surgery. Lymphocytes isolated from the polyps were thenstained with cell surface markers to identify B cells, plasma-blasts, CD4� T cells, and CD8� T cells. These populations ofcells were sorted using fluorescence activated cell sorting(FACS). Quantitative polymerase chain reaction (PCR) testingwas performed to investigate pro-inflammatory (IL-2, -4, -5,-6, -17, -21, IFN-�, TNF- �) and anti-inflammatory (IL-10,-13, and TGF -�) cytokine expression among the different cellpopulations.RESULTS: IL-6, TNF- �, and TGF -� were expressed in allB cell samples tested (7/7). Strikingly, IFN-� transcripts weredetected in five of the seven B cell samples. Expression of IL-6was significantly higher among B cells than CD4� and CD8�T cells. TGF -� expression was comparable among B cells,plasmablasts, and CD4� and CD8� T cells.CONCLUSION: B cells isolated from nasal polyps serveantibody-independent functions as evidenced by inflammatoryand anti-inflammatory cytokine expression identified usingPCR. The cytokine profile of the B cells differed from theprofiles of the plasmablasts, CD4� and CD8� T cells. Theresults of this initial study provide further insight into thecomplex pathophysiology of chronic rhinosinusitis with nasalpolyps.

Bacterial Pattern in Chronic Sinusitis and Cystic

Fibrosis

Andres Godoy, MD (presenter); Gloria Ribalta, MD;Isabel Largo, MD

OBJECTIVE: Assess the correlation between pathogenic bac-teria found in bronchoalveolar lavages and paranasal cavitycultures in patients with cystic fibrosis that underwent endo-nasal endoscopic sinus surgery.METHOD: Data collection was from a prospective case seriesand occurred during July 2001 to August 2009, evaluating 16patients with diagnosis of CF that underwent endonasal endo-scopic sinus surgery with cultures samples from bronchoalveo-lar lavages and paranasal cavities from the Otolaryngologydepartment of Clinica Las Condes. Statistics was accomplishedusing Fisher’s Exact Test, analyzing the correlation betweenupper airway cultures and lower airway cultures.RESULTS: The most frequent microorganism in cultures ofparanasal cavities and bronchoalveolar lavages were P. aerugi-nosa, S. Aureus, and Streptococcus viridans. Statistical analy-sis revealed a significant positive correlation between upperairway cultures (paranasal cavities) and lower airway cavities(bronchoalveolar lavages) for the two most frequent microor-ganisms, P. aeruginosa and S. aureus, (p � 0.007 and p �0.0303 respectively).CONCLUSION: We obtained a positive correlation betweenbronchoalveolar lavages and sinus cultures, within a polymi-crobial clinical setting, once more confirming the idea of aunified airway, thus possibly affirming their role as reservoirs

of microorganism for the lower airway. We found chronicrhinosinusitis with polyps to be a common clinical presentationin patients with CF, with a possible role of S. Aureus as apathogenic factor. Further studies are required to indicate therole of antibiotics and the pathogenesis of the microorganismsas a manifestation of clinical severity.

Balloon Dilatation: Tool for Revision Frontal Sinus

Surgery

Michael Friedman, MD (presenter); Tanya Pulver,MD; Christopher Leesman, DO

OBJECTIVE: 1) Demonstrate the value of balloon dilatationas an aid for simplifying access to the frontal sinus in classicalrevision surgery. 2) Demonstrate office-based placement of adrug-eluting balloon for treating early recurrent disease.METHOD: Balloon dilatation was used as an adjunct to clas-sical endoscopic sinus surgery in 200 patients undergoingrevision frontal sinus surgery. Video clips were selected fromfour cases in order to demonstrate the value of this tool inconjunction with classical surgery. Placement of a drug-elutingballoon in the office setting was also demonstrated.RESULTS: Balloon dilatation utilizing transillumination isdemonstrated to facilitate clear identification of the frontalsinus, minimizing the risk of bleeding and misidentification ofthe natural outflow tract. This is followed by classical micro-debridement surgery to complete the dissection. A secondvideo demonstrates office-based placement of a drug-elutingballoon under local anesthesia. This procedure allows for thedirect application of steroid and anti-fungal therapy for treatingearly recurrent disease without requiring a return to the oper-ating room.CONCLUSION: Balloon dilatation is a useful adjunct to clas-sical endoscopic frontal sinus surgery, permitting clear identi-fication of the frontal sinus. Drug-eluting balloons can beplaced under local anesthesia in the office setting for treatingearly recurrent disease, potentially avoiding return visits to theoperating room.

Biofilm Disruption and Gel Rhinotopic Therapy for

RCRS

Mohannad Alqudah, MD (presenter); Mary AnnJabra-Rizk, PhD; Jeff Leid, PhD

OBJECTIVE: To determine if gel rhinotopic therapy is aneffective strategy for treatment and for biofilm disruption inrefractory chronic rhinosinusitis (RCRS).METHOD: This prospective open-label study was conductedover a period of 18 months and included 23 patients withrefractory CRS. Therapy consisted of weekly endoscopic sinusdebridement followed by intra-sinus installation of a hydroxyl-ethylcellulose gel that releases slowly mometasone and anantibiotic (chosen based on nasoendoscopic guided cultures

P125Oral Presentations

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