panel discussion and case presentations.

Thursday evening provided the opportunity for attendees and faculty to interact in a more informal setting at the course reception held in the Westin’s Georgian Room.

On Friday morning participants were transported to the Hospital of the University of Pennsylvania to observe live surgery cases presented by Dr. Kennedy and Dr. Palmer.  The Friday afternoon program offered additional lectures and was highlighted by the Penn Distinguished Skull Base Professorship featuring presentations by Heinz Stammberger, MD, Professor and Head, Department of General ENT, Head and Neck Surgery, Medical University of Graz, Austria, and Theodore H. Schwartz, MD, Professor of Neurosurgery, Otolaryngology, Neurology and Neuroscience, Weill Cornell Medical College, New York.

Participants were returned to the University of Pennsylvania School of Medicine on Saturday morning to view live demonstration cadaver dissections conducted by Dr. Stammberger and Dr. Nicolai, using state-of-the-art powered instrumentation and image-guidance systems.  Course registrants were also offered the opportunity to participate in hands-on cadaver dissection labs at the School of Medicine, filling a total of 84 lab slots over the course of the program.

Penn’s Gabriel Tucker Professor and Chair, Department of Otorhinolaryngology – Head and Neck Surgery, Bert W. O’Malley, Jr. MD and Charles Harrison Frazier Professor and Chair, Department of Neurosurgery, M. Sean Grady, MD, recognize the Penn Distinguished Skull Base Professors, Theodore H. Schwartz, MD and Heinz Stammberger, MD.

Course directors pose with Penn Distinguished Skull Base Professors: l. to r., James N. Palmer, MD, Bert W. O’Malley, Jr., MD, Heinz Stammberger, MD, Theodore H. Schwartz, MD, M. Sean Grady, MD, Noam A. Cohen, MD, PhD, and John Y.K. Lee, MD.
Course directors, distinguished visiting faculty and Penn course faculty gather for the official Faculty Photo.

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Otolaryngology Underwater 2010
Highlights

On November 2 – 7, 2010, the Department of Otorhinolaryngology – Head and Neck Surgery presented the CME-accredited 5th International Update Course: Otolaryngology Underwater on the island of Bonaire in the Netherland Antilles for 35 participants from 16 states and 7 countries.

This outstanding program provided the opportunity for practicing Otolaryngologists to update their knowledge in a broad spectrum of topics in their field, including rhinology, endoscopic sinus surgery, management of head and neck tumors, advances in robotic surgery, pediatric otolaryngology, cochlear implants, and facial plastic surgery. Several lectures also highlighted the otolaryngologic effects of scuba diving.

This was truly an international educational experience. Invited faculty hailed from all across the US, including Northwestern University in Chicago, M.D. Anderson Cancer Center in Texas, Boys Town National Research Center in Nebraska, Georgetown University in Washington, D.C, and the Mayo Clinic in Minnesota, as well as from around the globe, including the Hospital Angeles Lomas in Mexico, Karolinska Institute in Sweden, Helsinki University in Finland, and the Medical University of Graz in Austria. The course registrants also came from all corners of the US, and internationally as close to Bonaire as Venezuela and as far away as Russia!

When not participating in the formal lecture sessions, faculty and participants were able to take advantage of the superb diving opportunities offered by this small Dutch island off the coast of Venezuela, one of the “ABC” islands along with Aruba and Curacao. Because waters around Bonaire have been protected by an actively managed marine park for the past 30 years the island boasts the most pristine coral reefs and diverse marine life throughout the Caribbean.

Faculty, participants and dive staff attend the BBQ-on-the-Beach at the Banana Tree Restaurant, hosted by Plaza Resort Bonaire.
Dr. Elena Vladykina, a course participant from Russia, prepares to dive.
Elena gives the divers’ universal “OK” sign.

Course directors David Kennedy, left, and Bert O’Malley, Jr., second from the right, pose with faculty and friends.

Bert W. O’Malley, Jr., MD, Gabriel Tucker Professor and Chairman of Penn’s Department of Otorhinolaryngology – Head and Neck Surgery (center), shares his Penn “Top 10” t-shirt with John, a Holland native, now a dive master at the Toucan Dive Shop in Bonaire.

