Gretchen M. Oakley

Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations

Diagnostic strategies employed for cases of cerebrospinal fluid (CSF) rhinorrhea vary widely due to limited evidence‐based guidance.

Familial risk of chronic rhinosinusitis with and without nasal polyposis: genetics or environment.

Chronic rhinosinusitis (CRS) is a highly prevalent inflammatory condition, with significant effects on morbidity and quality of life, yet little is known about its pathogenesis. Preliminary evidence suggests there is a heritable component to the multifactorial etiology of CRS; however, our understanding of this genetic susceptibility is limited.

Middle turbinate edema as a diagnostic marker of inhalant allergy

Middle turbinate edema could be a characteristic feature of aeroallergen sensitization. In this study we sought to determine the diagnostic characteristics of middle turbinate edema as a marker of inhalant allergy.

Management of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations: Cerebrospinal fluid rhinorrhea management

Management strategies employed for cases of cerebrospinal fluid (CSF) rhinorrhea vary widely because of limited evidence‐based guidance.

Establishing a Familial Basis for Papillary Thyroid Carcinoma Using the Utah Population Database

IMPORTANCE Determining if relatives of patients diagnosed as having papillary thyroid carcinoma (PTC) are at increased risk of developing the same cancer--and if so, which relatives and to what degree--would help identify those who require closer clinical attention. This could lead to earlier cancer detection and improved prognoses. OBJECTIVE To define the familial risk of PTC using a unique population research database. DESIGN, SETTING, PARTICIPANTS Retrospective review at a tertiary care facility using the Utah Population Database, which is linked to medical records and the Utah Cancer Registry, from 1966 through 2011. The study population comprised 4460 patients diagnosed as having PTC in Utah between 1966 and 2011 and their first- through fifth-degree relatives and spouses. These patients were compared 5:1 with matched, population-based controls. MAIN OUTCOMES AND MEASURES Statistically significant increased risk of PTC in any first- through fifth-degree relatives or spouses of patients diagnosed as having this cancer. RESULTS First-, second-, and third-degree relatives of PTC probands had a significant increased risk of developing this cancer compared with population controls. First-degree relatives of probands were at a 5.4-fold increased risk (P < 10(-15)) of being diagnosed as having this cancer themselves. Second- and third-degree relatives had a 2.2-fold (P < 10(-11)) and 1.8-fold increased risk (P < 10(-8)), respectively. Siblings of probands were at highest risk (odd ratio, 6.8; P < 10(-15)). There was no significant increased risk observed in spouses of probands. CONCLUSIONS AND RELEVANCE In the largest population study to date, a high risk of PTC is confirmed in first-degree relatives. Furthermore, significant increased risk extends to second- and third-degree relatives but not to spouses of probands. Translational studies are needed to better define the genetic predisposition to familial papillary thyroid cancer and for the development and implementation of optimal screening approaches.

Corticosteroid nasal irrigations are more effective than simple sprays in a randomized double-blinded placebo-controlled trial for chronic rhinosinusitis after sinus surgery: Corticosteroid irrigation RCT in CRS

Persistent mucosal inflammation in patients with chronic rhinosinusitis (CRS) often results in ongoing symptoms, recurrence of polypoid mucosa, infective exacerbations, and further systemic medication despite surgical intervention. Debate exists as to the most effective topical therapy in CRS.

Familial risk of pediatric chronic rhinosinusitis

To determine the risk of chronic rhinosinusitis (CRS) in relatives of children with a diagnosis of CRS.

Utility of Image-Guidance in Frontal Sinus Surgery

The frontal sinus can present a challenging surgical dissection for the endoscopic surgeon. Image guidance as a surgical adjunct has become widely accepted for surgeries in this area. It can help verify vital structures and manage disorienting surgical conditions, improving surgeon confidence in performing safer and more complete surgery. It is relied upon heavily for placement of limited external frontal sinusotomies for disease beyond the endoscopic reach, and for mapping the frontal sinus for osteoplastic flap bony cuts. Its use has contributed to the expanding role of endoscopic surgical approaches for paranasal sinus inflammatory and neoplastic disease.

Total intravenous anesthesia improves intraoperative visualization during surgery for high-grade chronic rhinosinusitis: a double-blind randomized controlled trial: TIVA for high-grade CRS

Total intravenous anesthesia (TIVA) has been proposed as a method to reduce blood loss during endoscopic sinus surgery (ESS). Impaired sinonasal visualization due to mucosal bleeding may be burdensome in cases of chronic rhinosinusitis (CRS) with high‐grade inflammatory disease, suggesting a role for TIVA in that disease subgroup.

The price of pain in chronic rhinosinusitis: Pain in CRS

Chronic rhinosinusitis (CRS) is associated with productivity losses exceeding US