The 2024 American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Annual Meeting & OTO EXPO took place from September 28 to October 1, 2024, in Miami Beach, Florida. This event serves as the premier gathering for AAO-HNS, providing attendees with the opportunity to stay informed about the latest research and best practices, participate in networking activities, and discover the newest innovations in the field.

At AAO-HNSF 2024, groundbreaking research on Rhinosinusitis was presented, highlighting the most recent developments and breakthroughs in the field. This research provides valuable insights for healthcare professionals and researchers, presenting new perspectives and potential solutions to enhance patient outcomes.

Let us now delve into the key takeaways of the research presented at AAO-HNSF 2024, with a focus on Rhinosinusitis, and explore the cutting-edge advancements that are shaping the landscape of rhinology and allergy.

Adiponectin as a Potential Biomarker in Chronic Rhinosinusitis

  • Key Takeaways
    • Adiponectin, an adipokine with various isoforms, plays a crucial role in exerting tissue-specific anti-inflammatory and pro-inflammatory effects. Studies have shown that adiponectin expression differs between Hispanic and non-Hispanic individuals and is associated with the development and severity of numerous chronic inflammatory conditions.
    • In this investigation, the researchers evaluated preoperative clinical outcomes and adiponectin expression in ethmoid tissues of Hispanic and non-Hispanic patients diagnosed with chronic rhinosinusitis (CRS). Despite similar levels of adiponectin expression between the two ethnic groups, the average expression in CRS ethmoid tissue was higher compared to the non-CRS group. This finding suggests a potential involvement of adiponectin in the pathophysiology of CRS.
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Assessment of Patient Response After 12-Month Treatment With Biologics for Chronic Rhinosinusitis With Nasal Polyps

  • Key Takeaways
    • Chronic Rhinosinusitis with nasal polyps (CRSwNP) is primarily linked to a TH2 inflammatory reaction and often coexists with asthma in 30-70% of cases, sharing a common pathophysiological cascade. Mepolizumab, an IL-5 antagonist monoclonal antibody, is utilized to inhibit the TH2 inflammatory response in these cases. Identifying the most suitable candidates for this treatment is a key focus of ongoing research.
    • The objective of this study is to assess the clinical response of patients with CRSwNP, with or without mild asthma, following 12 months of anti-IL5 therapy. The results indicate that the 12-month anti-IL5 treatment for CRSwNP may lead to improvements in quality of life and olfaction scores, although there was no significant impact on endoscopic findings. Further investigation is necessary to identify clinical factors that could potentially predict a patient’s response to anti-IL5 therapy.
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Assessment of Patient Satisfaction With Dupilumab for Chronic Rhinosinusitis With Nasal Polyps

  • Key Takeaways
    • The monoclonal antibody Dupilumab, targeting the anti-IL-4/IL-13 receptor, has received approval for the treatment of severe and recurrent chronic rhinosinusitis with nasal polyps (CRSwNP). Studies have demonstrated its effectiveness in reducing nasal polyps and improving olfaction. However, there remains a lack of sufficient investigation into patient satisfaction with Dupilumab.
    • Treatment with Dupilumab for CRSwNP could potentially enhance patient satisfaction, particularly in individuals with comorbid asthma. It is important to note that the frequency of injections may impact the overall efficacy of Dupilumab therapy.
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Chronic Rhinosinusitis and Systemic Autoimmune Diseases Among Patients With World Trade Center Occupational Exposure

  • Key Takeaways
    • Chronic rhinosinusitis (CRS) has been linked to systemic autoimmune diseases (SAID), but there is limited data on their association in high-risk populations. Our study aimed to determine if SAID is an independent predictor of CRS in individuals with World Trade Center (WTC) occupational exposure.
    • Our findings did not support the notion that individuals with a history of SAID are at a higher risk of developing CRS, even in a population with heightened exposure to both CRS and SAID. Further research with larger sample sizes is necessary to explore the potential connection between SAID and CRS, including the underlying mechanistic pathways.
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Effect of Nasal Polyp-Derived Innate Lymphoid Cells on Chronic Rhinosinusitis

