4. Laryngoscope, 126:1033-1038, 2016.

Sebaceoma is a rarely encountered, benign, adnexal neoplasm which can occur in the head and neck. The treatment is surgical excision, and recurrence is rare. Sebaceoma can occur as part of Muir-Torre syndrome, and in these patients there is an increased risk of other sebaceous lesions and visceral malignancy; thus, genetic testing and surveillance should be strongly considered.

Presentation schedule is subject to change. For the most up-to-date information, visit www.entannualmeeting.org. nasal polyposis (CRSwNP) and if low serum vitamin D level correlated with the severity of CRSwNP. In vitro: We used the cultured nasal polyp-derived fibroblasts to investigate the in vitro effect of vitamin derivatives (calcitriol and tacalcitol) on the production of matrix metalloproteinase (MMP)-2 and MMP-9 .Methods: Patients with latest diagnosis of CRSwNP undergoing elective endoscopic sinus surgery were recruited, and patients with malignancies or asthma were excluded. The severity of CRSwNP was assessed with the Lund-Mackay score and polyp grading system. Vitamin D status was assessed by measuring circulating 25-hydroxyvitamin D (25OHD) by using commercial chemiluminescence immunoassay. Resected polyps were used for primary fibroblast culture. The fourth to eighth passage of human fibroblasts were used for the experiments.Results: Serum 25OHD levels (ng/mL ± SD) were significantly lower in patients with CRSwNP (21.4 ± 5.7) than in those with CRSsNP (28.8 ± 6.2) (P < .001). A significantly negative relationship was found between serum 25OHD level and polyp grade (r = -0.63, P = .001), indicating lower serum 25OHD was associated with higher polyp grade. Serum 25OHD was inversely related to both LM score and total IgE level as well. However, statistical significance was not found. In the in vitro study, we demonstrated that TNF can significantly induce the secretion of MMP-2 and-9 from nasal polyp fibroblasts and this effect was significantly suppressed by adding calcitriol and tacalcitol.Conclusions: A significantly lower vitamin D level was found in a group of Taiwanese CRSwNP patients, which revealed an association with greater nasal polyp size. The study on the influence of vitamin D on inflammatory processes in NP may shed a light not only on the mechanism of its etiology but also prove its potential use in the pharmacology of NP.Objectives: Determine the safety of ambulatory oropharyngeal surgery in adults with obstructive sleep apnea.Methods: Retrospective cohort study. Relevant data were collected from patients aged 18+ years with obstructive sleep apnea (OSA) receiving head and neck airway surgery between September 1, 2005, and September 15, 2012.Results: Out of 315 patients with complete data, 243 (77.14%) were managed as inpatients and 72 (22.86%) in an ambulatory manner. The mean Apnea/Hypopnea Index (AHI) for the inpatient and ambulatory groups were 35.99 and 18.43, respectively (P < .00). The mean body mass index (BMI) for the inpatient and ambulatory groups was 34.12 and 30.79, respectively (P < .0002). When calculating the incident risk ratio of changes in AHI or BMI, AHI exhibited a significantly increased contribution. There were no complications in the ambulatory cohort.Conclusions: When evaluating body habitus and polysomnographic data, OSA patients who underwent oropharyngeal procedures and were discharged on the same day were significantly different than those who were admit...

Objectives: (1) Describe the anatomy of the incisive foramen.(2) Describe the endoscopic approach to the greater palatine artery. (3) Recognize the importance of the greater palatine artery as a cause of recurrent anterior epistaxis.Methods: Cadaveric and radiographic study of the incisive foramen; illustrative case series. Seventy computed tomography (CT) scans were reviewed, and measurements were made of the incisive foramina's distance to the anterior nasal spine and subnasale. An endoscopic approach to the incisive foramen was completed in 20 cadavers, and measurements of the distance from the anterior nasal spine to the incisive foramen were documented. We also present an illustrative case series of patients who underwent endoscopic cautery of the greater palatine artery.Results: Radiographic review of the incisive foramen revealed a mean anterior nasal spine to incisive foramen distance on the right and left of 7.9 and 8.1 mm, respectively. The mean distance from the subnasale to incisive foramen on the right and left were 24.7 and 24.9 mm, respectively. Cadaveric measurements preliminarily correspond to radiographic measurements.Conclusions: Endoscopic cauterization of the greater palatine artery is a safe and effective method to control recurrent anterior epistaxis. The incisive foramen can be predictively found within 1 cm of the anterior nasal spine. Preoperative evaluation of a CT scan can help aid a surgeon in determining the relative contribution of the greater palatine artery to the anterior septal blood supply, and guide surgical approach to control recurrent anterior epistaxis. Our case series corroborates the above. Endoscopic Balloon Dacryocystorhinostomy Kevin E. McLaughlin, MD (presenter)Objectives: (1) Describe new endoscopic balloon technique for dacryocystorhinostomy. (2) Review preliminary outcomes of endoscopic balloon DCR.Methods: This study has 2 parts. The first entails a cadaver study looking at feasibility of applying balloon dilation technology to nasolacrimal duct obstruction. Five cadavers (10 sides) were used to confirm the technique. All 10 nasolacrimal ducts were successfully cannulated and dilated with a 5 × 16 mm balloon via a 70° guide. The second part of the study details our preliminary experience using this technique in patients referred to a tertiary rhinology clinic for nasolacrimal duct obstruction.Results: A total of 5 patients have enrolled in our prospective study. All patients were successfully cannulated. Follow-up ranges from 1 to 6 months. Resolution or decrease of preoperative epiphora has been noted in all 5 patients.Conclusions: Transnasal endoscopic balloon dilation of the nasolacrimal duct system may be a possible therapeutic option for the treatment of nasolacrimal duct obstruction. Furthermore, this may be a particularly attractive option for patients who are not candidates for a general anesthetic or cannot be taken off of anticoagulant medication. Further study is warranted.

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