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1. Sinonasal Undifferentiated Carcinoma: A 15-Year Single Institution Experience

Author

Workman, Alan D, Brody, Robert M, Kuan, Edward C, Baranov, Esther, Brooks, Steven G, Alonso-Basanta, Michelle, Newman, Jason G, Rassekh, Christopher H, Chalian, Ara A, Chiu, Alexander G, Weinstein, Gregory S, Feldman, Michael D, Adappa, Nithin D, O'Malley, Bert W, and Palmer, James N

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Trials and Supportive Activities, Clinical Research, Cancer, SNUC, sinonasal undifferentiated carcinoma, survival, treatment paradigms, prognosis, Neurology & Neurosurgery, Dentistry
Abstract

Objective  Sinonasal undifferentiated carcinoma (SNUC) is an aggressive neoplasm, with conflicting existing literature regarding prognosis and treatment due to the rarity of disease. Characterization of optimal SNUC management is necessary for improved outcomes. Study Design  Case series with planned data collection and analysis. Setting  Hospital of the University of Pennsylvania and Pennsylvania Hospital. Participants  Patients with pathologically confirmed SNUC treated within a 15-year period were identified, and records were obtained and evaluated for several demographic characteristics. Main Outcomes Measures  Disease-specific survival from diagnosis was the primary endpoint, while disease recurrence was a secondary endpoint of the study. Results  Twenty-seven patients with established SNUC were included in this cohort, with a median age of 55 years. Eighty-five percent of patients were surgically treated, and 85% of patients presented with stage IV disease. Two-year disease-specific survival was 66% and 5-year disease-specific survival was 46%. Ninety-six percent of patients received both chemotherapy and radiation as adjuvant treatment. Nodal disease at presentation and disease recurrence both significantly decreased patient survival ( p

