8/2/2019 Newsletter Spring 09
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Heads Up !
stoph E. Schreiner, PhD, MD
and Research Vice Chairman
id W. Eisele, MD
fessor and Chairman
YouOtoKnowNewsandEvents
Clinical Research Awards
Steven J. Wang, MD
Recipient of the Triological S
2009 Mosher Award
Basic Science Awards
Etienne de Villers-Sidani,
Recipient of a 3-year Clinicia
Scientist Phase I Fellowship
Canadian Institutes of Health
Research
Faculty Awards
Lawrence R. Lustig, MD w
2009 recipient of the Eugene
Derlacki, MD Research Grant
the American Hearing Resea
Foundation. Dr. Lustigs rese
focus will be the role of synu
in the mammalian cochlea.
Resident Awards
Harry S. Hwang, MD
Recipient of the 2009 Triolog
Society Western Section Shir
Baron Resident Research Aw
Harry S. Hwang, MD
Recipient of an 08/09 Reside
Clinical and Translational Res
Funding Award
Clinical and Translational Sci
Institute, UCSF
In the News
Of special note, faculty mem
Lawrence Lustig, MD prov
charity cochlear implant surg
a deaf Iraqi boy. We congrat
Dr. Lustig and his team on th
effort of medical goodwill.
Research Update:Steven W. Cheung, MD
A core feature of thedepartments research mission
is combining basic withclinical research to validate
pathophysiological mechanismsof disease and guiding thedevelopment of innovative
treatment strategies. An exampleof such a combined approach isillustrated in the work of StevenW. Cheung, MD, AssociateProfessor in the Department of
Otolaryngology Head and NeckSurgery, who provides clinicalcare in the areas of otology,neurotology, skull base surgery,
and implantable hearing devices.
Dr. Cheungs research addressesissues related to learning andreorganization of the neocortex
in auditory, somatosensory,
and motor systems. Recently,Dr. Cheung completed a study
focused on alterations inauditory cortex function in mildasymmetric hearing loss.Cortical plasticity refers to the
brains ability to reorganize
its functional capabilities byreconguring informationprocessing machinery andcustomizing accessible and
incipient programs to learn newskills. This dynamic processenables animals and humans tomeet unfamiliar environmentalchallenges by responding with
requisite skills and successfulstrategies.
Cortical plasticity also allows
the central nervous systemto compensate for functionaldecits as a result of peripheralorgan injury, such as hearingloss in acoustic trauma and
University of California, San Francisco / Department of Otolaryngology Head and Neck Surgeryume 6, Issue 1 / Spring 2009
Chairmans Address
We are pleased to present the
Spring 2009 edition of Heads Up!,
the UCSF Otolaryngology Head
and Neck Surgery Newsletter.
This edition highlights several
important developments
including the introduction of a
new faculty member, a review of
innovative melanoma treatments,
the appointment of Dr. Michael
M. Merzenich to the Institute of
Medicine, exciting CME course
offerings, and more.
Please join me in welcoming
Dr. Anna K. Meyer, a Pediatric
Otolaryngologist - Head and
Neck Surgeon, who joined our
our department in October 2008.
She treats pediatric patients
with a full range otolaryngologic
disorders ranging from airway
and chronic ear disease to
congenital head and neck masses
and craniofacial syndromes.
Dr. Steven J. Wang provides us
with a review of important head
and neck melanoma treatment
options including a number of
specialized services such as
sentinel lymph node mapping.
Using a collaborative approach
with UCSF dermatologists and
medical oncologists, Dr. Wang
provides comprehensive
surgical management for thisdisease at our Head and Neck
Surgical practice at the UCSF
Comprehensive Cancer Center.
We congratulate Dr. Michael M.
Merzenich for his appointment to
the Institute of Medicine of the
National Academies and describe
the research innovations in
neural plasticity that have been
the hallmark of his important
scientic accomplishments.
In addition, our Research Vice
Chairman, Dr. Christoph E.
Schreiner, provides us with a
basic science research update
with a focus on the cortical
plasticity work of Dr. Steven W.
Cheung.
Furthermore, we highlight prior
departmental CME courses.
We hope you can join us for
upcoming courses including
the Pacic Rim Otolaryngology-
Head and Neck Surgery Update
and Laryngeal Endostroboscopy
Courseboth in February 2009.
