Massachusetts Eye & Ear/Harvard Medical School

Massachusetts Eye & Ear/Harvard Medical School 243 Charles Street Boston, MA 02114 (617) 573-3669 Jeremy D. Richmon, MD – Fellowship Co-Director Daniel D. Deschler, MD – Fellowship Co-Director Vanessa Aguilar – Coordinator     Program Website

Number of Fellowships: 1 Duration (in years) / Type: 1 year / 1 yr Clinical Department Chair: Jeremy D. Richmon, MD Faculty: Surgery Daniel G. Deschler, MD Kevin Emerick, MD Derrick T. Lin, MD Jeremy D. Richmon, MD Allen Feng, MD Mark Varvares, MD Radiation-Oncology Paul M. Busse, MD Annie Chan, MD Medical-Oncology John R Clark, MD Lori Wirth, MD Jung Park, MD SLP-speech Glenn Bunting, CCC-SLP SLP-Swallow Tesssa Goldsmith, CCC-SLP Allison Holman, CCC-SLP Racheal Kamer, CCC-SLP

Neurosurgery William T. Curry, MD Fred Barker, MD Radiology Mary Beth Cunane, MD Amy Juliano, MD Pathology William Faquin, MD Peter Sadow, MD Prosthodontics Matthew Jackson, DMD Infectious Disease Marlene Durand, MD Miriam Barshak, MD Research Daniel Faden, MD Srinivas Vinod Saladi, Ph.D

PROGRAM DESCRIPTION

Overview: The Head and Neck Fellowship program at Massachusetts Eye and Ear provides advanced clinical training in head and neck oncology, microvascular free flap and pedicled reconstruction, advanced skull base surgery, transoral robotic surgery, and thyroid and parathyroid surgery. In conjunction with the Massachusetts General Hospital Cancer Center, the fellow will receive comprehensive multidisciplinary training in the management of patients with advanced head and neck cancer.

Objectives: The fellow will oversee the care of all head and neck cancer patients being treated at Massachusetts Eye and Ear/Massachusetts General Hospital. The fellow will assist with the teaching of residents in ablative head and neck surgical procedures. He/she will receive extensive training in free flap and pedicled reconstruction, skull base surgery, and transoral robotic surgery. The fellow is expected to participate in tumor board, multidisciplinary clinic, resident teaching rounds, and specialty tumor board conferences.

Strengths: The Division of Head and Neck Oncology at Massachusetts Eye and Ear serves as the premier referral center for advanced head and neck cancer care in New England. The high clinical volume provides the fellow with extensive experience in the management of these patients. At the Eye and Ear, the fellow will have the unique opportunity for close interaction with national leaders in the fields of radiology, pathology, and speech and swallow therapy, while the collaborative efforts with the Massachusetts General Hospital will provide experience with radiation and medical oncology, neurosurgery, thoracic surgery, and surgical oncology.

Eligibility: The fellow candidate must have completed residency in Otolaryngology – Head and Neck Surgery. Candidates should be board certified or board eligible, US or Canadian citizens, and be eligible for full Massachusetts State Medical Licensure.

Fellows’ Duties/Responsibilities: The fellow plays an integral role on the head and neck service. The fellow is expected to transition to junior faculty level over the course of the year with graduated increased autonomy and independence in managing complex head and neck cancer patients both in and out of the operating room. Fellows typically spend 4 days in the operating room and 1 day in clinic a week. He/she will round on all patients and provide support to the resident team where and when necessary. Fellows are expected to attend multidisciplinary tumor conference. The fellow is expected to be available to manage urgent patient care issues 3 weekends a month.

Research Opportunities:  All fellows are expected to participate in clinical research projects throughout the year.

Supervision, Teaching & Call: Appropriate supervision in and out of the operating room is provided at all times. Increased autonomy is the expectation with comfort being achieved in managing the breadth of head and neck oncologic surgery and reconstruction.

The fellow is expected to teach residents in the operating room and conduct teaching rounds on the ward.

Fellows take occasional adult OHNS call with Mass Eye and Ear faculty. An attending faculty member backs up the fellow at all times..