Published
2019

3. International consensus statement on allergy and rhinology: Sinonasal tumors

Author

Kuan, Edward C., primary, Wang, Eric W., additional, Adappa, Nithin D., additional, Beswick, Daniel M., additional, London, Nyall R., additional, Su, Shirley Y., additional, Wang, Marilene B., additional, Abuzeid, Waleed M., additional, Alexiev, Borislav, additional, Alt, Jeremiah A., additional, Antognoni, Paolo, additional, Alonso‐Basanta, Michelle, additional, Batra, Pete S., additional, Bhayani, Mihir, additional, Bell, Diana, additional, Bernal‐Sprekelsen, Manuel, additional, Betz, Christian S., additional, Blay, Jean‐Yves, additional, Bleier, Benjamin S., additional, Bonilla‐Velez, Juliana, additional, Callejas, Claudio, additional, Carrau, Ricardo L., additional, Casiano, Roy R., additional, Castelnuovo, Paolo, additional, Chandra, Rakesh K., additional, Chatzinakis, Vasileios, additional, Chen, Simon B., additional, Chiu, Alexander G., additional, Choby, Garret, additional, Chowdhury, Naweed I., additional, Citardi, Martin J., additional, Cohen, Marc A., additional, Dagan, Roi, additional, Dalfino, Gianluca, additional, Dallan, Iacopo, additional, Dassi, Camila Soares, additional, de Almeida, John, additional, Tos, Angelo P. Dei, additional, DelGaudio, John M., additional, Ebert, Charles S., additional, El‐Sayed, Ivan H., additional, Eloy, Jean Anderson, additional, Evans, James J., additional, Fang, Christina H., additional, Farrell, Nyssa F., additional, Ferrari, Marco, additional, Fischbein, Nancy, additional, Folbe, Adam, additional, Fokkens, Wytske J., additional, Fox, Meha G., additional, Lund, Valerie J., additional, Gallia, Gary L., additional, Gardner, Paul A., additional, Geltzeiler, Mathew, additional, Georgalas, Christos, additional, Getz, Anne E., additional, Govindaraj, Satish, additional, Gray, Stacey T., additional, Grayson, Jessica W., additional, Gross, Bradley A., additional, Grube, Jordon G., additional, Guo, Ruifeng, additional, Ha, Patrick K., additional, Halderman, Ashleigh A., additional, Hanna, Ehab Y., additional, Harvey, Richard J., additional, Hernandez, Stephen C., additional, Holtzman, Adam L., additional, Hopkins, Claire, additional, Huang, Zhigang, additional, Huang, Zhenxiao, additional, Humphreys, Ian M., additional, Hwang, Peter H., additional, Iloreta, Alfred M., additional, Ishii, Masaru, additional, Ivan, Michael E., additional, Jafari, Aria, additional, Kennedy, David W., additional, Khan, Mohemmed, additional, Kimple, Adam J., additional, Kingdom, Todd T., additional, Knisely, Anna, additional, Kuo, Ying‐Ju, additional, Lal, Devyani, additional, Lamarre, Eric D., additional, Lan, Ming‐Ying, additional, Le, Hien, additional, Lechner, Matt, additional, Lee, Nancy Y., additional, Lee, Jivianne K., additional, Lee, Victor H., additional, Levine, Corinna G., additional, Lin, Jin‐Ching, additional, Lin, Derrick T., additional, Lobo, Brian C., additional, Locke, Tran, additional, Luong, Amber U., additional, Magliocca, Kelly R., additional, Markovic, Svetomir N., additional, Matnjani, Gesa, additional, McKean, Erin L., additional, Meço, Cem, additional, Mendenhall, William M., additional, Michel, Loren, additional, Na'ara, Shorook, additional, Nicolai, Piero, additional, Nuss, Daniel W., additional, Nyquist, Gurston G., additional, Oakley, Gretchen M., additional, Omura, Kazuhiro, additional, Orlandi, Richard R., additional, Otori, Nobuyoshi, additional, Papagiannopoulos, Peter, additional, Patel, Zara M., additional, Pfister, David G., additional, Phan, Jack, additional, Psaltis, Alkis J., additional, Rabinowitz, Mindy R., additional, Ramanathan, Murugappan, additional, Rimmer, Ryan, additional, Rosen, Marc R., additional, Sanusi, Olabisi, additional, Sargi, Zoukaa B., additional, Schafhausen, Philippe, additional, Schlosser, Rodney J., additional, Sedaghat, Ahmad R., additional, Senior, Brent A., additional, Shrivastava, Raj, additional, Sindwani, Raj, additional, Smith, Timothy L., additional, Smith, Kristine A., additional, Snyderman, Carl H., additional, Solares, C. Arturo, additional, Sreenath, Satyan B., additional, Stamm, Aldo, additional, Stölzel, Katharina, additional, Sumer, Baran, additional, Surda, Pavol, additional, Tajudeen, Bobby A., additional, Thompson, Lester D. R., additional, Thorp, Brian D., additional, Tong, Charles C. L., additional, Tsang, Raymond K., additional, Turner, Justin H., additional, Turri‐Zanoni, Mario, additional, Udager, Aaron M., additional, van Zele, Thibaut, additional, VanKoevering, Kyle, additional, Welch, Kevin C., additional, Wise, Sarah K., additional, Witterick, Ian J., additional, Won, Tae‐Bin, additional, Wong, Stephanie N., additional, Woodworth, Bradford A., additional, Wormald, Peter‐John, additional, Yao, William C., additional, Yeh, Chien‐Fu, additional, Zhou, Bing, additional, Palmer, James N., additional, Abiri, Arash, additional, Adams, Carrie D., additional, Ayoub, Noel F., additional, Bitner, Benjamin F., additional, Boyd, Jacob T., additional, Chang, Michael T., additional, Chapurin, Nikita, additional, Chaskes, Mark B., additional, Chua, Andy, additional, Chung, Sei Y., additional, Contrera, Kevin J., additional, Dilley, Katelyn K., additional, Dutra, André Zanette, additional, Eide, Jacob G., additional, Fenberg, Rachel, additional, Godse, Neal R., additional, Jawad, Basit, additional, Johnson, Jared, additional, Johnson, B. Jake, additional, Judd, Ryan, additional, Khalife, Sarah, additional, Khosravi, Pooya, additional, Kolarski, Mirko Manojlovic, additional, Kong, Keonho A., additional, Kshirsagar, Rijul S., additional, Lee, Joseph S., additional, Lin, Tian‐Yun, additional, McCormick, Justin P., additional, Melder, Katie, additional, Morse, Elliot, additional, Nguyen, Theodore V., additional, Norwood, Timothy G., additional, Pang, Jonathan C., additional, Parsel, Sean M., additional, Patel, Prayag S., additional, Ringel, Barak, additional, Schneider, Alexander L., additional, Spielman, Daniel B., additional, Spock, Todd, additional, and Vasudev, Milind, additional

