Otolaryngology - Department of Otolaryngology | Weill Cornell

Transcription

Otolaryngology - Department of Otolaryngology | Weill Cornell
Otolaryngology
at Weill Cornell Medical College
Head & Neck Surgery
Otology/Neurotology
Plastic and Reconstructive Surgery
Hearing and Speech
and related disciplines
SECOND EDITION
–1–
about Weill Cornell Medical College
Weill Cornell Medical College is among the top-ranked clinical and academic medical research centers in the
country. Partnered with the renowned NewYork-Presbyterian Hospital (currently ranked #6 in the nation by
U.S.News & World Report), the Medical College comprises 23 academic departments focusing on the sciences
underlying clinical medicine; the study, treatment and prevention of human diseases; and maternity care.
Weill Cornell Medical College has recognized the urgent need for health-care professionals in developing
nations. To address this growing problem, the Medical College has broadened its scope by establishing a
Middle East campus—Weill Cornell Medical College in Qatar—where students from throughout the Middle
East and Asia come to study for the Weill Cornell M.D. degree. Other education and clinical programs in
Tanzania, Brazil and Turkey have allowed Weill Cornell Medical College to train physicians in those parts of the
world most in need of high-quality health care.
The Weill Cornell Medical College campus on the Upper East Side of Manhattan.
from the chairman
Welcome to the Department of Otorhinolaryngology at
Weill Cornell Medical College. This issue of our departmental
report will describe for you some of the many accomplishments of our faculty.
We moved into beautiful new space in the Weill Greenberg
Center in 2007, and although it was more than double the
size of our previous space, we have already outgrown it. And
so we are excited about moving our growing and dynamic
Pediatric Otolaryngology section into newly-renovated
space on the Weill Cornell campus in early 2009.
Under the leadership of Dr. Joseph Montano, our Hearing and Speech program is growing beyond expectations,
and we are adding a cochlear implant program in the
near future. In fact, all of our clinical programs—including
Allergy, Head and Neck, Laryngology, Otology/Neurotology,
Plastic and Reconstructive Surgery, Rhinology, Sleep Medicine, etc.—are growing steadily.
Our Department is also the administrative home of
the newly-opened Center for the Performing Artist at
NewYork-Presbyterian/Weill Cornell Medical Center, which
will soon be a highly sought after resource for the vast performing artist community in New York City.
We are proud that our faculty are regularly invited to present at national and international programs. In addition, our
Department continues to host several popular CME courses
every year.
Again, thank you for your interest in Otolaryngology at
Weill Cornell.
Michael G. Stewart, MD, MPH
Professor and Chairman
Dr. Michael Stewart
growing a hospital
the history of NewYork-Presbyterian Hospital/Weill Cornell
T
he grand façade of NewYork-Presbyterian Hospital/Weill Cornell Medical Center is such a
fixture of the Upper East Side neighborhood where it is located, that many people assume the
Hospital/Medical College campus has been there forever. And yet the history of the institution, built on the site of a former brewery, is long and varied.
The oldest hospital in New York City, and the second oldest hospital in the country, the
New York Hospital was founded in 1771 by a Royal Charter from King George III of England (a copy
of which is on display at the Hospital). The Charter established
“The Society of the New York
Hospital in the City of New York
in America” and a Board of Governors.
The history of New York
Hospital is intimately related to
the history of New York City.
At the first graduation exercises
of the medical school of King’s
College, held in Trinity Church
in 1769, Dr. Samuel Bard, Professor of the Practice of Medicine, established the need for a
“Public Hospital for the Reception of the Poor Sick of this Government and City.” He stressed The second location of New York Hospital on West 15th and 16th Streets in Manhattan.
the triple missions of patient
care, research, and teaching which such an institution should fulfill. The small hospital was erected
on a plot of land along the west side of Broadway between what is presently Worth Street and Duane
Streets. It was set back about 90 feet from Broadway, allowing considerable space on all sides for lawn
and future buildings.
The journey toward the establishment of a medical center began in 1912. Dr. Lewis Stimson, a
founding faculty member and chairman of the Department of Surgery at Cornell University Medical
College and an attending surgeon at New York Hospital, along with George Baker, Sr., a governor of
New York Hospital since 1899 and wealthy benefactor, facilitated an affiliation agreement between
Cornell University Medical College, located at 477 First Avenue, and The Society of the New York
Hospital, then located at West 15th and 16th Streets between Fifth and Sixth Avenues. George Baker, Sr.
gave an initial donation of $250,000 to New York Hospital. The following year, the college’s benefactor,
Oliver Hazard Payne, donated $4,000,000 to Cornell University Medical College.
In 1917, the idea of merging New York Hospital, Presbyterian Hospital, Cornell University
Medical College, and Columbia University’s College of Physicians and Surgeons into one medical center was proposed. Instead, Presbyterian Hospital and Columbia University joined to
build Columbia-Presbyterian Medical Center, which opened in 1928, on Manhattan’s Upper
West Side. An agreement between Cornell University and The Society of the New York Hospital to establish their own medical center was signed on June 14, 1927. It wasn’t until 80 years
later that New York Hospital and Columbia-Presbyterian Hospital would finally merge. –4–
In the affiliation document, New
York Hospital agreed to buy the necessary land and build a general hospital that would include facilities for
patient care, the training of medical
students, and research laboratories.
