2017 Annual Message From The Chair
Stanford Otolaryngology-Head & Neck Surgery (OHNS) is special. We are blessed with a warm and collegial culture among our community of 286 faculty, trainees, and staff. We strive for, and achieve, excellence in all of our core missions: clinical care, education, and research. In clinical care, we have depth, breadth, and high levels of expertise in all of the specialty areas of contemporary OHNS. We enjoy the finest clinical facilities at Stanford and cutting edge technology in our clinics and operating rooms. Our remarkable group of clinician-scholars in training ensures a bright future for our field. Our peerless basic and translational science faculty are both immensely creative and highly productive.
The core strength of Stanford OHNS is its outstanding faculty. In 2003, the year we became a department, we had 5 faculty. We begin 2017 with 45 faculty (19 Professors, 6 Associate Professors, 14 Assistant Professors, 6 Instructors). In addition, we have 4 affiliated faculty at Santa Clara Valley Medical Center, and new affiliates in our University Health Care Alliance offices in San Ramon and San Jose.
In 2017 we expect to add 6 additional faculty with searches underway in pediatric OHNS, laryngology, otology - neurotology, facial plastic surgery, head and neck endocrine surgery, and basic science as well as expanding our affiliated network in the South Bay and East Bay regions.
OHNS Faculty in Leadership Roles
Stanford OHNS is well represented among the medical center and school leadership. Lloyd Minor is the School of Medicine Dean. Eben Rosenthal is the Ann & John Doerr Medical Director of the Stanford Cancer Center and Associate Director of Clinical Care for the Stanford Cancer Institute. Ed Damrose begins his three-year term as Stanford Health Care Chief of the Medical Staff this year and Peter Koltai is a recent past Chief of the Medical Staff at Stanford Children’s Hospital.
Stanford OHNS scholars have remained highly productive this year. PUBMED lists 268 peer reviewed publications for Stanford otolaryngology in 2016, which does not include books, chapters, abstracts, or editorials. Working with our departmental web designer, Crystal Chen, we have comprehensively modernized our websites (http://med.stanford.edu/ohns). Our research community has been especially creative in using latest web design elements (http://med.stanford.edu/ohns/research/labs.html).
This year we produced two publications about our department. An 86-page booklet published in November 2016 describes the ways Stanford OHNS contributes to health care, scientific innovation, education, and our community. In this booklet, we share stories that illustrate the type of care, teaching, and inquiry that makes Stanford OHNS such a special place. We also produced a convenient guide to our adult and pediatric services.
Our immensely talented trainee population includes 20 OHNS residents, 2 ACGME accredited fellows (pediatrics, neurotology), and 8 instructors (head & neck surgery (2), sinus surgery (2), facial plastics surgery, laryngology, sleep surgery, and neurotology. We also have a number of graduate students, post-doctoral research fellows, instructors, and visiting scholars. Dozens of Stanford and visiting medical students are on rotation throughout the year.
This year, thanks to the efforts of John Oghalai, Alan Cheng, and Anna Messner we obtained a T32 training grant. This NIH funded program, intended to produce scientist-surgeons, will allow selected residents to undertake 2 years of funded research in addition to their 5 clinical years. To accommodate this new program, and our departmental growth, Stanford OHNS was approved by the Otolaryngology Residency Review Committee (RRC) to increase from 4 to 5 residents per year starting in 2017 for a total of 25 residents in our program by 2021.
Our T-32 research training program now has two tracks. One is a 7-year residency research track, which combines 5 years of clinical training in OHNS with 2 years of research training starting after the PGY2 year. The second is a 2-year post-residency track, which will be used to provide a research experience for those individuals that desire an extended research experience after residency training. Both tracks are post-doctoral fellowships for otolaryngology residents, with the main difference being that the first track has the research block in the middle of residency training and the second track has the research block after residency has been completed. Both tracks provide guidance on how to balance research and clinical responsibilities in order to prepare the trainees to become independent physician-scientists.
