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Heads Up !
rew H. Murr, MD
ssor and Clinical Vice Chairman
id W. Eisele, MD
essor and Chairman
YouOtoKnowNewsandEvents
Clinical Research Awards
Eric J. Kezirian, MD is a 20
recipient of the Triological So
Research Career Developme
Grant.
Basic Science Awards
OHNS Postdoctoral Fellow, R
Froemke, PhD was awarded
NIH Pathways to Independen
Award - K99/R00.
Professor Emeritus
Michael M. Merzenich, PhD
is the 2008 recipient of an N
Eureka subcontract with the
University of Mississippi.
Teaching Awards
James D. Pletcher, MD wa
honored with the 2008 Franc
A. Sooy, MD Award for Clinic
Excellence.
Steven J. Wang, MD was
honored with the 2008 Roge
Boles, MD Award for Excellen
Clinical Faculty Teaching.
Resident Awards
Harry S. Hwang, MD receiv
a American Academy of
Otolaryngology - HNS
Resident Research CORE Gra
Frederick C. Roediger, MD
received a American Rhinolo
Society Resident Research C
Grant as well as the 2008 KeC. Lee, MD Resident Award f
Outstanding and Meritorious
Service and Team Leadership
New Appointments
Laura Alley Kirk, MSPAS,
has joined the Parnassus fac
practice.
Katherine C. Yung, MD ha
joined the UCSF Voice Cente
the 08/09 Laryngology Fellow
CLINICAL NEWS
The 2008 residency application
season has drawn to a close and
the match results are in! UCSF
Otolaryngology - Head and
Neck Surgery did extremely wellthis year and we matriculated
an outstanding group of
residents in the PGY-1 year:
Terrence Metz, MD from Loyola
University, Megan Durr, MD
from Johns Hopkins University,
and Jonathan George, MD, from
Duke University, will be starting
their PGY-1 year at UCSF. Jolie
Chang, MD, Kevin Huoh, MD, and
Gerald Kangelaris, MD, nished
their internships to join us as
PGY-2s in Otolaryngology - Head
and Neck Surgery. In the 2008
residency match, we received250 applications for 3 positions
and interviewed 40 students. An
unprecedented 100% of our rst
40 invitations for interview were
accepted without a need to refer
to wait-listed candidates.
This strong interest in our
department from prospective
residents is a very positivereection on the strength of
our programs. Since the recent
construction of the Robert
A. Schindler Surgical Skills
Classroom, our department
has one of the most modern
surgical training facilities both
nationally and internationally.
With the recruitment of Osamu
Tetsu, MD, PhD, a head and
neck cancer basic scientist, our
research programs continue to
achieve greater innovation and
discovery. We have a powerful
clinical outcomes research unit
University of California, San Francisco / Department of Otolaryngology Head and Neck Surgeryme 5, Issue 2 / Summer 2008
CHAIRMANS ADDRESS
We are pleased to present the
Summer 2008 edition of Heads
Up!, the UCSF Otolaryngology
Head and Neck Surgery
Newsletter. This edition
highlights several exciting
developments including recent
awards, an update on our clinical
and educational programs and
our annual resident graduation
dinner and Sooy endowed
lecture. We will also behighlighting Lawrence R. Lustig,
MD and Lisa A. Orloff, MD, recent
recipients of the Francis A. Sooy
Endowed Chair and the Robert
K. Werbe Endowed Distinguished
Professorship respectively.
In this edition, we focus on the
innovations of the UCSF Voice
Center and the UCSF Minimally
Invasive Skull Base Program
(MISB).
Through a multidisciplinary
team of clinicians including
speech-language pathologists,laryngologists, voice trainers
and neurologists, the UCSF Voice
Center provides outstanding
treatment plans to address the
problems and challenges for
professional voice users.
The Minimally Invasive Skull
Base Program provides cutting-
edge endoscopic approaches
to tumors of the skull base
including the expanded
endonasal approach. This two-
surgeon technique is performed
at only a few institutions in the
United States.
June is a very special time of
year when we hold our annual
graduation dinner and Sooy
endowed lecture. This year,
Donald A. Leopold, MD, Professor
and Chairman of the Department
of Otolaryngology - Head and
Neck Surgery at the University
of Nebraska, presented excellent
lectures on the treatment of
dysosmia and endoscopic frontal
sinus surgery. Our graduation
dinner was enjoyed by all and
in our Summer 2008 Heads Up!
issue, we update you on several
honors and accolades shared by
our faculty and residents.