In turn, Cornell University agreed
to share in the costs of building and
maintaining the medical school facilities. In addition, the New York
Hospital–Cornell Medical College
Association was formed. The Joint
Administrative Board, consisting of
three hospital governors, three university trustees, and a member-atThe original Cornell Medical College at 477 First Avenue in Manhattan.
large, administered the association.
The Central Brewing Company and several row houses that were on the site of the current medical center were demolished in early 1929. The ground-breaking ceremony for the new medical center
was held on June 17, 1929.
The hospital hired the Boston architectural firm of Coolidge, Shepley, Bulfinch and Abbott. The
final plans included a 27-story central tower (F Building–Baker Tower). The first nine floors were designated for the general hospital of 459 beds (later reduced to 300 beds); floors 10 and 11 for operating
rooms; floors 12-17 for private patients; and the top floors for the living and recreational quarters for
the house staff. Payne Whitney Psychiatric Clinic had its own building (now the site of Greenberg
Pavilion).
The College buildings were placed on York Avenue so that the view of the river would be reserved
for the patients. The Medical College had four wings housing facilities for anatomy (A Building),
bacteriology and immunology (B Building), physiology (D Building) and biochemistry and pharmacology (E Building). Along the central corridor (C Building) were facilities for the pathology laboratories, library, and administrative offices.
To date, NewYork-Presbyterian Hospital/Weill Cornell Medical Center (formerly New York
Hospital-Cornell Medical Center) has been a leader in medical advancements that included the first
eye bank in the United States (1944) and the first kidney transplant (1963) and the first MRI machine (1983) in the New York metropolitan area. The medical center patient care facilities include the
William Randolph Hearst
Burn Center; the Perinatology Center, the Rogosin
Kidney Center (Rogosin
Institute); the Thalassemia
Center (oldest in the country, founded in 1944); the
Blood Bank (first in New
York State, second in nation,
founded in 1938); the Center for Reproductive Medicine and Infertility; and the
International Health Care
Service.
In 1998, the Medical
The New York Hospital/Cornell Medical College campus as it appeared in the early 1930’s.
College was renamed the
Joan and Sanford I. Weill Medical College of Cornell University (now shortened to Weill Cornell
Medical College in daily usage). New York Hospital and Presbyterian Hospital merged in 1997 to
form NewYork-Presbyterian Hospital with two distinct medical centers (NewYork-Presbyterian Hospital/Columbia University Medical Center and NewYork-Presbyterian Hospital/Weill Cornell Medical Center) that brought to full circle the vision of unity that had begun in 1917.
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leading the way
P
hysicians in each of the diverse specialties
of medicine rely on communication between colleagues at national meetings to
learn of the key basic science and clinical research
advances that will lead to better practices. For
academic otolaryngologists, one of those groups
is the Society of University
Otalaryngologist-Head and
Neck Surgeons.
SUO-HNS, as it is often
referred, is more than four decades old and has a membership of over 500 physicians.
The Society addresses issues
pertinent to academic Otolaryngology all over the country. This year, Dr. Michael
Stewart, chairman of Weill
Cornell Medical College’s
Department of Otorhinolaryngology, is serving as the
president of SUO–HNS, and
is responsible for planning
the society’s annual meeting,
which was held this fall in Chicago. The focus of this year’s
meeting was on excellence in
education, from students and
residents to practitioners.
“There is a lot of work involved in putting together a
meeting, but it’s quite an honor to be elected,” Dr. Stewart
said.
The Society’s annual
meeting is popular and wellattended with frequent repeat
attendees, because the meeting focuses entirely on issues
that are currently most critical
to academic medicine. A typical meeting will incorporate
a great deal of audience participation in the proceedings, as well as panel discussions and presentations. For more than 12 years, Dr. Stewart has
actively participated in the discussion and debate as a member of SUO-HNS. Dr. Stewart also
served at one time on the organization’s council,
helping to provide leadership and direction.
“People bring their best practices and other
doctors learn from that and take it home and
–6–
adapt it,” Dr. Stewart said. “It is not a scientific
meeting where faculty present basic and clinical research. Rather, it’s a meeting where people
discuss education, research and administration.”
Joining Dr. Stewart as the president of a
subspecialty society is Dr.
Samuel Selesnick, vice chairman of the Department of
Otorhinolaryngology at Weill
Cornell, and the next president of the American Neurotology Society.
“Drs. Stewart and Selesnick
have always served as leaders
in their field and as a source of
great pride for Weill Cornell
Medical College,” said Dr.
Antonio M. Gotto Jr., Dean
of the Medical College. “That
they have been selected to
Dr. Michael Stewart
lead their respective professional organizations is further
evidence of their impressive
and distinguished careers.”
