August 02, 2022
3 min read
Disclosures: Grayson reports no relevant financial disclosures.
Clinicians do not have to wait for cutting-edge research to improve treatment. Breakthroughs already can impact care, Jessica Warren Grayson, MD, MS, member of Healio’s Allergy/Asthma Peer Perspective Board, said.
“In our group, we are working on the etiology and management of chronic sinusitis, as well as outcomes in surgical procedures,” Grayson, assistant professor and director of clinical research as well as adjunct assistant professor in the department of neurosurgery at the University of Alabama at Birmingham (UAB) Marnix E. Heersink School of Medicine, told Healio.
Jessica Warren Grayson
“Most recently, we have described an orbital transposition procedure to allow for reaching far lateral frontal sinus pathology while keeping the surgery endoscopic,” she continued. “We have also reported on our excellent cosmetic outcomes from repairing frontal sinus fractures endoscopically.”
Grayson wears multiple hats, as she is an associate at the Minority Health scientist and Health Disparities Research Center, medical director of otolaryngology at The Kirklin Clinic of UAB Hospital, and a member of the divisions of head and neck surgery and rhinology and anterior skull base surgery of the hospital’s department of otolaryngology.
We spoke with Grayson about her work in these diverse areas and how they relate to allergy and asthma care.
Healio: How did you come to pursue otolaryngology as your specialty?
Grayson: I originally wanted to do general surgery and go on to do surgical oncology. However, when I spent my time on those clinical rotations in medical school, there was something missing.
My advisor spent some time talking to me about what I loved about medicine and surgery — including office-based procedures, long-term relationships, complex anatomy and opportunities for both urgent/emergent care and specialized care — and suggested I look into otolaryngology. I spent a month seeing open head and neck cancer operations, endoscopic sinus surgery, pediatric airway surgery and complex ear cases, and I was hooked for life.
Healio: Do you have a particular area of otolaryngology that you enjoy the most?
Grayson: I have subspecialty training in rhinology and anterior skull base surgery, so I spend my days managing allergic rhinitis and septal deviations to cystic fibrosis sinusitis, broad airway inflammation to frontal sinus trauma, and cerebrospinal fluid leaks to complex skull base resections.
Healio: What challenges do you face regularly in practice that keep you up at night?
Grayson: The biggest hurdle we face is ensuring patients have what they need medically and surgically without having to pay exorbitant prices for it — when we struggle to get images covered in network or medications covered with insurance or find a cheaper alternative for those who are uninsured. Our team works tirelessly on this, but we want everyone we take care of to have a similar experience and outcome.
Healio: What do you like to do outside of clinical practice?
Grayson: I teach in the academic setting and direct resident and medical student research. I also enjoy being outdoors and running.
Healio: What would you say has been the most exciting development in otolaryngology as it pertains to allergy/asthma treatment over the last decade?
Grayson: Monoclonal antibody therapy for airway inflammation is a wonderful adjunct tool for helping manage patients with recalcitrant inflammatory sinusitis and asthma. Historically, the 10% of patients for whom surgery and topical corticosteroids weren’t enough to control the disease suffered. They underwent multiple procedures and sometimes stayed on long-term steroids, which come with many risks. Monoclonal have antibodies added additional treatment options for patients who need more than the standard management. It has improved outcomes in those difficult-to-treat patients.
Healio: What advances are you most looking forward to over the next 10 years?
Grayson: Point-of-care endotyping of chronic rhinosinusitis to provide personalized patient care. Endotyping is determining what inflammatory cells are driving the sinusitis and asthma in these patients with broad airway inflammation. If we know which cells are driving each individual’s disease, then we can provide patient-tailored care based upon that. I hope for a day of point-of-care testing or a single lab that will return and tell us how to classify patients and, based on that, we can build out algorithms of care that provide them with the best possible outcomes. This type of patient-specific or precision care is the forward movement of medicine, and I think it will revolutionize how we manage these patients.
For more information:
Jessica Warren Grayson, MD, MS, can be reached at UAB Hospital, 1802 6th Ave. South, Birmingham, AL 35233.