Published
2023
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6. Profiling ACE2 and TMPRSS2 expression in sinonasal mucosa

Author

Price Michael E, Nallani Rohit, Bodine Jared S, Gaur Gunjan, Arnold Levi, Humphrey Bryan, Ottemann Brendan, O’Neil Maura F, Sykes Kevin J, Beahm D David, Qiu Jianming, Chiu Alexander G, and Thomas Sufi Mary

Subjects
General Medicine
Abstract

Rhinologists may be one of the highest-risk subspecialties in otolaryngology for exposure to SARS-CoV-2 as the sinonasal passage seems to be a reservoir for the virus. Previous data indicate nasal epithelial cells express the primary receptor for SARS-CoV-2, Angiotensin-Converting Enzyme-2 (ACE2). However, no data exist profiling the regional expression of ACE2 or the expression of transmembrane serine protease 2 (TMPRSS2), an additional protease necessary for SARS-CoV-2 viral entry, within the sinonasal cavity. We sought to assess for anatomic expression of ACE2 and TMPRSS2 throughout the nasal cavity and paranasal sinuses. We hypothesize that ACE2 and TMPRSS2 are expressed throughout the nasal cavity and paranasal sinuses. To test this hypothesis, we sampled various regions of the sinonasal cavity from patients undergoing rhinology procedures and used immunohistochemical staining to profile ACE2, compare ACE2 expression between regions, and compare ACE2 expression between patients and patient characteristics. We found ACE2 and TMPRSS2 are present throughout the sinonasal cavity without a regional pattern among anatomic regions in our patients. We found no statistically significant correlation in ACE2 expression with patient characteristics such as age, sex, or BMI. We also did not find a statistically significant correlation between ACE2 and TMPRSS2 quantitative expression. ACE2 expression trended higher in males compared to females for six out of seven regions excluding the nasal floor. In conclusion, ACE2 and TMPRSS2 are expressed ubiquitously throughout the sinonasal cavity. ACE2 expression may be higher in the sinonasal cavity in males compared to females. These data implicate that SARS-CoV-2 is unlikely to discriminate between anatomic regions as a point of entry and that anatomic regions likely are similar in viral load. Thus, all rhinology and skull base surgeries, independent of encounter of the anatomic region in the sinonasal cavity, predicate screening for SARS-CoV-2, and necessary personal protective equipment.

Published
2022

7. Dedication

Author

Chiu, Alexander G., primary, Palmer, James N., additional, and Adappa, Nithin D., additional

Published
2019
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12. Contributors

Author

Adappa, Nithin D., primary, Adelson, Robert T., additional, Antunes, Marcelo, additional, Balsalobre, Leonardo, additional, Barham, Henry P., additional, Becker, Daniel G., additional, Becker, Samuel S., additional, Bleier, Benjamin S., additional, Chandra, Rakesh, additional, Chiu, Alexander G., additional, Choby, Garret, additional, Citardi, Martin J., additional, Cohen, Noam, additional, Conley, David B., additional, Fakhri, Samer, additional, Ference, Elisabeth H., additional, Govindaraj, Satish, additional, Grayson, Jessica, additional, Harsh, Griffith R., additional, Harvey, Richard J., additional, Hwang, Peter H., additional, Iloreta, Alfred Marc C., additional, Joe, Stephanie A., additional, Kingdom, Todd T., additional, Kuan, Edward C., additional, Lee, Jivianne T., additional, Lee, John M., additional, Leung, Randy, additional, Lobo, Brian C., additional, Luong, Amber U., additional, Lupa, Michael, additional, Man, Li-Xing, additional, Mantravadi, Avinash V., additional, Mattos, Jose, additional, Miyake, Marcel Menon, additional, Naidoo, Yuresh, additional, Nayak, Jayakar V., additional, O’Malley, Bert W., additional, Orlandi, Richard, additional, Palmer, James N., additional, Parasher, Arjun, additional, Pearlman, Aaron N., additional, Nagata Pignatari, Shirley Shizue, additional, Ramakrishnan, Vijay R., additional, Reed, Jeremy, additional, Sacks, Raymond, additional, Sansoni, E. Ritter, additional, Schlosser, Rodney, additional, Sindwani, Raj, additional, Sivasubramaniam, Rahuram, additional, Stamm, Aldo Cassol, additional, Suh, Jeffrey D., additional, Thamboo, Andrew, additional, Vaezeafshar, Reza, additional, Vandergrift, William A., additional, Wang, Eric W., additional, Wei, Calvin, additional, Welch, Kevin C., additional, Woodworth, Bradford A., additional, Wormald, P.J., additional, and Yip, Jonathan, additional

