PENN STATE OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Division Update Winter 2016
PennStateHershey.org/otolaryngology
New Multidisciplinary Facial Nerve Disorders Clinic Opens in Hershey
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Facial weakness has a profoundly detrimental effect on quality-of-life. Patients often have difficulty communicating both verbally and non-verbally, which can be socially and physically debilitating. Due to asymmetries or unintended movements of various facial muscles, a patient’s inadvertent facial gestures may lead to misinterpretation of expressions. Vital functions such as eating, speaking and drinking may be limited for patients; common actions, such as blinking, brow lifting and smiling may lead to unpleasant facial movements. This can limit quality-of-life, decrease social interactions and, in some cases, cause social isolation. Caring for patients with facial nerve disorders is complex and typically requires multiple specialists for optimum outcomes. This past summer, in an effort to maximize the care of these patients, the multidisciplinary Facial Nerve Disorders Clinic at Penn State Health Milton S. Hershey Medical Center opened its doors to both pediatric and adult patients. As founder and clinic co-director, Jessyka Lighthall, MD, director of facial plastic and reconstructive surgery, leads a team of two plastic and reconstructive surgeons, two therapists with advanced training in facial rehabilitation and a nurse coordinator. Other specialists involved include neurotology, head and neck surgery, adult and pediatric neurology, ophthalmology and neurosurgery. As a multidisciplinary program, patients may also obtain any necessary laboratory, imaging and electrodiagnostic studies that may be requested as part of their care. A goal of this new practice includes higher quality clinical outcomes for improved physical and emotional patient care.
For questions or to refer a patient, please call 717-531-1405. The Facial Nerve Disorders Team Jessyka G. Lighthall, MD Founder and Co-Director, Facial Nerve Disorders Clinic Director, Facial Plastic and Reconstructive Surgery Assistant Professor, Department of Surgery Division of Otolaryngology–Head and Neck Surgery
Donald R. Mackay, DDS, MD, FRCS, FACS, FAAP Co-Director, Facial Nerve Disorders Clinic William P. Graham III Professor of Plastic Surgery Professor of Surgery & Pediatrics Chief, Division of Plastic Surgery Vice Chair, Department of Surgery
Cathy Henry, MD Assistant Professor, Surgery Division of Plastic and Reconstructive Surgery
Nicole Fisher, CCC /SLP, MS Facial Rehabilitation Specialist Speech Language Pathologist
Sue Keener, PT, BS, MBA Facial Rehabilitation Specialist Supervisor, Outpatient Physical Therapy
Marilyn Tayvinsky, LPN Nurse Coordinator
Message from the Chief Fall 2016 brought great news for the Division of Otolaryngology–Head and Neck Surgery at Penn State Health Milton S. Hershey Medical Center. For the first time, our division has been ranked as one of the best in U.S. News and World Report for ear, nose and throat care. During the past few months, the division has experienced tremendous progress. Our faculty members continue to be recognized as national leaders in research, education and clinical care in our field. Jessyka Lighthall, MD, recently founded and directs the newly established multidisciplinary facial nerve disorders program, which offers comprehensive patient-centered care for those with facial paralysis. Our combined otolaryngology and neurosurgery team, led by Neerav Goyal, MD, continues to flourish focusing
on minimally invasive skull-based surgery. We have also seen growth in our pediatric airway clinic led by Jason May, MD, caring for pediatric patients with complex airway disease. As chief of the division, I am inspired by the talented faculty, residents and dedicated staff who care for a growing number of patients. I invite you to explore the pages of our latest newsletter to learn about our efforts as we continue to discover, teach and heal. Best wishes for a happy fall and winter season.
David Goldenberg, MD, FACS Baron Professor and Chief, Otolaryngology–Head and Neck Surgery
Medical Center named among best in ear, nose and throat care by U.S. News and World Report U.S. News and World Report has recognized Penn State Health Milton S. Hershey Medical Center as one of the best hospitals for in ear, nose and throat care. The U.S. News Best Hospitals rankings help guide patients to hospitals that deliver outstanding care across 25 specialties, procedures and conditions. The Best Hospitals methodologies include objective measures, such as patient survival, the number of times a given procedure is performed, infection rates, adequacy of nurse staffing and more.
