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Department of OtolaryngologyMedical College of Georgia1120 Fifteenth StreetAugusta, Georgia 30912-4060

The OTO Observer

Newsletter

Non-Profit Org.

U.S. POSTAGE

PAIDPermit No. 210

Augusta, Georgia

Otolaryngology-Head and Neck Surgery Faculty and Areas of Interest

David J. Terris, MD, ChairmanThyroid and parathyroid surgery

Stilianos Kountakis, MD, Vice ChairmanRhinology and sinus surgery

Mitchell B. Austin, MDPediatric otolaryngology

Achih H. Chen, MDFacial plastic and reconstructive surgery

Christine G. Gourin, MDHead and neck oncologic surgery

Alan J. Johnson, MDOtology and neuro-otology

Frederick N. Klippert, MDGeneral otolaryngology

Edward S. Porubsky, MDGeneral otolaryngology

Gregory N. Postma, MDLaryngology and swallowing disorders

Lori M. Burkhead, PhD, CCC-SLPSpeech Language Pathology

Minimally Invasive SurgicalManagement of Thyroid and

Parathyroid Disorders

November 10-11, 2006Augusta, Georgia

Distinguished Guest Faculty

Rocco Bellantone, M.D.University Cattolica del Sacro Cuore, Rome, Italy

Quan-Yang Duh, M.D.University of California, San Francisco, CA

Brendan Stack, Jr., M.D.University of Arkansas, Little Rock, AR

Program Co-Chairs

Christine G. Gourin, M.D. and David J. Terris, M.D.Department of Otolaryngology

Medical College of Georgia

Register early. Participation in the Lab is limited

The OTO ObserverThe Newsletter of the Department of Otolaryngology

Medical College of Georgia

Inside This Issue

Burkhead Joins FacultyPhone Numbers and Web Site

Address

Faculty HighlightsMessage from the ChairHonors

Consultant of the Year

Clinical HighlightsNew Members Join Head and

Neck Tumor BoardOral Cancer Screening Day

Staff HighlightsBurress Joins StaffStar Award

CMEGrand RoundsContinuing Education Symposia

Clinical SpotlightMinimally Invasive Thyroid and

Parathyroid Surgery

ResearchPublications

Resident & Alumni NewsHail and FarewellPicture from the Archives

BURKHEAD JOINS FACULTY

We are proud to announce the recruitment ofanother key faculty member.

Dr. Lori M. Burkhead joined our department asAssistant Professor of Otolaryngology andClinical Research Scientist in the Center forVoice and Swallowing Disorders, where she willbe teaming up with Chief of Laryngology,Gregory Postma.

Dr. Burkhead earned her Bachelor’s Degree ofSpeech and Hearing Sciences from the University of South Alabama,and her Master’s Degree in Communication Sciences from the MGHInstitute in Boston, a program with clinical and academic affiliations withboth Harvard University and the Massachusetts Institute of Technology.She enjoyed a successful clinical career as a speech-languagepathologist in acute care, inpatient and outpatient rehabilitation settingsbefore returning to academia to obtain a Ph.D. in RehabilitationSciences from the University of Florida in 2005.

Dr. Burkhead’s clinical and research interests include rehabilitation ofvoice and swallowing in critically ill patients with special emphasis onissues unique to tracheostomy and ventilator dependency, and voicerestoration and rehabilitation of dysphagia due to head and neckcancer and a variety of neurologic etiologies including progressivedisease processes, stroke, and brain tumors.

Volume 4, Issue 1 SUMMER 2006

MCG LEADS THE WAY

IN MINIMALLY INVASIVE

THYROID AND

PARATHYROID SURGERY

Phone Numbers and WebSite Address

Appointments: (706) 721-4400Academic Ofc: (706) 721-6100Fax: (706) 721-0112

To learn more about recentevents in the department, visit:www.mcg.edu/otolaryngology

FACULTY HIGHLIGHTS SUMMER 2006

HonorsLori Burkhead was the recipient of a travel awardto attend the 3rd Annual Clinical ResearchConference in Washington, DC, sponsored by theDeafness Research Foundation, NIH, and the AAO.