Published
2019
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22. Factors affecting adherence to intranasal treatment for allergic rhinitis: A qualitative study.

Author

Fox, Meha G., Cass, Lauren M., Sykes, Kevin J., Cummings, Emily L., Fassas, Scott N., Nallani, Rohit, Smith, Josh B., Chiu, Alexander G., and Villwock, Jennifer A.

Subjects
PATIENT compliance, ALLERGIC rhinitis, MEDICAL personnel, NOCEBOS, SALINE irrigation, FLUTICASONE
Abstract

Objective: To determine the facilitators of and barriers to adherence to use of intranasal pharmacotherapy (daily intranasal corticosteroids and/or antihistamine, and nasal saline irrigation [NSI]), for allergic rhinitis (AR). Methods: Patients were recruited from an academic tertiary care rhinology and allergy clinic. Semi‐structured interviews were conducted after the initial visit and/or 4–6 weeks following treatment. Transcribed interviews were analyzed using a grounded theory, inductive approach to elucidate themes regarding patient adherence to AR treatment. Results: A total of 32 patients (12 male, 20 female; age 22–78) participated (seven at initial visit, seven at follow‐up visit, and 18 at both). Memory triggers, such as linking nasal routine to existing daily activities or medications, were identified by patients as the most helpful strategy for adherence at initial and follow‐up visits. Logistical obstacles related to NSI (messy, takes time, etc.) was the most common concept discussed at follow‐up. Patients modified the regimen based on side effects experienced or perceived efficacy. Conclusions: Memory triggers help patients adhere to nasal routines. Logistical obstacles related to NSI can deter from use. Health care providers should address both concepts during patient counseling. Nudge‐based interventions that incorporate these concepts may help improve adherence to AR treatment. Level of Evidence: 2 [ABSTRACT FROM AUTHOR]

Published
2023
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30. Creation of a Novel Preoperative Imaging Review Acronym to Aid in Revision Endoscopic Sinus Surgery.

Author

Karadaghy, Omar A., Peterson, Andrew M., Fox, Meha, White, Jacob, Bhalla, Vidur, Beahm, David, Villwock, Jennifer, and Chiu, Alexander G.

Abstract

Objectives: (1) Identify anatomic contributions to chronic rhinosinusitis (CRS) necessitating revision endoscopic sinus surgery (RESS). (2) Create a clinical acronym to guide imaging review prior to RESS that addresses pertinent sites of disease and potential sites of surgical morbidity. Data Sources: Ovid MEDLINE, Embase and Medline via Embase.com, Web of Science Core Collection, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. Review Methods: Systematic search was performed using a combination of standardized terms and keywords. Studies were included if they investigated anatomic contributions to persistent CRS requiring RESS or the relationship between anatomic landmarks and surgical morbidity. Identified studies were screened by title/abstract, followed by full-text review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were strictly followed. Results: In total, 599 articles met screening criteria, 89 were eligible for full-text review, and 27 studies were included in the final review. The identified anatomic sites of interests are broad; the most frequently cited anatomic region was retained anterior ethmoid cells (22/27 studies), followed by posterior ethmoid cells (14/27 studies). Using the consolidated information, a clinical acronym, REVISIONS, was created: Residual uncinate, Ethmoid cells (agger, Haller, supraorbital), Vessels (anterior and posterior ethmoid), Infundibulum, Septal deviation, I (eye) compartment, Onodi cell, Natural os, and Skull base slope and integrity. Conclusions: The REVISIONS acronym was developed as a tool to distill the unique anatomic contributions of primary endoscopic sinus surgery failure into a format that can be easily incorporated in preoperative radiologic review and surgical planning to optimize outcomes and minimize complications. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review.