For 2016-17, 153 hospitals were ranked in at least one specialty, while 1,628 received a ‘high performing’ rating in one or more specialties, procedures or conditions. In rankings by state and metro area, U.S. News recognized hospitals that were high-performing across multiple areas of care. The rankings are published in the U.S. News “Best Hospitals 2017” guidebook. For more information, visit the U.S. News Best Hospitals website, health.usnews.com/best-hospitals.
“I’m very proud of our growth and accomplishments as a team, as our faculty members continue to be recognized as national leaders in clinical care, research and education,” “We have made great strides together and are now poised to enter another chapter of our division’s history with truly cutting-edge clinical care and ambitious research initiatives.” –David Goldenberg, MD, FACS Baron Professor and Chief, Otolaryngology–Head and Neck Surgery
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New Employees AUDIOLOGISTS
PHYSICIANS ASSISTANT
Mallory Snyder, AuD, is an audiologist and recent University of Pittsburgh graduate where she earned her undergraduate degree in communication science and disorders, as well as her Doctorate of Audiology degree. She completed her fourth year externship at Children’s Hospital of Pittsburgh. In May, she joined the audiology team and, in August, was recognized as a Hershey Hero.
Erin C. Roy, PA-C, joined the division in August 2016 after graduating with the inaugural Penn State College of Medicine physician assistant (PA) program class in May. She earned her undergraduate degree in biology from Bucknell University in 2014. She has previous experience as a nursing assistant in both hospital and nursing home settings. She spent her elective rotation during PA school here in the Penn State otolaryngology clinic before beginning her official employment with us.
Stephanie Milks, AuD, CCC-A, FAA, is a recent Bloomsburg University graduate where she earned her degree in speech pathology and audiology in 2001, and, in 2006, her Doctorate of Audiology. She serves as a member of the professional development committee for the American Academy of Audiology and as supervisor for the Healthy Hearing Program for Special Olympics. She has a clinical interest in vestibular disorders, evaluations and rehabilitation. She joined the audiology team in April 2016.
Jessica Wagner, AuD, CCC-A, became a full-time audiologist with the team following her graduation in May 2016. She first joined audiology in 2015 as an audiology extern. She earned her Bachelors of Science in communicative disorders in 2012, then her Doctorate of Audiology in 2016 from Northern Illinois University. Jessica was voted otolaryngology employee of the month twice, already: November 2015 and September 2016. Her primary clinical interests include both vestibular assessment and pediatric diagnostic testing.
HEAD AND NECK ENDOCRINE FELLOW Elizabeth Cottrill, MD, is a native of West Virginia. She graduated from Vanderbilt University for her undergraduate studies and the University of Arkansas for medical school. In June 2016, she completed her surgical residency in OTO-HNS at the University of Pennsylvania. Dr. Cottrill is the first participant in the Penn State Health Otolaryngology Fellowship in Endocrine Surgery, which is accredited by the American Head and Neck Society and focuses specifically on thyroid and parathyroid diseases. She is mentored by David Goldenberg, MD, in otolaryngology–head and neck surgery and Brian Saunders, MD, and Melissa Boltz, MD, in general surgery.
RESIDENTS Dr. Robert Saadi, PGY-1, grew up in Erie, Pa. He graduated from the University of Pittsburgh in neuroscience. He completed medical school at Penn State College of Medicine before joining the otolaryngology residency program here at Penn State Health Milton S. Hershey Medical Center.
SPEECH LANGUAGE PATHOLOGIST Suzanne B. Lynch, MA, CCC/SLP, is a speech/ language pathologist (SLP) who joined the team in September 2016. She has been an SLP at Penn State Health Milton S. Hershey Medical Center since 2000. Suzanne earned both her undergraduate and Master’s degrees from the University of Pittsburgh. She has been the recipient of six awards for continuing education from the American Speech/Language and Hearing Association. She holds certifications in both the Lee Silverman Voice Treatment and the Neuromuscular Electrical Stimulation for dysphagia. Her special interests include head and neck cancer, dysphagia and aural rehabilitation following cochlear implantation.
Christopher Pool, MD, joined otolaryngology in the summer of 2016, as the research track resident. As the second research track resident, Dr. Pool will fulfill a year of research in the Institute for Personalized Medicine before entering the clinical years of residency. He is a graduate of Yale University where he studied molecular biology and graduated medical school at the Icahn School of Medicine at Mount Sinai.
