More from August 2013 - Vol. 32 No. 08

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Codifying Lateral Graft Tympanoplasty: A House Clinic Legacy
Michael Hoa, MD; Eric P. Wilkinson, MD; and John W. House, MD House Research Institute and House Clinic, Los Angeles, CA The conceptual origins of the lateral graft tympanoplasty exist in early approaches to the repair of tympanic membrane (TM) perforations with artificial drumheads as reviewed extensively by E.A. Chu, MD, and Robert K. Jackler, MD. Of note, physicians Marcus Banzer, James Yearsley, and Joseph Toynbee all proposed and utilized various artificial drumheads to TM perforations (pig bladder, cotton-wool pellet, and India rubber disc, respectively). Subsequently, C. J. Blake utilized a paper patch in 1875 to occlude a TM perforation. The use of the paper patch presaged the first true tympanoplasty—”myringoplasty”—performed in 1878 by E. Berthold, who described two essential elements of the technique: preparation of the margin of the perforation and application of the graft. This technique languished in obscurity due to an inability of Berthold’s contemporaries to replicate his results until 1952, when Horst Wullstein and Fritz Zöllner, who coined the term tympanoplasty, popularized the technique using split-thickness and full-thickness skin grafts. The advent of sulfonamide antibiotics in the 1930s and advances in surgical technique to control infections of the middle ear and mastoid, along with the use of operating microscopes in the U.S., set the stage for development, refinement, and codification of the modern technique for lateral graft tympanoplasty. While Americans Howard P. House, MD, William F. House, MD, and James L. Sheehy, MD, were not the first to detail aspects of the lateral graft tympanoplasty technique, particularly considering German literature, these individuals were innovative in detailing the lateral graft or overlay approach. In particular, Drs. Bill House and Sheehy codified the technique into four distinct steps: Raising the vascular strip, Removal of the canal wall skin and the squamous layer of the TM remnant, Enlarging the ear canal, ensuring that the entire TM annulus is visible, and Application of ear canal skin. While some controversy exists in the English literature on the origin of using temporalis fascia as a graft for perforation repair, this use of temporalis fascia is attributed to J. Heermann in Germany and Lloyd A. Storrs in the U.S. in 1963. Dr. Sheehy acknowledged this advance and transitioned from canal skin grafts to temporalis fascia grafts, with dramatic improvement in surgical results. This resulted in the final codification of the modern lateral graft tympanoplasty technique, replacing application of ear canal skin to the perforation with placement of the fascia graft and replacement of the ear canal skin. This article was presented as an Otolaryngology Historical Society paper in 2010. For sources and further reading, visit www.entnet.org/Bulletin for a longer version of the article. William F. House, MD, 1923-2012. Besides his later work with cochlear implants, William House helped codify technical aspects of the lateral graft tympanoplasty. James L. Sheehy, MD, 1926-2006. Dr. Sheehy brought an outcomes research approach to the realm of otologic surgery and helped define how otologic research is conducted today. His codification of lateral graft tympanoplasty made the technique more accessible to later generations of surgeons.
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Operation Restore Hope: Cebu, Philippines
David J. Crockett, MD Resident Physician at the University of Utah Throughout my life I have enjoyed assisting and serving those less fortunate. I have also felt an obligation to use the skills I have learned to benefit others. One of my mentors at the University of Utah, Harlan R. Muntz, MD, has worked closely with and participated in multiple humanitarian missions with an organization titled Operation Restore Hope (ORH). Since 1992, ORH has been dedicated to the management and care of underprivileged children with cleft lip and palate deformities in the Philippines. In February, I had the opportunity to assist ORH by participating in a humanitarian trip to Cebu, Philippines. The team consisted of surgeons from the United States, including Dr. Muntz, Robin A. Dyleski, MD, Craig W. Senders, MD, and Shane A. Zim, MD. Anesthesiogists, nurses, and medical assistants from Australia also donated their expertise. Finally, many local nurses, students, and other volunteers also participated in the care of the patients. The Rotary Club of Cebu helped organize the trip in conjunction with ORH. The Rotary Club was an amazing host and without their local participation such a trip would have been difficult. A Seventh-Day Adventist hospital (H.W. Miller Hospital) volunteered two rudimentary operating rooms. Two operating beds were placed in each room in order to perform four cases simultaneously. An old gymnasium was turned into a recovery room using cots, and student nurses assisted the patients. Our weeklong trip involved the assessment, medical and surgical management, and post-operative care of children with cleft deformities. All patients originated from poor socioeconomic circumstances. The need for cleft surgery is greater than I imagined in this region of the world. The turnout of patients and families desiring treatment was overwhelming. In the end, we were able to complete 85 cleft surgeries. This mission trip was not a sacrifice, but an inspiring, rewarding, and defining experience. The capability of these children to enjoy life and have fun in spite of their deformity was inspiring. The overpowering gratitude expressed by the parents and families after the surgeries was extremely rewarding. The experience to refine my skills by collaborating and working with proficient medical caretakers, who have a strong desire to serve those less privileged, has motivated me to continue with further humanitarian efforts throughout my life. On the last day, we performed a cleft lip repair on a 10-year-old girl. The change in her countenance, when we saw her on rounds after surgery, confirmed my conviction of how important these mission efforts are to the people that they treat. I only wish that she could have had such a surgery much earlier in her life. I highly recommend taking advantage of any opportunity to perform humanitarian service. The satisfaction you will receive by making such a large impact on a person, who is unable to compensate you, will be extremely satisfying and gratifying. I would like to thank my supervising physician, Dr. Muntz, for the invitation to participate in this rewarding humanitarian mission and the AAO-HNSF Humanitarian Efforts Committee and the Alcon Foundation for sponsoring my trip. To learn more about Operation Restore Hope, visit www.operationrestorehope.org.
