Controversies in the Contemporary Management of Nasal and Sinus Disease

PROGRAM DESCRIPTION: The last decade has witnessed considerable evolution in the management of nasal and sinus disease. This has emerged from a proliferation in technology, novel therapeutics, mounting clinical experience, clinical and translational evidence, and better understanding of the pathophysiologic basis of many nasal and sinus disorders. Simultaneously, socioeconomic pressures from governmental and commercial payers have impacted practice patterns. The cumulative effect of these forces has led to many novel and alternate treatment pathways in the management of various sinonasal conditions. Consequently, this has also led to controversies regarding what constitutes best practice regarding objective outcomes, economic value, and patient and provider satisfaction. The panel is comprised of an experienced and diverse group of fellowship trained rhinologists, each with close to 20 years in clinical experience in the field of rhinology. The group will examine these controversies, largely utilizing a case-based format where clinical case scenarios will highlight one or more particular points of controversy.
Potential topics to be explored include:
• Surgery in the office versus an ASC versus hospital outpatient department
• Balloon sinus dilation versus conventional endoscopic sinus surgery
• What constitutes appropriate medical therapy prior to considering sinus surgery
• Value of nasal or sinus surgery in sleep apnea
• Optimal pain management in sinonasal surgery
• Novel devices for management of rhinitis and postnasal drip
• Office approaches for treatment of nasal valve obstruction
• Use of biologics in chronic rhinosinusitis with polyps
The discussion will include aggregate of evidence-based recommendations, current practice guidelines, and reasoned expert opinion. The panel will address how these cases may have been handled in the past, and how the existing environment has shaped current and future clinical practice.

OUTCOME OBJECTIVE 1: Identify areas of variation in practice patterns in the management of nasal and sinus disease.

OUTCOME OBJECTIVE 2: Explore how the advent of new surgical devices and novel therapeutics and better understanding of the disease process has led to controversies in medical decision making.

OUTCOME OBJECTIVE 3: Apply evidence base medicine and current treatment guidelines, supplemented with expert opinion from extensive clinical experience to promote best patient-centered outcomes.

BACKGROUND STATEMENT: New technology and socioeconomic factors have led to novel, alternative therapies in managing sinonasal conditions; with controversies in optimal management. Panels, utilizing patient based cases, are imperative to guide robust decision making grounded in science and sound experience.