UW Otolaryngology-HNS
Winter 2023 Newsletter
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Neal Futran, MD, DMD
Allison T. Wanamaker Professor and Endowed Chair
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Dear friends,
With the department revving up again after a joyous holiday season, 2023 is on pace to be another wonderful year. We were able hold in-person retreats in the fall for both faculty and trainees where leaders from across UW Medicine and Seattle Children’s shared near- and long-term plans. We then refined our mission and vision statements to reflect our goals for the department and create alignment with the institutions:
- We provide comprehensive state of-the-art care for all.
- We train the next generation of clinicians and leaders.
- We pioneer research through innovation and discovery.
- We are the preeminent resource for care and consultation throughout the region.
- We promote the field on national and international stages.
- Core values that drive these goals are excellence, leadership, empathy, teamwork, and innovation.
Throughout this newsletter you will see snippets of amazing work our department members are doing to fulfill these aspirations. Key to accomplishing this is financial support beyond what the University can provide. While our faculty pursue all available funding opportunities, philanthropic contributions are necessary to meet the challenge of sustaining excellence in the setting of limited resources.
We are actively looking for partners to support our training programs as well as dedicated research time for faculty. I am available and would love to talk with you about engaging in any aspect of your interest.
With gratitude,
Neal
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MESSAGE FROM THE RESIDENTS |  |
Hello from the ‘23 chiefs!
And we're back! As graduating chiefs, we’ve seen this department through its ups and downs over the past 6 or 7 years. We survived the trials of COVID for the past 3 years, and we’re getting back into the rituals that define the work-hard/play-hard attitude of the UW residency. We loved seeing everyone in the department at the in-person graduation and holiday party, both held at swanky new venues. For those of you who missed it, there is video documentation of our chairman belting out one of his Journey favorites with the entire resident crew. Ski day was also back in full force with zero resident injuries!
The department continues to expand in all directions! The year has brought more UW Oto babies than ever before: six faculty and two resident babies arrived, prompting the research residents to look into babysitting as a moonlighting option.
We’re also looking for new faculty across specialties and hospitals and are excited to learn from more talented academic surgeons, colleagues, and researchers. Our APP team at UW Montlake has grown substantially with the addition of multiple providers including a new inpatient APP team, an initiative driven by resident input to help prioritize resident education.
We can’t wait to read about the tremendous ways UW Oto continues to change and grow in the future as we join your ranks as UW alumni in a few short months!
Best,
Neeraja, Kaitlyn, Grace, and Austin
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We Appreciate Your Support! | | |
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As I'm sure many of you know, U.S. News & World Report partners with Doximity to determine their annual ratings of hospitals and specific departments within them. These rankings do impact our reputation and standing in our community and among our peers. As you reflect on your own relationships, training, and work with the department, I would very much appreciate your participating in the survey and including us in your choices. We always strive for excellence and improvement in all we do. | |
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A particular challenge for UW Otolaryngology is that, although University of Washington Medical Center, Harborview Medical Center, and Seattle Children's Hospital are all part of our program, they are considered as separate entities in the survey and can dilute our impact. If you specifically include the University of Washington Medical Center in your list, that would help the most, and I greatly appreciate your support.
-Neal Futran, MD, DMD
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Bly & Whipple on Resident Selection Disproportionality | |
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The Institute of Medicine and others have argued that a diverse healthcare workforce reflecting population demographics can improve access to high-quality health care, patient satisfaction, and health outcomes. Yet a recent study by UW faculty members Randall Bly, MD, and Mark Whipple, MD, MS, and others examined residency applicants and matches for 11 specialties over a several-year period and found that White applicants continue to be matched at disproportionately higher rates than applicants of underrepresented racial and ethnic groups, suggesting systemic disparities within the residency selection process.
First published in JAMA, the study, titled “Racial and Ethnic Differences in Resident Selection in 11 Specialties, 2013-2018,” was highlighted in the December 22, 2022, edition of Physician’s Weekly. The study recommends further research to find out why these differences exist.