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Penn State Health Participates in Otolaryngology Education Alliance The OEA (Otolaryngology Education Alliance) Lectureship is bestowed on promising junior faculty to promote educational exchange and enable inter-institutional collaboration. Recipients visit other OAE institutions to deliver Grand Rounds and meet with host faculty, fellows and residents to catalyze new creative endeavors. Participating institutions include University of Maryland School of Medicine, Penn State College of Medicine, Weill-Cornell Medical College, Sidney Kimmel Medical College at Thomas Jefferson University and Johns Hopkins School of Medicine.
Visiting Professors May 12, 2016 Visiting Professor—Maria Suurna, MD, FACS Assistant Professor, Department of Otolaryngology— Head and Neck Surgery at Weill Cornell Medical College “Where are we now and the future of obstructive sleep apnea surgery”
June 9, 2016 Visiting Professor—Joseph Curry, MD Associate Professor, Department of Otolaryngology—Head and Neck Surgery at Sidney Kimmell Medical College, Jefferson University “Microvascular Reconstruction of Complex Cranioorbitofacial Defects”
September 8, 2016 Visiting Professor—Michael Orsini, MD, FACS Penn State College of Medicine Alumnus and Clinical Assistant Professor at the University of Pittsburgh School of Medicine “Otolaryngology Secrets”
June 23, 2016 Visiting Professor—Ronna Hertzano, MD, PhD Associate Professor, Otorhinolaryngology-Head and Neck Surgery at University of Maryland “A Cell Type-Specific Approach to the Inner Ear”
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Launching a Local ThyCa Chapter
We encourage patients and their families to attend our support group meetings.
Janice Schan Penn State ThyCa facilitator 717-531-8945 pennstatehersheythyca@gmail.com
Thanks to the work of Janice Schan, a thyroid cancer survivor and patient, we have launched a local chapter of ThyCa, a nation-wide thyroid cancer survivor network. The organization helps to provide a network of services like educational opportunities and research support to survivors and healthcare professionals around the world. In July, we hosted the inaugural meeting of the ThyCa Support Group. Facilitated by Ms. Schan, the group provides an opportunity for patients and families to share their stories and learn more about thyroid cancer. Support groups provide an opportunity for patients to meet others facing similar challenges. The ThyCa support group is free and available to all fighters, survivors and their families, friends and supporters. Meetings are held the third Sunday of every month.
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Research Track Resident Focuses on Thyroid Cancer Genomics Christopher Pool, MD, completed his undergraduate degree in molecular biology at Yale University, and then spent two years at the Walter Reed Army Institute of Research developing a malaria vaccine. While in medical school at the Icahn School of Medicine at Mount Sinai, he was invited to complete a one-year research fellowship in the field of otolaryngology. He was fortunate to combine his interests in both infectious diseases and free-flap surgery by investigating surgical site infections after free-flap surgery. His research led to new standards of care in the antibiotic regimen during free-flap reconstruction, under the guidance of Julio Aguirre-Ghiso, PhD, professor of medicine, hematology and medical oncology, and professor of otolaryngology. Dr. Pool was also involved in laboratory research investigating a compound that maintains the dormant state of a head and neck cancer cell line, preventing it from metastasizing. Dr. Pool’s research efforts at Penn State Health Milton S. Hershey Medical Center focus on thyroid cancer genomics. He is continuing the research started by Darrin Bann, MD, the inaugural research track resident. This research is based on creating a mouse model for human thyroid cancer using a DNA editing technique known as
CRISPR. Dr. Pool is working to identify a thyroid cancer molecular expression profile to help thyroid surgeons offer treatment with greater confidence. He is also using a new technology to study the large-scale genomic variations in thyroid cancer that may lead to the discovery of driver mutations currently undetectable by other technologies.
Thank You to Our Generous Donors • A special thank you to Benjamin Olewine III and family for their generous donation and support of the robotic surgery program. • Thank you to Froman, Orsini, Rago & Associates for their generous donation to our otolaryngology division in honor of alumnus Michael Orsini, MD. The gift was in memory of his father Anthony Orsini.
