Frontal Sinus Inverted Papilloma: Surgical Challenges and Outcomes of a Multi-Institutional Cohort.

Objectives: Inverted papilloma (IP) is typically a benign sinonasal tumor with a propensity to recur. The surgical treatment of IP arising from the frontal sinus is complicated by proximity to the orbit and skull base. The objective of this study is to describe the surgical challenges when managing this disease and report treatment outcomes in a multicenter cohort.

Nodal metastasis in surgically treated sinonasal squamous cell carcinoma.

Objectives: Tumor factors such as subsite and stage impact the risk of lymph node metastasis (LNM) and overall risk in sinonasal squamous cell carcinoma (SNSCC). We sought to identify the rates of patients presenting with or without clinical LNM for different tumor subsites and stages of surgically-treated SNSCC, determine the concordance between clinical and pathologic LNM after neck dissection (ND), and identify predictors of occult LNM.

Methods: The National Cancer Database was queried for patients with surgically-treated SNSCC from 2004 to 2016.

Comparative analysis of AI-generated study guides in otolaryngology education.

Introduction: Resident physicians training in otolaryngology frequently utilize dense traditional textbooks like "Cummings: Otolaryngology Head and Neck Surgery," widely regarded as the gold standard for educational content in the field. However, integrating artificial intelligence (AI) into educational methods offers potential enhancements to traditional methods of trainee learning. This study evaluates the accuracy, relevance, and clarity of AI-generated study guides for otolaryngology residents and their efficacy in graduate level education.

Comparative Analysis of Biopsy Techniques for Cervical Lymphoma: A Retrospective Cohort Review.

Introduction: Lymphoma is the most common neck mass malignancy in adults but can present diagnostic challenges due to controversy surrounding the best initial biopsy approach. In this study, the authors characterize the diagnostic pathway in adults with lymphoma (or leukemia) presenting initially as a neck mass and examine the biopsy procedures required for diagnosis in a large community-based practice setting.

Methods: Using data from a retrospective cohort of 4103 adults referred to otolaryngology with a neck mass (5% found to be malignant), the authors identified the subset with lymphoma (or leukemia) and examined the time to diagnosis and the number and type of biopsies required for diagnosis.

Outcomes of Immunotherapy Treatment in Sinonasal Mucosal Melanoma.

Background: Sinonasal mucosal melanoma has poor survival despite multimodality treatment. While the impact of immunotherapy (IT) on metastatic cutaneous melanoma is well-defined, there are relatively little data on sinonasal mucosal melanoma.

Objective: We sought to define immunotherapy outcomes in patients with sinonasal mucosal melanoma.

Bleeding risk from nonsteroidal anti-inflammatory drugs after functional endoscopic sinus surgery: Analysis of the TriNetX database.

Objectives: Postoperative pain medications and aspirin before undergoing functional endoscopic sinus surgery (FESS) are managed carefully due to concern for bleeding. Little is known regarding the increase in the risk of bleeding for patients unable to stop aspirin as trials are limited in this area. We compared outcomes for patients undergoing FESS who were managed postoperatively with nonsteroidal anti-inflammatory drugs (NSAIDs) versus opioids.

Quality-of-Life Outcomes Following Endoscopic Resection of Sinonasal Inverted Papilloma.

Objectives: There is growing interest in assessing patient quality of life (QOL) following treatment of sinonasal tumors, including inverted papilloma (IP). We aimed to elucidate the natural history of postoperative QOL outcomes in IP patients treated with surgery.

Methods: Cases of sinonasal IP treated surgically at 4 tertiary academic rhinology centers were retrospectively reviewed.

Endoscopic Repair of Anterior Skull Base Cerebrospinal Fluid Leaks is Successful in Frail Patients.

Objective: Surgical frailty estimates a patient's ability to withstand the physiologic stress of an intervention. There is limited data regarding the impact of frailty on endoscopic cerebrospinal fluid (CSF) leak repair.

Methods: Patients undergoing CSF leak repair at two tertiary academic skull base programs were retrospectively reviewed.

Microdebrider complications in sinus surgery: Analysis of the openFDA database.

Objective: Functional endoscopic sinus surgery is a commonly performed otolaryngologic procedure that often uses the microdebrider device for tissue removal. Given the ubiquitous nature of the instrument, we sought to better define the patterns of device failure using the postmarket surveillance openFDA database.