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Parikh and Collaborators Awarded R01 | |
UW Oto professor Sanjay Parikh, MD, FACS, and his collaborators Emily Boss, MD, MPH, from Johns Hopkins, and Ron Mitchell, MD, from UT Southwestern, have received a grant from the National Institutes of Health (R01 HL 166504) to investigate the role of unconscious bias in clinician-family communication and surgical decision-making for children with sleep apnea.
Drs. Mitchell and Parikh will serve as site Primary Investigators, while Dr. Boss will serve as the overall Primary Investigator. Dr. Boss was our 2008 UW Oto fellow in pediatric otolaryngology.
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The University of Washington is among the best universities in the world, according to the 2023 World University Rankings published by Times Higher Education. The UW moved up three positions to tie for No. 26 with Northwestern University. | |
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The UW maintains its position as fourth among U.S. public institutions — behind UCLA, UC Berkeley and the University of Michigan — a spot it has held for the last 7 years. And that's not all . . .
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UW Oto-HNS in Nature:
Immune response to oral cavity tumors negatively impacted by the presence of periodontal pathogens
UW Oto assistant professor Brittany Barber, MD, MSc, and chair Neal Futran, MD, DMD, have recently published an article with Susan Bullman, PhD, from the Fred Hutch Cancer Center detailing the role of periodontic pathogens in oral cavity squamous cell carcinoma.
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This study demonstrated that Treponema denticola and Fusobacterium nucleatum, pathogens associated with chronic periodontitis, are found in high abundance in oral cancers and seem to create bacterial microniches that are highly immunosuppressive. It showed that the bacteria excluded T cells from attacking the microniches, thereby protecting cancer cells. It was observed that several known cancer pathways were upregulated within the microniches as well as known immune checkpoint proteins, CTLA-4 and PD-1. These findings have implications for response of tumors with certain microbial signatures to immune checkpoint therapy.
The work was published in Nature and is currently ongoing.
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Farewell to Dan Graney, MD | | |
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The department marks the loss of Dr. Daniel Graney with deep respect and sadness.
Dr. Graney taught head and neck anatomy and dissection to our residents for many years and was a truly indispensable contributor to the education of generations of UW Oto residents.
For those who went to medical school at UW, Dan was their first introduction to head and neck anatomy. He was a simply extraordinary teacher and facilitator of anatomy instruction.
He will be sorely missed.
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UW Laryngology at Fall Voice | |
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Well, well - what a great joy to gather past fellows and future prospects at Fall Voice in San Francisco! This is the largest Laryngology/SLP meeting anywhere in the world, and I am proud to say that the UW Laryngology/SLP team was all over the program! UW was represented in nearly every session, many panels - it was impressive. This next year’s meeting in Washington DC will feature Lisa Zughni, MS, CCC-LP, as one of the key leaders for the entire conference.
-Al Merati, MD
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UW Oto assistant professor Aria Jafari, MD, and co-authors were recipients of the 2022 Maurice Cottle Clinical Science Research Award from the American Rhinologic Society for their paper titled “Orbital Resection by Intranasal Technique (ORBIT): A new staging system for endoscopically resectable primary orbital tumors," presented by Jafari at the Fall ARS Scientific Meeting in September 2022 in Philadelphia. The award recognizes the best clinical research paper presented at the meeting and comes with a $1,000 prize. | |
Wilson to Serve on ASHA SIG | |
UW Oto speech pathologist Emily Wilson, MS, CCC-LP, a lecturer, clinical educator, and co-director of our Speech-Language Pathology fellowship, has been elected to serve as the Professional Development Committee Manager for the American Speech-Language Hearing Association’s (ASHA) Special Interest Group 3 - Voice and Upper Airway Disorders. ASHA’s SIGs were established to promote the exchange of professional and scientific information among its members. | |
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During her 3-year term, Wilson will be responsible for managing the committee, creating professional development content for SIG3, and recruiting speakers for master classes and invited lectures for the annual ASHA Conventions. She will also review and approve submissions to Perspectives, the professional journal of the ASHA special interest groups.