Neurotology, a subspecialty within otolaryngology,
encompasses lateral skull
base surgery and surgical
and medical treatment for
patients suffering from complex ear-related problems
such as hearing loss, tinnitus
and vertigo.
As president, Dr. Selesnick will oversee both the
fall meeting and the spring
annual meeting and reception. The fall meeting, which
Dr. Samuel Selesnick
was held in September, is a
half-day meeting on a specific set of topics. The program
features several lectures, panel discussions. The
annual meeting, which will be held in May,
consists of two half-day sessions. Investigators
submit their work for a blinded peer review selection process. In addition to accepted submissions, several panels as well as invited lectures
will be given. Each year, this is the largest gathering of neurotologists-skull base surgeons in
the country.
sinusitis: why me?
S
inusitis—inflammation of the paranasal
sinuses—in some form, affects 14 percent
of Americans and accounts for billions of
dollars in medical costs each year. It is one of the
most commonly reported diseases in the country, yet many questions surround its pathogenesis. The development of chronic rhinosinusitis
(CRS), defined as lasting at least 12 weeks, is a
complex multifactorial process characterized by
inflammation of nasal and sinus mucosa.
Generally, prolonged courses of oral antibiotics, along with anti-inflammatory treatments,
and often endoscopic surgical intervention are
reasonably effective treatments, and advances in
both techniques and technology have been significant. Despite this, there continue to be many
questions about the predisposing factors leading
to the development of the condition.
In an effort to shed light on those unknown
determinants, Dr. Ashutosh Kacker, Associate Professor of Otorhinolaryngology at Weill
Cornell Medical College, and his colleagues
investigated the segment of the population
that doesn’t respond to the traditional treatments for CRS, and whether genetic similarities
between those non-respondents could lead to new
therapies and a greater body of knowledge of CRS.
The primary objective of the experiments
was to compare gene expression in the sinus
mucosa of patients with CRS with expression
in normal subjects. Through the use of gene microarray technology — which allows the simultaneous analysis of the expression of thousands
of genes — Dr. Kacker and his colleagues examined the alterations in inflammatory mediator
expression in patients with CRS.
The studies found that there is consistent overexpression of four major genes of the
inflammatory pathway in patients with CRS as
compared with the normal population. Further research into the gene expression profiles,
Dr. Kacker concluded, may begin to reveal new
factors in the pathogenesis of CRS. Indeed, continued genetic analysis and even gene therapy
may hold future promise in the prognosis and
directed treatment of CRS.
–7–
striking a cord
the frustration­– and treatment­– of vocal fold paralysis
B
efore researchers can develop therapies to treat a disease, they first must
determine its natural course, or how it
will progress if left untreated. In vocal fold (or
cord) paralysis, information on the natural
course and outcome of the disease is largely
incomplete, even though the diagnosis of vocal fold paralysis (VFP) has been established
for over a century.
In a literature review study by Dr. Lucian
Sulica, Associate Professor, and published in
Laryngoscope, Dr. Sulica reviewed more than
700 cases of reported idiopathic VFP, or VFP
of unknown cause. “The disorder appears to
be managed according to time-honored assumptions regarding clinical course and outcome rather than information from clinical
observation,” Dr. Sulica noted in the study.
The mean rate of spontaneous resolution of
idiopathic VFP was 39%, but the variability from case series to case series was vast,
ranging from 19 to 83%. That made drawing
conclusions impossible. “The result is that
we can’t answer a very simple question that
every patient is likely to ask, which is: ‘Doctor, what is the chance that this is going to get
better?’” Dr. Sulica said. “We just don’t have
the information to give them.”
One of the main reasons for this variability lies in differences in how VFP and its
recovery are described and conceptualized.
For example, VFP has been thought of as an
all-or-none disorder, where the vocal fold is
either paralyzed or normal. “There is overwhelming evidence that that’s just not so,”
observes Dr. Sulica. “Vocal fold paralysis is
a graded phenomenon, and so is neural recovery.” Furthermore, “recovery,” as used historically, can refer to recovery of vocal fold
motion, or recovery of normal voice (even if
the vocal fold remains paralyzed.)
In hopes of introducing a universal language and vocabulary to VFP outcomes and
measurements, Dr. Sulica has begun a study
involving laryngologists at more than 15 aca-
demic medical centers, aimed at standardizing the way VFP is described.
In addition, Dr. Sulica has initiated a
prospective study to catalog VFP patients,
their symptoms and recovery process.
Patients presenting with new cases of VFP,
irrespective of cause, will undergo a battery
of endoscopic, acoustic and aerodynamic
Dr. Lucian Sulica
tests. In additional to monthly check-ups,
patients will undergo a similar battery of tests
at six months, at one year, and upon recovery.
Together, these investigations should go
a long way toward improving the information base needed to make accurate and effective treatment recommendations for VFP.
