Residents have an active role in the evaluation and management of head and neck cancers. The bulk of this experience occurs at the Stanford campus, and Palo Alto Veterans’ Administration Hospital where there are several hundred new head and neck cancer patient visits per year. In addition to formal grand rounds and teaching rounds relating to head and neck cancer, there is a multidisciplinary Tumor Board, consisting of surgeons, radiation therapists, oncologists, maxillofacial surgeons, speech therapists, neuroradiologists and pathologists which meet to discuss all new head and neck cancer patients. Besides allowing for careful clinical diagnosis and treatment planning, this Tumor Board affords an excellent opportunity for didactic teaching. Active involvement by medical students, residents, and faculty is solicited.

Under the guidance of three facial plastic surgeons, residents are exposed to a variety of techniques in facial plastic and reconstructive surgery.  These include facial reanimation, scar revision, and facial reconstruction following trauma and cancer excision. There is also exposure to patients desiring facial rejuvenation, and residents learn the latest techniques of facial aesthetic surgery.

Special emphasis is placed on functional and aesthetic nasal analysis for rhinoplasty patients. In addition to the regular Facial Plastic Surgery Conferences, there are two weekly clinics at Stanford dedicated solely to these services. A yearly Facial Plastic Surgery Course is held each Fall.  

Facilities include computer facial imaging, and a procedure room for aesthetic facial surgery, including state-of-the-art laser and IPL treatments.  Additional reconstructive experience is gained at the Santa Clara Valley Medical Center and Veterans Affairs-Palo Alto.

The centerpiece of the otology education program is at the Stanford campus. Residents are trained in the care of patients with otologic, neurotologic, vestibular, and skull base disorders, actively participating with teams of neurotologists, otologists, and audiologists in patient care. In addition to a programmed reading course, there are several educational conferences: Otology Grand Rounds, Weekly Chart Discussion, Journal Club, Audiology Rounds, Skull Base Grand Rounds, and Neuroradiology Grand Rounds.Surgical skills are further honed through a comprehensive Temporal Bone Surgical Dissection Course. Additional otologic surgical experience is afforded at the Santa Clara Valley Medical Center and Kaiser Permanente.

The Division of Rhinology offers a broad clinical experience in endoscopic sinus surgery, endoscopic skull base surgery and allergy. Residents rotate on the service during their R2, R4, and R5 years. The surgical case load includes primary sinus surgery, revision sinus surgery, frontal sinus surgery, endoscopic benign and malignant tumor resection, endoscopic pituitary surgery, and extended skull base approaches. Surgical navigation technology is used extensively. The operative experience is hands-on within a structured teaching environment. Residents also participate in preoperative and postoperative care in the outpatient rhinology clinic. A separate allergy clinic offers training in testing and treatment of inhalant allergy. Research opportunities are abundant and include the following topics: electrophysiologic characteristics of chronic sinusitis epithelium; ciliary regeneration in a rabbit model of sinus surgery; adaptive immunity in chronic sinusitis; clinical outcomes of sinus surgery; and novel models of surgical simulation.

Over recent years, there has been an increase in allergic disorders to epidemic proportions in children and adults. Many studies have determined that the immune system in patients with allergies (also called atopy), such as asthma, atopic dermatitis, food allergies, allergic rhinitis, allergic conjunctivitis and other atopic disorders, is overactive and skewed toward a certain subtype of immune cell called the Th2 cell. So far, there is a lack of understanding on how cells turn off this abnormal proliferation and activation of the Th2 cell.  The Nadeau laboratory has found that a type of cell called the natural regulatory T cells (nTreg) can decrease Th2 cell overactivation in allergies and this leads to reversal or improvement of the allergic condition. By understanding how Treg work, we hope to establish new diagnostic and therapeutic approached to prevent and treat allergic conditions. The Nadeau laboratory maintains a database and sample/tissue bank of healthy controls and patients treated at LPCH/Stanford Medical Center with allergic disorders. There are three main foci of the laboratory 1) since most allergic conditions start in childhood, we are examining the role of Th2 and Treg in different age groups with and without atopy, 2) since the activity of Th2 and Treg is determined by their interactions with other cell types, such as epithelial cells and dendritic cells, we are studying their effects on Th2/Treg interactions, and 3) since improvement of Treg function is associated with improvement of allergic conditions, we are designing new treatments (for example, sublingual immunotherapy, small molecule chemokines) that enhance Treg.

The pediatric otolaryngology portion of the residency training is centered at Lucile Salter Packard Children's Hospital . A pediatric otolaryngology and audiology clinic is located at the children's hospital. In addition to learning about common pediatric otolaryngology problems such as ear infections, tonsillitis, and sinusitis, residents will learn how to evaluate children with voice disorders, airway obstruction, hearing loss, nasal and/or neck masses and other less common otolaryngology problems. In addition, residents will learn how to care for otolaryngology problems in children with multiple congenital anomalies, as well as those who have undergone organ transplants, and have inherited diseases such as cystic fibrosis.