More than 40 Research Studies to Be Presented at Meeting

Newswise — More than 40 new medical research studies regarding pediatric healthcare will be presented at the 20th Annual Meeting of the American Society of Pediatric Otolaryngology (ASPO) http://www.aspo.us/ being held May 27-30, 2005, at the J.W. Marriott Las Vegas Resort in Las Vegas, NV. This is the nation's largest gathering of pediatric otolaryngologists, specialists who diagnose and treat pediatric ear, nose, and throat disorders.

The research studies being presented are:

SATURDAY, MAY 28, 2005

SPEECH, VOICE AND SWALLOWING

MULTICENTER INTER-RATER AND INTRA-RATER RELIABILITY IN THE EVALUATION OF VELOPHARYNGEAL INSUFFICIENCY, presented by David C Bloom, MD, Children's Hospital/University of Washington, Seattle, WA. Objective: The Golding-Kushner scale has been proposed as a standard for assessing velopharyngeal insufficiency (VPI) during nasoendoscopy, but its reliability has not been rigorously evaluated. Our objective was to explore inter-rater and intra-rater reliability of the Golding-Kushner scale.

EFFECTS OF TONSILLECTOMY ON SPEECH IN PEDIATRIC PATIENTS WITH VELOPHARYNGEAL INSUFFICIENCY, presented by Anna H. Grosz, MD, Oregon Health Science University, Portland, OR. Objective: To assess effects of tonsillectomy on speech assessment and flexible nasopharyngoscopy findings in pediatric patients with velopharyngeal insufficiency (VPI).

VALIDATION OF THE PEDIACTRIC VOICE-RELATED QUALITY OF LIFE INSTRUMENT (PV-RQOL), presented by Mark Boseley, Massachusetts Eye and Ear Infirmary, Boston, MA. Objective: To validate the Pediatric Voice Related Quality Of Life (PV-RQOL) Survey designed to assess voice changes over time in the pediatric population.

RADIONUCLIDE SALIVAGRAM VERSUS MODIFIED BARIUM SWALLOW FOR DETECTION OF PEDIATRIC ASPIRATION, presented by David L. Mandell, MD, Children's Hospital of Pittsburgh, Pittsburgh, PA. Objective: To determine: 1) the measure of agreement of saliva gram and modified barium swallow (MBS) in detecting pediatric aspiration; 2) if any individual subject characteristics influence either salivagram or MBS results.

HEARING LOSS EVALUATION

COMPUTED TOMOGRAPHY MEASUREMENTS OF THE NORMAL AND PATHOLOGIC COCHLEA IN CHILDREN, presented by Natacha Crozat-Teissier, Service ORL Hopital Robert Debre,Paris, France. Objective: to establish the CT measurements of the normal cochlea in children and to determine the radiological criterions correlated with a sensorineural hearing loss (SNHL).

ASSESSING THE VESTIBULAR AQUEDUCT AND MODIOLUS IN PEDIATRIC SENSORINEURAL HEARING LOSS: AUDIOLOGIC AND CT CORRELATION, presented by Mark Boston, MD, Cincinnati Children's Hospital, now in Phoenix, AZ.Objective: To correlate radiographic and audiometric findings in children with sensorineural hearing loss (SNHL).

THE EVALUATION OF IDIOPATHIC PEDIATRIC SENSORINEURAL HEARING LOSS: THE CURRENT PARADIGM, presented by John Greinwald, MD, Cincinnati Children's Hospital, Cincinnati, OH. Objective: To determine if a stepwise diagnostic paradigm is more diagnostically efficient and cost-effective than a simultaneous testing approach in the evaluation of idiopathic pediatric sensorineural hearing loss (SNHL).

AIRWAY: ASSESSMENT AND NEW TECHNIQUES

QUANTITATIVE CT ANALYSIS OF THE MANDIBLE AFTER DISTRACTION OSTEOGENESIS IN INFANTS WITH PIERRE ROBIN SEQUENCE (PRS), presented by Saswata Roy MD MS, Children's Memorial Hospital, Lincoln, NE.Objective: Management of infants with PRS traditionally have included: prone positioning, nasopharyngeal stents, and in the more severe cases tongue-lip adhesion and tracheotomy. Early mandibular lengthening via distraction osteogenesis provides an alternative to traditional methods of airway management in PRS infants. However, there is little in the literature that quantitatively demonstrates the changes in the skeletal, soft tissue and hypopharyngeal space with mandibular distraction.

