Digital Public Defence: Sigrun Skaar Holme

Cand.med. Sigrun Skaar Holme at Institute of Clinical Medicie will be defending the thesis "CT imaging of sinonasal disease in granulomatosis with polyangiitis" for the degree of PhD (Philosophiae Doctor).

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

Order a digital copy of the thesis here

Digital Trial Lecture - time and place

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Adjudication committee

  • First opponent: Associate Professor Surjith Vattoth, University of Arkansas for Medical Sciences, Little Rock, USA
  • Second opponent: Associate Professor Gunnar Tómasson, University of Iceland, Reykjavik
  • Third member and chair of the evaluation committee: Associate Professor Sinan Dheyauldeen, Institute of Clinical Medicine, University of Oslo

Chair of defence

Associate Professor Mona-Elisabeth Revheim, Institute of Clinical Medicine, University of Oslo

Principal Supervisor

Professor II Heidi Beate Eggesbø, Institute of Clinical Medicine, University of Oslo

Summary

Granulomatosis with polyangiitis is a multiorgan autoimmune disease which most often involves the upper and lower airways and the kidneys. The paranasal sinus disease in these patients can be aggressive and result in destructed sinus walls, saddle nose deformity or extensive osteitis (thickened bone).

The aims of the thesis were to develop methods to characterise and measure the paranasal sinus osteitis on computed tomography (CT) scans and to find predictors of the outcome of the paranasal sinus disease preferably already at baseline.
Two methods for osteitis assessment were identified: One scoring system and one diameter-based measure. The advantage of the diameter-based method was that the disease could be followed until complete obliteration of the sinus lumen by bone.
Three groups of patients were identified: About a third of the patients never developed osteitis. The next third had an osteitis which stabilised, and the last group had a progressive osteitis.

Patients with progressive osteitis had a higher osteitis progression rate around the time of the sinus surgery. This could be due to the surgery or due to a more active disease. Unfortunately, measures for the disease activity had not been included.
Patients with mucosal thickening or fluid or without any kidney involvement at baseline had more osteitis at last follow-up.

The conclusions were that there is need for a better disease activity measure for the paranasal sinus disease and that mucosal thickening or fluid seen at CT scans perhaps could work as this measure. Surgery correlated with a high degree of osteitis and is perhaps not a useful treatment option in these patients. Both conclusions must be confirmed by prospective studies.

Additional information

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Published June 8, 2021 12:22 PM - Last modified June 8, 2021 2:29 PM