Sincerely,
David W. Eisele, MD
Professor and Chairman
Otolaryngology - Head and Neck Surgery Newslet
Continued on back page
rand Roundsondays 5:00pm
arnassus, S-214
ead & Neck Tumoronferenceednesdays 7:30-9:00am3805, UCSF Helen Dilleramily Comprehensive Cancerenter
aryngeal Endostroboscopy:erformance andnterpretationCSF Voice and Swallowingenter 2330 Post St. 5th Floorebruary 12 - 13, 2009
acifc Rim OtolaryngologyHead and Neck Surgerypdatelton Hawaiian Villageonolulu, Hawaiiebruary 14 - 17th, 2009
ewis F. Morrison, MDndowed Lectureshipuest Lecturer:oger L. Crumley, MD, MBArofessor and Chairmanmeritus, Department oftolaryngology - Head andeck Surgery, UC Irvineerbst Hall, Mt. Zion
arch 12, 2009, 4:30 PM
or information aboutpcoming courses and lecturesease contactair Dunne: (415) 476-4952
voicing dysfunction in laryngepatients. However, not all for
plasticity create desirable senand motor compensatory outcSome examples are phantomperception of limb pain follow
amputation and tinnitus arisinvarious forms of hearing loss,focal dystonia, a degradation motor and coordinated movemin repetitive strain injury.
Dr. Cheung studies the role of
cortical plasticity in the creatio
8/2/2019 Newsletter Spring 09
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troducing
na K. Meyer, MD, FAAPdiatric Otolaryngologist -
ad and Neck Surgeon
ase join us in welcoming thewest member of our faculty
he Division of Pediatric
laryngology.
Anna K. Meyer, a specialist in
iatric otolaryngology - head
d neck surgery, was recruited
he UCSF Department of
laryngology Head and Neck
gery in October 2008 as an
istant Professor of Clinical
laryngology. Dr. Meyer is no
anger to San Francisco; she
w up in the Bay Area and
mpleted her medical schoolree here at UCSF.
Meyer trained in
laryngology - Head & Neck
gery at the University
Michigan. She pursued
interests in pediatric
laryngology with fellowship
ning at Childrens Memorial
spital in Chicago. During this
y year, Dr. Meyer had the
portunity to complete a large
mber of complex pediatric
way, otologic, and head and
k cases. One of her fellowship
ntors, Dr. Lauren Holinger,
world-renowned pediatric
airway surgeon, and another,
Dr. Nancy Young is an expert in
pediatric cochlear implantation.
During her fellowship, Dr. Meyer
performed research in the
genetics of pediatric hearing loss
and presented her work at the
American Society of Pediatric
Otolaryngology. In addition she
published a book chapter on
the hearing complications of
chemotherapy.
Along with her clinical activities,
Dr. Meyer is pursuing several
clinical research projects at UCSF.Dr. Meyers key research interests
focus on health disparities, as
well as cochlear implantation
and hearing loss, and medical
education.
At UCSF, Dr. Meyer sees patientsand operates at the Parnassus
campus. She treats pediatric
patients with a full range of
otolaryngologic disorders
including airway disease, chronic
ear disease and hearing loss,
choanal atresia, velopharyngeal
insufciency, acquired and
congenital head and neck masses
and craniofacial syndromes,
among others.
Dr. Meyer will soon see patie
at UCSFs East Bay satellite
facility at Valley Care Medica
Center in Pleasanton, CA. T
expected timeframe for the s
of this outreach clinic is SpriSummer 2009.
For more information about
Dr. Meyer, or to contact her,
please visit our website at
http://ohns.ucsf.edu/
To schedule an outpatient
appointment at our Parnassu
clinic, please call:
(415) 353-2757.
Pediatric Otolaryngologists Anna K. Meyer, MD, FAAP andKristina W. Rosbe MD , FAAP, FACS
SF OHNS Residentsosen to Compete at theond Annual AAO-HNSFdemic Bowl
year our Otolaryngology
ad and Neck Surgery
dency program was one of
teams selected nationally
articipate in the 2nd
ual American Academy of
aryngology-Head and Neck
ery Foundations Academic
l held on September 21,
8 in conjunction with the
demy meeting in Chicago.
residency program was
cted to participate because
s superlative performance
es among Otolaryngology
ing programs on the Home
y Course.
Chief Residents Drs. Theresa
Kim, Frederick Roediger, and
David Saito each received a
$1,500 travel grant to attend the
Chicago Academy meeting and
participate in the competition.
The Academic Bowl focused
on clinically oriented questions
which included images, video
clips from intra-operative
situations, radiographs, histology
and lab results. Each team
was given 10 seconds to reach
consensus and enter theirsolutions into key pads. Adding
to the excitement, audience
members could also enter their
solutions into key pads to test
their own knowledge. Correct
answers were announced to the
audience along with a rationale
to aid further learning.
