Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P295

Poster Presentations

Objectives: Eosinophilic chronic rhinosinusitis (ECRS) is
associated with poor treatment outcome, such as the higher
recurrence rate and less improvement of symptoms. However,
recent studies have reported that ECRS might not be correlated with poor outcome. A scoring system, the Japanese
Epidemiological Survey of Refractory Eosinophilic Chronic
Rhinosinusitis (JESREC) score, which consists of computed
tomography, endoscopic findings, and blood eosinophil percentage, was introduced to clinically diagnose ECRS. We
aimed to evaluate the practicability of the JESREC scoring
system and compare surgical outcomes of ECRS with that of
NECRS.
Methods: We evaluated patients with CRS treated with
endoscopic sinus surgery. Nasal polyps were divided into histologic ECRS and NECRS (h-ECRS vs h-NECRS) based on
tissue eosinophilic infiltration and divided into 10%, 20%,
and 30% depending on the degree of eosinophilic infiltration
and clinically classified using the JESREC score. We investigated the improvement of symptoms, the recurrence of nasal
polyp, and the presence of revision sinus surgery as the primary surgical outcome in subtypes of CRS based on the histologic results and JESREC scores.
Results: h-ECRS showed higher JESREC scores than
h-NECRS and more comorbidity with asthma. The proportion
of h-ECRS was higher in j-ECRS than in j-NECRS; however,
the JESREC score was not consistent with histologic findings.
The average J score of grade 3 was higher than that of grade 0.
However, the average J score of grade 1 to 2 was not significantly different. There was a nonsignificant difference in primary surgical outcomes between ECRS and NECRS, classified
by both histologic findings and JESREC scores.
Conclusions: A high JESREC score could be regarded as a
good predictor of ECRS. However, mild to moderate ECRS
may not be predictable with J score alone. ECRS and NECRS
showed comparable surgical outcomes and prognosis. ECRS
could not be responsible for the poor surgical outcome.
The Effect of Magistral Steroid Ointment on
Postoperative Crusting Following Sinonasal
Surgery
Mustafa Mert Basaran, MD (Presenter); Sinan Kocaturk;
Hande Arslan
Objectives: In this study, we investigated the effect of a magistral prednisone ointment on nasal mucosa healing and postoperative nasal symptoms in the early postoperative period. Thirty
healthy adult patients (10 women) between age 18 and 56 years
who underwent sinonasal surgery were included in the study.
Methods: After removal of nasal packing, the study group
patients received the magistral steroid ointment, and the control group received an antibiotic ointment with oxytetracycline, polymyxin B, paraffin oil, and Vaseline. On postoperative

day 4 and day 8, the patients were evaluated for encrustation
in nasal cavities and nasal symptoms of pain, stuffiness, sneezing, and discharge.
Results: Compared with topical antibiotic treatment, the
magistral steroid ointment application significantly reduced
postoperative crust formation in the nasal cavities. Among
subjective symptoms of pain, stuffiness, sneezing, and discharge, only pain and sneezing showed significant reduction
on steroid ointment application.
Conclusions: Postoperative care after nasal surgery aims to
prevent adhesions and clear the nasal passages to increase airflow and restore mucociliary activity. Our magistral ointment
with anti-inflammatory and moisturizing agents reduces postoperative crust formation.
Endoscopic Approach to a Giant Ethmoid
Osteoma Presenting as an Orbital Abscess
Subin Lee (Presenter); Jonathan Mallen, MD;
Todd E. Falcone, MD
Objectives: Osteomas are benign, slow-growing, bony tumors
that are generally asymptomatic until mass effect causes intracranial or intraorbital complications.
Methods: Here we report a case of a 24-year-old man who
presented to the emergency department with rapid onset
of right-sided periorbital edema, proptosis, cellulitis, and ophthalmoplegia following a sinus infection. Computed tomography (CT) showed an orbital abscess and a large 3.5-cm ethmoid
osteoma with extension into the orbit causing downward displacement of the globe. The patient had significant gaze restriction and elevated intraocular pressure (IOP) at 35 mm Hg. He
was taken urgently to the operating room for endoscopic sinus
surgery, including medial orbital wall decompression and subtotal excision of an ethmoidal-orbital osteoma.
Results: The patient had an immediate decrease in IOP into
the normal range following surgery and responded well to
medical treatment of the sinus and orbital infection. On further questioning, the patient admitted to chronic right orbital
and frontal headache previously diagnosed as migraine without prior imaging.
Conclusions: Sinus osteomas are typically small, usually in
the frontal sinus, and largely asymptomatic. This unique case
of a giant ethmoidal-orbital osteoma, because of its large
intraorbital extension, caused displacement of the globe and
an orbital abscess requiring urgent decompression and resection to avoid orbital compartment syndrome and vision loss.
Osteomas can be addressed through an open or endoscopic
approach and in an elective or urgent fashion based on the
size, clinical scenario, and surgeon experience.
Endoscopic Management of Sinonasal
Glomangiopericytoma: Institutional
Experience and Literature Review
Weining Yang, MD (Presenter); Allan Vescan, MD
Objectives: Sinonasal glomangiopericytoma (SNGPC) is an
uncommon benign lesion of the sinonasal tract. Diagnostic
and treatment options are incompletely characterized.

Rhinology/Allergy

The Comparison of Surgical Outcome of
Chronic Sinusitis, Classified According to
Histological Findings and JESREC Score
Yuju Seo (Presenter); Dong-Young Kim, MD;
Chae-Seo Rhee, MD, PhD

P295

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

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