Department of Otolaryngology

Spring, 2015
University of Missouri
School of Medicine
Volume 6, Issue 2
Department of OtolaryngologyHead and Neck Surgery
Message from the Chair
Once again, as we transition from an especially cold winter into spring time, the usual seasonal
scheduled activities and Department planning are underway. It is during this time of the year
that numerous things occur which typify our role in an academic health system.
March has been especially busy as all of our residents took their annual in training exam and as
always, we hope for an exceptional performance by our program, something we have enjoyed
over most of the last decade. The Department Faculty also attended their annual half-day
retreat during which we discussed our three missions: education, research and clinical care.
We reviewed the goals accomplished in the past year and set new goals and action plans for the
upcoming year. Research efforts and productivity specifically will receive significantly greater
emphasis in the School of Medicine in upcoming years. Our new Dean, Patrice Delafontaine,
M.D., started in December and is expected to lead the School of Medicine to much higher
levels of externally funded research. Finally in March, fourth year medical students at Mizzou
learned where they would spend the next several years - I’m, of course, referring to national
match day! The energy and excitement this time brings is always memorable.
In April, we hosted the Midwest Head & Neck Cancer Consortium meeting. This Consortium
is composed of the head and neck oncology sections from the University of Iowa, University
of Kansas, University of Minnesota, University of Missouri, University of Nebraska and the University of South Dakota. The group
strives to promote head neck education among residents and fellows in training, as well as engage in a collaborative research effort
for multiple head neck research studies. Among the highlights was a hands-on sialendoscopy course directed by Dr. Harry Hoffman,
Professor of Otolaryngology – Head and Neck Surgery at the University of Iowa. Our guest Faculty included Dr. Boyd Gillespie,
Professor of Otolaryngology – Head and Neck Surgery at the Medical University of South Carolina and Dr. Allison Ogden, Assistant
Professor of Otolaryngology – Head and Neck Surgery at Washington University.
Finally, we have seen some changes in our clinical Faculty. Dr. Jim Denneny has departed MU and begun his tenure as Executive
Vice President/CEO of the American Academy of Otolaryngology-Head and Neck Surgery in Alexandria, VA. Dr. Arnaldo Rivera
joined the Department to provide otologic and neurotologic services, education and research efforts. This summer we will lose a very
solid faculty member, Dr. Abigail McEwan, who has been with us for the past year. Her husband will be finishing his plastic surgery
residency and she will accompany him to begin their new practices.
And so, these are among the many many activities and transitions
occurring in the Department. The energy, dedication and innovation
of our administrative staff, Residents and Faculty are paramount for
our successes during this busy season each year.
Robert P. Zitsch III, M.D.
William E. Davis Professor and Chair
In This Issue:
Message from the Chair......................................... 1
Midwest Head & Neck Cancer Consortium.......2-3
Columbia Facial Plastic Surgery............................ 4
It’s a Match............................................................ 4
Graduates of 2015.................................................. 4
Recent Publications................................................ 5
New Faculty........................................................... 6
Alumni Spotlight.................................................... 6
Legacy of Service.................................................. 7
Endowment Update................................................ 8
Midwest Head & Neck Cancer Consortium
The University of Missouri was very proud to host the 8th Annual
Midwest Head & Neck Cancer Consortium in mid-April over a
particularly beautiful three spring days. The meeting consisted of
a hands-on sialendoscopy course, top notch fellow and residents
research presentations and concluded with a research meeting to
discuss current collaborative projects and future endeavors.
A special thanks to our course Faculty – Henry Hoffman, M.D. from
the University of Iowa; M. Boyd Gillespie, M.D. from the Medical
University of South Carolina; and Allison Ogden, M.D. from
Washington University who took the time to come and share their
expert knowledge with colleagues and trainees alike.
Also, congratulations to our research winners! 1st Place – Bridget
Hopewell, M.D. (MO), 2nd place – Bob Eppsteiner, M.D., (IA), 3rd
place – Matt Johnson, M.D. (NE).
Bridget Hopewell, M.D.
Greg Renner, M.D.
Jeff Baldwin (Cook Medical), Eric Errante (Karl Storz), M. Boyd Gillespie, M.D.,
Henry Hoffman, M.D., Troy Wingler (Cook Medical), Robert Zitsch, M.D.
Matt Johnson, M.D., Bridget Hopewell, M.D.