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• Each year the Milton S. Hershey Medical Center’s Volunteer Advisory Board chooses to distribute the profit from its gift shop and Penn State store to support services at Milton S. Hershey Medical Center. This year, the volunteers presented our audiology program with a check for $38,000. The funds will be used to purchase an audiometer, VerifitReal Ear and otoacoustic emmissions machine.
First Biennial Temporal Bone Course hosted at Penn State In April, Huseyin Isildak, MD, held the first biennial two-day temporal bone course at Milton S. Hershey Medical Center. The training encompassed a comprehensive experience in temporal bone anatomy, disease and management of the ear, and applied surgical techniques. Presenters included Dr. Isildak, Beth Czarnecki, AuD, CCC-A, director of audiology, Sangam Kanekar, MD, assistant professor of neuroradiology, and Jason May, MD, pediatric otolaryngologist.
Temporal Bone Course
Jason May, MD, pediatric otolaryngologist, recently spoke at the 23rd Annual Pennsylvania Audiology Convention. This three-day event was held at the Harrisburg Hilton, and Dr. May discussed the medical and surgical aspects of hearing loss.
Beth Czarnecki, AuD, CCC-A, director of audiology, is currently serving as the vice president of education for the Pennsylvania Audiology Association. She helped to organize the speakers for the 23rd Annual Pennsylvania Audiology Convention.
for the Digital Era: Is your profile up to date? Doximity is the largest online professional network of U.S. physicians. It offers a searchable directory of 700,000 U.S. physicians, HIPAA-secure case collaboration and physician-to-physician messaging. In addition, Doximity’s online residency navigator tool helps medical students find a residency program by offering reviews and survey data from current and former residents. U.S. News & World Report also uses the survey information provided by Doximity to rank residency programs in the United States. U.S. News & World Report is using Doximity solely for the distribution of the physician reputation surveys. To register, go to doximity.com.
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Alumni Night at AAO-HNSF During the annual American Academy of Otolaryngology—Head and Neck Surgery in San Diego, Calif., 50 Penn State alumni and friends gathered to reconnect with fellow colleagues at the Striders Club.
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Neerav Goyal, Neerav Goyal, MD, MPH, Dr. Huseyin Isildak, MD and Frank Garritano, MD
David Goldenberg, MD, FACS, Garret Choby, MD, Frank Garritano, MD, Shivani Shah-Becker, MD, Dr. Ashley O’Connell-Ferster, MD and Michael Ferster
Garret Choby, MD, John McGinn MD, FACS, Frank Garritano, MD, Eelam Adil, MD, MBA, FAAP, David Goldenberg, MD, FACS.
Ayesha Khalid, MD, David Goldenberg, MD, FACS, Eelam Adil, MD, MBA, FAAP and Betty Cek, LPN
Frank Garritano, MD, Genevieve Andrews, MD, and Eelam Adil, MD, MBA, FAAP
Cooper Scurry, MD, Rich Ferraro, MD, and Fran Ruggiero, MD, FACS
Scholarly Activity Presentations: Baker A, Fanelli D, Kanekar S, Isildak H. A review of temporal bone CT Imaging with respect to pediatric bone-anchored hearing aid placement. ANS Meeting at COSM, May 2016, Chicago, IL, and PAO-HNS Scientific Meeting, June 2016. Oral presentation and poster presentation. Clark CM, Shah-Becker S, Goyal N. Aerophagia and subcutaneous emphysema in a patient with Rett syndrome. AAO-HNS, September 2016, San Diego, CA. Poster presentation. Emerick K, Deschler D, Goyal N. Total Parotidectomy defect reconstruction with the submental flap. AHNS Annual Meeting, July 2016, Seattle, WA. Poster presentation. Funk E, Baker A, Goldenberg D, Goyal N. An Overview of retractor systems used in transoral robotic surgery. PAO-HNS Scientific Meeting, June 2016 and AAO-HNS Annual Meeting, September 2016, San Diego, CA. Poster presentation. Greenleaf E, Shah-Becker S, Goyal N, Hollenbeak C, Boltz M. Resource utilization associated with postoperative neck hematoma after thyroid and parathyroid surgery. AHNS, July 2016, Seattle, WA. Poster presentation. Puram SV, Sinha S, Sethi RK, Goyal N, Emerick KS, Lin DT, Durand ML, Deschler DG. Transfusion in head and neck patients undergoing pedicle flap reconstruction: Practice patterns and a comparative analysis by flap type. AHNS Annual Meeting, July 2016, Seattle, WA. Poster presentation.