For instance, for many physicians the current
VFP treatment advice to patients is to wait
one year for spontaneous improvement before surgical correction. “That’s a long time
to be without an effective voice,” Dr. Sulica
observed. “If we can identify patients who
are unlikely to recover early, then we can
treat them far sooner.”
–8–
faculty textbooks
T
he number of textbooks written and edited
by members of the Department of Otorhinolaryngology will soon be increasing
thanks to several new faculty publications.
Upcoming texts include: “Revision Surgery in Otolaryngology,” by Drs. David Edelstein, Samuel Selesnick, Robert Ward and
Norman Pastorek; a book from Dr. Joseph
Montano; two new books from Dr. Lucian
Sulica, one of which will be called “Classics
in Voice and Laryngology”; and “Differential Diagnosis in Otolaryngology–Head
and Neck Surgery,” by Drs. Michael Stewart and Samuel Selesnick.
“Our upcoming textbook on differential diagnosis should play an important
part in the process of helping a clinician
who is presented with an unusual or unfamiliar problem,” Dr. Stewart said. “The text
will be available in paper and electronic
versions, and will be well-organized with
cross-references and links to other pertinent areas. Some editors and chapter authors are experts from around the country.”
“Vocal fold paralysis is at once the most
common and the most problematic diagnosis in neurolaryngology,” Dr. Sulica said. “Our
notions of what is actually happening in these
cases are oversimplified, and basic science research has shown us that many of
our assumptions are wrong. The text ‘Vocal
Fold Paralysis’ is meant to fix that—to bring
all relevant information from laryngeal
nerve physiology to medical management
to surgical technique—together between
two covers. It is designed as a complete,
definitive reference on the topic.”
Faculty-produced books that are
now available include “Head, Face and
Neck Trauma” by Dr. Stewart; “Practical
Endoscopic Skull Base Surgery,” by Dr.
Vijay Anand; “Your Survival Guide to
Cosmetic Surgery,” by Dr. LaBruna, and
the aforementioned “Vocal Cord Paralysis,” by Dr. Sulica.
–9–
it’s nothing to sneeze at
unlocking the future of allergy immunotherapy
T
he American Academy of Allergy, Asthma and Immunology estimates that more than 50
million Americans are affected by allergies, and that more than one half of all U.S. citizens
test positive for one or more allergens, such as pollen, dust, mold and animal dander.
For those patients most susceptible to allergic reactions, environmental and medical remedies—including allergen avoidance and medications—can help diminish an allergen’s effects.
Allergy immunotherapy, more commonly known as “allergy shots,” is another common treatment for allergy sufferers. Regular injections of a tiny dose of the allergen protein slowly build the
body’s immunity to that allergen, relieving the patient of symptoms that range from a frustrating
sneezing bout to far more serious, possibly even lethal, reactions.
While the efficacy of this treatment is highly favorable, the prospect of three to five years worth
of regular injections can be a significant obstacle to patient compliance.
With an eye toward retaining success rates while reducing the number of required injections,
Dr. William Reisacher, Assistant Professor of Otorhinolaryngology at Weill Cornell, has begun
studying the use of injectable controlled-release microspheres in allergy immunotherapy.
In partnership with the Biomedical Engineering Department at Cornell University in Ithaca,
Dr. Reisacher will inject mice with microscopic biodegradable spheres loaded with an allergen specific to grass pollen. The spheres are designed to slowly release the allergen at a consistent rate.
This method, Dr. Reisacher suspects, will not only reduce the number of injections a patient will receive, but will also reduce the risk of a dangerous
allergic reaction since the injections will deliver a more consistent dose of the allergen than current immunotherapy methods
can provide.
There is already an existing body of research on biodegradable microspheres for protein delivery and the
controlled release of human growth hormone. In a study
published in the Journal of Controlled Release in 2003, Drs.
V. R. Sinha and Aman Trehan at the University Institute
of Pharmaceutical Sciences at Panjab University in Chandigarh, India, concluded that “the question of feasibility of
injectable biodegradable microspheres as a protein delivery
system remains open to debate.” The study found that, among
other issues, retaining the stability of the protein is key to the
method’s efficacy.
However, while most proteins need to
function properly within the body to
be effective, allergy desensitization only requires fragments of
protein to be released from the
microspheres in order for the
immune system to recognize
the allergen.
Currently, Dr. Reisacher is
studying the rate of antigen release from the microspheres.
The animal component of
the study is likely to begin
in late 2008.
– 10– –10 –
innovation vs. oversight?
I
n the arena of surgical innovation, there seems to be a prevailing belief that the cumbersome process of approvals
and oversight may have served to hinder the development
of new techniques and improvement upon existing practices.
While it is critical to ensure safe and responsible research,
too much oversight may put undue burden on those trying to
broaden the scope of surgical therapies.
In hopes of furthering this debate, Dr. Max M. April, Professor of Clinical Otorhinolaryngology, Dr. Michael G. Stewart, Professor and Chairman of Otorhinolaryngology, and Dr.