Bob Eppsteiner, M.D.
Henry Hoffman, M.D., Allison Ogden, M.D.,
M. Boyd Gillespie, M.D.
Bridget Hopewell, M.D., M. Boyd Gillespie, M.D.,
Aru Panwar, M.D.
2
2015
2015 Midwest Head & Neck Cancer Consortium attendees
M. Boyd Gillespie, M.D.,
Andrew Coughlin, M.D.
Model demonstration
Matt Johnson, M.D., M. Boyd Gillespie, M.D., Blake Hyde, M.D.
Veronique Wan, M.D., Troy Wingler,
Mike Deutschmann, M.D.
Allison Ogden, M.D., Tabitha Galloway, M.D.
3
Columbia Facial Plastic Surgery
The eyes: the window to our soul, the purveyor of wisdom…the talebearer of age. Our eyes are the focal point of our faces. They
sparkle, they crease and they squint under bright light. They’ve been known to give both our emotions and our age away.
Maintaining Healthy skin around the eyes: Because it is thinner, it not only tends to be the first place to show signs of
aging, but is more sensitive than the rest of the skin. Therefore, extra care needs to be taken when choosing a skincare product.
Sunscreen, Retin-A, and Topical vitamin C are the gold standard for this area. Vitamin C plays an essential role in collagen and
elastin production and acts as an antioxidant.
Neuromodulators: Neuromodulators work by temporarily
blocking signals within the muscles, therefore limiting their
movement. The result is a rested, refreshed appearance, not
frozen or overdone. Natural results are always our goal.
Neuromodulator treatments last an average of 3-4 months.
Dermal Fillers: One of the most important areas of the
face is the transition zone between the eyes and the cheeks.
After
Before
This is one of the earliest places to show signs of fatigue or
aging. When there is lack of support beneath the skin in this area, the surface becomes uneven, creating shadows, dark circles or
even bags under the eyes. The answer: fillers. Fillers offer a natural solution to restoring lost facial volume. Dermal fillers plump
the skin and promote a youthful and rested appearance.
Surgical Eye Rejuvenation: Looking for a more dramatic effect? When puffy, drooping, saggy or tired-looking eyes have
become a permanent facial fixture, an eyelift surgery (blepharoplasty and or brow-lift) may be your best option. These treatments
are not indicated for wrinkles (although smoother skin is a result). Eyelid surgery involves the repositioning and/or removal of
excess skin and adipose tissue as well as a reinforcement of the muscle and tendon tissues around the eyes. This can be used in
combination with a brow lift which surgically lift the forehead and brow position.
It’s a Match!
Lauren Umstattd, M.D.
Chris Kennel, M.D.
We are delighted to have Lauren Umstattd (Stephenson) and
Chris Kennel join the Department in July. Lauren is a Missouri
native originally from Kansas City. She’ll be completing a
trifecta at Mizzou – undergraduate education, medical school
education and residency training. Chris comes to MU after
completing his undergraduate education at Goshen College,
followed by medical school at the University of Colorado.
Welcome Lauren and Chris!
Graduates of 2015
Tabitha L.I. Galloway, M.D.
Jason A. Showmaker, M.D.
Tabitha L.I. Galloway, M.D. will be heading to Cleveland,
Ohio to complete a head and neck microvascular fellowship
at the Cleveland Clinic. She plans to return to MU and join
the Faculty in 2016.
Jason A. Showmaker, M.D. is a native Missourian and plans
to stay that way. Dr. Showmaker will be going just a few miles
south to Jefferson City to practice general otolaryngology at
Capital Regional Medical Center.
4
Recent Publications
Agrawal A, Civantos FJ, Brumund KT, Chepeha DB, Hall NC, Carroll WR, Smith RB, Zitsch RP, Lee WT, Shnayder Y,
Cognetti DM, Pitman KT, King DW, Christman LA, Lai SY. [99mTc]Tilmanocept Accurately Detects Sentinel Lymph Nodes
and Predicts Node Pathology Status in Patients with Oral Squamous Cell Carcinoma of the Head and Neck: Results of a Phase
III Multi-institutional Trial. Ann Surg Oncol. 2015 Feb 11. [Epub ahead of print]
Chen N, Stephenson LA, Jorgensen JB, Zitsch RP 3rd. Stretch of the minimally invasive incision during thyroid and parathyroid
surgery. Otolaryngol Head Neck Surg. 2014 Oct;151(4):582-5.