AIRWAY AUGMENTATION AND MAINTENANCE THROUGH LARYNGEAL CHEMODENERVATION IN CHILDREN WITH IMPAIRED VOCAL FOLD MOBILITY, presented by Marshall E. Smith MD, Salt Lake City, UT. Objective: Botulinum toxin has proven useful in a variety of laryngeal disorders, mainly spasmodic dysphonia. Injection into laryngeal muscles that affect phonation would also be expected to influence airway patency when injected into these same muscles that control laryngeal adduction. We report its use in children diagnosed with bilateral impaired laryngeal mobility (laryngeal paresis/paralysis) to augment the airway.

SINGLE STAGE PEDIATRIC LARYNGOTRACHEAL RECONSTRUCTION USING BIOABSORBABLE MINIPLATES: A CASE SERIES, presented by Robert C. Sprecher, MD, Case Western Reserve University, Cleveland, OH. Objective: To review the efficacy and safety of bioabsorbable miniplates as an alternative to autologous grafts in single stage anterior laryngotracheal reconstruction for subglottic stenosis.

TONSILS AND ADENOIDS " OUTCOMES

MICRODEBRIDER PARTIAL TONSILLECTOMY VS ELECTROSURGICAL TONSILLECTOMY: A RANDOMIZED, DOUBLE-BLIND, PAIRED-CONTROL STUDY OF POSTOPERATIVE PAIN, presented by Matthew T. Lister MD, Massachusetts Eye and Ear Infirmary, Boston, MA. Objective: Test the hypothesis that microdebrider intracapsular tonsillotomy (MT) results in less postoperative pain than electrosurgical extracapsular tonsillectomy (ET).

POSTOPERATIVE RECOVERY AFTER MICRODEBRIDER OR MONOPOLAR TONSILLECTOMY: A PROSPECTIVE, RANDOMIZED, SINGLE-BLINDED STUDY, presented by Steven E. Sobol, MD, Emory University, Atlanta, GA.Objective: Recent retrospective studies have suggested that microdebrider intracapsular tonsillectomy (MIT) may result in a faster postoperative recovery when compared to monopolar electrocautery tonsillectomy (MET). This study prospectively assesses the postoperative recovery in patients randomly selected to receive either PIT or MET.

EFFECTS OF ADENOTONSILLECTOMY IN CHILDREN WITH ASTHMA, presented by David Karas, MD, Yale University, New Haven, CT.Objective: To assess whether adenotonsillectomy results in an improvement in the signs and symptoms of previously diagnosed asthmatics, including a decrease in the need for medical intervention.

OBSTRUCTIVE SLEEP APNEA, TONSILS AND ADENOIDS

ADENOIDECTOMY FOR OBSTRUCTED BREATHING: WHAT IS THE RISK OF FUTURE TONSILLECTOMY OR REVISION ADENOIDECTOMY, presented by Elizabeth Mitchell, MD, Walter Reed Army Medical Center, Washington DC. Objective: Determine if pediatric patients undergoing adenoidectomy for the (co)indication of obstruction have an increased likelihood of undergoing eventual tonsillectomy or second adenoidectomy compared to patients undergoing adenoidectomy for chronic ear disease alone.

OBSTRUCTIVE SLEEP APNEA IN CHILDREN: A SURVEY OF PRACTICE PATTERNS presented by Ron Mitchell, MD, Virginia Commonwealth University, Richmond, VA. Objective: The American Academy of Pediatrics recommends objective testing with polysomnography (PSG) prior to adenotonsillectomy for obstructive sleep apnea (OSA) in children. Several studies have also shown that a clinical diagnosis correlates poorly with the presence or severity of OSA as confirmed by PSG. The purpose of this study was to examine surgical practice patterns among pediatric otolaryngologists.

THE EFFICACY OF TELEPHONE FOLLOW-UP AFTER TONSILLECTOMY AND ADENOIDECTOMY, presented by Dwight T. Jones, MD, Children's Hospital Boston, Boston, MA.Objective: To evaluate the efficacy of telephone follow-up after tonsillectomy and adenoidectomy.

AIRWAY " FOREIGN BODY, TRACHEOTOMY AND INTUBATION

THE UROLOGICAL STONE BASKET FOR PEDIATRIC AIRWAY FOREIGN BODY RETRIEVAL, presented by Brian W. Downs, MD, Neurosciences Hospital, CB #7070, Chapel Hill, NC. Objective: To demonstrate the role of a parachute-type urological stone basket in combination with the rigid bronchoscope for the retrieval of selected pediatric airway foreign bodies. Emphasis will be placed those foreign bodies that are particularly difficult to retrieve with standard foreign body forceps.