Schwartz, S., Shah-Becker, S., Andrews, G. (2016 Jan) Malignant transformation of Warthin tumor presenting as a satellite lesion to the skin. TRIO, 2016, Miami, FL. Poster presentation. Sethi RK, Puram SV, Parikh A, Yarlagadda B, Goyal N, Tjoa T, Varvares MA, Rocco J, Emerick KS, Lin DT, Durand ML, Deschler DG. Predicting length of stay in head and neck patients who undergo free flap reconstruction. AHNS Annual Meeting, July 2016, Seattle, WA. Poster presentation. Shah-Becker S, Derr J, Saunders B, Oberman BS, Baker A, Carr MM, Goldenberg D. Early neurocognitive improvements following parathyroidectomy. AAO-HNS, September 2016 San Diego, CA. Oral presentation. Shah-Becker S, Roberts C, Ferster AO, Sedeek K, Carr MM. Preliminary results: Intraop IV acetaminophen in pediatric tonsillectomy. AAO-HNS, September 2016, San Diego, CA. Oral presentation. Shah-Becker S, Derr J, Saunders B, Oberman BS, Baker A, Carr MM, Goldenberg D. Early improvements in mood and sleep following parathyroidectomy for primary hyperparathyroidism. AHNS, July 2016, Seattle, WA. Poster presentation. Shah-Becker S, Greenleaf E, Hollenbeak C, Goyal N. Neck hematoma after major head and neck surgery: Risk factors and resource utilization. AHNS, July 2016, Seattle, WA. Poster presentation. Sinha S, Puram SV, Sethi RK, Goyal N, Emerick KS, Lin DT, Durand ML, Deschler DG. Deep Vein Thrombosis Risk Stratification in Head and Neck Reconstruction : A Comparative analysis in free and pedicle flap patients. AHNS Annual Meeting, July 2016, Seattle, WA. Poster presentation. Teixido M, Baker A, Isildak H. Migraine and benign positional paroxysmal vertigo: A single institution review. AAO-HNSF Annual Meeting, September 2016, San Diego, CA. Poster presentation. Tjoa T, Deschler DG, Rathi VK, Goyal N, Yarlagadda B, Rich DL, Emerick KS, Lin DT, Durand ML. Pneumonia and other nonsurgical site nosocomial infections after major head and neck pedicled and free flap reconstructive surgery. AHNS Annual Meeting, July 2016, Seattle, WA. Oral presentation.
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Publications: Baker A, Fanelli D, Kanekar S, Isildak H. Review of Temporal Bone CT Imaging With Respect to Pediatric Bone-anchored Hearing Aid Placement. Otol Neurotol 2016 Oct; 37(9):1366-9. Baker A, Camacho F, Andrews G, Mackley H. A retrospective analysis of the role of adjuvant radiotherapy in the treatment of cutaneous melanoma. Cancer Biol Ther 2016, Aug 15: 1-5. Carr MM, Derr JB, Karikari K. Decisional conflict and regret in parents whose children undergo tonsillectomy. Otolaryngol Head Neck Surg. 2016 Jun 21. pii: 0194599816655996. [Epub ahead of print] Gonzalez-Castro, J, Lighthall, JG. Antibiotic use in facial plastic surgery. Facial Plast Surg Clin North Am. 2016 Aug;24(3):347-56. Hariri BM, Payne SJ, Chen B, Doghramji L, Adappa ND, Palmer JN, Kennedy DW, Niv MY, Lee RJ. In vitro effects of anthocyanidins on sinonasal epithelial nitric oxide production and bacterial physiology. Am J Rhinol Allergy. 2016 Jul;30(4):261-8. Harounian JA, Schaefer E, Schubart J, Carr MM. Pediatric adenotonsillectomy and postoperative hemorrhage: Demographic and geographic variation in the US. Int J Pediatr Otorhinolaryngol 2016 Aug;87:50-4.