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Penn Rhinology and Comprehensive Skull Base Courses 2010
Highlights

On March 11-14, 2010, the Department of Otorhinolaryngology – Head and Neck Surgery, in cooperation with the Department of Neurosurgery, presented the CME-accredited Penn International Rhinology and Comprehensive Skull Base Courses to 140 attendees from around the globe. Participants hailed from 16 different countries and 20 different U.S. states.

James N. Palmer, MD, the Director of the Division of Rhinology in the Department of ORL-HNS, served as Executive Course Director. Co-directors included Bert W. O'Malley, Jr., MD, Professor and Chairman, David. W. Kennedy, MD, Rhinology Professor, Alexander G. Chiu, MD, Associate Professor, and Noam A. Cohen, MD, PhD, Assistant Professor from the Department of ORL-HNS, as well as M. Sean Grady, MD, Professor and Chairman of the Department of Neurosurgery, and Heinz Stammberger, MD, Professor and Head of the Department of General ENT Head and Neck Surgery at the Medical University of Graz, Austria. Distinguished faculty from the University of Pennsylvania as well as other renowned universities throughout the United States and Canada took part in the course.

The program included 3 1/2 days of didactic lectures, presented at the Westin Philadelphia Hotel. Presentations focused on the medical and surgical advances in the management of sino-nasal disease and skull base disorders. There was specific emphasis on the frontal and sphenoid sinuses, chronic rhinosinusitis, skull base surgery, medical therapy, pediatric sinusitis, image guidance and powered instrumentation and endoscopic management of benign and malignant skull base tumors.

Participants were also transported to the Hospital of the University of Pennsylvania and the School of Medicine to observe live surgery cases presented by Dr. Kennedy and Dr. Palmer and cadaveric demonstration dissections presented by Dr. Stammberger and Dr. Aldo Stamm. Attendees also had the opportunity to register for hands-on cadaveric laboratories to practice a variety of procedures and improve their surgical skills.

This marks the 25th anniversary of the Rhinology course. Dr. David Kennedy, credited with the introduction and pioneering of functional endoscopic sinus surgery in the U.S., established the Rhinology course in the mid-1980's and continued to offer the program annually when he joined the Penn faculty 19 years ago. This year we were pleased to be able to expand the program to include the endoscopic Skull Base course, highlighted by the Penn Distinguished Skull Base Professorship featuring presentations, demonstration dissections, and 3D lectures by Dr. Albert L. Rhoton, Jr., MD, Professor and Chairman Emeritus, Department of Neurosurgery, University of Florida and Aldo C. Stamm, MD, PhD, Director, Sao Paulo ENT Center, Brazil.


Course Directors and Distinguished Skull Base Professors, pictured from l to r: D. Kennedy, S. Grady,
A. Rhoton, A. Stamm, B. O'Malley, H. Stammberger, J. Palmer, and A. Chiu.


Course Directors and Department Chairs M. Sean Grady, MD (Neurosurgery), left, and
Bert W. O'Malley, Jr., MD (Otorhinolaryngology – Head and Neck Surgery), right, present the 2010 Distinguished Skull Base Professorship plaques to honorees Albert L. Rhoton, Jr., MD (second from left) and Aldo C. Stamm, MD, PhD (third from left)


Course participants view 3-D Skull Base lecture as presented by Dr. Rhoton!

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Thursday, April 16, 2009

Dr. David Kennedy welcomed attendees to the 2009 Rhinology World Conference, a compilation of the XIII International Rhinologic Society, the XXVIII International Symposium on Infection and Allergy of the Nose, the 2009 Spring Meeting of the American Rhinologic Society, and the Basic Course of the American Academy of Otolaryngic Allergy.  Dr. Valerie Lund opened the meeting with her keynote address on a Contemporary Overview of Chronic Rhinosinusitis (CRS).  Her talk set the tone for the following sessions as they delved into the pathogenesis of CRS.