Wilson will also serve on SIG3's Coordinating Committee, led by Aaron Johnson, PhD, from NYU, and on the Voice and Upper Airway topic committee, where she will work with Amanda Gillespie, PhD, from Emory developing topics and speakers for the ASHA Conventions and writing abstract reviews.
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Adidharma Is Inaugural Haynes Scholar
UW Oto resident Lingga Adidharma, MD, has won the Haynes Award for Innovation in otolaryngology - head and neck surgery from Vanderbilt University. Dr. Adidharma has the additional distinction of being chosen as the inaugural Haynes Scholar. She has been invited to VUMC to present her work: “Artificial Intelligence for Generating Surgical Highlight Reels.”
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Rubinstein Honored at Trio Sections Meeting | |
Merati Featured on BackTable ENT Podcast: “Who Is the Future Otolaryngologist?” | | |
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UW Oto professor Al Merati, MD, spoke for an hour about current and future challenges facing the journey of students and residents in Otolaryngology-HNS. Is academic Otolaryngology serving our incoming students/residents well as they prepare for their careers?
Ep. 80 - Who is the Future Otolaryngologist?
In this episode of BackTable ENT, Dr. Gopi Shah and Dr. Ashley Agan interview Al Merati, chief of laryngology at the University of Washington, about the changing demographics of otolaryngology trainees. Merati asks: “What conversation do we have as leaders in the field to anticipate and plan for your tomorrows long after the laryngosaurs have retired?”
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Kohlberg Quoted in Huffpost
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UW Oto assistant professor Gavi Kohlberg, MD, was recently quoted in a Huffpost article reposted in Yahoo! News titled “The Signs Of Hearing Loss You Shouldn't Ignore.” Kohlberg notes that hearing loss is widely under-diagnosed and under-treated. He examines some of the “regular” annoyances people deal with day to day which may actually be signs of hearing loss. | |
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New Hope for Post-Covid Smell Loss | |
A new study on smell loss after Covid has found evidence of continued inflammation and an immune response that persists long after the virus is gone. | | |
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UW Oto assistant professor Aria Jafari, MD, told NBC News that the study does a good job describing and providing evidence for a possible mechanism that would explain what he sees in his clinic regularly. Current therapies, such as nasal steroid rinse and smell training, have had some success, but patients suffering a persistent loss longer than 18 months are tougher to treat. Jafari hopes that continued research will lead to better understanding and treatment options. | |
UW Student Ryan Carlson Makes Significant Early Impact With JAMA-OtoHNS Paper on Genetic Tool for Hearing Loss
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Ryan Carlson, a student in UW’s Medical Scientist Training Program (MSTP) who was funded by our department’s T32 training grant, has published a large study on the genetics of sensorineural hearing loss in JAMA-OtoHNS, which was recently featured on the front page of UW Medicine | Newsroom. He did this work in the laboratory of his PhD mentor, Professor Mary-Claire King, PhD, in Genome Sciences and the Virginia Merrill Bloedel Hearing Research Center. He accessed a clinical population at the Center for Human Development and Disability with the assistance of audiologist Lisa Mancl, and in the otolaryngology clinic at Seattle Children's with the assistance of Drs. Rubinstein, Horn, Ou, and Sie. The study has received extensive coverage in the media, and Dr. King commented that it attracted an astonishing level of attention. Well done, Ryan! | |
Dahl Awarded Pilot Fund Grant | |
UW Oto associate professor Jake Dahl, MD, PhD, MBA, FACS, was awarded a grant through Seattle Children's Pediatric Pilot Fund, a program from the Center for Clinical and Translational Research (CCTR). The fund is designed to support investigators initiating "proof of concept" testing, obtaining preliminary findings, or conducting other activities necessary to prepare for competitive, full-scale grant applications. Dr. Dahl's project is titled "Role of Fibroblast Growth Factor Recept-2 in Tracheal Development: Implications for a Clinical Airway Management." | |
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UW Medicine Speech Language Pathology Breaks Ground in Diagnostics and Therapeutics | | |
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An image using High-Resolution Pharyngeal Manometry (HRPM) technology | |
Swallowing difficulties are responsible for more morbidity and mortality than nearly any clinical matter cared for by otolaryngologists and speech-language pathologists. High-resolution pharyngeal manometry (HRPM) is an innovative adjuvant tool that is changing the diagnosis and management of pharyngeal dysphagia in many ways. Under the leadership and clinical expertise of Angelina Fitzgerald, CCC-SLP (pictured above), our UW team became one of a handful of programs across the country offering this as both a diagnostic and therapeutic technique for swallowing disorders. The emerging HRPM technology is allowing for a more detailed analysis of swallowing impairments while also guiding both laryngologists and speech-language pathologists into effective decision making. Additionally, HRPM can also facilitate the efficacy of exercise training and coordination/timing of an elicited swallow with use of topographic pattern recognition patient biofeedback. This is an extension of high-resolution esophageal manometry (HREM), used for years by otolaryngologists, gastroenterologists, and foregut surgeons for many disorders. | |
Trythall’s Vision for APPs in Healthcare | |
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A big welcome to our new Advanced Practice Provider (APP), Paige Trythall, who has begun her appointment at our Montlake campus.
