Houston Methodist Researchers Bring Clinical Insight and Global Perspective to COSM 2026

From repurposing everyday therapies to redefining when not to operate, Houston Methodist faculty will showcase a wide-ranging portfolio of research at the Combined Otolaryngology Spring Meetings (COSM) 2026, held April 22–26 in Phoenix.

Houston Methodist’s featured otolaryngology research will highlight innovations in prevention, precision medicine, surgical decision-making and global health that reflect the organization’s commitment to translating clinical observation, emerging science and real-world data into more precise and practical patient care.

Common nasal spray, reimagined as prevention

On April 26, Houston Methodist researchers will present new evidence that the over-the-counter intranasal medication azelastine — long used as an antihistamine — may significantly reduce recurrent acute sinus infections.

The retrospective cohort study of more than 150 patients with recurrent acute rhinosinusitis (RARS) found that azelastine use was associated with a 57% reduction in annualized acute rhinosinusitis episodes.

The findings build on emerging evidence that the drug’s benefits extend beyond allergy control. In addition to its antihistamine effects, azelastine appears to reduce nasal inflammation more broadly and may limit viral uptake in the nasal mucosa — a key trigger for downstream bacterial sinus infections.

For clinicians, the implications are notable: a widely available, low-risk therapy could serve as the first viable preventive strategy for a condition historically managed reactively.

“This is an old drug with a new purpose,” said Dr. Omar Ahmed, who helped lead the study. “By targeting inflammation and viral susceptibility simultaneously, the medication can interrupt the persistent cycle of recurrent infection that defines RARS.”

The team’s findings also lay the groundwork for prospective trials — and potentially a shift toward prevention-first management in a population with limited options.

When less intervention may be the best option

On April 25, Houston Methodist researchers will present a new study that reconsiders tumor management in older adults.

Focusing on patients age 70 and older with vestibular schwannomas — benign tumors of the balance nerve — a Houston Methodist research team found that most tumors follow a slow, often indolent course, safely allowing the majority of patients to avoid surgery altogether.

The analysis suggests that age at diagnosis plays a critical role in treatment decisions. While younger patients may eventually require intervention due to long-term tumor growth, older patients with small, slow-growing tumors may never reach that threshold.

“In many of these cases, observation is not just reasonable — it’s preferable,” said Dr. Jeffrey Vrabec, the study’s principal investigator.

Only about 20% of patients in the cohort required surgery, with the remainder managed through observation or radiation. The findings support a more conservative, individualized approach that weighs tumor biology alongside life expectancy and symptom burden.

For clinicians, the study reinforces a key principle: not all tumors demand immediate action, particularly in populations where overtreatment may carry unnecessary risk.

Genetics points toward a more precise future for sinus disease

Houston Methodist researchers are also advancing the field of chronic rhinosinusitis (CRS) management by addressing a long-standing gap in genomic research: the underrepresentation of non-European populations.

On April 26, Houston Methodist researchers will present findings from a recent whole-genome sequencing study identifying distinct genetic signals associated with CRS across different ancestry groups. The study features data from more than 6,000 participants in the NIH All of Us program.

Among the findings were ancestry-specific variants linked to immune signaling, epithelial function and mucociliary clearance — including genes such as CCDC40 in African ancestry populations and pathways related to extracellular matrix remodeling in others.

The results highlight the heterogeneity of CRS and suggest that genetic susceptibility — and ultimately treatment response — may differ meaningfully across populations.

“No one has really looked at this at this scale before,” said Dr. Omar Ahmed, principal investigator for the study. “This is the first step toward understanding how genetics may shape disease in different groups.”

While the work remains exploratory, it points toward a future in which CRS management could be tailored based on underlying biology — a shift from one-size-fits-all treatment to precision medicine.

Measuring the hidden toll of war on patients and providers

Extending beyond traditional clinical research, Houston Methodist investigators are also examining the human impact of care delivery in extreme conditions.

In collaboration with international partners, Dr. Anthony Brissett and colleagues studied psychiatric morbidity and burnout among Ukrainian facial trauma patients and health care providers during active conflict.

On April 22, the researchers will present findings suggesting a striking unmet mental health burden. A majority of Ukrainian participants — both patients and providers — screened positive for depression, anxiety or PTSD, often without prior diagnoses. Among providers living and working within Ukraine, scores were significantly higher than those of international volunteers.

The study also uncovered a nuanced pattern among volunteer clinicians: Psychological stress appeared to peak after two to three missions before declining, suggesting a potential adaptation effect over time.

“What we’re seeing is both an underrecognized burden and an opportunity,” Dr. Brissett said. “There may be critical windows where targeted mental health support could make a meaningful difference.”

The research adds to a limited but growing body of literature on health care delivery during active conflict — and highlights the need to support not only patients, but also the clinicians who care for them.