Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P32

P32
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.
Outcome Objectives: (1) Analyze common primary laryngeal framework surgery failure patterns. (2) Recognize limitations of revision laryngeal framework surgery to avoid
complications and establish proper patient expectations. (3)
Perform revision laryngeal framework surgery with success
knowing the pitfalls.

Otology/Neurotology

THRIVE: A Novel Adjunct in Airway
Management for Laryngological Surgery
Margaret L. Naunheim, MD (Moderator); Dale C. Ekbom, MD;
Alexander Gelbard, MD; Reza S. A. Nouraei, PhD, FRCS
Session Description: Transnasal humidified rapid insufflation
ventilatory exchange (THRIVE) is a method for high-flow oxygen delivery using nasal prongs. This tool is used in intensive
care units and emergency departments for patients with respiratory compromise, but it also has utility in the operating room.
THRIVE can increase apnea time while preventing de--saturation
in patients undergoing short laryngological procedures, allowing an unobstructed view of the glottis. It can also prevent
quick desaturation in patients who may be a difficult exposure
prior to definitive airway management (eg, jet ventilation).
The panelists will discuss what THRIVE is, how it works, and
the type of patient for whom it is optimal. First, the system
itself will be described, followed by an explanation of the
physiology behind it. Finally, the panelists will discuss a number of cases in which this tool was successfully used, as well
as cases in which it was not ideal. Throughout the session, the
pearls and pitfalls of using THRIVE will be discussed. In conclusion, THRIVE is a practical and safe adjunct to airway
management that can be implemented immediately; physicians should feel comfortable adding this tool to their
repertoire.
Outcome Objectives: (1) Recognize the physiology of airway management using THRIVE. (2) Implement THRIVE as
an adjunct to airway management in the operating room. (3)
Recognize inherent limitations and patient factors that may
restrict appropriateness of THRIVE.
Vocal Fold Leukoplakia: Cases, Controversy,
and Management
Lee M. Akst, MD (Moderator); Kenneth W. Altman, MD, PhD;
Matthew S. Broadhurst, FRACS; Vyas M. N. Prasad, MSc, FRCS
Session Description: This panel presentation comprehensively reviews evaluation and management of laryngeal leukoplakia. Updated from prior years, this iteration will explore
management strategies through focus on a case-based
approach. Although "white vocal fold lesions" are common,
management remains challenging: Doing "too little" may
allow precancerous lesions to progress, while doing "too
much" may create unnecessary dysphonia. Using cases, panel
discussion, and encompassing a variety of expert opinions and
surgical techniques, this panel presentation will provide a
framework for balancing oncologic with functional outcomes.
It will highlight challenges, controversies, and merging paradigms in laryngeal leukoplakia care. There will be focus on

surgical approaches that can be applied in current practice,
including use of KTP and CO2 lasers and also discussion of
what techniques are appropriate in the absence of a laser.
Discussion will also include future technologies and adjuvant
care of laryngeal leukoplakia, encompassing narrow-band
imaging, optical coherence tomography, chemotherapy, radiotherapy, and photodynamic therapy as they apply to current
and future state-of-the-art management.
Outcome Objectives: (1) Describe the risk of laryngeal leukoplakia progression to cancer, with the need to balance oncologic efficacy with function. (2) Review current and emerging
techniques for accurate diagnosis, staging, and surveillance of
laryngeal leukoplakia. (3) Discuss treatment alternatives for
laryngeal leukoplakia in the office and operation rom, mentioning KTP, CO2, and cold-instrument techniques.
Zenker's Diverticulum: Do You Have All the
Tools?
Rebecca J. Howell, MD (Moderator); Brianna K.
Crawley, MD; Milan R. Amin, MD; Philip A. Weissbrod, MD
Session Description: Treatment approaches for Zenker's
diverticulum have multiplied over the past 20 years, as interventional gastroenterologists have applied their flexible endoscopic techniques to this pathology. Sufficient data have now
been amassed to support the safety and efficacy of the flexible
endoscopic approach. Although most otolaryngologists already
possess the skills required to apply the flexible endoscopic
technique, few have embraced this technology. This session
presents the flexible, rigid, and combined approaches to
Zenker's diverticulum, as well as the specific tools required, to
ensure that otolaryngologists can offer all options to their
patients. Patient selection, advantages, and drawbacks to each
approach will be discussed. The goal of this session is to provide clinical information on preoperative, intraoperative, and
perioperative (complications) for each technique and to introduce the flexible endoscopic approach to Zenker's diverticulum in an otolaryngology practice, ensuring that our patients
receive the best care in each clinical scenario.
Outcome Objectives: (1) Plan and perform flexible, rigid, or
combined endoscopic approaches to Zenker's diverticulum.
(2) Recognize patient characteristics that favor one endoscopic approach over others. (3) Describe adverse events
associated with each endoscopic and open approach.

Otology/Neurotology
The Chronically Draining Ear: Why Current
Management Fails and What We Should Be
Doing
Michael B. Gluth, MD (Moderator);
Peter Santa Maria, MBBS; Wade Chien, MD
Session Description: We discuss the underlying basis for why
ears chronically drain in chronic suppurative otitis media and
cholesteatoma. We discuss relevant biomechanics and acoustic principles, microbiology, immunology, biochemistry, and

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

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