Rhinology/Allergy A Surgical Training Model for Endoscopic Sinus Surgery Carl Snyderman, MD (presenter) OBJECTIVE: Endonasal surgery of the cranial base requires extensive training in anatomy and endoscopic techniques. A training model for simulation of endoscopic surgery of the paranasal sinuses and cranial base was developed that 1) rep- licates the surgical experience and 2) provides a measurable learning curve. METHOD: The anatomical model is generated from CT data and has bone generated from a 3D printer and silicone applied to recreate nasal soft tissue. Design requirements were surgical simulation with real surgical instruments and the objective detection of injured structures at risk (orbit, dura, internal carotid artery, and optic nerve). RESULTS: Using this teaching model, it is possible to dem- onstrate a learning curve and track the progress of a surgeon (duration of surgery, number and location of injuries). Ana- tomical and pathological variations can be introduced to pro- vide a varied surgical experience. CONCLUSION: This model replicates the surgical experi- ence and allows the surgeon to monitor the learning curve. The use of actual surgical instruments provides realistic haptic feedback. Future trials will demonstrate the contribution of surgical simulation on surgical proficiency in the operating room. Acute Sinusitis Following Endoscopic Skull Base Surgery Arthur Wu, MD (presenter); Marvin Bergsneider, MD; Marilene Wang, MD OBJECTIVE: To determine the incidence of antibiotic use for acute sinusitis in patients with a recent history of endoscopic skull base surgery. METHOD: This is a retrospective chart review of all patients at a single institution (UCLA Medical Center) who underwent endoscopic skull base surgery for benign or malignant tumors from January, 2008 to November, 2009. Patients without a documented follow up note in the chart or with less than three months follow-up since surgery were excluded. Antibiotic us- age, name of antibiotic used, patient symptoms, type of tumor, and number of months since surgery at last examination were recorded for every patient. RESULTS: 126 patients satisfied the inclusion and exclusion criteria. 21 patients required antibiotics in the postoperative period. 17 patients were given antibiotics specifically for acute sinusitis (13.5%). Two patients required antibiotics for acute otitis media postoperatively. Two patients were prescribed mupirocin for documented Methicillin-resistant Staphylococ- cus aureus nasal colonization. The most common complaints of patients diagnosed with acute sinusitis were headache and increased nasal drainage. The average follow-up was 5 months for patients with sinusitis and 4.3 months for those without sinusitis (not clinically significant, p=0.53). CONCLUSION: Endoscopic skull base surgery is a recent technique which has been shown to be safe and effective for select tumors of the skull base. Significant sinonasal symptoms occur in the immediate postoperative period. In this study we show that acute sinusitis which requires antibiotic treatment affects 10-15% of patients. Prompt treatment with appropriate antibiotics results in resolution of symptoms. Additive Effect of Silymarine in Allergic Rhinitis Treatment Mehdi Bakhshaee, MD (presenter); Farahzad Jabbari, MD; Saeed Hosseini, MD; Reza Farid Hossaini, MD; Mohammad Hadi Sadeghian, MD OBJECTIVE: Allergic rhinitis is the most common allergic disorder. Beside its huge costs, it affects quality of life in many ways. Although the role of oxidative stresses in the pathophys- iology of allergic rhinitis has been confirmed in a few studies and the protective effect of silymarine against oxidative stresses has been proved in various organs, no study has yet been conducted on the effect of silymarine as an antioxidant plant in the management of allergic rhinitis. METHOD: In a clinical trial, 60 patients with signs and symp- toms of allergic rhinitis and a positive skin test were randomly divided into two groups (study and control). Nasal smear eosinophil percentage, serum IgE and cytokine (IL-4, 5, IFN- gamma ) levels were measured. Silimarine was administered for the study group, while the control group received placebos for 1 month. At the end of the treatment period, clinical and laboratory signs and symptoms were reviewed again and their results were compared by statistical methods. RESULTS: A significant improvement in the clinical symp- toms based on SNOT-20 was observed in both groups (p0.05), whereas post-treatment serum IgE level was higher in the silimarine group. CONCLUSION: Considering the effective role of silimarine in reducing the severity of allergic rhinitis symptoms, this safe and low-risk antioxidant plant could be used as an additive drug beside other routine modalities. Allergic Rhinitis: Cytopathological Correlations with ARIA Walid Abou Hamad, MD (presenter); Ali Dirani, MD; Maguy Cherfan, MD; Homere Al Moutran, MD; Amine Haddad, MD, FRCSC OBJECTIVE: The primary objective of this study is to iden- tify a pathophysiological rationale behind the Allergic Rhinitis P123 Oral Presentations ORALS