Sincerely,
David W. Eisele, MD
Professor and Chairman
Otolaryngology - Head and Neck Surgery Newslet
Continued on back page
oger Boles Endowedectureship
obby R. Alford, MDaylor College of Medicineeptember 4, 2008
CSF Voice Conferencerand Hyatt San Franciscoctober 16-18, 2008
CSF Endocrine Surgeryourser Francis Drake Hotel, SFctober 24-25, 2008
obert Schindler Endowedectureshipruce J. Gantz, MD
niversity of Iowaovember 20, 2008
acifc Rim Otolaryngologyead and Neck Surgerypdatelton Hawaiian Villageonolulu, Hawaiiebruary 14-17th, 2009
ead and Neck Tumoronferencevery Wednesday 7:30-9am3805, Mt. Zion
or information aboutpcoming courses and lecturesease contactair Dunne: (415) 476-4952
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CULTY FOCUS:an H. El-Sayed. MD, FACS
ce joining the faculty in 2003,
n El-Sayed, MD, FACS haslored innovative endoscopic
proaches to tumors of the
ll base. Initially he addressed
ll base and paranasal sinuses
mors using endoscopic
isted approaches, until the
hnical challenges of endoscopic
ection were mastered.
rently, as the Director of the
laryngology Minimally Invasive
ull Base (MISB) Program, Dr.
Sayed has been a driving
ce behind the development of
active endoscopic skull base
m able to deliver effective careough either traditional open
novel expanded endonasal
proaches. Along with Andrew
dberg, MD and colleagues
m neurosurgery, Drs. Michael
Dermott, Andrew Parsa and
nish Aghi, the core MISB
m utilizes a two-surgeon
proach to address tumors of
anterior, central, and lateral
ll base. Recently, Dr. El-Sayed
introduced the endoscopic
hniques to the neurospine
m for the management of
tain spinal conditions.
panded endonasal approaches
(EEA) using a two-surgeon
technique is performed routinely
at few centers nationally. The
technique consists of creating a
corridor through the nose with
the removal of the ethmoid
sinuses and middle turbinate. By
removing the posterior half of the
septum, enough room is created
in the nasal cavity to allow two
surgeons to work simultaneously.
This four handed surgery allows
enough visualization and access
to address large tumors.
Using this technique, central
skull base lesions such as large
pituitiary tumors, meningiomas
around the optic nerve in the skullbase, or tumors involving the
clivus and nasopharynx can be
addressed. Lesions in the anterior
skull base, even with signicant
intracranial extension have been
resected using EEA with slight
modication of the approach. By
widely opening the nasal cavity
from orbit to orbit and from the
frontal sinus to the sphenoid
sinus, lesions in the anterior skull
base are accessible. Patients
that would have required a facial
incision or open craniotomy, such
as for esthesioneuroblastomas,
are now addressed in most cases
through the nose. Even more
daunting lateral lesions involving
the pterygoid or infratemporal
fossa can be attacked. Difcultlesions such as juvenile
nasopharyngeal angiobrom
schwannomas, and maligna
tumors have been resected
these techniques. The lesio
are reconstructed with a pe
naso-septal ap (NSF) thatreach along the entire skull
Over a 16 month period, si
introduction of the NSF in 2
through 2007, 28 patients h
successful reconstruction of
skull base with the NSF. Tw
did fail due to a prior histor
radiation, but no patients in
series developed a CSF leak
Dr. El-Sayed recently prese
his approach to the lateral s
base using an endoscopic a
maxillotomy in 17 patients
World Congress of Endosco
Skull Base Surgery in Sao P
Brasil and he presented the
nasal septal ap experience
Triologic Western Section m
He has also presented his w
nationally and international
the past year. Future direct
include further renement o
instrumentation, the techni
and approaches. While a lea
the west coast in the introd
of these techniques, the MI
a strong foundation and is c
of providing either tradition
open or endoscopic techniq
tailored on a case by case b
SF VOICE &WALLOWING CENTER:
ltidisciplinarytient Care
clinical mission of the UCSFce and Swallowing Centero provide care for patientsh communication disorders.accomplish this goal, atidisciplinary team of cliniciansuding speech-languagehologists, laryngologists, voiceners and neurologists has
n assembled. Patients whotheir voice professionallyet from the expertise ofclinicians at the center. Thisent group not only includes
ors and singers, but alsochers, lawyers, businessple and physicians. Researchshown that the early
ntication of voice problems isds to an increased chance ofrecovery. This is critical forprofessional voice user whose
eer may be in jeopardy.