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Education Product Abound at the AcademyU® Learning Station Demonstration
The 2013 Annual Meeting and OTO EXPOSM is the world’s best gathering of otolaryngologists, together with the world’s largest collection of products and services for the specialty. In keeping with this tradition, many of the education products offered through AcademyU® will be on display at the AcademyU® Learning Station. AcademyU®, the Foundation’s comprehensive otolaryngology education source, contains hundreds of learning options presented in a variety of formats to complement different learning styles. Developed by leading expert volunteers, the materials are designed to deliver relevant education that is meaningful to your practice. The education resources are divided into five platforms: Knowledge Resources, Subscriptions, Live Events, eBooks, and Online Education. In this article, we will explore some of the various education resources that will be demonstrated at the Vancouver Convention Center by the knowledgeable Academy staff. The AcademyU® Learning Station will demonstrate AcademyQ: Otolaryngology Knowledge Assessment Tool™. The award-winning app was developed by nationally recognized otolaryngology-head and neck surgery experts and offers otolaryngology-head and neck surgeons the opportunity to review information they need to prepare for certification examinations. More than 400 questions are presented in eight specialty sections. Every question is accompanied by an explanation of the correct answer with references for further study. The user can highlight text, mark questions for future review, and record audio and text notes. Also on display will be our library of more than 100 online courses and lectures covering all aspects of the specialty. Online courses are self-paced learning activities developed through the AAO-HNSF education committees. Online lectures are based on the annual meeting instruction courses of the same name. Each lecture provides the highlights of these key sessions. Online courses and lectures can be taken to earn AMA PRA Category 1 Credit™ and are available at no charge to all Academy members. Six eBooks will be available for review. These include the Resident Manual of Trauma to the Face, Head, and Neck and Primary Care Otolaryngology, 3rd edition. All eBooks are available for free download on the website and can be viewed in PDF form on most computers and mobile devices. The ENT Exam Video SeriesSM, designed for medical students, residents, non-otolaryngologist health professionals and staff, will also be on display at the Learning Center. The series depicts how to perform a thorough examination of the ear, oral cavity, face, nose, neck, nasopharnyx, and larynx. Images and video of normal anatomy, normal variances, and common abnormalities have been added to enhance the learning experience. The ENT Exam Video SeriesSM is hosted on the official AAO-HNS YouTube page and is linked to the AcademyU® homepage. The Academy staff onsite will be able to give attendees information about and opportunities to subscribe to all the various education products offered through AcademyU®, including Home Study Course, Patient Management Perspectives in OtolaryngologySM (PMP), COOLSM, and others. For a complete listing of all AcademyU® education resources visit www.entnet.org/academyu.
