Parkinson's disease is a neurodegenerative disease that causes the death of dopaminergic neurons in the substantia nigra. The resulting dopamine deficiency in the basal ganglia leads to a movement disorder that is characterized by classical parkinsonian motor symptoms. Parkinson's disease is recognized as the most common neurodegenerative disorder after Alzheimer's disease. PD ethiopathogenesis remains to be elucidated and has been connected to genetic, environmental and immunologic conditions. The past decade has provided evidence for a significant role of the immune system in PD pathogenesis, either through inflammation or an autoimmune response. Several autoantibodies directed at antigens associated with PD pathogenesis have been identified in PD patients. This immune activation may be the cause of, rather than a response to, the observed neuronal loss. Parkinsonian motor symptoms include bradykinesia, muscular rigidity and resting tremor. The non-motor features include olfactory dysfunction, cognitive impairment, psychiatric symptoms and autonomic dysfunction. Microscopically, the specific degeneration of dopaminergic neurons in the substantia nigra and the presence of Lewy bodies, which are brain deposits containing a substantial amount of α-synuclein, have been recognized. The progression of Parkinson's disease is characterized by a worsening of motor features; however, as the disease progresses, there is an emergence of complications related to long-term symptomatic treatment. The available therapies for Parkinson's disease only treat the symptoms of the disease. A major goal of Parkinson's disease research is the development of disease-modifying drugs that slow or stop the neurodegenerative process. Drugs that enhance the intracerebral dopamine concentrations or stimulate dopamine receptors remain the mainstay treatment for motor symptoms. Immunomodulatory therapeutic strategies aiming to attenuate PD neurodegeneration have become an attractive option and warrant further investigation.

RD is a common self-limited disorder, more frequent in the elderly, which may occur after the physical treatment for BPPV. The DHI score at the time of BPPV diagnosis represents a useful tool to quantify the impact of this vestibular disorder on the quality of life and to estimate the risk of RD after CRPs.

No abstract

Presentation schedule is subject to change. For the most up-to-date information, visit www.entnet.org/annual_meeting. Conclusions: There is a higher treatment success in patients treated surgically. There is no significant correlation between AAR and NOSE scale and VAS. This is considered because the AAR and subjective scales are complementary and they measure different aspects of NO. Therefore, the AAR and the NOSE scale are helpful instruments to be used together for the diagnosis of NO and to measure objective therapeutic success and the feeling of satisfaction by the patient.Objectives: (1) Quantify the changes in the number of ciliated cells, ciliary beat frequency, and mucociliary transport of the nasal mucosa in smokers.(2) Evaluate if these cytologic and functional changes in smokers are permanent or reversible after smoking cessation.Methods: Ninety healthy volunteers recruited from the staff of A. Fiorini Hospital, Sapienza University of Rome, were enrolled in this study from September 2013 to January 2014. Volunteers were divided into 3 groups (smokers, nonsmokers, and ex-smokers) composed of 30 subjects each. Cytological features of nasal mucosa and effectiveness of nasal mucociliary clearance were studied focusing on 4 parameters: 1) ratio between the number of ciliated cells and mucous-secreting cells analyzed through microscopic observation of nasal scraping specimens; 2) in vitro evaluation of ciliary motility; 3) survival time of the ciliated cells analyzed by phase-contrast microscopy; 4) nasal mucociliary clearance assessed by saccharin transit time test.Results: All parameters are significantly reduced in the group of smokers compared to the nonsmokers (P < .05). However, there are no statistically significant differences between the nonsmoker and ex-smoker groups (P > .05).Conclusions: Cigarette smoking causes cytological modifications of nasal mucosa that influence the effectiveness of mucociliary clearance. Our study, although preliminary and conducted on a limited number of cases, suggests that these changes are not permanent and that nasal mucosa of ex-smokers would recover normal cytologic and functional features. Early versus Delayed Endoscopic Sinus Surgery in Patients withChronic Rhinosinusitis: Impact on Health Care utilization Michael S. Benninger, MD (presenter); Chantal E. Holy, PhD; Raj Sindwani, MD; Claire Hopkins, MD, FRCS Objectives: Using a patient cohort with chronic rhinosinusitis (CRS) refractory to medical management, evaluate the impact of early versus delayed endoscopic sinus surgery (ESS) in terms of postoperative health care utilization. Methods: The MarketScan CCAE database was queried. Patients with ESS in 2010 and complete medical history from 2004 to 2012 were identified. Diagnoses of CRS or polyposis prior to 2005 as well as ESS prior to 2010 were exclusion criteria. Patients were characterized by time interval of first CRS diagnosis to ESS and grouped as follows: (1) <1 year (N = 888); (2) 1-2 years (N = 267); (3) 2-3 years (N = 300); (4) 3-4 years (N = 414);...

ORAL PRESENTATIONSpatients were stage Ib, 4 patients were stage IIa, and 3 patients were stage IIb. The tumor stages, feeding vessels, operating time, complications, and recurrence were observed and recorded. Eight patients received preoperative angiographic embolization, and 3 patients received intraoperative external carotid artery clamping. Transnasal or transpterygoid and posterolateral wall of maxillary sinus approaches are used for tumor resection. Results:The mean duration of the surgery was 2 hours. The mean intraoperative blood loss of patients who received preoperative hyperselective embolization was 470 mL, patients who received intraoperative external carotid artery clamping was 510 mL, and patients who did not receive arterial supply blocking was 930 mL. After surgery, CT scan or MR image showed total removal of the tumor was achieved in all patients. No postoperative complications were observed. All patients were followed-up for 9 months to 3 years (mean 1.5 years), and no recurrence was founded. Conclusion:Endoscopic resection of JNA is a difficult but effective operation. The key techniques to remove tumor are bleeding control, drilling-out the bone that the tumor invaded. Endonasal surgery combined with a preoperative embolization of the arterial supply can control blood loss. For small and intermediatesized JNA (Radkowski Ia-IIb), endoscopic surgery is an appropriate choice. If the tumor extends into lateral fossa infratemporalis or deep into the skull base,we do not recommend it. General OtolaryngologyEvidence-Based long-term Outcomes in ESS Martin L. Hopp, MD, PhD (presenter); Narine Vardanyan, MHA; Shawn Nasseri, MD Objective: 1) Analyze appropriateness of endoscopic sinus surgery. 2) Understand the long-term results of endoscopic sinus surgery at an academic institution with an academic and private practice blend of patients using the Sino Nasal Outcome Test ("SNOT 22") statistically validated tool.Method: Included consecutive patients undergoing sinus surgery at CSMC since January 2009 who were able to complete SNOT-22 prior to surgery. Three hundred fifty patients were included from 17 physicians. Patients mailed the postop form 3, 6, and 12 months following surgery. Patients ranged from 22 years to 67 years split between 220 females and 330 males. Results:The results were quite impressive for patients from immediate to long-term (12 month) postoperative results. The results were statistically significant in demonstrating an improvement of symptoms overall and in all 4 subcategories with a univariate analysis demonstrating P values of <.001. These results were very exciting due to the multi-cultural and varied nature of the patients ranging from tertiary care academic referrals to community otolaryngology patients. Conclusion:It was concluded that endoscopic sinus surgery was effective with results reaching statistical significance in demonstrating an improvement of symptoms overall and in all 4 sub-categories with a univariate analysis demonstrating P values of <.001. Scientific findings...