How Otolaryngologists Can Apply Predictive Medicine to Patient Care

There is a test for early cellular changes in the throat, analogous to a Pap smear, but its utility is still being evaluated (Cancer Prev Res (Phila). 2011;4:1346-1349). There’s also hope that widespread adoption of the HPV vaccine will prevent many cases of oropharyngeal cancer.

Meanwhile, genetic analysis of head and neck cancers continues, a very active research area, with the hope of personalizing treatment based on a tumor’s molecular signature. (Adv Exp Med Biol. 2013;779:165-177; Head Neck Oncol. 2010;2:8).

Chronic Sinusitis

New work also suggests that typing bitter taste receptors in patients with recurrent sinus or upper respiratory tract infections may inform treatment strategies (J Clin Invest. 2012;122:4145-4159). “Bitter taste receptors exist in the respiratory mucosa,” said Dr. O’Malley, “and specific recep-tors are involved in the detection of specific types of bacteria.” Genetic variability of those bitter taste receptors affects the strength of the response and explains a great deal of individual variability.

With some 20 million visits for chronic sinusitis every year in the U.S. and a half million surgeries to fix the problem, said Dr. O’Malley, “it’s a significant health care issue.” A test that can identify the bitter taste receptor genotype might help determine who would benefit from surgery versus a course of antibiotics.