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Basic & Translational Miniprogram and Neel Lecture Focus on Laryngology/Broncho-Esophagology
Monday, September 30 8:00 am–11:50 am, East Ballroom A Joel H. Blumin, MD, developed the 2013 AAO-HNSF Basic & Translational Research mini-program with the assistance of Clark A. Rosen, MD, chair, Voice Committee, and Milan R. Amin, MD, chair, Airway and Swallowing Committee. The guest speakers are leaders in the field of Laryngology/Broncho-Esophagology. The 2013 Neel Distinguished Research Lecturer, Martin A. Birchall, MD, FRCS, was selected to complement these miniseminars. Miniseminar: Reflux—Pathophysiology to Management Miniseminar: Airway—Advances in Management Miniseminar: Voice—From Cells to Song Miniseminar: Dysphagia—From Science to Clinical Practice Tuesday, October 1 9:30 am-10:30 am, East Ballroom B Neel Distinguished Research Lectureship Martin A. Birchall, MD, FRCS, FMedSci Dr. Birchall’s research revolves around restoration of laryngeal function and understanding of laryngeal inflammation. In 2008, he was co-leader of the team that performed the world’s first stem cell-based organ transplant, an airway in a 30-year-old woman. In 2010, the team replaced the entire trachea in an 11-year-old boy at Great Ormond Street Hospital for Children, London. In October 2010, Dr. Birchall was part of the multinational surgical team at UC Davis that performed the world’s second documented (and first functionally reinnervated) laryngeal transplant, with the recipient now talking and swallowing. Dr. Birchall runs a research program looking at ways of applying stem cells and tissue engineering to disorders of the head and neck, airways, and esophagus. Clinically, he specializes in voice and swallowing disorders, as one of four internationally renowned laryngologists at the Royal National Throat Nose and Ear Hospital/Ear Institute. Dr. Birchall was Morgan Stanley/Daily Telegraph Briton of the Year in 2008 (Science and Technology) and was the first ENT surgeon to be elected to the Academy of Medical Sciences in 2010.
Mark Your Calendars: Health Policy Education Opportunities at 2013 Annual Meeting
During the 2013 AAO-HNSF Annual Meeting & OTO EXPOSM in Vancouver, British Columbia from September 29-October 2, the Physician Payment Policy (3P) Workgroup and AAO-HNS Health Policy team are proud to put together two miniseminars for attendees. These miniseminars are a must attend for any member, so mark your calendars. Alternative Payment Models and Academy Advocacy Learn about the future direction of payment and importance of 3P and Academy’s role in future directions of payment, and the importance of developing future payment models. Topics include updates on Accountable Care Organizations (ACOs) bundled payment and risk adjustment, and quality reporting initiatives. In addition, panel members will discuss Academy advocacy progress and accomplishments in the health policy realm, such as Wellpoint’s revision of its coverage policy for tonsillectomy in children. By attending this miniseminar you will learn about current healthcare reform initiatives, new payment models, Academy efforts on Capitol Hill related to SGR repeal, the role of the BOG in development of future payment strategies, measure development, regulation, and reporting. Pearls on How to Successfully Transition to ICD-10 Coding by 2014 Based on feedback from the Centers for Medicare & Medicaid Services (CMS) the implementation date for ICD-10 has been finalized as October 1, 2014. In light of this, the Academy has undertaken numerous efforts to aid Members in preparing for this transition. Prior efforts include the development of an ICD-10 Superbill, available on the Academy website: http://bit.ly/entICD10. In addition, the health policy team and 3P leaders are offering a 2013 miniseminar that will assist otolaryngologists in determining the impact the transition from the International Classification of Diseases 9th Version of diagnostic codes (ICD-9) to the 10th version ( ICD-10) will have on their practice and other healthcare providers. The presentation will provide a timeline of essential activities for successful implementation. In this session the Academy will provide a third party payer perspective, a physician perspective, and an administrator perspective on ICD-10 and how practices and providers can prepare to ensure a smooth transition. This is the largest change to the healthcare system in our history and careful planning and action will be necessary in order to successfully implement ICD-10. The deadline for transitioning to ICD-10 is October 1, 2014 and it is anticipated to cause problems for unprepared physicians and practices. For physicians in private practice, it will be especially important to learn how you can successfully make this important administrative/coding transition. In this miniseminar we will explore common implementation hurdles, outlining why it is important to get started now, and how physicians will be impacted by clinical documentation issues. Finally, we will review the most commonly billed ENT ICD-9 diagnosis codes and provide examples reflecting what they will look like in ICD-10-CM. These and other miniseminars presented at the 2013 annual meeting are aimed at educating members on issues that affect everything from their practice to the specialty as a whole. For more information on these, and other seminars, check out the Academy’s Annual Meeting & OTO EXPO website and preliminary program at www.entannualmeeting.org.