CHANGES IN THE CRICOARYTENOID JOINT INDUCED BY INTUBATION IN NEONATES, presented by Shyan Vijayasekaran FRACS, Cincinnati Children's Hospital, Cincinnati, OH..Objective: The aim of this study is to characterize changes in the thyroarytenoid muscle and cricoarytenoid joint in infants who have been intubated for prolonged periods. We hypothesize that prolonged intubation leads to cricoarytenoid joint fixation in a subset of patients.

INFANT TRACHEOTOMY: RESULTS OF A SURVEY REGARDING TECHNIQUE, presented by Francis P. Ruggiero MD, Pennslyvania State University COM, Hershey, PA.Objective: To identify practice patterns regarding infant tracheotomy technique among pediatric otolaryngologists.

ASPO " (ACUTE SINUSITIS, PAPILLOMA, OROPHARYNGEAL TRAUMA)

CIDOFOVIR MODULATED GENE EXPRESSION IN RECURRENT RESPIRATORY PAPILLOMATOSIS, presented by David M. Poetker, MD, Medical College of Wisconsin, Milwaukee, WI. Objective: Recurrent respiratory papillomatosis (RRP) is a benign aerodigestive tract neoplasm. Cidofovir, an antiviral drug, has demonstrated efficacy in slowing and/or reducing RRP recurrence. This investigation examined the differential gene expression of RPP before and after cidofovir use in vivo.

INTRACRANIAL COMPLICATIONS OF ACUTE SINUSITIS AND THEIR OUTCOMES, presented by John A. Germiller, MD, PhD, Children's Hospital of Philadelphia, Philadelphia, PA. Objective: Intracranial complications of sinusitis are challenging conditions with potentially significant morbidity and mortality. This study reviewed experiences with this condition to gain insight into patterns of presentation, imaging, microbiology, therapy, disease course, and outcome.

EVALUATION AND MANAGEMENT OF PEDIATRIC OROPHARYNGEAL TRAUMA, presented by Ryan J. Soose, MD, University of Pittsburgh, Pittsburgh, PA.Objective: To devise a management protocol for pediatric oropharyngeal trauma by examining the clinical factors that influence medical decision-making in these children.

SUNDAY, MAY 29, 2005

OTITIS AND CHOLESTEATOMA

RESPONSE OF TRANSEPITHELIAL SODIUM ABSORPTION AND CHLORIDE SECRETION TO INTERLEUKIN-1 IN CULTURED MIDDLE EAR MUCOSA, presented by David L. Mandell, MD, Children's Hospital of Pittsburgh, Pittsburgh, PA. Objective: To determine the effect of interleukin-1 (IL-1, a pro-inflammatory mediator associated with otitis media with effusion (OME)), on middle ear transepithelial sodium (Na+) absorption and chloride (Cl-) secretion, and thus on middle ear mucosal absorptive or secretory properties.

OTITIS MEDIA AS A BIOFILM DISEASE IN HUMANS, presented by Joseph E. Kerschner, MD, Children's Hospital of Wisconsin, Milwaukee, WI. Objective: Consideration of biofilms as an underlying cause of infectious disease has significantly altered the understanding, approach and treatment of infections. Recent animal models have suggested that otitis media (OM) may also be a biofilm mediated process. This study was undertaken to determine if biofilms are present in the middle ear (ME) of patients undergoing ventilation tube (VT) insertion for recurrent OM (ROM) and OM with effusion (OME)

CLINICAL FEATURES OF RETRACTION POCKETS AND CHOLESTEATOMAS IN CHILDREN WITH CLEFT PALATE, presented by Françoise Denoyelle, MD, PhD, Hôpital Trousseau, Paris, France. Objective: To analyze the features of severe retraction pockets (RP) and cholesteatomas in children with cleft palate compared to children without cleft.

