POSTERSspecific antibodies. ABRs on NMMII-A mutants were performed at various frequencies.Results: In WT mice, NMMII isoforms localize to the apical junction between hair and supporting cells. In eGFP-NMMII-A-or -B mice, NMMII isoform antibodies show a similar pattern of distribution, but are potentially expressed at different amounts. At the adhesion belt, the isoforms take on a "sarcomericlike" pattern. NMMII inhibition results in variability of hair cell shape. In NMMII-C KO mice, NMMII-A demonstrates a new distribution and NMMII-B is upregulated. ABRs reveal an absence of hearing loss in NMMII-A D1424N and R702C mutant mice compared to controls.Conclusion: NMMII has a previously unrecognized "sarcomericlike" pattern of organization, compatible with a contractile structure. Absence of hearing loss in NMMII-A mutants indicates that hearing loss may require a secondary insult, and isoforms have potential for compensation and overlap in function, which may also mitigate hearing loss. Method: The 3D Cone-beam CT images of the 12 patients with Ménière diseases who underwent an endolymphatic mastoid shunt operation between 2008 and 2011 were obtained at our hospital. We assessed location, size, and shape of the ELS. The results of preoperative assessments were compared with the operational findings. Otology/NeurotologyResults: First we present clear and sharp 3D pictures of ELS and the semicircular canal using volume rendering incomparable to conventional CT. In 11 patients, the ELS was located exactly along the Donaldson line. In one patient, it was located inferiorly to the line. Size of the ELS was moderate in 6 patients, small in 5, and exceedingly small in 1. Cross section of the sac was circular in 3 patients, oval and flat in 8, and unverified in 1 because the size was too small. The above findings agree with the operational findings closely. Conclusion:In 3D Cone-beam CT, we could get more informative and better quality images than in conventional CT. Thanks to the preoperative realistic 3D images of ELS and the semicircular canal, we could perform the sac operation more safely and easily. Imaging information thus obtained may help deepen the understanding of Ménière's disease. Otology/Neurotology Method:We conducted an endoscopic dissection of 5 human temporal bones. The dissections were performed using traditional ear surgery instruments and sinonasal endoscopes. Two different endoscopic pictures of the same anatomical image were taken and merged using a computer program to generate stereoscopic anaglyphic images. Results:We were able to generate excellent quality stereoscopic 3D endoscopic images of the anatomy of the middle ear. Conclusion:Endoscopic middle ear surgery is becoming more popular. However there are still several limitations, such as the lack of specialized instruments and anatomical studies. We got excellent 3D pictures of the endoscopic anatomy of the middle ear, which can be used to help guide surgeons during procedures. Otology/Neurotology Enlarged Vestibular Aqueducts from Autosomal R...

ORAL PRESENTATIONSintervention. Allergic fungal sinusitis is the most common cause followed by chronic rhinosinusitis, with a ratio of 2:1. Rhinology/AllergyOutcomes of a Novel Titanium Nasal implant for Nasal Valve Dysfunction Aileen Cunningham, MBBCh, MA, MRCS (presenter); George G. Fayad, MD, MBA, FRCS Objective: 1) Analyze an initial cohort of UK patients undergoing surgery for nasal valve dysfunction with a novel titanium nasal implant, the Breathe-Implant à Wengen. 2) Assess surgical outcomes, operative complications, subjective symptom improvement, and patient satisfaction with this new procedure in order to improve current practice and inform future patients.Method: Retrospective case note evaluation collated demographic details, indications, examination findings, imaging reports, operative details, length of follow-up, surgical outcomes, and complications. Patients were contacted by telephone to complete a postoperative symptom evaluation questionnaire consisting of 4 procedure specific questions and a modified Glasgow Benefit Inventory (GBI) consisting of 11 questions.Results: Twenty-three patients underwent the procedure since 2009. Seventeen patients had nasal obstruction as the primary indication for surgery. Mean follow-up 3.6 months (range, 1-9 months). One patient had persistent postoperative nasal obstruction requiring further surgery. A total of 18 patients completed the questionnaire. Patient evaluation of postoperative nasal obstruction was found to be mean score of 1.5 (scale of 0 = no obstruction and 10 = complete nasal obstruction). Cosmetic appearance following insertion of the implant was reported as worse in 8 patients. A total of 72% reported that they would undergo the procedure again, and 83% felt that the operation made their overall life better. Conclusion:This unit is the first in the UK to use this device for nasal valve dysfunction. Our preliminary outcome data has found low complication rates and high patient satisfaction with improved symptoms and quality of life. However, cosmetic outcomes are an important issue to discuss with all potential Breathe-Implant patients. Rhinology/AllergyPreoperative Planning Using 3D Reconstructions and Virtual Endoscopy for location of the Frontal Sinus Joao-Flavio Nogueira, Jr, MD (presenter); Daniel N. Cruz, MD Objective: Demonstrate the production of 3D reconstructions from CTs of patients and compare them to the surgery's actual endoscopic images.Method: Prospective study. The CTs files of 10 patients were reconstructed with a specific program. The reconstructions were performed before the surgeries, and a virtual endoscopy was made. The actual endoscopic images of the recess and frontal sinus region were compared to the virtual images.Results: The 3D reconstruction and virtual endoscopy were made in 10 patients submitted to the surgery. The virtual images had a large resemblance with the actual surgical images. Conclusion:With relatively simple tools and a personal computer, we demonstrated the possibility to generate 3D reconstructions an...