A native of Utah, Trythall earned her BS and MS in nursing from the University of Cincinnati (UC). She worked in UC's Department of Otolaryngology-Head and Neck Surgery for 12 years in multiple subspecialties including head and neck and cancer oncology with complex reconstruction, neurotology, laryngology, airway disorders and rhinology. She eventually became the department’s Lead APP, responsible for improving APP productivity (outpatient and inpatient), accurate charge capture, patient accessibility, cross coverage with facility changes, and decreasing wait times.
In 2018 she became Vice President of Advanced Practice Providers at the UC Physicians. In this role, she was responsible for over 400 APPs across all UC specialties. The experience reinforced her sense of the value of diversity in how she communicated and approached conflict and growth. She also had significant exposure to business management and financial planning and budgeting.
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Trythall is a passionate advocate for the role of APPs in patient-centered healthcare. For the past 5 years, Trythall notes, US News and World Report has ranked NPs and PAs in the top 5 best jobs. Further, APPs are a core component to team-based care, especially in the surgical setting, and they help to bridge gaps in the quality, accessibility, and affordability of healthcare across diverse groups. | |
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In otolaryngology alone, the U.S. APP workforce grew approximately 35% over the past 5 years, and there was a 51% increase in APP Medicare billing from 2016- 2021. Utilizing APPs in our own surgical specialty has resulted in an increase in number of new patient visits and decreased wait times while maintaining patient satisfaction and surgeon productivity.
Trythall firmly believes that APPs can play a key role in managing volume efficiently, as well as in diagnosing and treating a variety of otolaryngology conditions. She believes the best approach to integrating APPs is one that embraces patient-centered factors, particularly in relation to access, preference of providers, and operational efficiencies. With her capable leadership, Trythall has already become an invaluable addition to our clinical community.
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Gloves Off at the Trio Bowl | |
Our UW Oto team: Drs. Cassie Pan, Jo Bellairs, and Jacob Brady | Well done to the UW Trio Bowl team who performed admirably at last week’s festivities with the biggest turnout in recent years! UW Oto residents Cassie Pan, Jo Bellairs, and Jacob Brady, under the guidance of UW Oto assistant professor Zain Rizvi, MD, performed well, finishing in the top tier. The great news is that our partners/co-trainees and neighbors at Madigan Army Medical Center (shown below) were this year's winners, Drs. Jagatkumar Patel, Travis Dunn, and Zachary Nygren. We are proud of our long term partnership between UW Oto-HNS and Madigan! | |
The winning team from Madigan Army Medical Center:
Drs. Jagatkumar Patel, Travis Dunn, and Zachary Nygren
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Med Students & Residents Present at Trio | |
From left: Hans Baertsch, Douglas Kempthorne, and Dax Cvancara | |
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UW was well represented at this year’s Triological Combined Sections meeting in sunny Coronado, CA. Three outstanding medical students presented at the meeting:
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Hans Baertsch, MS4, was selected for a podium presentation for work during his dedicated research year at UW (completed in 2022) examining the neurophysiology of the aging larynx (with Cvancara, p.88). Mentor: Dr. Neel Bhatt).