  • Key Takeaways
    • Innate lymphoid cells (ILCs) play a crucial role in the development of chronic rhinosinusitis with nasal polyps (CRSwNP), with Staphylococcus enterotoxin B (SEB) from Staphylococcus aureus being a well-known microbial component that contributes to chronic inflammation, including local eosinophilia in CRSwNP.
    • This study aimed to investigate the specific involvement of ILCs in the cellular responses induced by SEB in CRSwNP. The findings of this study indicate that ILCs within nasal polyps are indeed implicated in the pathogenesis of CRSwNP following exposure to SEB. Notably, ILCs appear to exacerbate eosinophilic inflammation by increasing IL-13 production in response to SEB.
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Exploring Predictive Factors for Chronic Rhinosinusitis Surgery: Retrospective Analysis of Initial Patient Complaints and Management

  • Key Takeaways
    • Patients suffering from Chronic Rhinosinusitis (CRS) frequently endure a lengthy and challenging healthcare journey before receiving a definitive diagnosis and appropriate treatment. The primary objective of this study is to evaluate how initial patient complaints can help predict the need for surgical intervention in CRS, with the ultimate goal of expediting diagnosis, reducing the number of clinic visits, and enhancing patient access to effective treatment options.
    • Interestingly, the findings of this study did not show any significant associations between patients presenting with symptoms falling under the major sinus category and the rates of surgical referrals. However, a negative correlation was observed between symptoms categorized as minor sinus issues and the likelihood of surgical referral. Additionally, the results indicated the existence of a standardized medication protocol for patients who ultimately required surgical intervention.
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Investigating the Relationship Between Home Mold Exposure and Chronic Rhinosinusitis Subtype

  • Key Takeaways
    • Exposure to mold has been associated with inflammation in various airway diseases and is considered a potential trigger for chronic rhinosinusitis (CRS). Environmental fungi have the ability to interact with the microbiome, influencing immune responses and exacerbating disease. While the connection between mold and CRS is well-documented in cases of allergic fungal CRS, the impact of mold exposure on other CRS phenotypes and disease severity remains unclear. This study aims to compare levels of home mold exposure among individuals with different CRS phenotypes and assess its relationship with disease burden.
    • Preliminary findings from this pilot study suggest that individuals with chronic rhinosinusitis without nasal polyps (CRSsNP) exhibit a higher incidence of mold growth compared to those with chronic rhinosinusitis with nasal polyps (CRSwNP). However, individuals with CRSwNP experience more severe mold exposure. Furthermore, individuals with mold growth in their homes tend to report lower SNOT-22 and LKE scores compared to those without mold growth. These initial results indicate that mold exposure may impact CRS phenotypes and disease severity in varying ways, underscoring the need for further investigation.
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Periostin Regulates Tissue Remodeling in Chronic Rhinosinusitis With Nasal Polyps: Effect of Glucocorticosteroid

  • Key Takeaways
    • Periostin plays a crucial role in the development of chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP). Glucocorticoids (GCs) are commonly used anti-inflammatory drugs to treat CRS; however, the exact mechanism by which they inhibit periostin-induced tissue remodeling remains unclear. Our study aims to investigate the expression of periostin, α-SMA, and extracellular matrix (ECM) components in sinonasal tissues, as well as to evaluate the inhibitory mechanism of GCs in sinonasal fibroblasts and mucosa.
    • Our findings suggest that GCs serve as therapeutic agents for CRSwNP by effectively inhibiting tissue remodeling through their suppressive effects on the Src/Akt/mTOR signaling pathway. This research sheds light on the potential benefits of GCs in managing CRSwNP and provides valuable insights into the underlying mechanisms of their action.
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The Advent Approach: Optimizing Nasal Outcomes in Sleep and Chronic Rhinosinusitis at Lower Cost

  • Key Takeaways
    • A properly functioning nose is essential for overall health, requiring a clear nasal airway, healthy sinuses, and minimal inflammation of the nasal/sinus mucosa. The purpose of this study was to evaluate the effectiveness of in-office balloon sinus dilation (BSD) and radiofrequency (RF) procedures in improving breathing and sleep quality, as measured by the Nasal Obstruction Symptom Evaluation (NOSE) and Epworth Sleepiness Scale (ESS) patient-reported outcomes.
    • The combination of BSD and RF procedures, which reduce nasal swell bodies and inferior turbinates, performed in an office setting under local anesthesia, has shown to produce results comparable to more traditional methods done under general anesthesia in an ambulatory surgery center (ASC). By adopting this approach, we can greatly enhance access to care for patients with nasal and sleep issues, utilizing procedures that carry lower risks, lower costs, and faster recovery times without the need for narcotic pain relief.
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Thank you for joining us for this recap of the AAO-HNS Annual Meeting & OTO EXPO. We recommend visiting this link to explore the entirety of these posters as well as the many others showcased during this exciting event. 

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