Erbele ID, Bernstein JG, Schuchman GI, Brungart DS, Rivera A. An initial experience of cochlear implantation for patients
with single-sided deafness after prior osseointegrated hearing device. Otol Neurotol. 2015 Jan;36(1):e24-9.
Farmer RW, McCall L, Civantos FJ, Myers JN, Yarbrough WG, Murphy B, O’Leary M, Zitsch R, Siegel BA. Lymphatic
Drainage Patterns in Oral Squamous Cell Carcinoma: Findings of the ACOSOG Z0360 (Alliance) Study. Otolaryngol Head
Neck Surg. 2015 Mar 6.
Gov-Ari E, Leann Hopewell B. Correlation between pre-operative diagnosis and post-operative pathology reading in pediatric
neck masses--a review of 281 cases. Int J Pediatr Otorhinolaryngol. 2015 Jan;79(1):2-7
Lanigan A, Tompkins AJ, Rivera A. Unilateral ear and temporomandibular joint discomfort. JAMA Otolaryngol Head Neck
Surg. 2014 Sep;140(9):873-4.
Lever TE, Brooks RT, Thombs LA, Littrell LL, Harris RA, Allen MJ, Kadosh MD, Robbins KL. Videofluoroscopic Validation
of a Translational Murine Model of Presbyphagia. Dysphagia. 2015 Mar 18. [Epub ahead of print]
Mikals SJ, Schuchman GI, Bernstein JG, Rivera AL. Cochlear implantation leading to successful stapedectomy in the
contralateral only-hearing ear. Ear Nose Throat J. 2015 Mar;94(3):105-7.
Miller DL, Puricelli MD, Stack MS. Virology and molecular pathogenesis of HPV (human papillomavirus)-associated
oropharyngeal squamous cell carcinoma. Biochem J. 2012 Apr 15;443(2):339-53.
Taylor SR, Jorgensen JB. Use of fluorescent angiography to assess donor site perfusion prior to free tissue transfer.
Laryngoscope. 2015.
Todd NW, Fainberg JC, Ukatu CC. Venable CY, Segel P. Pain-only complaint about cochlear implant device: A five-patient
pediatric experience. Cochlear Implants Int. 2015 Jan 7. [Epub ahead of print]
Ukatu CC, Desai NK, Todd NW. Site for bone-anchored hearing system for children younger than 5 years. Otolaryngol Head
Neck Surg. 2015;152(2):348-52.
Vijayakumar S, Lever TE, Pierce J, Zhao X, Bergstrom D, Lundberg YW, Jones TA, Jones SM. Vestibular dysfunction, altered
macular structure and trait localization in A/J inbred mice. Mamm Genome. 2015 Apr;26(3-4):154-72
5
New Faculty
Arnaldo L. Rivera, M.D.
Arnaldo L. Rivera, M.D. recently joined the
Faculty in the Department of Otolaryngology
– Head and Neck Surgery. Dr. Rivera
completed his undergraduate education
at the Interamerican University of Puerto
Rico, followed by his M.D. at the University
of Puerto Rico. He joined the Navy and
subsequently trained at the National Naval
Medical Center in Bethesda, MD and the
National Capital Consortium in Washington
DC. Dr. Rivera then went to Northwestern
University Hospital where he obtained
additional training in otology/neurotology.
Since that time he’s been practicing and
training residents in the Navy at the National
Capitol Consortium, and also served during
Operation Continuous Promise on the USSN
Comfort. Dr. Rivera has participated in
Humanitarian Missions worldwide and is
a member of the FDA panel for ENT. His
primary clinical interests including deafness,
cochlear implants, skull base tumors and
facial nerve pathology.
Alumni Spotlight
Susie Early, M.D. graduated from the Otolaryngology Head and Neck Surgery residency training program in 2004.
Since that time she’s been in a general private practice in
Columbia, Missouri. Other
than working to build and
manage a practice, she
and her husband are busy
raising three sons, ages
11, 7 and 6. She loves the
Tigers - especially football
and basketball (hoping for a
better season next year!), as
well as traveling and skiing.