PAST FELLOWS

• Vicente Resto, MD, PhD – Chair, Professor, University of Texas, Galveston
• Jose Sanclement, MD – Assistant Professor, University of Oklahoma
• Jeremy Richmon, MD – Associate Professor, Mass Eye and Ear – MEEI Profile
• Anthony Nichols, MD – Associate Professor, Division Chief, University of Western Ontario
• Vasu Divi, MD – Assistant Professor, Stanford University Medical Center – Stanford Profile
• Audrey Erman, MD – Assistant Professor, University of Arizona
• Alice Lin, MD – Kaiser Permanente, Affiliated faculty USC,  Los Angeles, CA
• Mark Herr, MD – US Army, San Antonio, TX
• Bharat Yarlagadda, MD – Assistant Professor, Lahey Clinic, Boston University – Lahey Clinic Profile
• Neerav Goyal, MD, MPH – Assistant Professor, Penn State Hershey – Penn State Profile
• Tjoson Tjoa, MD –  Assistant Professor, UC Irvine
• Heather Osborn, MD – Assistant Professor, Yale University
• Joseph Zenga, MD – Assistant Professor, Medical College of Wisconsin

Previous fellow research projects while at MEEI:

Vicente Resto, MD, PhD:

• Resto VA, Chan A, Deschler DG, and Lin DT. Extent of Surgery in the Management of Locally Advanced Sinonasal Malignancies. Head and Neck 2007; 30(2): 222-229.
• Resto, VA, McKenna, MJ, Deschler, DG.  Pectoralis Major Flap in Composite Lateral Skull Base Defect Reconstruction. Arch Otolaryngol Head Neck Surg 2007;133:490-494.

Jeremy Richmon, MD

• Richmon, J.D., Samji, H.A., Deschler, D.G.  National Laryngopharyngectomy and Reconstructive Surgery Survey. Laryngoscope. 2009 Aug;119(8):1472-8.

Anthony Nichols, MD

• Nichols AC, Faquin WC, Westra WH, Mroz EA, Begum S, Clark JR, Rocco JW. HPV-16 infection predicts treatment outcome in oropharyngeal squamous cell carcinoma. Otolaryngol Head Neck Surg. 2009 Feb;140(2):228-34.
• Michaud WA, Nichols AC, Mroz EA, Faquin WC, Clark JR, Begum S, Westra WH, Wada H, Busse PM, Ellisen LW, Rocco JW. Bcl-2 blocks cisplatin-induced apoptosis and predicts poor outcome following chemoradiation treatment in advanced oropharyngeal squamous cell carcinoma. Clin Cancer Res. 2009 Mar 1;15(5):1645-54.
• Nichols AC, Finkelstein DM, Faquin WC, Westra WH, Mroz EA, Kneuertz P, Begum S, Michaud WA, Busse PM, Clark JR, Rocco JW. Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer. Clin Cancer Res. 2010 Apr 1;16(7):2138-46
• Nichols AC, Kneuertz PJ, Deschler DG, Lin DT, Emerick KS, Clark JR, Busse PW, Rocco JW. Surgical salvage of the oropharynx after failure of organ-sparing therapy. Head Neck. 2011 Apr;33(4):516-24.
• Vasu Divi, MD
• Divi V, Lin DT, Emerick KS, Rocco J, Deschler DG.  (2011). Primary TEP Placement In Patients With Laryngopharyngeal Free Tissue Reconstruction And Salivary Bypass Tube Placement. Otolaryngology—Head and Neck Surgery, 144 (3), 474-476.

Mark Herr, MD

• Deschler DG, Herr MW, Kmiecik JR, Sethi R, Bunting G. Tracheoesophageal voice after total laryngopharyngectomy reconstruction: Jejunum versus radial forearm free flap. Laryngoscope. 2015 Dec;125(12):2715-21
• Gray ST, Herr MW, Sethi RKV, Diercks, G, et al. Treatment outcomes and prognostic factors including papillomavirus (HPV) for sinonasal undifferentiated carcinoma: A retrospective review. Head Neck. 2015 Mar;37(3):366-74.
• Emerick KS, Herr MW, Lin DT, Santos F, Deschler DG. Supraclavicular artery island flap for reconstruction of complex parotidectomy, lateral skull base, and total auriculectomy defects. JAMA Otolaryngol Head Neck Surg. 2014 Sep;140(9):861-6.
• Herr MW, Bonanno A, Montalbano LA, Deschler DG, Emerick KS. Shoulder function following reconstruction with the supraclavicular artery island flap. Laryngoscope. 2014 Nov;124(11):2478-83.
• Emerick KS, Herr M, Deschler DG. Supraclavicular flap reconstruction following total laryngectomy. Laryngoscope. 2014 Aug;124(8):1777-82.
• Chambers KJ, Lin DT, Meier J, Remenschneider A, Herr M, Gray ST. Incidence and survival patterns of cranial chordoma in the United States. Laryngoscope. 2014 May;124(5):1097-102.

