Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P297

Poster Presentations

Gender-Specific Quality-of-Life Differences
in Chronic Rhinosinusitis
Laylaa Ramos Arriaza, MD (Presenter); Conner J.
Massey, MD; Vijay R. Ramakrishnan, MD
Objectives: Recent attention to gender differences in disease
presentation, provider bias, and treatment outcomes have
revealed findings of considerable interest in major diseases.
Limited inquiry in chronic rhinosinusitis (CRS) indicates
significant gender differences in quality of life and possible
treatment outcomes.
Methods: Clinical meta-data from a prospective study of
CRS treatment outcomes were examined. A random forest
machine-learning model was used to rank variables in predicting the total Sino-Nasal Outcome Test (SNOT)-22 score.
Gender differences in disease presentation and SNOT-22 subdomains were assessed using linear regression adjusting for
age, polyposis, smoking status, and prior treatments.
Results: A total of 520 patients were included (mean age
48.3 years, 50.9% female). Earlier age of presentation was
observed in women (46.6 vs 50.1 years, P = .008). Women
were more likely to present with nonpolyp CRS (34.1% vs
43%, P = .046). Men had a higher CT Lund-Mackay score
(11.3 vs 9.5, P = .004); however, mean endoscopy scores were
similar by gender. Notably, women scored higher in mean
total SNOT-22 (46.9 vs 40.9, P = .001), and in ear/facial, psychological and sleep subdomains (P = <.0001, .0034, .0065,
respectively).
Conclusions: Our study demonstrates significant gender differences in disease presentation, particularly in age and disease phenotype, as well as nonrhinologic metrics of CRS.
These differences are consistent with the sparse existing literature and indicate that further study is needed to assess gender
differences in CRS from clinical and biological perspectives.
Applying SNOT-22 subdomains and consideration of gender
may be necessary for personalized medicine in CRS, moving
forward.

Hereditary Hemorrhagic Telangiectasia
Syndrome (Osler-Weber-Rendu), as a Cause
of Recurrent Epistaxis
Carlos Alberto López, MD (Presenter); Andres Sanchez
Gonzalez, MD; Teresa Gonzalez G
Objectives: Hereditary hemorrhagic telangiectasia is a
pathology that has a genetic component of autosomal dominant inheritance of variable penetrance. It is characterized by
fragility of the vascular lesion conditioning mucocutaneous
telangiectasias, which are responsible for the hemorrhages
they present; the most frequent of these is epistaxis, in 90% of
patients. Three genes involved in the development of the disease have been identified: ENG, ACVLR1, and MADH4. The
diagnosis is established by 2 clinical criteria of Curaçao, and
fulfilling 3 of them is considered a safe diagnosis. The objective of the case study is to inform the ear, nose, and throat
community about the existence of this syndrome to make an
early diagnosis and to be able to give timely treatment to avoid
life-threatening complications.
Methods: We present the case of a 56-year-old female
patient who presented to the emergency department for spontaneously presenting recurrent epistaxis and severe integumentary pallor.
Results: The physical examination shows multiple telangiectatic lesions in the nasal cavity, nasal vestibule, facial region,
oral cavity, and palms. Biochemical results show normo-
chromic normocytic anemia, mild thrombocytopenia, direct
pattern hyperbilirubinemia, and other normal liver tests. In
negative immunologic studies, the patient clinically met diagnostic criteria; there was no genetic confirmation, but she had
first-degree relatives with the same clinical manifestations.
Conclusions: It is of great importance to know that a cause of
repeated epistaxis can occur as a result of a hereditary-type
condition such as hereditary hemorrhagic telangiectasia syndrome, which is underdiagnosed. Making the diagnosis allows
for preventive and symptomatic treatment for the patient and
performing screening and prophylactic therapy for affected
family members.
House Dust Mite Sublingual Immunotherapy in
Children Versus Adults With Allergic Rhinitis
Jin Youp Kim (Presenter); Chae-Seo Rhee, MD, PhD
Objectives: To compare the effects of sublingual immunotherapy (SLIT) in adults and children on various factors: clinical efficacy, quality of life (QOL), satisfaction, immunological
parameters, and adverse events.
Methods: Subjects who were sensitized to house dust mites
and treated with SLIT for at least 2 years were enrolled.
Seventy patients who completed questionnaires measuring
nasal symptoms and Rhinoconjunctivitis Quality of Life
Questionnaire (RQLQ) scores and underwent serologic tests
for immunologic parameters at initial, 1-year, and 2-year
follow-up were selected and divided into 2 groups based on

Rhinology/Allergy

to teach restaurant workers about allergic reactions. The search
terms that were used were hypersensitivity, anaphylaxis, epi-
nephrine, restaurants, food handling, education, pamphlets,
knowledge, data collection, surveys, questionnaires, allergies,
anaphylaxis, EpiPen, epinephrine, restaurant, diner, chef,
waiter, waitress, cross-contamination, food handling, food han-
dlers, education, webinar, seminar, competency, lecture, work-
shop, training, program, survey, questionnaires, test, and pilot.
Results: The following interventions were identified: fact
sheet, poster, online training program, in person lectures,
menu analysis, and multiple trainings. Although not all of
these interventions have been evaluated, an increase in awareness and change in practice was consequently observed.
Conclusions: Educational interventions can be effective in
changing the practices of restaurant employees. Additional
research should be conducted on interventions performed on a
larger scale.

P297

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

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