Christine Gourin was inducted into the TriologicalSociety, and was promoted to Associate Professor.She has also been appointed Chief of the Divisionof Head and Neck Surgery effective in July.

Stil Kountakis participated in the annual MCGfundraiser “Doctors Who Cook”, and was a visitingprofessor at the University of Texas-Houston.

Gregory Postma was a featured speaker at UCSF,and several laryngology symposia held in New YorkCity and Las Vegas. He was a visiting professor atPenn State University and at SUNY-Stonybrook,and an invited speaker for the Birmingham, CentralPennsylvania and Georgia Societies ofOtolaryngology.

David Terris was appointed as Senior Examiner forthe American Board of Otolaryngology and was avisiting professor at Eastern Virginia MedicalSchool, the University of Cincinnati, the Universityof North Carolina, and the University of Illinois.

Message from the Chair

David Adams was unanimously selected as the recipientof the 2006 Otolaryngology Consultant of the YearAward. David has been with the Medical College ofGeorgia Department of Cellular Biology and Anatomysince 2002. Prior to joining MCG, David worked as anattorney and also spent over 20 years as a funeral homedirector. He is presently the Director of the MCGAnatomical Donation Program. His tireless efforts overthe past year have been essential to the success ofnumerous educational programs and symposiaconducted by the department. We are grateful forDavid’s many contributions to our clinical and academicpursuits, and he is truly worthy of this honor. A plaquememorializing his achievement will be presented at thePorubsky Symposium Dinner.

Welcome to the seventh issueof the OTO Observer, nowedited by Dr. Christine Gourin.The growth of the departmentcontinues this year with theaddition of Dr. Lori Burkhead(see front cover) to Dr. GregoryPostma’s rapidly expandingCenter for Voice andSwallowing Disorders.

Our first Endocrine-Head and Neck fellow (SusanAnderson) will start with us in August, and she joinsthe Thyroid/Parathyroid Center (directed by

Endocrinologist Ted Chin) that has emerged as aleader in the Southeast, particularly in minimallyinvasive and endoscopic surgical techniques (seeClinical Spotlight). Partnerships like this centerhave been critical to our successes.

We hope you will enjoy learning about the latestactivities in our department.

David J. Terris, M.D., F.A.C.S.Porubsky Professor and Chairman

CONSULTANT OF THE YEAR

To share your news with the other alumni, please send updates to Donna Black atdonnab@mcg.edu or call 706-721-6100.

SUMMER 2006 RESIDENT AND ALUMNI UPDATE

Hail

Jason Champagne Helen Perakis Susan Anderson Subinoy DasIncoming 1st year Incoming 1st year Incoming Endocrine/ Incoming RhinologyResident, is a graduate Resident, is a graduate Head and Neck Fellow, Fellow, is a graduateof LSU. of Boston University. is a graduate of Des of the University of

Moines University. Virginia.

R. Tyson Deal will be Charles Mixson will be Manoj Kumar will be Francis Ling will bejoining a group practice joining a group practice joining a group practice joining a group practicein Augusta, GA. in Athens, GA. in Syracuse, NY. in Ontario.

Drs. Brian McKinnon, Murray Grossan, Stil Kountakis and AlanJohnson (left to right) at the MCG Alumni Reception in Los Angeles.

Picture from the ArchivesMCG Alumni and faculty enjoyed a reception hostedby Dr. Murray Grossan, M.D., MCG class of ‘48, athis home in Beverly Hills during the 2005 AmericanAcademy of Otolaryngology-Head and NeckSurgery Annual Meeting.

