Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P142

Rhinology/Allergy

P142
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
Loyola University Medical Center from 2009 to 2019. Patients
and worse CRS-specific QOL in patients with presumed CRS,
were identified by the diagnosis of angioedema (ICD-10 T78.3
we were unable to find an association.
or ICD-9 995.1). Data collected included basic demographics,
Rhinologic Treatment Trends Among
subjective symptoms, physical examination findings, larynCovid-19 Patients With Anosmia
goscopy findings, disposition, and airway intervention.
Results: Of the first 100 of 819 patients with a diagnosis of
Claudia I. Cabrera, MD, MS (Presenter); Kenneth D.
angioedema who were reviewed, 20 had edema isolated to the
Rodriguez, MD; Brian D. D'Anza, MD
lips and/or face. Eleven patients (55%) presented with lip
Objectives: (1) Study the rhinologic treatments in addressedema, 3 (15%) with face edema, and 6 (30%) with both lip and
ing COVID-19-related smell and taste complaints. (2)
face edema. Two patients (10%) with positive laryngoscopy
Examine the use of nasal steroids among patients with anosfindings had both lip and face involvement, whereas no patients
mia and COVID-19. (3) Examine the concomitant symptoms
with isolated single-site edema had laryngoscopy findings.
among patients diagnosed with anosmia.
Conclusions: The preliminary chart review demonstrates that
Methods: A query on May 2020 of the TrineTX de-identimost patients with lip or face edema do not have positive
fied patient database was made including COVID-19-positive
laryngoscopy findings. Additional chart review and data analpatients and International Statistical Classification of Disea-
ysis may reveal a stronger relationship between an angioses, Tenth Revision (ICD-10) code for anosmia. The query
edema patient's presenting signs and symptoms and their FL
included patients from January 1, 2020, to date from 13 health
examination to further aid in the management of this common
care organizations. The resultant population of patients with
otolaryngology consult.
ICD-10 codes for COVID-19 and anosmia were reviewed for
associated medications as well as other symptoms involving
Standardization of the Nasal Provocation
smell and taste disorders.
Test: Which Assessment Scale to Choose?
Results: Eighty-four patients with a positive diagnosis of
Young Hyo Kim (Presenter)
COVID-19 and anosmia were identified from 94,811 patients.
The mean age was 38 years old, ranging from 8 to 81 years; 73%
Objectives: There is yet no standardized method for the
were female; 27% were male. From this cohort 33% were diagnasal provocation test (NPT). We tried to standardize NPT
nosed with concomitant parageusia, 24% with other unspecified
protocol adopting the European Academy of Allergy &
disturbances of smell and taste, and 12% parosmia. A review of
Clinical Immunology (EAACI) position paper. We also comnasal treatments revealed 27% received nasal topical agents, and
pared the diagnostic efficacy of subjective measures, such as
from this only 31% received steroidal nasal sprays.
nasal and ocular symptoms, using a visual analog scale (VAS),
Conclusions: This research suggests the incidence of anosand objective measures, such as peak nasal inspiratory flow
mia is similar to what was reported by the American Academy
(PNIF), minimal cross-sectional area (MCA), and total nasal
of Otolaryngology-Head and Neck Surgery. Up to one-third
volume (TNV) measured by acoustic rhinometry.
of patients report associated types of smell and taste disorders
Methods: Thirteen patients with allergic rhinitis (AR group)
beyond smell loss. Despite evidence attesting to their lack of
and 22 patients with nonallergic rhinitis (NAR group) were
efficacy in viral-related anosmia, over a quarter of patients are
enrolled. We sprayed Dermatophagoides pteronyssinus (Dp)
receiving intranasal steroid sprays. Further education is
allergen into each nasal cavity. Before and after the Dp chalneeded to prevent inappropriate intranasal treatment of
lenge, we measured the VAS change of nasal symptoms (nasal
COVID-19-related anosmia.
obstruction, rhinorrhea, sneezing, and itching), ocular symptoms, and change of PNIF, MCA, and TNV.
The Role of Flexible Laryngoscopy in
Results: The AR group showed a significant worsening of
Asymptomatic Angioedema Isolated to the
all
symptoms 15 minutes after the challenge (P < .0001).
Lips and Face
Thirty minutes after the challenge, nasal obstruction and rhiTemitope Adetola Adeyeni (Presenter); Aaron Domack, MD;
norrhea were still significantly worse in the AR group (P <
Christopher Britt, MD
.0001). For sneezing and itching, although the AR group
Objectives: Flexible laryngoscopy (FL) is a critical part of
showed a significant difference compared with the NAR
the angioedema workup because it localizes and qualifies the
group, the difference was smaller (P = .012 and P = .039). The
extent of airway involvement. Ideally, it would be used in
ocular symptoms, PNIF, MCA, and TNV all showed a significases that are suspicious for airway involvement to avoid
cant difference between groups, 15 and 30 minutes after the
overutilization of otolaryngology resources. In practice, howchallenge (P < .05). Through the receiver-operating characterever, most patients presenting with angioedema will undergo
istic (ROC) analysis, we found that the area under the curves
FL. The purpose of this study was to reveal the relationship
of nasal obstruction (0.977), rhinorrhea (0.906), and TNV
between angioedema isolated to the lips or face and findings
(0.979) was higher than those of sneezing (0.755), itching
on FL, while also investigating presenting symptoms predic(0.673), and MCA (0.836).
tive of airway involvement.
Conclusions: The NPT according to the EAACI guidelines could
Methods: This is a single-institution retrospective chart
be useful in diagnosing AR. The VAS changes of nasal obstrucreview of all adult patients with angioedema that presented to
tion, rhinorrhea, and TNV had higher diagnostic accuracy.

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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