In the Round Table session Dr. Claus Bachert discussed the role of superantigens in CRS such as the Staphylococcus aureus antigen and its implication in IgE synthesis and eosinophil influx, and its association with a Th2 response in nasal polyposis.  Dr. Noam Cohen spoke about the importance of mucociliary clearance and presented new data that demonstrated Pseudomonas aeruginosa conditioned media inhibits not only mechanostimulation of beating cilia but also recruitment of “reserve” cilia.  Dr. James Palmer discussed the role biofilms play in inflammation and presented recent findings that the presence of biofilms in CRS are associated with a unique inflammatory milieu including elevated levels of T helper cells, B cells, and neutrophils as well as cytokines and chemokines that suggest a Th1 and possibly Th17 skewing.  Dr. David Kennedy, in a discussion of osteitis, presented evidence that neoosteogenesis is a significant occurrence in the disease process and there is a significantly higher amount of bone turnover in CRS vs. Control sinuses. Dr. Heinz Stammberger closed the session arguing that Allergic Fungal Sinusitis (AFS) is actually a misnomer as there is no evidence to show that IgE-allergies cause AFS.  Discussion at this panel led to the consensus that CRS is a multi-factorial disease manifesting in several phenotypes, but that all arise from the disruption of mucociliary clearance resulting in mucostasis.

The following session, the Great Debate moderated by Dr. Alex Chiu, included a contrast and comparison of the different surgical strategies including Sinuplasty, MIST, FESS, Nasalization, and Balloon Dilation.  Presentations were given by Dr. Jean-Michel Klossek, Dr. Bradley Marple, Dr. Reuben Setliff, Dr. Michael Setzen, and Dr. Frederick Kuhn.

In a mini seminar on Evidence Based Medicine in Rhinology, Dr. Richard Orlandi pointed out that most of the evidence supporting FESS is either retrospective or prospective but without comparison groups.  Likewise, the support for image guidance in FESS is mostly level 4 uncontrolled studies as it is difficult and ethically unsupported to get randomized control groups.  Dr. Wytske Fokkens, in a discussion of therapeutics, presented evidence that oral antibiotics (>12 weeks) are relevant in non-polypoid CRS but there is still no evidence to support its effectiveness in nasal polyposis.  Evidence supporting topical steroids and saline irrigations are found in both disease states with the inclusion of oral steroids in the case of nasal polyps.  Finally, Dr. Fenna Ebbens discussed the lack of evidence implicating specific species of fungi in rhinosinusitis.

In a mini seminar on Mucosal Innate Immunity and CRS, Dr. David Conley opened with an overview on the current understanding of innate immunity highlighting the resident dendritic cells and their role in T cell recruitment and ultimately Th1 or Th2 skewing.  Dr. Andrew Lane presented new data on chitin and its possible role in Th2 skewing.  Dr. Robert Schleimer demonstrated that anti-microbial genes such as the S100’s as well as a protease inhibitor, SPINK5, are minimally expressed in CRS and their failure may contribute to the progression of disease.

In a mini seminar on Management Strategies for Chronic Rhinitis Dr. Eugenia Vining spoke about the importance of preserving the middle turbinate and presented several cases of rhinitis.  Dr. Fabiana Valera presented evidence that in a comparison of different steroids, glucocorticoids are the best treatment for the majority of rhinitis symptoms.  Dr. Christian von Buchwald talked about the use of FESS in CRS and presented several cases that do not fit the European Position Paper on Rhinosinusitis and Nasal Polyps.  Dr. Yosef Krespi gave an additional talk about the use of light and laser therapy as potential treatment regimes in CRS including RhinoLight with its mixed visible and ultraviolet (UV) light technology, Bionase, which uses visible light to treat allergies, and a combination of methylene blue and red light therapy that has already been demonstrated to be successful at pre-operative prophylactic elimination of MRSA in carriers.