The competition was spirited and
intense. While UCSF placed third,
the experience proved to be an
excellent educational experience
for everyone involved. Please
join us in congratulating our
resident team for their excellent
work representing UCSF!
For more information about
our residency program, please
visit our website at
http://ohns.ucsf.edu/
Anna K. Meyer, MD, FAAP
Continuing MedicalEducation
Innovative CME course offerings
are a priority for the UCSF
Department of Otolaryngology -
Head and Neck Surgery. A number
of exciting programs have been
offered this past October including
the UCSF Voice Conference and the
Head and Neck Endocrine Surgery
Course.
The UCSF Voice Conference,
with its accompanying Hands-On Singing and Acting Voice Day
component, was held this year in
San Francisco at the Sir Francis
Drake Hotel. Course Directors
Mark Courey, MD and Sarah
Schneider, MS, CCC-SLP planned
an exciting program for attendees
that included the scientic and
clinical applications of laryngeal
electromyography and behavior
intervention techniques for voice
therapy.
Our Head and Neck Endocrine
Course was held at the GrandHyatt in San Francisco and was
organized by Course Directors Lisa
Orloff, MD, and David Eisele, MD.
This program focused on ofce-
based examination of the thyroid
and parathyroid glands and related
pathology, including the use of
ultrasound-guided ne needle
aspiration (FNA) of thyroid no
and enlarged lymph nodes. Iaddition, there were applied s
sessions to learn FNA techniq
which conference participants
found especially valuable.
More informative and exciting
programs are planned for
2009 including Laryngeal
Endostroboscopy: Performanc
Participation from February 1
13th, 2009 at the UCSF Voice
Swallowing Center, and the Pa
Rim Otolaryngology-Head and
Neck Surgery Update at the H
Hawaiian Resort in Honolulu fFebruary 14th - 17th, 2009.
To learn more about our CME
courses and to register, pleas
http://cme.ucsf.edu/cme/ and
on the Courses By Departme
Pacifc Rim Otolaryngology
Head and Neck Surgery
Update 2008, Honolulu, Ha
. Fred Roediger, David
o and Theresa Kim
8/2/2019 Newsletter Spring 09
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ofessor Emerituschael M. Merzenich, PhDnored by Prestigious
ward
November 25, 2008, the
partment of Otolaryngology
ead and Neck Surgery held
eception at UCSF to honor
fessor Emeritus Michael M.
zenich, PhD, an elected
mber of the Academy of
ences, who was recently
med a member to the Institute
Medicine (IOM).
M membership was conferred
n only 65 Americans in
8 and is considered one
he highest honors in the
ds of health and medicine.
Merzenich was nominated
nymously by a current
mber of the IOM for his
ime achievement in the eld
eural plasticity, the brains
ity to change its response
perties and connections
oughout life.
ablished in 1970 by the
ional Academy of Sciences,
M is a leading resource for
ependent, scientically
rmed analysis and
ommendations on human
health issues. Its members
provide the highest caliber of
scientic advice to government
policy makers on health
initiatives nationally and globally.
As a part of his IOM membership,
Dr. Merzenich will be traveling to
Washington, D.C. in April 2009 to
sign the Register of Notes of the
National Academy of Sciences,
a 100 year old organization
established originally in the time
of Abraham Lincoln. When asked
about his reaction to this award,
Dr. Merzenich expressed surprise
and commented humbly that
it must be because he was the
most senior of his colleagues (in
years). Dr. Merzenich has oftenstated that his research efforts
were ultimately the collaborative
achievements of many domestic
and international scientists who
have worked along side him or
have been mentored by him both
in the departments Coleman
Memorial Laboratory and abroad.
Being selected for IOM
membership is an afrmation
that Dr. Merzenichs life work
is appropriately regarded as
important medical and histori
knowledge, in addition to
being viewed as signicant in
the domain of basic science
discoveries.