Giving Opportunities

Designate Your Gift to MCG Otolaryngology■■ Porubsky Library Fund..........................$ __________■■ Barton Otolaryngology Fund................ $ __________■■ Temporal Bone Lab Fund .................... $ __________■■ Otolaryngology Research Fund ...........$ __________■■ Area of Greatest Need......................... $ __________■■ Other: ________________________...$ __________

TOTAL ...........$ __________■■ Check enclosed to MCG Foundation, Inc. ■■ CREDIT CARD please complete the following

____MC ____Visa ____AE ____DiscoverCard #_____________________________Exp._______Name on card: _________________________________Signature Required:__________________________________________________________________________Full Name ____________________________________Address ______________________________________City ________________State__________ Zip________Daytime Telephone _____________________________Email Address _________________________________

Gifts are tax-deductible to the extent provided bylaw. MCG fiscal year runs July 1 to June 30. For

more information, call 706-721-6100 or visitwww.mcg.edu/giving.

Farewell

Terris DJ, Gourin CG, Chin E. Minimally invasivethyroidectomy: basic and advanced techniques.Laryngoscope 116:350-356, 2006.

Gourin CG, Xia Z, Han Y, French AM, O’Rourke AK,Terris DJ, Adam B. Serum protein profile analysis inpatients with head and neck squamous cellcarcinoma. Arch Otolaryngol Head Neck Surg132:390-397, 2006.

Weinberger PM, Yu Z, Haffty BG, et al. Molecularclassification of oropharyngeal squamous cell cancersidentifies a subset of human papilloma virus-associated tumors with favorable prognosis. J ClinOncol 24: 736-47, 2006.

Psyrri A, Kassar M, Yu Z, Bamias A, Weinberger PM,et al. Effect of epidermal growth factor receptorexpression level on survival in patients with epithelialovarian cancer. Clin Cancer Res 11:8637-43, 2005.

Psyrri A, Bamias A, Yu Z, Weinberger PM, et al.Subcellular localization and protein levels of cyclin-dependent kinase inhibitor p27 independently predictfor survival in epithelial ovarian cancer. Clin CancerRes 11:8384-90, 2005.

Psyrri A, Yu Z, Weinberger PM, et al. Quantitativedetermination of nuclear and cytoplasmic epidermalgrowth factor receptor expression in oropharyngealsquamous cell cancer using automated quantitativeqnalysis. Clin Cancer Res 11:5856-5862, 2005.

Nordsmark M, Bentzen SM, Rudat V, Brizel D,Lartigau E, Stadler P, Becker A, Adam M, Molls M,Dunst J, Terris DJ, et al. Prognostic value of tumoroxygenation in 397 head and neck tumors afterprimary radiation therapy. An international multi-center study. Radiother Oncol 77:18-24, 2005.

Pang K, Terris DJ. Screening devices: An evidence-based analysis. Am J Otolaryngol 27:112-8, 2006.

Guo D, Han J, Adam BL, et al. Proteomic analysis ofSUMO4 substrates in HEK293 cells under serumstarvation-induced stress. Biochem Biophys ResCommun 337:1308-18, 2005.

McMains KC, Kountakis SE. Fronto-orbital-ethmoidmucoceles. Oper Tech Otolaryngol Head Neck Surg17:19-23, 2006.

Moretz WH III. Subjective headache before and afterendoscopic sinus surgery. Audio-DigestOtolaryngology. The Difficult Headache Patient.Volume 39, Issue 10, 2006.

RESEARCH SUMMER 2006

PublicationsBach KK, Belafsky PC, Wasylik K, Postma GN,Koufman JA. Validity and reliability of the GlottalFunction Index (GFI). Arch Otol Head Neck Surg131:961-964, 2005.

Johnston N, Dettmar PW, Lively MO, Postma GN,Belafsky PC, Birchall M, Koufman JA. Effect ofpepsin on laryngeal stress protein response: Role inLPR. Ann Otol Rhinol Laryngol 115:47-58, 2005.

Halum SL, Postma GN, Bates, DD, Koufman JA.Incongruence between histologic and endoscopicdiagnosis of Barrett’s Esophagus using transnasalesophagoscopy. Laryngoscope 116:303-306, 2006.

Moretz WH III, Postma GN, Burkhead LM, Balan A.High-resolution esophageal manometry. ENT 85:85,2006.