Author

Somani, Shaan N., Yu, Katherine M., Chiu, Alexander G., Sykes, Kevin J., and Villwock, Jennifer A.

Abstract

Objective: Consumer wearables, such as the Apple Watch or Fitbit devices, have become increasingly commonplace over the past decade. The application of these devices to health care remains an area of significant yet ill-defined promise. This review aims to identify the potential role of consumer wearables for the monitoring of otolaryngology patients.Data Sources: PubMed.Review Methods: A PubMed search was conducted to identify the use of consumer wearables for the assessment of clinical outcomes relevant to otolaryngology. Articles were included if they described the use of wearables that were designed for continuous wear and were available for consumer purchase in the United States. Articles meeting inclusion criteria were synthesized into a final narrative review.Conclusions: In the perioperative setting, consumer wearables could facilitate prehabilitation before major surgery and prediction of clinical outcomes. The use of consumer wearables in the inpatient setting could allow for early recognition of parameters suggestive of poor or declining health. The real-time feedback provided by these devices in the remote setting could be incorporated into behavioral interventions to promote patients' engagement with healthy behaviors. Various concerns surrounding the privacy, ownership, and validity of wearable-derived data must be addressed before their widespread adoption in health care.Implications For Practice: Understanding how to leverage the wealth of biometric data collected by consumer wearables to improve health outcomes will become a high-impact area of research and clinical care. Well-designed comparative studies that elucidate the value and clinical applicability of these data are needed. [ABSTRACT FROM AUTHOR]

Published
2022
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32. The GSDMB rs7216389 SNP is associated with chronic rhinosinusitis in a multi‐institutional cohort

Author

Zack, Dana E., primary, Stern, Debra A., additional, Willis, Amanda L., additional, Kim, Alexander S., additional, Mansfield, Corinne J., additional, Reed, Danielle R., additional, Brooks, Steven G., additional, Adappa, Nithin D., additional, Palmer, James N., additional, Cohen, Noam A., additional, Chiu, Alexander G., additional, Song, Brian H., additional, Le, Chris H., additional, and Chang, Eugene H., additional

Published
2021
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33. sj-pdf-1-ajr-10.1177_1945892421992659 - Supplemental material for Educational Informed Consent Video Equivalent to Standard Verbal Consent for Rhinologic Surgery: A Randomized Controlled Trial

Author

Penn, Joseph P., Rohit Nallani, Dimon, Erin L., Daniels, Taylor C., Sykes, Kevin J., Chiu, Alexander G., Villwock, Mark R., and Villwock, Jennifer A.

Subjects
110315 Otorhinolaryngology, FOS: Clinical medicine
Abstract

Supplemental material, sj-pdf-1-ajr-10.1177_1945892421992659 for Educational Informed Consent Video Equivalent to Standard Verbal Consent for Rhinologic Surgery: A Randomized Controlled Trial by Joseph P. Penn BS, Rohit Nallani MD, Erin L. Dimon BS, Taylor C. Daniels BS, Kevin J. Sykes PhD, MPH, Alexander G. Chiu MD, Mark R. Villwock MS, Jennifer A. Villwock MD in American Journal of Rhinology & Allergy

Published
2021
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38. Does Surgery for Nasal Obstruction Improve Eustachian Tube Dysfunction?

Author

Virgen, Celina, Sawaf, Tuleen, Renslo, Bryan, and Chiu, Alexander G.

Abstract

A review of current literature on the surgical management of nasal obstruction for eustacian tube dysfunction suggests potential benefit. However, due to the lack of prospective studies with control groups definitive benefit cannot be determined. Further studies are necessary to evaluate the role of nasal surgery in this patient population. [ABSTRACT FROM AUTHOR]

Published
2023
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