In sharing her memories
of residency... “I never
Susie Early, M.D., & family
realized in residency how
much I would miss the team aspect. As a resident, we rounded
as a team, operated as a team and hung out as teams. There
was always someone to ask or bounce an idea or question off
of. My first few years in private practice were an adjustment
and when I look back I realize how much I missed the team
and group. I think that added to the anxiety you first have when
you step out on your own from residency. I can look back and
realize I had great training and exposure and I can see now
how lucky I was to have faculty and upper level residents who
were patient and good role models.”
As for the Faculty... “I can still hear their sayings in my
head as a operate or do clinic at times and can see how they
approached cases - Dr. Templer “like a broken clock I am
right twice a day” and as he told me during my first sinus case
with him “you are going to teach this guy when he wakes up
what sinus pain means;” Dr. Davis “char doesn’t bleed” when
returning to the OR for a tonsil bleed and hoping I can always
look as composed and calm as he did in and out of the OR;
Dr. Renner telling us he had seen a preacher with a mandible
fracture when we said it never happens to guys behaving,
and his Tuesday afternoon clinics with local procedures and
learning to watch what I say out loud as the patient is awake (I
had/have a bit of a potty mouth); and Dr. Zitsch who inspires
fear and admiration all at once - “did you see that vessel?”,
“use your scissors like a big girl,” and to this day the sound of
Pink Floyd makes me slightly nervous - but it was Dr. Zitsch
who I first let know I was pregnant and I was nervous, he told
me it would be ok (this was after he laughed thinking I was
joking and then saw my face - true story). I hoped to grow up
and be like the guys who trained me - polite, confident, good
surgeons and good clinicians. I truly like all of them and I miss
working with them.”
6
A Legacy Of Service
“She’s beautiful,” her father said when we asked how her first night after the
surgery had been. Even when we asked how well she was eating, or if she’d
been in any pain, all he would answer was, “Beautiful,” as her mom quietly
nodded. They had travelled many hours on a crowded bus from a UN refugee
camp near the Kenyan-Somali border to AIC-CURE hospital to be seen by
our team of surgeons.
In October, I travelled with AAOHNS members Dr. David Chang, Dr.
Cameron Kirschner, Dr. Eric Dobratz, and Dr. Cooper Scurry to the
picturesque mountainside town of Kijabe, Kenya. Teams of US surgeons
travel here several times a year to provide surgical service to affected children.
This was Dr. Chang’s 9th trip to Kijabe and I was fortunate to be a part of a
lineage of residents from the University of Missouri to accompany him.
Due to the long-term relationship
established
between
ENT
teams and the staff of the
AIC CURE hospital, we
were able to start swiftly
and efficiently. Patients
were scheduled for us
to see daily over our
two weeks. During
that time we ran two
operating rooms with
nurses who were very
skilled and had previous
experience with our team.
The operating rooms
were large and had reliable
electricity, sufficient instruments,
and reasonably short turnover time.
After
Patients were admitted to a 24-bed ward
with two monitored beds as a “step-down” unit with the staff being very
familiar with care of post-surgical lip and palate surgery. Care instructions in
Swahili were accompanied by donated stuffed animals to complement their
healing faces.
Before
Pre-Op Visit
Surgery Prep
This was my first, yet certainly not my last, medical mission trip as a physician.
Dr. Chang’s trips should serve as a model for humanitarian medical trips in
which service is given in an attitude of genuine mutual respect. We could not
have accomplished what we did without the tremendous support of the staff
at the AIC-CURE hospital, and they certainly continue our work throughout
the entire year. I was privileged to accompany him on this most memorable
journey.
-Bridget L. Hopewell, M.D. PGY4
Post-Op Checkup
7
Department of Otolaryngology Head and Neck Surgery
University of Missouri-School of Medicine
One Hospital Dr., MA314
Columbia, MO 65212
Endowment Update
T
hank you again to everyone who has already donated to fully
fund the William E. Davis, M.D. Endowment! It’s not too late
to support this goal. We have currently raised $904,331!
Please visit our website at ent.missouri.edu, Gift Opportunities tab.
904,331
800,000
To donate?
1. Visit ent.missouri.edu
2. Choose “Gift Oppotunities” tab
Department Contact
Information
1.1 million
600,000
400,000
200,000
Robert P. Zitsch III, M.D. • zitschr@health.missouri.edu • (573) 882-8173
One Hospital Dr., MA314 • Columbia, MO 65212 • ent.missouri.edu