After his early pioneering wor
the development of the cochle
implant at UCSF,
Dr. Merzenich later branched
off into inventive and ground-breaking treatments for
improving the lives of the age
and those suffering from auti
dyslexia and schizophrenia
through novel and innovative
intensive listening therapies a
visual therapies. Dr. Merzenic
has become a national leader
cognitive ways to re-train the
brain to improve its operation
in the face of illness. His Bra
Fitness and Brain Fitness 2:
Sight and Soundinformationa
programs have been broadca
PBS television over the past t
years with enthusiastic public
response. We congratulate Dr
Merzenich for this distinguish
honor and wish him continued
success on his research
contributions.
even J. Wang, MDsltidisciplinary
eatment Approaches toad and Neck MelanomaUCSF
ven J. Wang, MD joined the
ulty of the UCSF Department
Otolaryngology Head and
k Surgery in 2003. Dr. Wanghead and neck surgeoncializing in the treatment ofign and malignant disorders ofhead and neck. He provides
gical care of tumors of thecavity, larynx, thyroid and
vary glands, as well asaneous malignancies includinganoma and non-melanoma
n cancers. Additionally,
Dr. Wang has expertiseperforming head and neckmicrovascular reconstructivesurgery.
While melanoma is the third mostcommon type of skin cancer, itis the number one cause of skincancer death. One Americandies from melanoma almostevery hour (every 62 minutes).The number of new cases ofmelanoma in the United Stateshas increased 600% in the past50 years. Melanoma can occur atany age, including children andyoung adults. Twenty-ve tothirty percent of all melanomasoccur in the head and neck. Aswith all cancers, early detectioncan improve ones chances for a
favorable outcome.
The appropriate managementof melanoma involves amultidisciplinary team approach.Dr. Wang works closely withdermatologists, radiationoncologists, and medicaloncologists from the UCSFMelanoma Tumor Board to providesurgical care for melanomas ofthe head and neck.
Melanomas involving the skinof the head and neck may arisein and around the face, scalp,
and neck, and present uniquechallenges for surgical excisionand reconstruction. Dr. Wangs
approach seeks to achieveappropriate margins around themelanoma while preservingfunction and cosmesis.
One of the specialized servicesfor the treatment of head andneck melanomas provided byDr. Wang is sentinel lymphnode mapping and biopsy. Thisminimally invasive techniquehelps to identify metastaticmelanoma in lymph nodes thatare undetectable by clinical examor radiologic imaging. With thistechnique, patients undergoa pre-operative injection of aradioactive tracer in their primarymelanoma in order to identifythe site of the sentinel nodes.The sentinel nodes are furtherpinpointed intraoperativelythrough use of a hand-held probe.
Early detection of lymphaticmicrometastases allows
identication of patients whorequire node dissection surgwell as other systemic theraMulticenter clinical trials havdemonstrated that the use osentinel lymph node biopsy cimprove survival for intermethickness melanoma.
For more information about
Dr. Wang, or to contact him,
please visit our website at:
http://ohns.ucsf.edu/
To schedule an appointment
our Head and Neck Cancer CClinic, please call:
(415) 885-7528even J. Wang, MD
From left: David W. Eisele MD, Michael M. Merzenich, PhD,
Christoph E. Schreiner, PhD, MD
Minimally Invasive Sentinel
Lymph Node Biopsy. Arrow
Indicates Blue Dye-Stained
Lymph Node Node Seeker and Gamma
Probe for Sentinel Lymph
Node Identifcation
8/2/2019 Newsletter Spring 09
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ontactUs
eneral Otolaryngologyediatric Otolaryngology
tology and Neurotology
hinology and Sinus Surgeryeep Surgery
15-353-2757
ead and Neck Surgeryead and Neck Endocrine
urgery
CSF Salivary Gland Center
15-885-7528
ochlear Implant Program
15-353-2464
CSF Voice and Swallowingenter
acial Plastic Surgery
15-885-7700
udiology
15-353-2101
nline
ttp://ohns.ucsf.edu/
HeadsUp!Volume6,Issue1
Department Chairman,
Editor in Chief:
David W. Eisele, MD
Executive Editor:
Deborah Samii, MA, Ed
Managing Editor:
Emerald Light
Editors:
Matt ForbushJonathan Hecht, MPA/HSACatherine Lee, MPHHolly Wong, MA
Special thanks tocontributing writers:
Steven W. Cheung, MDChristoph Schreiner, PhD, MDSteven Wang, MD
treatment of perceptual
cits caused by different formsearing loss. He observed
nimal experiments thatpoorer hearing ear in mildmmetric hearing loss triggereditory cortex to reorganize inunexpected way. He studied
cortical representation ofnd in auditory cortex onopposite side of the poorerring ear. Shortly after
ring loss onset, corticalresentation of the poorerring ear became degradedle cortical representation ofbetter hearing ear remained
mal. The divergence intical representation of the twos created misalignment ofuency maps, which may give
to perceptual ambiguity andntom auditory perception oritus.
er several months passed,
wever, the initial misalignmentsrequency maps becamech less prominent and there functional reconstitution
binaural hearing. There
a measurable cost to brain
plasticity mechanisms that were
responsible for realignmentof frequency maps. Corticalrepresentation of the betterhearing ear became deteriorated.In essence, binaural hearing
was sufciently important thatauditory cortex sacriced hearingsensitivity in the better hearingear to foster frequency map
alignment between the two ears.