David E. Rosow, a resident in the NewYork-Presbyterian Hospital/Columbia and Weill Cornell campus program, investigated
the volume of innovation-related research published over the
last 20 years to determine if review-board oversight potentially
impacted the number of papers published.
Dr. Max April
Drs. April and Rosow, along with Ilya Likhterov, a thirdyear medical student at Weill Cornell, reviewed every abstract
from six months of the years 1988 and 2006 in the following
journals: Laryngoscope, Otolaryngology–Head and Neck Surgery
and Archives of Otolaryngology–Head and Neck Surgery. After all
identifying information—author, publication and year of publication—was removed, the abstracts were reviewed and classified independently by at least two authors into one of three
groups: innovation, modification or neither.
There were 367 publications reviewed from 1988, and 548
from 2006. And the proportion of articles representing either
innovation or modification was significantly lower in 2006.
Of those 367 articles reviewed from 1988, 59 of them, or
18.3 percent, represented either innovation or modification,
while only 67 of 548 (10.8 percent) of the articles for 2006
could be classified into those two categories. However, articles
representing true innovation were even scarcer. Only four
papers in both years were found to fit that category, and there
Dr. David Rosow
was no significant statistical difference between the two periods.
The study, entitled, “Is Surgical Innovation Reduced With
More Strict Regulations?” concludes that one possible cause for the decrease in reported innovation
and modification may be increased barriers for research approval in the modern era. “At a minimum,
even with rapid approval and no change in protocol, a research consent must be obtained, and some
may feel that even this could have a chilling effect on patient acceptance and study accrual,” the paper
states.
Other possible explanations are increases in the overall number of papers being published, or
increased reporting of basic laboratory research in otolaryngology journals.
While the analysis does not prove cause and effect, it is an important finding that suggests further
study is needed. “Our hope is that these data will encourage further investigation into the topic,” Dr.
April said.
Dr. Rosow presented the paper at the Department’s Resident Research Day in June, and it was presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery
in Chicago in September.
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center stage
specialized care for the performing artist debuts at WCMC
W
hile the impact of illness is always a concern to a patient, for a performing artist the stakes can
be higher. For example a neurological disorder causing a hand tremor is troubling, but to a
professional pianist it can be career-threatening.
At NewYork-Presbyterian Hospital/Weill Cornell Medical Center, we have always been a center
for care of the performing artist, and our many specialists are well-versed in the unique issues surrounding the performing artist. However, we hope to improve the level of efficiency and organization
of care with the opening of the Center for the Performing Artist at NewYork-Presbyterian Hospital/
Weill Cornell in July 2008.
The Center will bring together specialists and subspecialists from all disciplines – including primary
care—with triage, coordination, and assistance with navigating the sometimes-confusing healthcare
system. Up until now, the performing artist was often faced with a
fractured and frustrating labyrinth of disconnected doctors and
hospitals, and one of the goals of the Center is to provide integrated care in all aspects of medicine for the performing artist—keeping them off the examination table and on the stage.
In addition to the large network of experienced specialists, another advantage of the Center is our system-wide electronic
medical record which allows easy communication between clinicians. The Center will be administratively
based in the Department of Otorhinolaryngology, with Dr. Michael Stewart serving as the
Center’s Director.
“New York City is such a natural
location for something like this,” said
Dr. Stewart. “There are so many performing artists as well as schools
and institutions for performing artists at various levels
here. It is only natural that
there would be a center
for medical care for the
artist as well.”
In addition to
providing integrated
comprehensive clinical care, the Center
will support research,
education, and outreach initiatives, to improve the overall health
status for the performing artist community.
With the concentration
of artists and performance opportunities, coordinated efforts by the
Center should have a real
impact.
12 ––
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One of the Weill Cornell physicians who
will figure prominently in the Center for the
Performing Artist is Dr. Lucian Sulica, Associate Professor of Otorhinolaryngology, who is a
nationally recognized expert in voice disorders
with extensive experience with the performing
voice. Any number of conditions can present
due to the unique stress and wear created by the
demands of the stage or recording studio. Polyps, nodules, spasmodic dysphonia, granuloma
and Reinke’s edema can wreak havoc on the
voice. Using advanced techniques such as videostroboscopy and laryngeal electromyography,
Dr. Sulica is able to identify subtle abnormalities
and determine treatments ranging from vocal
rest to vocal cord injections, microscopic vocal
cord surgery and laryngeal framework surgery.
In addition to sophisticated techniques, expert
voice therapy is available from speech language
pathologists, some of who have performing experience themselves.
Paul Schaefer, a principal cast member in the
Broadway production of “The Phantom of the
Opera,” came to Dr. Sulica last March after an
unsatisfying experience with another physician.
Suffering from a vocal hemorrhage that was not
improving with rest, Schaefer’s successful singing career suddenly seemed to be in jeopardy.
Frustrated with substandard care and insurance difficulties, Schaefer was at his wit’s end
when he came to Dr. Sulica. “I have friends who
go to doctors all over the country,” Schaefer says.
“This is our bread and butter. To be able to get this
kind of care right in my own backyard is unbelievable.”