Friday, April 17, 2009

Dr. Heinz Stammberger delivered the keynote address on the second day of the conference with a discussion of the Evolution of Functional Endoscopic Sinus Surgery (FESS), emphasizing the role that videos had on being one of the driving forces in spreading the technique throughout the world.  The following Round Table session provided a discussion of current surgical techniques.  Dr. James Palmer, in his discussion of current powered instrumentation, presented the many different advantages of power from polyp to bony removal, but also gave words of caution of the catastrophic complications that can result in misuse.  He also introduced the latest in power instrumentation, a hydrodebrider that would act as a pulse irrigator for the sinuses designed to help remove mucosal biofilms.   Dr. Howard Levine talked about the use of balloons in sinuplasty, which was contrasted by Dr. Wytske Fokkens’ discussion of radical procedures including Draf III techniques for frontal sinus surgery.  Dr. Alex Chiu elaborated on extended frontal sinus procedures including the modified Lothrop, trephine, and osteoplastic flap as well as frontal sinus obliteration and unobliteration.  Dr. David Kennedy discussed the changes in surgical approach since FESS first originated, stressing the key points of mucosal preservation and avoidance of bone exposure. Finally, Dr. Heinz Stammberger discussed changes in frontal sinus surgery.

Dr. Bert O’Malley, Jr. moderated a debate about Open vs. Endoscopic Approaches for Malignancy.  Dr. Ivo Janecka argued for the external approach while Dr. Piero Nicolai rebutted with the successful examples of various endoscopic approaches. Dr. O’Malley concluded the session with a presentation of a case of a patient with a radiation induced low-grade salivary gland tumor in the infratemporal fossa.  Drs Janecka and Nicolai were able to argue their respective sides throughout Dr. O’Malley’s management of the case. 

In a lively debate about the Genetics vs. Environment role in CRS, Dr. Martin Desrosiers argued that susceptibility to the development of CRS is primarily genetically determined and provided data showing gene association with CRS patients compared to healthy controls.  On the other hand Dr. Wytske Fokkens argued that the environment plays a major part in the development of CRS, stating that there is no evidence to support that CRS runs in families and also highlighted published data linking smoke and other pollutants to CRS.  At the end of the debate a vote was cast by the audience and it was almost unanimously decided that it is a combination of both genetic predisposition and environmental stimulation that leads to a diseased state.

Dr. Niels Hoiby initiated the session on Mucosal Biofilms by talking about mucoid-producing Pseudomonas aeruginosa that are found in the sinuses of patients with Cystic Fibrosis (CF).  Dr. Christian von Buchwald followed this with a more in-depth look at the genotypes of P. aeruginosa in the sinuses of CF patients and found that in 13 patients with Pseudomonas, all had different genotypes of the bacteria, which were sequentially found in the lungs, suggesting a more active role of Rhinologists may be indicated.  Dr. Jeff Leid discussed the robustness of biofilm growth in the face of the immune system.   Dr. Erica Thaler presented a novel device called the “Electronic Nose” which is capable of differentiating biofilm from non-biofilm forming bacteria and may be a potentially useful diagnostic tool in CRS.  Finally, Dr. Alkis Psaltis discussed the clinical relevance of biofilms and presented a prospective study that implicated biofilms with worse endoscopic and radiographic findings as well as worse post-operative quality of life scoring.

In an Instructional Course on Topical Therapies, Dr. Richard Harvey presented information on various delivery devices such as the neti pot and squeeze bottles, which he determined were the most effective at irrigating the sinuses.  Dr. Chris Brown discussed the impact of saline rinses in sinusitis and determined that isotonic saline is more often effective than hypertonic saline.  Dr. Alex Chiu introduced a novel steroid eluting biodegradable stent that has been shown to be an effective anti-inflammatory topical agent in a rabbit model of bacteria-induced sinusitis.  Dr. Larry Kalish discussed the lack of evidence that anti-fungals and anti-bacterial topical agents are safe and effective, however there is some evidence supporting the use of mupirocin in the sinuses.  Finally, Dr. Noam Cohen presented data that suggests surfactants, such as J&J’s baby shampoo, are effective at preventing bacterial biofilm formation and at the same time maintain the integrity of the mucosal cilia.

