Residency

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 who 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.

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. The centerpiece of the otology education program is at the Stanford campus. Additional otologic surgical experience is afforded at the Santa Clara Valley Medical Center.

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.

The full spectrum of disease that impacts voice and swallowing are seen and treated in our division, accounting for over 2000 patient visits and 300 surgeries per year.  Surgical techniques emphasized include laryngeal framework surgery (thyroplasty, arytenoid adduction); injection laryngoplasty; operative microlaryngoscopy; endoscopic and open partial laryngectomy; and endoscopic and open airway reconstruction, including tracheal and cricotracheal resection.  Residents gain early exposure and expertise in the evaluation of voice and swallowing disorders, videostroboscopy and interpretation, and office-based procedures including injection of the vocal fold and transnasal esophagoscopy.  Rotation on the laryngeal surgical service begins in the R2 year and progresses through the chief year, with increasing levels of responsibility afforded accordingly.  The Division of Laryngeal surgery has an active research arm with emphasis on the development of new technologies to aid diagnosis and therapy.  This includes high resolution MRI imaging to detect early invasive laryngeal cancer, real time MRI imaging of the larynx and pharynx to better characterize voice and swallowing disorders, and the application of robotic systems to aid laryngeal surgery.  Instruction in advanced laryngeal concepts and the management of challenging laryngeal problems is emphasized in our monthly Laryngology Conference. There is considerable opportunity to publish and to present at national meetings, with emphasis placed on helping our residents establish a strong academic track record and gain exposure to national leaders in the field of laryngeal surgery.

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. 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 Division of Sleep Surgery works closely with the Stanford Center for Sleep Sciences and Medicine to provide a multidisciplinary approach to this specialty in five different clinical settings: Stanford, Santa Clara Valley Medical Center, the Palo Alto Veterans' Affairs Hospital, and Lucile Packard Children's Hospital. Residents are exposed to a variety of sleep disorders which are frequently co-morbid with sleep disordered breathing as well as the most advanced surgical techniques practiced around the world. Moreover, residents are specifically trained in the diagnosis and medical management of obstructive sleep apnea and interpretation of sleep studies.

As the birthplace of sleep medicine, responsible for several breakthroughs in sleep surgery, Stanford aims to continue to provide unparalleled opportunities in sleep education and academic innovation.

The pediatric otolaryngology portion of the residency training is centered at Lucile Salter Packard Children's Hospital. A pediatric otolaryngology and audiology clinic are 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.