icians for this population
st be sensitive to minutenges in voice quality, rangeeffort that may not be
mediately noticed by non-ce clinicians when listeninghe conversational speakingce. Common complaintsm vocal performers includehange in voice quality, vocal
fatigue or discomfort (despite anormal speaking voice), a crackin the upper register, difcultyprojecting, or subtle changes inresonance. Business people, onthe other hand, may experiencesignicant deterioration in theirspeaking voice and be unableto maintain the rigorous vocal
demands of running an ofce orparticipating in conference callsand meetings. For all these variedvoice pathologies hoarsenessis often the only descriptoron referral. Careful attentionto other symptoms is key tounderstanding the best optionsfor intervention. The sooner the
referral to a multidisciplinaryvoice team the more likelyoptimal results will be achieved.Collaboration provides aneffective and powerful skill-set forvoice evaluation and managementthrough medical, surgical andbehavioral approaches.
For example, a jazz singer cameto the UCSF Voice and SwallowingCenter after several monthsof vocal difculties. She hadsought attention from individualpractitioners, but her vocalproblems had not been resolvedand her career was threatened.
For years, the singer hadperformed nightly with pianoaccompaniment and withoutvocal difculty. When she besinging with a full band, howshe began to notice decreasvocal range and increasedroughness in her voice. The obtained a thorough history laryngology examination incvoice analysis and laryngealstroboscopy throughout her vocal range. Excess muscletension was identied in herat rest and while speaking. T
stroboscopic examination shthat the patient had polyps oboth vocal folds. The team fethat these were caused by thway she was using her voicein singing and speaking.
The ndings from the evaluawere reviewed with the patieand treatment plans werediscussed in detail. The teamand patient decided to proceby instructing her to modify vocal habits and improve votechnique through speaking singing voice therapies. With
treatment her voice recovershe has avoided surgicalintervention and is currentlyable to meet all her performdemands. This example illusthat treating the voice of aprofessional voice user with multidisciplinary team approyields the best results.
Mark S. Courey, MD examines a patient with his team; from
left: SLPs Sarah Schneider and Joey Thorton.
Ivan H. El-Sayed, MD, FACS
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ADUATION EVENTS;NUAL SYMPOSIUM,DOWED LECTURE ANDNNER
end of the year eventsmmenced with the 6th Annualident Research SymposiumFriday, June 27, 2008. Kristariguez-Bruno, MD placed with her topic: Novelhod to Quantify Pharyngeall Weakness in Patients withphagia. Second place went
David Saito, MD for his talkRheological Properties of
onasal Secretions in Patientsh Chronic Rhinosinusitis.resa Kim, MD placed third
h her presentation on Auditory
ction and Cochlear Histology inosin Knockout Mice.
Saturday morning June 28th thefaculty and residents gathered forthe 2008 Francis A. Sooy Lecturewith guest speaker Donald A.Leopold, MD, FACS, Professor
and Chairman, Department ofOtolaryngology - Head and NeckSurgery, University of NebraskaMedical Center.
Dr. Leopold gave two very wellreceived lectures on TreatingDysosmia, From Saline toSurgery and Can All FrontalSinus Surgery Be Endoscopic?.
The Sooy Lectureship is anendowed program in theDepartment of Otolaryngology -Head and Neck Surgery, at theUniversity of California, San
Francisco that honors the memoryof Dr. Francis A.Sooy. Dr. Sooywas Chairman ofthe Departmentof Otolaryngology Head and NeckSurgery from 1958to 1972. He servedas UCSFs fourthChancellor from1972 to 1982,following which hewas Professor ofOtolaryngology untilhis passing in 1986.
The Otolaryngology
- Head and Neck Surgery annualyear end dinner was held on June28, 2008 at the Westin SaintFrancis Hotel in San Francisco.Arthrocare, Karl Storz Endoscopy-America, GlaxoSmithKline, Gyrus,and Medtronic Xomed providedgenerous corporate sponsorshipfor our Sooy Endowed Lectureshipand dinner and Joseph Gallo andthe Ernest & Julio Gallo Winerygraciously donated the superbwine for our event. Attendeesdined in the St. Francis Suiteoverlooking beautiful San
Francisco Union Square.Watching our senior residents
graduate and welcoming ounew residents aboard wasvery exciting; however, maattendees found it especialrewarding to see this years
teaching awards conferred department faculty membeSteven Wang and James Ple
The Roger Boles TeachingExcellence award is given ttime faculty members in hoour former Chairman RogeMD. This years recipient SWang, MD was honored forextraordinary mentorship tresidents, his encouraging and his leadership.