Many of our residents and fellows take advantage of the rich educational environment of Stanford. The Stanford Society of Physician Scholars provides training and mentoring core academic skills through evening sessions throughout the year. The SPECTRUM 1-week intensive course in clinical research educates on study design and performance. A number of our trainees and faculty have participated in the renowned Stanford Biodesign program which teaches medical device innovation and entrepreneurship.
The exceptional quality of today’s trainees insures that the future of our specialty will be in the best of hands. Our residents are having great success in obtaining fellowship positions and the graduates of our instructor/fellows programs obtain excellent faculty positions. Among our residency graduating class of 2016, 3 graduates went on to sub-specialty fellowship and one joined a regional private practice with continued Biodesign engagement.
2016 OHNS Residency Graduates
- Jennifer Alyono: Neurotology Fellowship at Stanford
- Anais Rameau: Laryngology Fellowship at UC Davis
- Ryan Williams: Sleep Surgery Fellowship at Stanford
- Elizabeth Zambricki: Palo Alto Medical Foundation & Medical Device Innovation
We have undertaken a number of initiatives designed to enhance the educational value of our website. OHNS grand rounds and CME courses are available online on our departmental website and iTunes channel. Over 2000 original illustrations are online in our skull base, neurotology, and otology atlases. We are in the midst of expanding this resource to encompass all of OHNS.
Nik Blevins and a team of computer scientists and engineers have created a haptic reinforced sinus and temporal bone surgical simulator. Our Perkins Microsurgery Teaching Laboratory has newly installed LED based microscopes with high definition video displays. Kwang Sung utilized the microsurgery lab for performing a phonomicrosugical simulation study with the residents. Twice a year Dr. Jennifer Lee, who is trained in surgical simulation, leads all OHNS residents through varied simulations such as “carotid blowout”, “anaphylaxis” and “angioedema.” For student use, we purchased two otoscopy simulators; one for the department and the other was donated to the medical school’s simulation facility.
We have completed our departmental introductory textbook, a multi-authored work created entirely by our faculty and trainees and are in the process of making it available online. It goes under the title SOITO: Stanford Online Interactive Textbook of Otolaryngology. The text is targeted primarily for medical students, beginning residents, and patients interested in a reliable source of sophisticated medical information. The concept is to make available a well-illustrated online text, continuously updated, and made freely available to trainees and patients worldwide. Under the editorial leadership of Dr. Jennifer Lee this 72 chapter project has taken a couple of years to produce and has several hundred original illustrations.
Working with the Stanford Faculty Development Center (SFDC), we launched our surgical teaching course in 2014. Anna Messner, an SFDC-trained facilitator, leads an annual teaching course oriented to teaching skills in the operating room to new OHNS faculty, fellows and the chief residents.
About twenty Stanford students rotate in our department as part of the general surgery core clerkship; and approximately 20 sub-interns come from other institutions. Our visiting sub-intern rotation has become very popular, highly competitive, draws high outstanding applicants from around the country.
Stanford OHNS Research Overview
Stanford is a research-intensive school of medicine and we are a research-intensive department. Our commitment to basic and translational research is well illustrated by the growth of our annual research budget from under $5,000 (2003) to over an estimated $10 million in 2017. We have some 12,000 sq. ft. of research space with our major laboratory in the Edwards building and additional facilities in Lokey Stem Cell, Grant, and CCSR buildings. All will coalesce into the new Biomedical Innovations Building starting construction this year with anticipated occupancy in late 2019.
In late 2016, departmental faculty have more than 64 competitive extramural grants and are principal investigator on 11 NIH R-01s, U01, 2 DoDs, a CIRM award and 18 industry grants. Our basic science research community consists of 110 faculty, post-docs, researchers, students and other trainees.
At our 7th annual research retreat in October, the entire department participated and each of our faculty presented their research plans for the coming year. Both extramural funding and philanthropy remain strong. Trainees present their research progress as part of our annual graduations ceremonies each June.