Bharat Yarlagadda, MD

• Durand ML, Yarlagadda B, Rich DL, Lin DT, Emerick KS, Rocco JW, Deschler DG. The time course and microbiology of surgical site infections after head and neck surgery. Laryngoscope. 2015; 125(5): 1084-9.
• Puram SV, Yarlagadda B, Sethi R, Muralidhar V, Chambers KJ, Emerick KS, Rocco JW, Lin DT, Deschler DG. Transfusion in head and neck free flap patients: Practice patterns and a comparative analysis by flap type. Otolaryngol Head Neck Surg. 2015; 152(3): 449-57
• Yarlagadda B, Deschler DG, Rich DL, Lin DT, Emerick KS, Rocco JW, Durand ML. Head and neck free flap surgical site infections in the era of the Surgical Care Improvement Project. Head Neck. 2015, Jan 12. Epub ahead of print.
• Goyal N, Emerick KS, Deschler DG, Lin DT, Yarlagadda B, Rich DL, Durand ML.Risk factors for surgical site infection after supraclavicular flap reconstruction in patients undergoing major head and neck surgery. Head Neck. 2016 Apr 21. Epub ahead of prin.
• Lin DT, Yarlagadda B, Sethi RK, Feng AL, Shnayder Y, Ledgerwood LG, Diaz JA, Sinha P, Hanasono MM, Yu P, Skoracki RJ, Lian TS, Patel UA, Leibowitz J, Purdy N, Starmer H, Richmon JD. Long-term functional outcomes of total glossectomy with or without total laryngectomy. JAMA Otolaryngol. Head Neck Surg. 2015; 141(9): 797-803.
• Yarlagadda B, Meier J, Emerick K, Lin DT, Deschler DG. Loco-regional control of tongue base adenoid cystic carcinoma with primary resection and radial forearm free flap reconstruction. ENT Journal. 2014. Manuscript accepted.
• Richmon JD, Yarlagadda B, Wax MK, Patel U, Diaz J, Lin DT. Locoregional and free flap reconstruction of the lateral skull base. Head Neck. 2014; 37(9): 1387-91.
• Icuspit P, Yarlagadda B, Garg S, Johnson T, Deschler DG. Heat and moisture exchange devices for patients undergoing total laryngectomy. ORL – Head and Neck Nursing. 2014; 32(1):20-23.
• Yarlagadda B, Hatton E, Huettig J, Deschler DG. Patient and staff perceptions of social worker consultation before surgical therapy for head and neck cancer. Health and Social Work. 2015; 40(2): 120-124.
• Mohan S, Puram SV, Yarlagadda B, Nosé V, Deschler DG. Ossifying Parotid Carcinoma ex Pleomorphic Adenoma. Case Rep Otolaryngol. Vol. 2015, Article ID 395358, 2015.

Neerav Goyal, MD 

• Goyal N, Deschler DG. Minimally Invasive Removal of Mandibular Hardware after Free Flap Reconstruction. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 2015;153(5):888-890.
• Goyal N, Lin D. Management of Recurrent HPV-Related Oropharyngeal Cancer. Curr Otorhinolaryngol Rep. 2015;3(2):56-62.
• Goyal N, Jowett N, Dwojak S, et al. Use of the submental vessels for free gracilis muscle transfer for smile reanimation. Head Neck. June 2016.
• Goyal N, Emerick KS, Deschler DG, et al. Risk factors for surgical site infection after supraclavicular flap reconstruction in patients undergoing major head and neck surgery. Head Neck. April 2016.
• Goyal N, Parikh A, Lin D. Clinical outcomes of transoral robotic-assisted surgery for the management of head and neck cancer. Robot Surg Res Rev. September 2015:95.
• Naunheim MR, Goyal N, Dedmon MM, et al. An Algorithm for Surgical Approach to the Anterior Skull Base. J Neurol Surg Part B Skull Base. 2016;77(4):364-370.