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Douglas Kempthorne, MS4, presented a poster in laryngology research (p.247).
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Dax Cvancara, MS3, a UW medical student who is completing a dedicated research year in the department, presented posters in both rhinology (p.136) and laryngology (with Baertsch, p.241). Mentors: Drs. Aria Jafari and Neel Bhatt.
And, besides competing admirably in the Trio Bowl (see article above), three residents shined bright with a total of four poster presentations in head and neck cancer-related research. Mentor: Dr. Zain Rizvi.
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WISH Surgical Simulation Course | |
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The annual Leslie Watson Facial Plastic Reconstructive Surgery Simulation Course, led by UW Oto faculty Amit Bhrany, Nina Lu, Kris Moe, and Maya Sardesai, was held once again this year at Harborview Medical Center's WISH lab - the premiere simulation training facility for healthcare education serving the WWAMI region (Washington, Wyoming, Alaska, Montana, & Idaho).
During this course, UW Oto-HNS residents benefit from lectures and demonstrations from prominent surgeons from around the region and are able to practice on human cadavers to perfect their skills. For years this course has been a highlight of the academic year and an exceptional opportunity for residents.
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UW Oto-HNS Hosts Pediatric Thyroid Symposium | | |
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Dr. Huston was recently appointed as chief of the Division of Laryngology in the Department of Otolaryngology-Head & Neck Surgery at Washington University in St. Louis. Dr. Huston completed a fellowship in laryngology here at the UW in 2019 and subsequently accepted a faculty position at WUSTL. She specializes in voice, airway, and swallowing disorders and is interested in how mental health and laryngological diseases intersect.
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Anna Castiller, MS, CCC-SLP
Anna Castiller, our 2021-22 speech-language pathology fellow, has accepted a full-time position with Kaiser Permanente in Redmond, WA. In addition to evaluating and treating patients with communication disorders and dysphagia, she has a particular interest in the identification and treatment of pediatric voice disorders. She has also accepted a per diem position at the VA Puget Sound where she will spend 1-2 days a week assessing and treating inpatients and outpatients with voice, swallowing, and cognition issues.
Anna writes, "Upon moving across the country to the beautiful state of Washington, I quickly encountered a wonderful group of clinicians to practice, learn, and grow with. I am grateful for the opportunity to train with the OTO-SLP team and for the relationships formed during my fellowship year."
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Our warmest congratulations to UW Oto assistant professor Zain Rizvi and family! | |
Academic Training and our Field of Otolaryngology – HNS | The mission of our department to train surgeon scientists and scholars is aligned and intertwined with our position in a world-class research medical school that lives inside one of the world’s leading research universities. This is who we are at the University of Washington Department of Otolaryngology – HNS. By all accounts, UW Oto-HNS is indeed living our mission, even as we grow and adapt and learn. | |
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I took this photo recently at the British Natural History Museum in London. I was struck by the mystery of how these beautiful concentric spherical structures form over time and under great pressure. How things become what they become - and how the environment they are in drives this transformation - has been on my mind.
- ALM
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If we are to imagine ourselves as leaders in the field more broadly – and certainly as a place where leaders of the future train – I hope we ask ourselves: What responsibility do we have - or does any otolaryngology program have - to our field in general? Academic otolaryngology nobly serves as a training ground; we are passionate about training and discovery in addition to patient care. But we also serve as gatekeeper to all otolaryngology careers. Is academic otolaryngology attuned to the needs of the field in general? to our workforce? to the impact of subspecialization? to trainee debt? to the appeal to broaden and enrich the pool of applicants to our field and normalize all career paths? To me, these are questions that should be asked by all stakeholders in Otolaryngology-HNS.
Send me your ideas on this topic at amerati@uw.edu - the discussion begins.
-Al Merati, MD
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