A delicate surgery returned Mr. Schaefer to
the stage, where he feels stronger than ever.
With the Weill Cornell Center for the Performing Artist, stories like Schaefer’s will become
a common refrain, as professional performers
from all over the city realize that there is a hospital and team of medical experts ready and waiting
to put them in contact with the very best in an
array of fields. “We needed a comprehensive hospital or clinic that puts this all together in terms
of our bodies and voices,” Schaefer says. “Because
everything is so specific to what we are doing.”
The new multidisciplinary center will also
work in collaboration with the Methodist Center for Performing Arts Medicine at the Methodist Hospital in Houston, Texas, which is an
established center of excellence. The partnership
between the centers at Methodist Hospital and
NewYork-Presbyterian Hospital/Weill Cornell
will facilitate collaboration in research, treatment
and clinical protocols.
– 13 –
– 13 –
news from the department
Drs. Max April, William Kuhel, Anthony LaBruna, Samuel Selesnick, Michael Stewart,
Lucian Sulica, and Robert Ward were all recognized as “Best Doctors” by regional and nationwide magazines as of 2008.
Ashutosh Kacker, MD, was inducted as a Fellow in the Triological Society.
Samuel Selesnick, MD, is President-elect of the American Neurotology Society.
Lucian Sulica, MD, was visiting professor at Georgetown University School of Medicine.
Michael Stewart, MD, MPH, was named a Director of the American Board of Otolaryngology.
William Reisacher, MD, was an Examiner for Fellowship candidates for the American Academy
of Otolaryngic Allergy.
Anthony LaBruna, MD, serves as an item-writer for the American Board of Plastic Surgery, and
on the Task Force for New Materials for the American Board of Otolaryngology.
Samuel Selesnick, MD, was an Oral Examiner for the American Board of Otolaryngology.
Max April, MD, was named as a consultant to the Ear Nose and Throat Devices Advisory Panel
of the U.S. FDA.
Michael Stewart, MD, MPH, is President of the Society of University Otolaryngologist-Head
and Neck Surgeons.
Robert Ward, MD, served on the nominating committee for the American Society of Pediatric
Otolaryngology.
Max April, MD, and Robert Ward, MD, were invited to participate in the 2008 European Society of Pediatric Otolaryngology meeting in Budapest, Hungary.
Erich Voigt, MD, was an invited speaker at SUNY-Downstate College of Medicine.
Michael Stewart, MD, MPH, was program chair for the 2008 Eastern Section meeting of the
Triological Society, in Philadelphia.
Samuel Selesnick, MD, was visiting professor at the Vanderbilt University/Sisson International
Workshop in Colorado, and the Hospital Lariboisiere in Paris, France, and was an invited speaker
at the Politzer Society meeting in Cleveland.
Robert Ward, MD, was visiting professor at the Massachusetts Eye and Ear Infirmary/ Harvard
Medical School.
Michael Stewart, MD, MPH, was visiting professor at the University of Kansas, the University of
Indiana, the University of Minnesota, the University of Mississippi, and the University of Rochester.
Michael Stewart, MD, MPH, was an invited speaker at the Otolaryngology symposium at
Kuban State Medical University in Krasnodar, Russia.
Lucian Sulica, MD, was an invited speaker at Long Island Jewish Medical Center and Long Island
College Hospital. In addition, he was a featured speaker at the Frontiers in Laryngology Symposium of the University of Texas Health Science Center at San Antonio, and an invited panelist at
the John F. Daly Day Otolaryngology Symposium of New York University School of Medicine.
Joseph Montano, EdD, was named to the Advisory Board of the Hearing Rehabilitation Foundation.
The Department has sponsored several highly successful CME courses in the past several months:
Otolaryngology Update in NYC, held at the W Hotel (Directors: Drs. Stewart and Selesnick)
Advanced Endoscopic Sinus Surgery, held at Weill Cornell (Directors: Drs. Anand and Stewart)
Recent Developments in Amplification: Technology, Verification and Management, held at Weill Cornell
(Director: Dr. Montano)
Update on Pediatric Feeding and Swallowing, held at Weill Cornell (Director: Dr. Montano)
NYC Pediatric Airway Symposium, held at Weill Cornell (Co-Director: Dr. Ward)
14––
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faculty in the media
Departmental faculty are often called upon by print, television and electronic media outlets
to comment on various areas of interest to the general public. A sampling of those appearances
is listed below:
Dr. Michael Stewart
OUTLET
TOPIC
WABC-TV CNN Dramatic Health
CBS Early Show CBSNews.com CBS Early Show CNN Live
CW11
Boston Herald
CNN.com
Daily Telegraph Healthday.com
U.S.News
UPI
New York Times
Fox News
New York Times New York Times WABC-TV
Surgery for “tongue tied” pediatric patients
Comments on risks and benefits of ear candling
Surgery for “tongue tied” pediatric patients
Screaming fans and damaged vocal cords
Vertigo caused by the film “Cloverfield”
Vertigo caused by the film “Cloverfield”
Vertigo caused by the film “Cloverfield”
Vertigo caused by the film “Cloverfield”
Vertigo caused by the film “Cloverfield”
Vertigo caused by the film “Cloverfield”
Vertigo caused by the film “Cloverfield”
Comment on study published in JAMA
Antibiotics and nasal steroids work no better than placebo
Far-reaching risks of smoking
Vestibular neuronitis
Snoring myths
Advice on antihistamines and dehydration
How antihistamines work
NEJM study finding HPV is better predictor of throat cancer
Dr. Selesnick
WCBS-AM
New York Sun
Hearing restored for dancer
Tinnitus
Dr. Kacker
Seattle Times
Sneezing
Dr. LaBruna
Oprah Friends Radio
Dr. Montano
New York Times
Chronicle Herald
Does high-frequency noise harm one’s hearing?