Jameson M, Gross CW, Kountakis SE. FloSeal usein endoscopic sinus surgery: effect on postoperativebleeding and synechiae formation. Am J Otolaryngol27:86-90, 2006.

Jackson LL, Kountakis SE. Classification andmanagement of rhinosinusitis and its complications.Otolaryngol Clin North Am. 381143-53, 2005.

Post G, McMains KC, Kountakis SE. Adult nasaldermoid sinus cyst. Am J Otolaryngol 26:403-5, 2005.

Jameson MJ, Kountakis SE. Endoscopicmanagement of extensive inverted papilloma. Am JRhinol 19:446-51, 2005.

Pellitteri PK, Ferlito A, Rinaldo A, Shah JP, Weber RS,Lowry J, Medina JE, Gourin CG, et al. Planned neckdissection following chemoradiotherapy for advancedhead and neck cancer: is it necessary for all? HeadNeck 28:166-175, 2005.

Becker AM, Gourin CG, Terris DJ. Delayingpostoperative radiotherapy in advanced laryngealcancer. Otolaryngol Head Neck Surg 133:998-9,2005.

Ferlito A, Rinaldo A, Silver CE, Gourin CG, et al.Elective and therapeutic neck dissection. OralOncology 42:13-24, 2006.

Wei WI, Ferlito A, Rinaldo A, Gourin CG, et al.Management of the N0 neck- reference orpreference? Oral Oncology 42:115-122, 2006.

Two new medicaloncologists with head andneck oncology expertisewere recently recruited tothe multidisciplinary Headand Neck Tumor Board.Dr. Teresa Coleman isboard certified in MedicalOncology and came toMCG after previouslyserving on the faculty ofWake Forest University

School of Medicine. Shehas extensive experiencein clinical trials throughcooperative groupsincluding SWOG. Dr.Paul Bilodeau is boardcertified in MedicalOncology and has heldan adjunct teachingappointment at MCGsince 1998. He wasrecruited this year to a full

time faculty appointment as medical director ofMCG Health System’s Cancer Center.

Oral CancerScreening DayThe Department of Otolaryngology-Head and NeckSurgery participated for the fourth consecutive yearin the annual Oral Head and Neck CancerAwareness Week sponsored by the Yul BrynnerHead and Neck Cancer Foundation. As part of anationwide effort to improve early detection ofhead and neck cancer, free oral cancer screeningswere provided on April 19, 2006 with a total of 77individuals screened.

SUMMER 2006 CLINICAL HIGHLIGHTS

New Members Join Head and Neck Tumor Board

STAFF HIGHLIGHTSThe Department of Otolaryngology is pleased to welcome Mrs.Catherine Burress to our healthcare team. Cathy joins us as aPatient Care Assistant, and has taken on the role of surgeryscheduler for the department. She is originally from Plymouth,England where she was a State Enrolled Nurse (comparable to anLPN), specializing in Hospice Care. She and her family (husband,daughter and son) have lived in Greece and Spain while her husbandserved in the military, and recently relocated to Augusta from WestTexas.

Star AwardCongratulations to our physicians, nurses and staff on theiroutstanding customer service scores. The Otolaryngologypractice site was recently recognized with a Star award for theirhigh patient satisfaction results on the Press Ganey customerservice survey.

Teresa Coleman, MD

Paul Bilodeau, MD

CME SUMMER 2006

Grand Rounds2006-2007

Osteomed has been an invaluable supporter of departmentalCME events. Above, representatives from Osteomeddemonstrate new plating technology to MCG Otolaryngologyresidents.

Continuing EducationSymposiaThe 4

thAnnual Porubsky Symposium will be held on

June 9-10, 2006, in conjunction with Chief ResidentGraduation Weekend. This year’s symposium willfeature Dr. Roger Crumley, Professor and Chair ofthe Department of Otolaryngology-Head and NeckSurgery at the University of California-Irvine.