The Francis A. Sooy ClinicaExcellence award is given t
part-time and volunteer facin honor of our former Chaand University Chancellor FA. Sooy, MD. This year, theaward was conferred on JaPletcher, MD, with an enthustanding ovation from all dattendees. Dr. Pletcher seras a part-time attending atFrancisco General Hospital,he provides outstanding reteaching and exemplary seto the department. While iproud moment for Drs. WaPletcher, we all share in theof having outstanding teac
faculty.
BERT SWEETOWCEIVES DISTINGUISHEDHIEVEMENT AWARD
fessor Robert W. Sweetow PhD,ector of the Division of Audiologyhe Department of Otolaryngologyead and Neck Surgery, wasmed a recipient of The Americandemy of Audiologys 2008tinguished Achievement Award.s award is the Academys highestor, which is reserved for those
o have had an impact on thefession through their teachingclinical service.
Robert Sweetow is a criticaltner in the diagnosis andatment of hearing disordersur department. He is a giftedcian, teacher, and researcher
o has provided personal caremany patients with hearing, and has helped countlesser audiologists to improve theire for patents with hearing loss.iologists around the world
ognize the many contributionsde by Dr. Sweetow in the areasural rehabilitation, hearing aids,itus, counseling, and forensics.
Sweetows passion to providebest care for individuals
h hearing loss motivated himevelop the internationallyowned LACE, (Listening and
Communication Enhancement)training program. LACE is anevidenced-based self-paced programdesigned for home use in trainingthe brain to utilize skills that maydiminish with deciencies in hearing.It develops skills and strategies thathelp compensate for situations whenhearing is inadequate.
Dr. Sweetow is truly a pioneer inimplementing an effective andaffordable rehabilitative program forpeople with hearing loss.
In addition, Dr. Sweetow hasprovided outstanding serviceto the American Academy ofAudiology. He has participated inthe scientic programs of everyannual convention of the Academyand is among the their most notablemembers.
Kristin K. Egan, MD will
begin a Facial Plastic &Reconstructive SurgeryFellowship under Drs.Robert M. Kellman& Sherard A. Tatum,Syracuse University.
M. Jafer Ali, MD will
begin a Facial Plastic &Reconstructive SurgeryFellowship with Dr.James R. Koch in SanMateo, CA.
Theresa A. Gurn
MD will be joiningSanta Cruz MedicCenter, in Santa CCA.
UCSFOtolaryngology-Head&NeckSurWelcomesIncomingResidents
UCSFOtolaryngology-Head&NeckSurSalutesGraduatingResidents
Terrence Metz MMedical School:LoUniversity
Megan Durr MDMedical School:Johns HopkinsUniversity
Jonathan George MDMedical School:Duke University
Robert W Sweetow, PhD
up photo of faculty and residents at the 6th AnnualResident Research Symposium
Donald A. Leopold, MD, FACS infront of a painting honoring formerUCSF Chancellor Francis Sooy, MD
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ontactUs
neral Otolaryngologydiatric Otolaryngology
ology and Neurotology
nology and Sinus Surgeryep Surgery
5-353-2757
ad and Neck Surgeryad and Neck Endocrine
rgery
SF Salivary Gland Center
5-885-7528
chlear Implant Program5-353-2464
cial Plastic SurgerySF Voice and Swallowing
nter
5-885-7700
diology
5-353-2101
ine
p://ohns.ucsf.edu
HeadsUp!Volume5,Issue2
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:
Andrew H. Murr, MD
Ivan H. El-Sayed, MD
Mark S. Courey, MD
Sarah Schneider, CCC-SLP
Endowed Faculty Positions
Currently, the Department of
Otolaryngology Head and Neck
Surgery has 22 faculty members and
only 4 endowed faculty positions:
Dr. Lisa Orloff was recently named
the Robert K. Werbe Distinguished
Professor in Head and Neck Cancer.
Distinguished professorships are
the highest faculty honor one can
receive and signify UCSFs belief in a
faculty members past contributions
and future promise. As the Werbe
Distinguished Professor, Dr. Orloff will
augment her research and clinical
interest in studying applications of
ultrasonography to cancers of the
head and neck;
The Roger Boles, MD Endowed
Chair in Otolaryngology Education is
held by the Departments Vice Chair
and Residency Director, Dr. Andrew
Murr. Established in honor of Dr.
Boles, a former chairman of the
department and renowned educator,
the Boles Endowed Chair equips Dr.