The central theme of Stanford OHNS basic and translational research is to seek a better understanding of diseases in our field and inventing new therapies. Our research group, which is a mixture of basic scientists and surgeon – scientists, enjoys numerous collaborations throughout Stanford bioscience and technology. A major thrust of our research is to overcome hearing loss through regenerative means. To achieve this goal we have created the Stanford Initiative to Cure Hearing Loss, which is a long term, goal oriented, multidisciplinary research effort. (Heller, Ricci, Oghalai, Cheng, Mustapha, Chang, Grillet, Blevins, Fitzgerald, Jackler, and Minor)
Our clinical services continue their traditional double-digit growth annually – a trend which has been sustained annually for over a decade. Our focus is on high-quality tertiary care of complex diseases in the head and neck region. We have 8 clinical divisions: facial plastics, head & neck surgery, laryngology, otology/neurotology, pediatric, rhinology, sleep surgery, and comprehensive ENT. Space does not permit a full accounting of our areas of expertise, but I will highlight a few noteworthy examples.
Our clinical programs are housed in a number of locations. Laryngology, rhinology, facial plastic surgery, and comprehensive ENT are all housed in our departmental home building at 801 Welch Road on the Stanford campus. Our head and neck surgery program occupies most of the 3rd floor of the Blake-Wilbur building adjacent to our home building. Across the street are our pediatric clinics at the Mary Johnson Center with additional pediatric clinic space in Los Gatos. Otology/neurotology and pediatric otology are situated at the Stanford Ear Institute at Watson Court and sleep surgery at our Redwood City satellite.
In our Head & Neck Surgery Division, Chief Chris Holsinger leads our innovative transoral robotic program in which he is joined by Drs. Damrose, Capasso, and Sirjani. Lisa Orloff heads our very active thyroid-parathyroid program and is internationally renowned for her expertise in ultrasound. She is joined in head and neck endocrine surgery by Drs. Sunwoo and Holsinger. Dr. Davud Sirjani focuses on salivary gland surgery while Dr. John Sunwoo has special expertise in melanoma. Vasu Divi and Eben Rosenthal expertly perform microvascular free flap reconstructions. Michael Kaplan is our highly versatile, extremely busy, senior head and neck cancer surgeon. Speech therapist Ann Kearny provides care for post-laryngectomy voice restoration patients and Heather Starmer supports patients with swallowing disorders.
In our Rhinology Division, Chief Peter Hwang is constantly surrounded by international observation and our residents have begun calling it the “Hwangterage.” Peter has a busy practice of complex endoscopic sinus surgery, often taking on the most challenging cases. Both he and Drs. Jayakar Nayak and Zara Patel collaborate with neurosurgical colleagues on minimally invasive endoscopic skull base surgery including a substantial census of pituitary tumors. Dr. Nayak helped to develop a transnasal approach to the odontoid. The Stanford Sinus Center provides integrated care including cone beam CT imaging and allergic management by allergy specialists on site.
In our Laryngology Division, Chief Ed Damrose has special interests in rehabilitation of laryngeal paralysis and cancer of the larynx. His colleague Dr. Kwang Sung does a wide array of in office laryngeal procedures, including those requiring use of the laser. Kwang also has a strong interest in care of the professional voice, especially in entertainers. Speech therapist Elizabeth DiRenzo provides care for a wide range of voice disorders.
In our Sleep Surgery Division, Chief Robson Capasso tackles a wide variety of procedures to alleviate obstructive sleep apnea and snoring. Dr. Capasso is especially sophisticated in management of sleep disorders as he is dual trained in sleep medicine and sleep surgery. His colleague Dr. Stanley Liu, an MD/DDS oral surgeon specializes in reconstruction of the facial skeleton, such as maxillomandibular advancement, to open severe constrained upper airways.
In our Pediatric Division, Chief Anna Messner is highly experienced in the management of a wide variety of ear, nose and throat disorders in children. She has a long-standing interest in velopharyngeal insufficiency. Peter Koltai focuses his interest on complex sleep disorders in children while Douglas Sidell tackles aerodigestive tract disorders. Mai Thy Truong is a highly skilled pediatric ENT able to handle a wide spectrum of children’s otolaryngology problems with a special interest in vascular malformations. Dr. Truong and Dr. Kay Chang oversee a dedicated microtia clinic and together they are surgically creating superb ear reconstructions. Drs. Chang, Cheng, and Oghalai focus on pediatric otology (see below).