Heather Osborn, MD

• Tarabanis C, Abt NB, Osborn HA. Intraoperative cardiac arrest etiologies in head and neck surgery: a comprehensive review. Head Neck 2018; 40:1299-1304.
• Osborn HA, Rathi VK, Tjoa T, Goyal N, Yarlagadda BB, Rich DL, Emerick KS, Lin DT, Varvares MA, Deschler DG, Durand ML. Risk factors for thirty-day readmission following tissue transfer reconstruction of oncologic defects of the head and neck. Laryngoscope 2018; 128:343-349.
• Colaianni A, Bowe S, Osborn HA, Lin DT, Richmon JD, Hartnick C. Robotic epiglottopexy for severe epiglottic prolapse preventing decannulation. Int J Pediatr Otorhinolaryngol 2017; 102:157-159.
• Abt N, Derakhshan A, Naunheim M, Osborn HA, Deschler DG. Facial nerve sacrifice during parotidectomy: a cautionary tale in pathologic diagnosis. Am J Oto 2017; 38(3):358-359.
• Osborn HA, Lin DT. P16 and HPV discordance in oropharyngeal squamous cell carcinoma: what are the clinical implications? Ann Hematol Oncol 2016; 3(11): 1123.
• Osborn HA, Park JC, Saba NF, Blanchard P, Lin DT. Malignancies of the paranasal sinuses and skull base. Head and Neck Cancers: Evidence-based Treatment with Medical, Surgical, and Radiation Therapy. New York: Demos Medical Publishing/Springer Publishing Company, 2018. 359-370. Print.
• Osborn HA, Deschler DG. Deep neck space infections. Infections of the Ears, Nose, Throat and Sinuses. New York: Springer Publishing Company, 2018. 329-347. Print.

Joseph Zenga, MD

• Bartholomew RA, Zenga J, Lin DT, Deschler DG, Richmon JD. Tip-on-Tip Scapular (TOTS) Flap for Reconstruction of Combined Palatectomy and Rhinectomy Defects. Facial Plast Surg. 2018 Aug;34(4):389-393.
• Zenga J, Parikh AS, Emerick KS, Lin DT, Faquin WC, Deschler DG. Close Margins and Adjuvant Radiotherapy in Acinic Cell Carcinoma of the Parotid Gland. JAMA Otolaryngol Head Neck Surg. 2018 Nov 01;144(11):1011-1016.
• Zenga J, Goldsmith T, Bunting G, Deschler DG. State of the art: Rehabilitation of speech and swallowing after total laryngectomy. Oral Oncol. 2018 Nov;86:38-47.
• Abdul-Aziz D, Zenga J, Deschler DG. The Difficult Secondary Tracheoesophageal Puncture: A Technique for Safe Insertion. ORL J Otorhinolaryngol Relat Spec. 2018 Nov 28;81(1):10-15.
• Chen JX, Zenga J, Emerick K, Deschler D. Sublingual gland excision for the surgical management of plunging ranula. Am J Otolaryngol. 2018 Sep – Oct;39(5):497-500.
• Zenga J, Galaiya D, Choumanova I, Richmon JD. Endotracheal Tube Obstruction Caused by Cuff Hyperinflation. Anesthesiology. 2018 Sep;129(3):581.
• Zenga J, Lin BM, Chen J, Deschler DG. Microsurgical instrument-assisted facial nerve dissection for deep lobe parotid tumors. Laryngoscope. 2018 Nov;128(11):2529-2531.
• Zenga J, Gross J, Fowler S, Chen J, Vila P, Richmon JD, Varvares MA, Pipkorn P. Salvage of recurrence after surgery and adjuvant therapy: A systematic review. Am J Otolaryngol. 2018 Mar – Apr;39(2):223-227.
• Zenga J, Chen J, Deschler DG. Supraclavicular Artery Island Flap in Patients With Ports or Pacemakers. JAMA Facial Plast Surg. 2018 May 01;20(3):256-257.