Harounian JA, Schaefer E, Schubart J, Carr MM. Pediatric posttonsillectomy hemorrhage: demographic and geographic variation in healthcare costs in the United States. Otolaryngol Head Neck Surg. 2016 Aug; 155(2):289-94. Magister M, Chaikhoutdinov I, Andrews G. Surgical Management of Cutaneous Melanoma of the Head and Neck. Atlas of Head and Neck Surgery 2016, pages 271-83. McGinn JD. Endoscopic approach to cricopharyngeal hypertonicity and hypopharyngeal diverticulum. Oper Tech Otolaryngol Head Neck Surg 2016;27(2):67-73. Patel V, Andrews GA. Surgical Management of Noncutaneous Malignancies of the Head and Neck. Atlas of Head and Neck Surgery 2016, 263-70. O’Connell Ferster A, Jones J, Davis J, Weber B, Hawkshaw M, Sataloff RT. Efficacy of allograft fascia lata in tympanic membrane repair. Ear Nose Throat J. 2016 April-May;95(4-5):158-164. Payne S, Mitzner R, Kunchala S, Roland L, McGinn JD. Acute invasive fungal rhinosinusitis: A 15-year experience with 41 patients. Otolaryngol Head Neck Surg. 2016 April; 154(4):759-64.
Congratulations to our recent resident graduates, Benjamin Oberman, MD, and Hetal Patel, MD. Dr. Oberman is an attending physician at North Carolina Eyes, Ears, Nose and Throat in Durham, N.C. Dr. Patel is completing her fellowship in otology at Sarasota Memorial Hospital in Florida.
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Awards: Additional Awards: Genevieve Andrews, MD, received the Faculty Professionalism/Humanism in Surgery Award from the Penn State Health Milton S. Hershey Medical Center Department of Surgery in 2016.
• Bann D, Quyan, Sheldon K, Houser K, Baker M, Broach J, Gerhard G, Goldenberg D. A novel mutation in Dual Oxidase-2 causes highly penetrant familial thyroid cancer, PAO, June 2016, Bedford Springs, PA. First place poster presentation. First place, Penn State Health Milton S. Hershey Medical Center Resident Research Day, Hershey, PA. • May, J. CG CAHPS Dean’s List Provider Extraordinary Patient Satisfaction. • McGinn, J. HCAHPS Dean’s List Provider Extraordinary Patient Satisfaction. • Shah-Becker S, Derr J, Saunders B, Oberman BS, Baker A, Carr MM, Goldenberg D. Early neurocognitive improvements following parathyroidectomy. AAO-HNS, September 2016 San Diego, CA. Best of Orals.
David Goldenberg, MD, FACS receives the Helen Krause, MD, Distinguished Service Award 2016 from the Pennsylvania Academy Of Otolaryngology-Head And Neck Surgery Annual Scientific Meeting in Bedford Springs, PA. Pictured Above: Dr. Goldenberg stands with Robert Sataloff, MD, DVM from Drexel and Jeffrey Simons, MD from UPMC.
The Division of Otolaryngology—Head and Neck Surgery participates in a team building paint ball tournament this past summer
Resident Graduation: Aaron Baker, MD, Ashley O’Connell-Ferster, MD, Shivani Shah-Becker, MD, Sakeena Payne, MD, Hetal Patel, MD, and Benjamin Oberman, MD
Neerav Goyal, MD, and Shivani ShahBecker, MD, stand with their poster presentation, Neck Hematoma After Major Head and Neck Surgery: Risk Factors and Resource Utilization. The poster, written by Neerav Goyal, MD, Shivani Shah-Becker, MD, Melissa Boltz DO, Erin Kenning Greenleaf, MD, and Christopher Hollenbeak, PhD, received third place poster presentation award during the AHNS Annual Meeting held in Seattle in July 2016.
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Penn State Health Milton S. Hershey Medical Center P.O. Box 855, MC A140 Hershey, PA 17033
SRG-11432-17 120916
During thyroid cancer awareness month in September, the crescent at Penn State Health Milton S. Hershey Medical Center was lit with teal, pink and blue, all of the colors for thyroid cancer awareness.
How to Refer a Patient • Adult and pediatric otolaryngology, head and neck cancer, facial reconstructive surgery, audiology and hearing aid services: 717-531-6822 • Cosmetic facial plastic surgery consults: 717-761-8900, option 5 • Facial Nerve Disorders Clinic: 717-531-1405 • Pediatric Airway Clinic: 717-531-6822 • Fax records for triaging review: 717-531-6160
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