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Panel Presentations

Rhinology/Allergy

Revision Sinus Surgery: When, Why, How?

Saturday, October 11, 2025
4:00 PM - 5:00 PM EDT
Location: 123-124
Disclosure(s):
Nathalia Velasquez, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Victoria S. Lee, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: Decision-making for choosing when to perform revision endoscopic sinus surgery is increasingly nuanced and complicated given the availability of new medical treatments such as innovative methods for steroid delivery and biologics targeting inflammation. Through case-based discussion, this session shows how the use of available data affects decision-making for revision endoscopic sinus surgery. We will address anatomic factors—including paranasal sinus mucoceles, residual uncinate process, maxillary sinus recirculation, middle turbinate lateralization, frontal and sphenoid ostial stenosis, and frontal recess neo-osteogenesis—seen on sinonasal imaging and endoscopy that suggest revision endoscopic sinus surgery success. The comprehensive otolaryngologist, advanced practice provider, and otolaryngologist-in-training will learn to utilize patient characteristics and anatomic findings to inform the decision for revision endoscopic sinus surgery versus more intensive medical management. The role of biologics in the management of the refractory sinus patient will be specifically discussed. Cases will illustrate the evidence for treating nasal polyposis with topical medications versus biologics versus revision endoscopic sinus surgery. We will also discuss tools of revision surgery, such as image guidance, augmented reality, balloon sinus dilation, and powered instrumentation. Surgical techniques and maneuvers for addressing common anatomic problems seen in the refractory chronic rhinosinusitis patient are described.

OUTCOME OBJECTIVE 1: Recognize and interpret sinonasal imaging and endoscopy findings that favor greater success of revision endoscopic sinus surgery versus alternative treatment options.

OUTCOME OBJECTIVE 2: Understand factors that help the clinician recommend topical corticosteroids, biologics, or revision surgery in the refractory nasal polyposis patient.

OUTCOME OBJECTIVE 3: Describe and implement surgical maneuvers to address common anatomic problems encountered in revision endoscopic sinus surgery.

BACKGROUND STATEMENT: We shall address the need for a nuanced, data-driven approach to managing the refractory chronic rhinosinusitis patient, including an emphasis on indications for revision endoscopic sinus surgery versus medical management, including the role biologics.

Comprehensive Otolaryngology Track Statement :

    Moderator(s)

  • Li-Xing Man, MSc, MD, MPA

    Associate Professor of Otolaryngology and Assistant Dean of GME Surgical Specialties
    University of Rochester
    Pittsford, New York, United States

    Disclosure information not submitted.

    • Panelist(s)

  • Nathalia Velasquez, MD

    Rhinology & Skull Base Surgery
    Kaiser Permanente Med Group - Northern California
    Fremont, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Victoria S. Lee, MD

    Associate Professor of Otolaryngology
    University of Illinois Chicago
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • GS

    George A. Scangas, MD

    Assistant Professor of Otolaryngology
    Metson and Scangas
    Boston, Massachusetts, United States

    Disclosure information not submitted.