POST-OPERATIVE OTOTOPICAL DROPS AS PROPHYLAXIS AGAINST VENTILATION TUBE OTORRHEA AND PLUGGING, presented by David M. Poetker, MD, Children's Hospital of Wisconsin, Milwaukee, WI. Objective: Ventilation tube (VT) placement is the second most common surgical procedure in the United States. Prophylactic post-operative ototopical antibiotic drops are commonly used to prevent otorrhea and maintain VT patency. Despite the frequency of VT placement, the widespread use of ototopical drops post-operatively and the costs involved in this therapy there have been no large, randomized, controlled trials comparing the efficacy of commonly used drops and a control population. This study was performed to assess the efficacy of ofloxacin (FLOX) and neomycin/polymyxin B sulfate (COS) ototopical drops in the prevention of post-operative otorrhea and VT plugging. HEARING LOSS " GENETICS

IMPACT OF GENETIC TESTING AND COUNSELING ON PARENTAL UNDERSTANDING AND ATTITUDES OF INFANTS WITH HEARING LOSS, Nina Shapiro, MD, UCLA School of Medicine, Los Angeles, CA. Objective: Determine the impact of genetic counseling and testing on parental understanding and perceived benefits and risks of genetic information before and after genetic testing and counseling on their infants with hearing loss.

THE INFLUENCE OF MUTATIONS IN THE SLC26A4 GENE ON THE TEMPORAL BONE IN AN ENLARGED VESTIBULAR AQUEDUCT POPULATION, presented by Colm Madden, MD, Cincinnati. OH.Objective: To correlate the genetic and detailed radiological findings in patients with enlarged vestibular aqueduct (EVA) to ascertain the contribution of SLC26A4 gene mutations to this phenotype.

INCIDENCE OF GJB2 HETEROZYGOSITY IN CHILDREN WITH SENSORINEURAL HEARING IMPAIRMENT, presented by David H. Chi, MD, Children's Hospital of Pittsburgh, Pittsburgh, PA. Objective: To determine the percentage of children with sensorineural hearing impairment (SNHI) who are heterozygotes for mutations of the GJB2 gene and characterize the phenotype of hearing loss in these children.

AIRWAY " OUTCOMES

PEDIATRIC CRICOTRACHEAL RESECTION: OUTCOMES AND RISK FACTOR ANALYSIS, presented by David R. White, MD, Cincinnati Children's Hospital, Cincinnati, OH.Objective: To identify risk factors for operation-specific outcomes of pediatric cricotracheal resection (CTR).

THE PRESENTATION AND MANAGEMENT OF LARYNGEAL CLEFT: A TWENTY YEAR EXPERIENCE, presented by Reza Rahbar, MD, Harvard Medical School, Boston, MA.Objective: To discuss the presentation, evaluation, and management of laryngeal cleft through a retrospective study in two tertiary pediatric medical centers from 1984 to 2004.

ANTERIOR AND POSTERIOR CARTILAGE GRAFT DIMENSIONS IN SUCCESSFUL LARYNGOTRACHEAL RECONSTRUCTION, presented by Peter J. Koltai, MD, Stanford University, Stanford, CA. Objective: To describe the dimensions of cartilage grafts used for successful laryngotracheal reconstructions (LTR) with the goal of establishing appropriate sizes for off the shelf tissue engineered cartilage grafts.

MONDAY, MAY 30, 2005

HEAD AND NECK

T AND NK LYMPHOCYTOPENIA IN CHILDREN WITH LYMPHATIC MALFORMATION, presented by Richard M. Tempero, MD PhD, University of Washington, Seattle, WA. 98115Objective: To determine whether an immunological abnormality exists in patients with lymphatic malformation (LM) given the high incidence of recurrent infection and inflammation in these patients. PEDIATRIC THYROID CANCER IN ONE INSTITUTION: AN EIGHTEEN-YEAR REVIEW, presented by Dwight. T. Jones, MD, Children's Hospital Boston, Boston, MA. Objective: To review the diagnosis and management of pediatric thyroid cancer over 18 years, including the identification of factors that predict management and diagnostic trends.

MUCOEPIDERMOID CARCINOMA OF PAROTID GLAND IN CHILDREN: A TEN YEAR EXPERIENCE, presented by Reza Rahbar, MD, Harvard Medical School, Boston, MA. Objective: To determine the presentation, pathologic features, treatment outcome, and prognosis ofmucoepidermoid carcinoma of the parotid gland in children.

PERSISTENT THYROGLOSSAL DUCT CYSTS: A INSTITUTION'S EXPERIENCE AND NEW METHOD OF MANAGEMENT, presented by Andrew F. Inglis, Children's' Hospital,Seattle, WA. Objective: To present a single institution experience in primary and persistent thyroglossal duct cyst (TGDC) management and describe a novel method for persistent TGDC removal, transhyoid pharyngotomy.

PEDIATRIC SIALOLITHIASIS:A CONSERVATIVE APPROACH, presented by Frederic Faure, University of Lyon, Lyon, FranceObjective: Sialendoscopy is a new procedure, aiming to visualize the lumen of the salivary ducts. This study assesses the efficacy of sialendoscopy as a diagnostic and interventional procedure in salivary ductal pathologies of children.

