Newsletter Spring 09

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


2/4

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!


our residency program, please

visit our website at


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


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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.


Dr. Wang, or to contact him,

please visit our website at:


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


4/4

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.


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

Newsletter Spring 09

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