Dr. Reisacher
New York Sun
WABC-TV
U.S. News Washington Post Forbes MedlinePlus Bio-Medicine InjuryBoard.com CBC News (Canada) DrKoop.com HealthCentral.com DentalPlans.com WFIE-TV (ABC Indianapolis)
Treating seasonal allergies
Spring allergies
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Oral flu vaccine for children and adults who fear needles
Treating allergies
Treating allergies
WXYZ-TC (Detroit)
WNBC-TV
WNBC-TV Dr. Ward
New York Family “Top NYC Doctors”
– 15 –
selected recent publications
Chhetri DK, Merati AL, Blumin JH, Sulica L, et al. Reliability
of the perceptual evaluation of adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 2008;117(3):159-65.
Endoscopic cranial base surgery: Classification of operative
approaches. Neurosurgery 2008;62(5):991,1002; discussion
1002-5.
Goldstein NA, Stewart MG, Witsell DL, et al. TO TREAT
Study Investigators. Quality of life after tonsillectomy in children with recurrent tonsillitis. Otolaryngol Head Neck Surg
2008;138(1 Suppl):S9-S16.
Sorin A, Voigt EP, McCance SE, et al. Anterolateral approach to the lower cervical spine: A step-by-step description. Ear Nose Throat J 2008;87(6):E12-5.
Grant N, Sulica L, DeCorato D. Calcium hydroxylapatite vocal fold injectable enhances on positron emission tomography. Otolaryngol Head Neck Surg 2008;138(6):807-8.
Kerscher K, Tabaee A, Ward R, et al. The residency
experience in pediatric otolaryngology. Laryngoscope
2008;118(4):718-22.
Likhterov I, Allbright RM, Selesnick SH. LINAC radiosurgery
and radiotherapy treatment of acoustic neuromas. Neurosurg Clin N Am 2008;19(2):345,65, vii.
Morris LG, Wen YH, Nonaka D, DeLacure MD,
Kutler DI, et al. PNL2 melanocytic marker in immunohistochemical evaluation of primary mucosal melanoma of the
head and neck. Head Neck 2008;30(6):771-5.
Reisacher WR. Anaphylaxis in the operating room. Curr
Opin Otolaryngol Head Neck Surg 2008; 16(3):280-4.
Stewart MG. Evidence-based medicine in rhinology. Curr
Opin Otolaryngol Head Neck Surg 2008;16(1):14-7.
Sulica L. The natural history of idiopathic unilateral vocal fold paralysis: Evidence and problems. Laryngoscope
2008;118(7):1303-7.
Tabaee A, Anand VK, Stewart MG, et al. The rhinology
experience in otolaryngology residency: A survey of chief
residents. Laryngoscope 2008;118(6):1072-5.
Chan DK, Lieberman DM, Musatov S, Goldfein JA, Selesnick SH, et al. Protection against cisplatin-induced ototoxicity by adeno-associated virus-mediated delivery of the
X-linked inhibitor of apoptosis protein is not dependent on
caspase inhibition. Otol Neurotol 2007;28(3):417-25.
Cheng J, Sauthoff H, Huang Y, Kutler DI, et al. Human
matrix metalloproteinase-8 gene delivery increases the
oncolytic activity of a replicating adenovirus. Mol Ther
2007;15(11):1982-90.
Schwartz TH, Fraser JF, Brown S, Tabaee A, Kacker A, et al.
Faculty and residents
with visiting professor
and 2008 Selfe lecturer
Dr. Jesus Medina. In
addition to delivering
the 2008 Selfe lecture,
Dr. Medina toured our
facilities, reviewed cases
with the residents, and
was an honored guest
at our multidisciplinary
Tumor Board.
– 16 –
Harrill WC, Pillsbury HC,3rd, McGuirt WF, Stewart MG.
Radiofrequency turbinate reduction: A NOSE evaluation.
Laryngoscope 2007;117(11):1912-9.
Shrime MG, Johnson PE, Stewart MG. Cost-effective
diagnosis of ingested foreign bodies. Laryngoscope
2007;117(5):785-93.