INNER EAR " BASIC SCIENCE

A FUNCTIONAL ANALYSIS OF DEAFNESS GENES, presented by Ryan B. Scannell, MD, University of Michigan, Ann Arbor, MI. Objective: Non-syndromic, autosomal dominant, low-frequency sensorineural hearing loss may result from mutations in either of two genes, WFS1 or DIAPH1 that encode the wolframin and diaphanous-related formin 1 (Drf1) proteins respectively. The objective of this study is to perform a functional analysis of these proteins. Specifically, to determine: the inner ear cell types that express wolframin and Drf1 and their subcellular localization in these cells; the proteins' expression patterns and subcellular localization in cultured cells derived from the mouse otocyst (IMO cells); and any reciprocal effects of decreased wolframin or Drf1 expression through RNAi-mediated knockdown experiments in IMO cells.

INTRACOCHLEAR ELECTRICAL STIMULATION INDUCES LONG TERM MODIFICATION OF GLIAL CELL SUBPOPULATIONS, presented by Martins Carvalho, Hôpital Morvan, Brest, France. Objective: To investigate the effects of intracochlear electrical stimulation (ICES) on glial subpopulations. In situ hybridization was performed with fluorescent labelled oligonucleotide probes designed to detect various glial markers in the dorsal (DCN) and the ventral cochlear nucleus (VCN) and in the central nucleus of the inferior colliculus (CNIC) of the rat. A2B5 was a marker of progenitors of glial cells, GFAP, vimentin were used as a marker of astrocytes, and O1 as marker oligodendrocytes and CD11 as a marker of microglial reaction.

ABNORMAL SEMICIRCULAR CANAL DEVELOPMENT IN MICE AFTER DISRUPTION OF BMP SIGNALING IN THE ADJACENT BRAINSTEM, presented by John A. Germiller, MD PhD, Children's Hospital of Philadelphia, Philadelphia, PA.Objective: Development of the inner ear is known to be influenced by the adjacent brainstem. As a first step toward understanding such regional interactions, we studied inner ear structure in a mutant mouse pedigree with abnormal dorsal brain development. These mice lack the most dorsal population of neurons as a consequence of loss of bone morphogenetic protein (BMP) signaling.

EFFECT OF CIDOFOVIR ON CYTOMEGALOVIRUS-INDUCED HEARING LOSS IN AN ANIMAL MODEL, presented by David R. White, MD, Cincinnati Children's Hospital, Cincinnati, OH.Objective: To evaluate the utility of therapy with the cyclic congener of the anti-CMV agent, cidofovir (CHMPC), for efficacy against CMV-induced hearing loss in a guinea pig model.

AIRWAY/ESOPHAGUS " TECHNOLOGY AND SCIENCE

LOCAL CONTROL OF MURINE SUBLOTTIS DEVELOPMENT, presented by Valerie Pires, Massachusetts Eye and Ear Infirmary and Case Western Reserve, Boston, MA. Objective: To determine if subglottic development is at least partially under local control and to determine which tissue layer(s) is predominantly responsible.

NOVEL APPLICATIONS OF THE MICRODEBRIDER IN PEDIATRIC AIRWAY CASES, presented by Cecilia Canto, MD, Children's Hospital of San Diego, San Diego, CA. Objective: Evaluate effectiveness and safety of the microdebrider in the treatment of airway lesions in children.

THE EX UTERO INTRAPARTUM TREATMENT (EXIT) PROCEDURE: NEW CHALLENGES, presented by Todd Otteson, Children's Hospital of Pittsburgh, Pittsburgh, PA. Objective: To highlight particularly challenging aspects of the Ex utero intrapartum treatment (EXIT) procedure not previously described and present a novel indication for the EXIT procedure.

SAFE PASSAGE: A PORCINE MODEL TO EVALUATE USE OF THE BRAVO pH CAPSULE IN INFANTS, presented by Marcella R. Bothwell, MD, University of Missouri-Columbia, Columbia, MO. Objective: Extra-esophageal reflux (EER) is a difficult diagnosis in the ENT pediatric population. A novel addition to the EER diagnostic armamentarium is the wireless Medtronic Bravo pH capsule system. Although Bravo has been successfully used to monitor upper esophageal pH in a 3-month-old, 6 kg infant, concerns exist about its use in smaller infants due to the capsule's size relative to the patient. This study sets out to determine a lower weight limit for safe passage of Bravo capsules using a piglet model.