The Department will host the Southern StatesRhinology course under the direction of Dr. StilKountakis on October 19-21, 2006. Featuredspeakers include Drs. John DelGaudio of EmoryUniversity, Frederick Kuhn of the Georgia Nasal andSinus Institute, Rodney Schlosser of MUSC, BrentSenior of UNC, and Michael Sillers of theBirmingham Nasal and Sinus Center.

A third TNE symposium will be held in conjunctionwith Emory University at the Georgia Society ofOtolaryngology annual summer meeting on July 27,2006 in Sea Island, GA.

A symposium on Minimally Invasive Surgery of theThyroid and Parathyroid Glands was held recentlyand featured Dr. Paolo Miccoli of the University ofPisa. This year’s course included two hands-onlaboratories featuring minimally invasive approacheswith live demonstrations by course faculty. Thecourse quickly sold out in advance and due to highdemand, a second course will be held on November10-11, 2006. The fall course will feature Drs. RoccoBellantone of Rome, Italy, Quan-Yang Duh of UCSFand Brendan Stack of the University of Arkansas.

Dr. Dennis Kraus (lower right) was a featured Grand Roundsspeaker in the 2005-2006 calendar year. (1st row from left: Drs.Gregory Postma, David Terris and Dennis Kraus; 2nd row fromleft: Drs. Stil Kountakis, Achih Chen and Christine Gourin)

Course participant Pierre Lavertu demonstrates a successfulminimally invasive thyroid lobectomy.

Speakers scheduled for the coming academic yearinclude Drs. Robert Miller, Executive Director of theAmerican Board of Otolaryngology; JamesNetterville, Professor, Vanderbilt University; GregoryWolf, Professor and Chairman, University ofMichigan; David Eibling, Professor and Vice-Chairman, University of Pittsburgh; and C. GaryJackson of the Otology Group of Vanderbilt.

SUMMER 2006 CLINICAL SPOTLIGHT

Minimally Invasive and Endoscopic Thyroid and Parathyroid SurgeryTheodor Kocher’s description of thyroidectomy (forwhich he was one of the few surgeons to receivethe Nobel Prize in Medicine) has stood the test oftime. Developed in the 1880’s, surgeons for morethan 100 years have performed thyroid surgery withlittle deviation from the original procedure. That haschanged dramatically in the past 5 years, asmodern thyroid surgeons are increasingly rejectingthe notion that an 8-10 cm neck incision isnecessary to remove all thyroid lesions.

Pioneered primarily in Italy by Paolo Miccoli, aminimally invasive thyroidectomy approach whichexploits both Harmonic technology and high-

resolutionendoscopyhas enabledtheperformanceof thyroid andparathyroidsurgerythroughincisions assmall as 3/4of an inch.Not only isthe surgeryable to be

performed with less dissection (enhancing the rateof wound healing) but it results in improvedvisualization by virtue of the 10-20x magnification,similar to endoscopic sinus surgery.

Because of the reduced tissue trauma involved withendoscopicthyroidectomytechniques,drains arevirtually neverrequired, andnearly allpatients aredischarged tohome 1 to 2hours aftersurgery.

The Medical College of Georgia has spearheadedthe development of minimally invasive thyroid andparathyroid techniques in this country. Both byvirtue of experimental and clinical investigations,and educational efforts (see CME column in thisissue) we have helped define indications for severalversions of minimal access neck endocrine surgery.

We were fortunate to beinvited by Laryngoscope toinaugurate the On-line videofeature of that journal withclips demonstrating theendoscopic technique.These can be viewed atwww.laryngoscope.com. Anew publication, ENToday,highlighted our experience

with minimally invasive thyroid surgery.

More recently, Dr.Terris hosted a livewebcast withProfessor Miccolithat featured a briefslide presentation,new video clips,and an onlinequestion andanswer session. The webcast has been archived,and can be viewed by visiting www.OR-live.com, ordownloaded from iTunes.

Ultrasonic ligation of the superiorthyroid artery. The external branch ofthe superior laryngeal nerve can beseen in the background.

The recurrent laryngeal nerve isdissected endoscopically.

Dr. David Terris performs an endoscopic thyroidectomywith the help of two assistants.