Introducti on and Aims: Real models and virtual simulators have been used with positive results in several fields of medicine. These new devices can enhance teaching, learning and also training in Otolaryngology, reducing associated costs and potentially reducing medical errors. We reviewed the literature on the real and virtual models and simulators used for education and training in our medical specialty, discussing some of them and the results achieved with such instruments. Moreover, we also discuss the future perspectives in education and training in our medical specialty. Methods: Literature review. Conclusions: Otolaryngology, a clinical and surgical field of medicine, should be at the forefront of this technological revolution. In our specialty, real models and virtual simulators and environments have a great teaching and learning potential. With equipment costs dropping, thanks to technological development, these tools tend to become increasingly more popular.

OBJECTIVE: 1) Recognize this rare entity with the constellation of progressive enophthalmos and hypoglobus, demonstrated by CT imaging of paranasal sinuses. 2) Understand the pathophysiology of this entity, based on chronic maxillary sinus obstruction with hypoventilation due to obstruction of the ostiomeatal unit. METHOD: In this study we present a classic case of Silent Sinus Syndrome and a review of the etiology, pathophysiology, radiologic findings and surgical treatment. RESULTS: Our patient showed the typical findings on paranasal sinuses CT with complete unilateral obstruction of the maxillary sinus and ostiomeatal unit with collapse of the orbital floor. CONCLUSION: A clear set of criteria is needed for the diagnosis, these including enophthalmos and hypoglobus in the absence of clinically evident sinusitis, emphasizing the importance of CT imaging in the diagnosis. The treatment consists in restoring sinus ventilation and correction of the orbital floor defects. Smoking and the Nasal AirwaySverre Steinsvaag, MD, PhD (presenter); Milada Cvancarova, MSc OBJECTIVE: 1) Study the relationship between cigarette consumption and endonasal geometry. 2) Study the relationship between cigarette consumption and nasal airflow. 3) Study the relationship between cigarette consumption and nasal congestion. METHOD: Design: Cross sectional. Conducted: 2001Conducted: -2007. Condition: nasal obstruction/congestion. Subjects: referred patients with chronic nasal or sleep related complaints. Setting: secondary referral hospital. Intervention: acoustic rhinometry and peak nasal inspiratory flow. Outcome measures: minimal cross-sectional area, nasal cavity volume, nasal congestion index, peak nasal inspiratory flow. Independent variables: daily cigarette consumption (pack years) Preliminary analyses of ongoing study. Statistical methods: Linear and logistic regressions. RESULTS: Pack years was inversely associated with selected measures for minimal cross-sectional area, nasal cavity volume and reversible nasal congestion (pϽ0.001-0.05). CONCLUSION:We have demonstrated an inverse association between important rhinometric measures and cigarette consumption (pack years), indicating that smokers exhibit narrower nasal cavities, perform lower inspiratory flow, and have a less compliant mucosa than non-smokers. Stentless Endoscopic DacryocystorhinostomyRosalind Simon (presenter); Gurdeep Singh OBJECTIVE: Dacryocystorhinostomy (DCR) is a procedure performed to drain the lacrimal sac in cases of nasolacrimal duct obstruction or in chronic dacryocystitis. It can be performed externally or endoscopically. The aim of this study is to describe endoscopic dacryocystorhinostomy with full sac exposure and primary mucosal anastomosis without stenting the lacrimal ostium and to report perioperative and follow-up results achieved with this procedure since April 2005. METHOD: Forty-seven consecutive patients (38 Females and 9 Males; mean age 46.7y; range 14-74y) who presented to the DCR clinic with epiphora secondary to nasolacrimal duct obstru...