In collaboration with Dr. Srikantan
Nagarajan, a Professor in theDepartment of Radiology at UCSF,
Dr. Cheung extended his studyto the clinical arena. Humansubjects with mild asymmetrichearing loss were studied withadvanced imaging techniques and
similar misalignments of corticalmaps were discovered. Clinicalresearch conrmation of basic
research ndings has motivatedthe development of new hearingrehabilitation strategies. Thesenew strategies will accountfor functional central hearingloss in the better hearing ear
and improve the treatment ofasymmetric hearing loss.
This vignette illustrates how basic
science can inform cliniciansabout the mechanisms underlyingdisease processes and howinterdisciplinary collaborationsare critical in forging a research
environment that breaks newground for the direct benet ofpatients.
UCSF Otolaryngology-Headand Neck Surgery is committed
ontinued from page 1
Dr. Karsten MunckTribute
We would like to say goodbyeand remember with fondnessKarsten Munck, MD. Karsten wasa charming and highly regardedformer resident in our depart-ment, who died suddenly onOctober 20, 2008 at age 38.Karsten completed his residencyin Otolaryngology - Head andNeck Surgery at UCSF in 2005.
At the time of his death Karstewas serving as a Major in the Air Force as an Otolaryngologi- Head and neck Surgon atDavid Grant Medical Center,Travis Air Force Base and atKaiser Permanente Hospital,Santa Rosa. Karsten was aloving husband, father, son &brother. Karsten has left us wia tremendous sense of loss anplethora of wonderful memorie
Karsten and Amber Munck
the 2005 Sooy Graduation
GIVING BACK:Resident Support is Key
As you may know, one of the
hallmarks of our department is
the training we offer to the next
generation of otolaryngologist
- head and neck surgeons . Each
year, our department matches
three resident applicants (out
of several hundred) for a ve-
year residency. Our residents
go through a comprehensive
training program, which covers
the breadth of Otolaryngology
Head and Neck Surgery in a widearray of clinical settings as well
as investigative work in the basic
sciences.
Our residents have an extremely
broad and balanced surgical
experience encompassing the
entire range of Otolaryngology-
Head and Neck Surgery. For
the past 15 years, 100% of our
graduating residents have become
board-certied during their rst
post-residency year.
Even though we have what isconsidered to be one of the nest
otolaryngology - head and neck
surgery resident training in the
country, it is often a great nancial
burden for residents to choose to
come here due to the high cost
of living in the San Francisco Bay
Area. And while we wrote about
how private support helps attract
and retain top-tier faculty in our
last newsletter, the same applies to
our ability to attract the best and
brightest residents. The following
are just a few examples of how
private support like yours helps
enhance our residency program:
Travel to national meetingspresent resident research pa
Manuscript submission fee
Visiting professor lectures
to discuss his/her clinical an
or research experience with
residents;
Learning activity in the Ro
A. Schindler, MD Surgical Sk
Classroom;
Resident book fund; and
Resident Research Day for
residents to present their an
research projects.
To help us provide consisten
generous support for our res
we are establishing a Resid
Endowment Fund. This Fu
with a goal of $500,000, wil
offset the many costs, includ
and in addition to those abov
residents incur annually.
All gifts, regardless of size, a
important for the benet of o
residency program and othe
areas of the department tha
enhanced by private philanth
The tremendous advances
happening in OHNS rely upo
partnerships with individualsyou. And while we realize th
the current economic climate
placed a nancial strain on a
us, we assure you that we w
be faithful stewards of all of
gifts.
For more information about
you can make a gift to the O
Residents Endowment Fu
have an impact on another a
the Department of Otolaryng
Head and Neck Surgery, p
contact Jeff Hauk, Directo
Development, at 415-502or [email protected]
to translational research. Thedepartment is well positioned
to develop fundamental newinsights into the neurologicalbases of communication disordersand to create pioneering
treatment protocols and productsfor patients. With further helpfrom our friends, alumni, andphilanthropic donors, we are
condent that we will continue tosucceed in these endeavors.
ven W. Cheung, MD