Murr with the resources to actively
manage one of the hallmarks of our
Department: the residency education
program;
The Georgia G. Sullivan Endowed
Chair in Hearing Research is held
by Dr. Patricia Leake. Dr. Leake is
leading the departments research
on cochlear implants and the effectof stimulation from an implant and
other potential neurotrophic agents
on the developing auditory nervous
system;
Dr. Lawrence Lustig was newly
named the Francis A. Sooy, MD
Endowed Chair in Otolaryngology.
Named for Dr. Francis Sooy, a past
chairman of the department and
former Chancellor of UCSF, funds
from the Sooy Chair will allow Dr.
Lustig to continue his innovative
research involving the molecularmechanisms controlling auditory hair
GIVING BACK
by Andrew N. Goldberg,
, and a dedicated presence
leep apnea research
er the direction of Eric J.
irian, MD. In addition,
. Andrew N. Goldberg,
ven J. Pletcher, and Ivan H.
Sayed are partnering with
neurosurgery colleagues
and the outer limits of
ll base endoscopic surgery.
his collaboration, we are
viding the latest technology
ESS technique in order toimize morbidity in surgery,
to address skull base
mors, CSF leaks, orbital
gery, and surgery for sinus
mors and sinus disease.
A. Orloff, MD continues
be on the cutting edge
ltrasound technology in
head and neck endocrine
gery practice. In
aboration with department
irman David W. Eisele, MD,
Orloff will be directing the
SF Head and Neck Endocrinegery Course in concert
h the American College of
geons Ultrasound Skills
rse on October 24-25, 2008
an Francisco.
order to expand patient
ess to the wider San
ncisco Bay Area, David
m, MD has opened a Marin
unty ofce for Facial
stic Surgery in Greenbrae,
fornia. In addition, Kristina
W. Rosbe, MD opened a new
Greenbrae satellite practice
in pediatric otolaryngology.
Dr. Rosbes practice is so
busy that our department
has recruited a second
pediatric otolaryngologist,
Anna K. Meyer, MD, who will
join the Division of Pediatric
Otolaryngology Head and
Neck Surgery in October of
2008.
At our San Francisco GeneralHospital (SFGH) practice,
we have recently recruited
a new nurse practitioner,
Christina Herrera, who was
previously employed by the
University of Pennsylvania,
Division of Rhinology. Ms.
Herrera will assist us with
the implementation of a new
computer based referral
system which will enable
our SFGH practice to be
more efcient and provide
better service to the patients
and physicians of the SanFrancisco Community Health
Network.Our trauma practice
at SFGH is an important
aspect of our residency
training and continues to
provide an outstanding
learning experience betting
the position of SFGH as the
only Level 1 trauma center
in the city and county of San
Francisco.
In summary, Otolaryngology
- Head and Neck Surgery
continues to move forward
with new recruitments,
innovative clinical and
research efforts, new practice
sites, and the introduction
of new CME courses. The
UCSF Otolaryngology Update
for 2009 will be held at the
San Francisco Ritz Carlton
in November 2009. We will
share more details about this
exciting program as the date
draws closer.
ntinued from page 1
HUGH SMITHRETIRES
After 34 years of
excellent service as
the Departments
Billing Coordinator
Hugh Smith has
retired. Hugh
has consistently
demonstrated
exceptional
professionalism and
dedication. His ongoing contribution tdepartment will be missed.
Hugh Smith
cell function, and clinical work
cochlear implants.
The strength of UCSF and the
Department of Otolaryngology
Head and Neck Surgery ow
its faculty. Attracting and keep
innovative faculty, is critical to
department to allow us to achi
our goals in education, researc
patient care.
Donors Make It Happen!
Faculty researchers can spend
up to thirty percent of their tim
applying for grants to sustain t
work, a demanding but necess
activity if they are to continue
investigations. Endowed Chair
and Distinguished Professorshi
provide a stable source of supp
that allows the holder to conce
on the research, clinical or tea
activities for which he or sheis renowned. Endowed faculty
positions provides independen
from the uctuations of govern
funding cycles and the growing
conservatism of granting agen
well as liberates the holder to
teaching excellence, and reliev
pressure to generate other sou
nancial support.
Creating an endowed faculty p
is one of the most lasting and
signicant contributions a dono
make. An endowed position cran enduring partnership betwe
donor and the ongoing achieve
of the recipient. Endowed posit
exist in perpetuity. Donors and
families can enjoy the rewards
generations.
For more information about
establishing a distinguished
professorship, or endowed cha
any other gift, please contact J
Hauk, Director of Development
415-502-6198 or