Jethanamest D, Morris LG, Sikora AG, Kutler DI. Esthesioneuroblastoma: A population-based analysis of survival
and prognostic factors. Arch Otolaryngol Head Neck Surg
2007;133(3):276-80.
Smith TL, Stewart MG, Orlandi RR, et al. Indications for
image-guided sinus surgery: The current evidence. Am J
Rhinol 2007;21(1):80-3.
Kellner DS, Fracchia JA, Voigt E, et al. Preliminary report on
use of AlloDerm for closure of intraoral defects after buccal
mucosal harvest. Urology 2007;69(2):372-4.
Liu JC and Stewart MG. Teaching evidence-based
medicine in otolaryngology. Otolaryngol Clin North Am
2007;40(6):1261,74, vii-viii.
Montano JJ. Self-assessment of tinnitus: An important
component of evaluation and treatment. ENT World Bulletin
2007;4:16.
Mussak E, Lin J, Prasad M. Cavernous hemangioma of
the maxillary sinus with bone erosion. Ear Nose Throat J
2007;86(9):565-6.
Shah AR, Pearlman AN, O’Grady KM, et al. Combined use
of fibrin tissue adhesive and acellular dermis in dural repair.
Am J Rhinol 2007;21(5):619-21.
Stewart MG, Neely JG, Paniello RC, et al. A practical guide
to understanding outcomes research. Otolaryngol Head Neck
Surg 2007;137(5):700-6.
Sulica L and Blitzer A. Vocal fold paresis: Evidence and
controversies. Curr Opin Otolaryngol Head Neck Surg
2007;15(3):159-62.
Sulica L, Simpson CB, Branski R, et al. Granuloma of
the membranous vocal fold: An unusual complication
of microlaryngoscopic surgery. Ann Otol Rhinol Laryngol
2007;116(5):358-62.
Tabaee A, Lando T, Rickert S, Stewart MG, Kuhel WI.
Practice patterns, safety, and rationale for tracheostomy
tube changes: A survey of otolaryngology training programs.
Laryngoscope 2007; 117(4):573-6.
Anand VK, Kacker A, Orjuela AF, et al. Inflammatory pathway gene expression in chronic rhinosinusitis. Am J Rhinol
2006;20(4):471-6.
– 17 –
department faculty
Michael G. Stewart, MD, MPH
Professor and Chairman of Otorhinolaryngology
Professor of Public Health
MD, Johns Hopkins University School of Medicine
MPH, University of Texas School of Public Health
Samuel H. Selesnick, MD
Professor and Vice Chairman of Otorhinolaryngology
Professor of Otorhinolaryngology in Neurological Surgery
Professor of Otorhinolaryngology in Neurology
MD, New York University School of Medicine
Max M. April, MD
Professor of Clinical Otorhinolaryngology
Professor of Clinical Otorhinolaryngology in Pediatrics
MD, Boston University School of Medicine
Ashutosh Kacker, MBBS
Associate Professor of Otorhinolaryngology
MB, BS, All India Institute of Medical Sciences
William I. Kuhel, MD
Associate Professor of Clinical Otorhinolaryngology
MD, University of Michigan Medical School
David I. Kutler, MD
The Anne Belcher MD Assistant Professor of Otorhinolaryngology
MD, Weill Cornell Medical College
Anthony N. LaBruna, MD
Associate Professor of Clinical Otorhinolaryngology
The James A. Moore Clinical Scholar in Otorhinolaryngology
Assistant Professor of Clinical Surgery (Plastic Surgery)
MD, Weill Cornell Medical College
Vikash K. Modi, MD
Assistant Professor of Otorhinolaryngology
Assistant Professor of Otorhinolaryngology in Pediatrics
MD, New Jersey Medical School
– 18 –
Joseph J. Montano, EdD
Director, Speech and Hearing
Associate Professor of Audiology in Clinical Otorhinolaryngology
EdD, Columbia University
Aaron Pearlman, MD
Assistant Professor of Otorhinolaryngology
MD, New York University School of Medicine
Mukesh Prasad, MD
Associate Professor of Clinical Otorhinolaryngology
MD, Johns Hopkins University School of Medicine
William Reisacher, MD
Assistant Professor of Otorhinolaryngology
MD, Mount Sinai School of Medicine
Rita M. Roure, MD
Assistant Professor of Otorhinolaryngology
MD, New York University School of Medicine
W. Shain Schley, MD
Associate Professor of Clinical Otorhinolaryngology
MD, Emory University School of Medicine
R. Lucian Sulica, MD
Associate Professor of Otorhinolaryngology
MD, Georgetown University School of Medicine
Erich P. Voigt, MD
Assistant Professor of Otorhinolaryngology
MD, SUNY-Health Science Center at Brooklyn/Downstate Medical Center
Robert F. Ward, MD
Professor of Otorhinolaryngology
Professor of Otorhinolaryngology in Pediatrics
MD, Weill Cornell Medical College
– 19 –
Department of Otorhinolaryngology
1305 York Avenue
New York, NY 10065
– 20 –
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