In our Facial Plastics Division, Chief Sam Most has built a highly successful aesthetic and reconstructive facial plastic surgery practice. Sam, who is known for his refined aesthetic sense and technical excellence, has special interests in rhinoplasty, alleviation of facial paralysis, and rejuvenation of the aging face. Oral surgeon Dr. Stanley Liu has a special interest in facial trauma and computer assisted, minimally-invasive repair of facial fractures.
In our Otology-Neurotology Division located in the Stanford Ear institute, Chief Nikolas Blevins is a renaissance surgeon handling all aspects of ear care and microsurgery. He and I along with our two very capable medical otologists Drs. John Shinn and George Shorago see most adult patients. Matt Fitzgerald, Chief of Audiology, oversees a large group of audiologists who provide diagnostic and rehabilitative services. The Children’s Hearing Center, led by Dr. John Oghalai, includes Drs. Kay Chang and Alan Cheng. Our very active cochlear implant center includes 4 surgeons (Drs. Blevins, Chang, Cheng, and Oghalai).
In our Comprehensive Otolaryngology Division faculty members Jennifer Lee and Uche Megwalu expertly manage a wide spectrum of otolaryngology medical and surgical diseases. Jennifer has a special interest disorders of the Eustachian tube and has now performed many endoscopies and balloon therapies of this structure.
Biomedical Innovations Building
Future home of OHNS Research Laboratories in 2019
New Sleep Surgery Facility
Our new sleep surgery clinic opened in 2016 with 4 specialized exam rooms, a large procedure room, and a simulation center for planning craniofacial procedures. This new facility is located at our Redwood City satellite adjacent to the Sleep Medicine program and Sleep Labs.
The New Stanford and Stanford Children's Hospitals
Stanford Medicine is very much looking forward to occupying two splendid, state-of-the-art new hospitals which are in advanced stages of construction and anticipated in the next 18-24 months. This $4 billion project will provide many more ICU beds and operating rooms and have private rooms for all patients.
Global Health Programs
We have an ongoing collaboration between with the University of Zimbabwe. Peter Koltai and Lisa Orloff are the most recent faculty members to visit (we have sent a total of 5 faculty members.) Our goal is to send 1-2 faculty members a year. The Chief of their program (Clemence Chidziva) visited Stanford in 2015 and two University of Zimbabwe OHNS junior faculty visited us this past summer and two more are coming in summer 2017. These learning experiences have been funded by the Stanford Center for Innovation in Global Health, the department, and the Koltai family.
Sam Most organizes an annual humanitarian mission to Phnom Penh, Cambodia, in conjunction with Face-to-Face, an organization within the American Academy of Facial Plastic and Reconstructive Surgery. Patients treated include adults and children with congenital, post-traumatic, and post-ablative defects. On his most recent trip Dr. Most was assisted by one of the Stanford OHNS residents and Elise, his daughter who is a Stanford freshman.
For the second time this year, we moved our alumni event at the American Academy of Otolaryngology-Head & Neck Surgery from Tuesday to Sunday evening. Gratitude to faculty member Mai Thy Truong who hosted in San Diego this fall and has generously offered to host again at next year’s meeting in Chicago.
Visiting professor Albert Mudry, who is probably the only otolaryngologist who also has earned a PhD in history, and I are writing a history of Stanford OHNS. This spans from the Stanford predecessor schools in the 19th century to the present and will be close to 50 pages long. We have compiled a list of discoveries and inventions introduced by department members and also a complete roster of Stanford OHNS residents since the program was founded in 1909. We expect to have a comprehensive history on our website during 2017.
Alumni are always welcome to return to the Farm for a visit! Please email me at email@example.com and we can set up a time for a chat and a tour.
— Robert K. Jackler, MD Sewall Professor & Chair (December 10, 2016)