Saturday, April 18, 2009

The keynote speaker for the third day of the conference was Dr. Aldo Stamm whose discussion went Beyond the Paranasal Sinuses.  This was followed by a Round Table discussion of surgical techniques and included presentations by Dr. Heinz Stammberger, Dr. Alexandre Felippu, Dr. Vijay Anand, Dr. Roy Casiano, Dr. Rodney Schlosser, and Dr. Piero Nicolai.

In a Great Debate about the role of Fungus vs. Bacteria in CRS, Dr. Jens Ponikau presented evidence that implicates fungi as being the predominant effecter of CRS due to its association with IL-5 and IL-13 as well as influx of eosinophils.  He also supported this by demonstrating that anti-fungals and anti-IL-5 therapies are successful at treating CRS.  Dr. Robert Kern argued that bacteria play a more important role in CRS due to evidence that the down-regulation of anti-microbial genes are associated with CRS patients and this allows bacteria to expand and flourish.

Dr. James Palmer opened the seminar on Skull Base Reconstruction with a presentation on laser tissue welding, a technique that uses a laser solder coagulum paired with energy from a copper diode laser to create a stable tissue-solder bond, for skull base repair.  The laser weld creates an instant bond between the solder and tissue and has a burst pressure that exceeds human intracranial pressure with no residual thermal tissue injury.  Dr. Balwant Gendeh discussed anterior cranial fossa fistula repair and gave examples such as the Bath Plug technique and in larger leaks involving the anterior and ventral skull base tumor, surgery of the nasal septal flap is preferred.  Dr. Roy Casiano spoke about the impact of etiology on graft repair of skull base defects (leak localization).  And Dr. Ricardo Carrau discussed the use of vascularized flaps for skull base repair and presented evidence that their use dramatically improves post-operative CSF leakage compared to no flap.

In a seminar on Frontal Sinus Fractures, Dr. Andrew Murr discussed possible approaches to frontal sinus injury including the midforehead approach, which can be disguised by forehead wrinkles, the bicoronal approach, a more cosmetically acceptable approach, and access directly through the laceration if one is present.  Dr. Steven Pletcher talked about long-term complications of frontal sinus obliteration including mucocele formation and necrosis and the pros and cons of endoscopic vs. external approaches in revision surgery.  And lastly, Dr. Jacob Steiger detailed the endoscopic approaches to frontal sinus fractures including endoscopic assisted frontal sinus trephine, endoscopic frontal sinusotomy with transnasal reduction, and endoscopic frontal sinusotomy for outflow tract obstruction.

In a seminar on Microbes in CRS, Dr. Neil Bhattacharrya presented evidence that pathogenic bacteria are more often seen in patients with CRS than in controls and acute exacerbation is often associated with a shift to these pathogenic bacteria.  Dr. Jeff Leid discussed several molecular assays with greater sensitivity than standard laboratory culturing for identifying communities of bacteria and these techniques are finding several classes of bacteria that are associated more with CRS tissue than healthy controls.  Dr. J.S. Lacroix discussed the efficacy of mupirocin treatment for Staphylococcus aureus carriage and presented evidence suggesting the presence of S. aureus in asymptomatic patients could be an indicator of poorer long-term outcome.  And Dr. Robert Kern described how the down-regulation of certain anti-microbial mucosal genes leads to the proliferation of bacteria and stimulation of ineffective immune cascades.

In a mini seminar on Wound Healing and FESS Dr. Parul Goyal discussed the importance of cilia function and presented evidence that cilia from diseased mucosa has a lower basal ciliary beat frequency (CBF) and that a low CBF is also associated with disorganization of cilia.  Also, cilia from diseased mucosa do not increase CBF by chemical or mechanical stimulants compared to control mucosa, implying a mucociliary defect in diseased mucosa.  Dr. Richard Orlandi discussed perioperative considerations in optimizing wound healing and emphasized the importance of continuing maximum medical therapy through the surgical appointment and to be selective post-operatively when debriding the sinuses, removing only the larger scabs to prevent scaring.  Finally, Dr. Rakesh Chandra discussed the enhancement of wound healing through biotechnology and discussed several experimental trials in animal models, such as the use of an autologous platelet gel, for promoting wound healing.

As reported by: Jennifer M. Kofonow, M.S

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