Methods: The openFDA database was queried for all microdebrider-related adverse events from January 1, 2000 to November 1, 2020.

Postoperative mometasone irrigations improve quality of life in skull base tumor patients.

Objectives: The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied. We quantified long-term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.

Methods: Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019.

Ocular Surface Adverse Events are not Associated with Dupilumab use in Nasal Polyp Treatment.

Objectives: Ocular surface reactions (OSR) have been associated with dupilumab for atopic dermatitis (AD) treatment. However, the association of dupilumab-associated OSR (DA-OSR) for nasal polyps (CRSwNP) treatment has not been studied. We evaluated DA-OSR for CRSwNP treatment using the FDA Adverse Event Reporting System (FAERS).

Impact of Frailty on Postoperative Outcomes in Extended Endonasal Skull Base Surgery for Suprasellar Pathologies.

Objective: Frailty metrics estimate a patient's ability to tolerate physiologic stress and there are limited frailty data in patients undergoing expanded endonasal approaches (EEA) for suprasellar pathologies. Elevated frailty metrics have been associated with increased perioperative complications in patients undergoing craniotomies. We sought to examine this potential relationship in EEA.

Multi-institutional Analysis of Endoscopic Sellar Surgical Volumes During the COVID-19 Pandemic.

Objective: We sought to quantify trends in operative volumes and complications of endoscopic sellar surgery before and after the COVID-19 pandemic onset.

Study Design: We performed a retrospective analysis.

Setting: TriNetX database analysis.

Frailty does not worsen postoperative outcomes in sinonasal squamous cell carcinoma.

Purpose: Sinonasal squamous cell carcinoma (SCC) is an aggressive malignancy frequently requiring surgical resection and adjuvant treatment. Frailty is a metric that attempts to estimate a patient's ability to tolerate the physiologic stress of treatment. There is limited work describing frailty in patients with sinonasal cancer.

Carcinosarcoma of the nasal cavity and paranasal sinuses: Review of the national cancer database.

Background: Carcinosarcomas are rare, aggressive malignancies that can arise in the nasal cavity and paranasal sinuses. There are limited outcome data available. Accordingly, we sought to use the National Cancer Database (NCDB) to characterize patient demographics and outcomes.

Determinants of Patient Refusal of Postoperative Radiation Therapy in Sinonasal Squamous Cell Carcinoma.

 Although adjuvant radiotherapy may be indicated in patients with sinonasal squamous cell carcinoma (SNSCC) following primary surgery, some patients choose to forgo recommended postoperative radiation therapy (PORT). This study aimed to elucidate factors associated with patient refusal of recommended PORT in SNSCC and examine overall survival.  Retrospective analysis of patients with SNSCC treated with primary surgery from the National Cancer Database diagnosed between 2004 and 2016.

The Utility of a "Second-Look" Debridement Following Endonasal Skull Base Surgery in the Pediatric Population.

 Sinonasal debridement is typically performed in the weeks following endonasal skull base surgery (ESBS). In the pediatric population, this second-look procedure may require general anesthesia; however, there is currently little evidence assessing the benefit of this practice.  This was a multicenter retrospective study of pediatric patients (age <18 years) undergoing a planned second-look debridement under general anesthesia following ESBS.

Craniopharyngioma surgery for rhinologists.

Purpose Of Review: Craniopharyngiomas are rare tumors that that present with loss of pituitary function in most cases. They present in a bimodal age distribution and the most common treatment paradigms include gross total resection or subtotal resection followed by radiation. Endoscopic transnasal access to intradural tumors has become increasingly common due to improvements in equipment, increased familiarity with the surgical corridor and anatomy, and reconstruction techniques.

Primary sinonasal lymphoma: A multi-institutional experience of clinical presentation, treatment, and outcomes.

Background: Sinonasal lymphoma (SL) is a heterogeneous, underrecognized neoplastic disorder with limited outcomes data. We sought to better define outcomes by subtype and treatment at 2 referral centers over the past 2 decades.

Methods: Demographics, clinicopathologic data, and treatment outcomes for patients treated for SL were queried from January 1, 2000 to December 31, 2021 at 2 tertiary academic medical centers.