Coding Resources
The Academy Health Policy team reminds members that it offers a wealth of coding and practice management resources, which are available to you on our website. Resources include information related to common member inquiries such as requests for global periods, questions about changes to CPT codes, national reimbursement rates, payer denials, and more. Please note that as of July 30, 2013, the coding hotline will no longer be available through the Academy. Members can email healthpolicy@entnet.org with questions about existing, and future, resources that would be beneficial for ongoing training and education related to coding. Coding education AAO-HNS Coding and Reimbursement Workshops conducted by Karen Zupko & Associates. Workshops: www.entnet.org/coding Coding guidance and detailed information about coding restrictions or changes to CPT codes CPT for ENT coding guidance articles: http://bit.ly/CPT4ENT Information on NCCI /MUE Edits: http://bit.ly/ENTcoding E/M Documentation guidelines: http://bit.ly/EMguide Code changes for CY 2013: http://bit.ly/2013codes Top 100 ENT billed services for CY 2013 (hospital outpatient and physician office settings): http://bit.ly/top100codes Assistance with payer appeals Template payer appeal letters for services commonly denied: http://bit.ly/entappeals Information and materials to support your practice in transitioning from ICD-9 to ICD-10 coding ICD-9/10 Information: http://bit.ly/entICD10 Background on the AMA CPT® Editorial Panel and RUC Processes Information on the RUC and CPT process, including the Academy’s New Technology Pathway process: http://bit.ly/entcptrvu Information on CMS quality initiatives and reporting programs PQRS: Information on PQRS:http://bit.ly/entPQRS PQRS Fact Sheet: http://bit.ly/PQRSfacts EHR Meaningful Use: Information on EHR Meaningful Use: http://bit.ly/entEHR EHR Meaningful Use Fact Sheet: http://bit.ly/EHRfacts E-Prescribing: Information on E-Prescribing: http://bit.ly/entErX E-Prescribing Fact Sheet: http://bit.ly/eRxfacts
Legislative and Political Advocacy ‘By the Numbers’
Wondering about AAO-HNS legislative and political advocacy efforts in 2013? Below is a brief overview of numbers associated with various AAO-HNS advocacy programs (January 1–June 30, 2013). 224 = Number of federal legislators (U.S. House and U.S. Senate) cosponsoring legislation to repeal the Independent Payment Advisory Board (IPAB). The AAO-HNS and others in the physician community continue to advocate for a “clean” vote on H.R. 351/S. 351. 1,733 = Number of AAO-HNS members who receive timely Government Affairs-related updates via the ENT Advocacy Network. To sign up, email govtaffairs@entnet.org. 225 = Number of Capitol Hill meetings with key Members of Congress and/or their staff. 26.5 = Percent cut to Medicare physician payments that was averted in January 2013. Efforts are underway to develop a legislative framework to permanently repeal the flawed SGR formula. 40 = Percent increase in ENT PAC receipts in the first two quarters of 2013. To learn more about ENT PAC, visit www.entpac.org (log-in using your AAO-HNS user-ID and password). 314 = Percent increase in the number of followers for Government Affairs social media tools, such as Twitter, Facebook, and LinkedIn. 139.1 = Cost (in billions) to repeal the flawed Sustainable Growth Rate (SGR) formula. This latest estimate from the Congressional Budget Office (CBO) represents a drastic reduction compared to previous projections that SGR repeal would cost as much as $300 billion. 65 = Number of political events attended to strengthen and/or establish key relationships with Members of Congress and their staff. 32 = Percent increase in ENT PAC Investors during the first two quarters of 2013. 345 = Approximate number of tweets sent from @AAOHNSGovtAffrs this year.
Legislative Spotlight: Audiology on the Offensive in the 113th Congress
More than two years since the Affordable Care Act (ACA) became law, it is now much easier to decipher the good, the bad, and the ugly in terms of how the new law will work and where additional reforms may be required. However, many key questions remain. One of the main tenets of the ACA was the importance of providing healthcare coverage to more, if not all, individuals. Yet, the law failed to address growing physician workforce shortages and the cautionary words from the physician community that coverage does not equal access. As we approach major ACA implementation deadlines scheduled for this fall, many policymakers are examining the access issue with a wider lens and looking toward various non-physician providers as a means to accommodate the pending flood of newly covered individuals. The United States is fortunate as we offer talented healthcare professionals across a wide spectrum of training and skill levels. In theory, the ACA seeks to increase quality, efficiency, and better promote collaboration and the value of team-based care within the healthcare delivery system. These are good concepts that in many ways go hand-in-hand with the diversity that is already present in our healthcare system. However, we must remain diligent in our efforts to ensure that the right provider is delivering the appropriate care at the correct time. The AAO-HNS believes that all properly trained and licensed healthcare professionals should be able to practice to the full extent of their applicable scope of practice. However, as healthcare reform implementation continues, we hope policymakers continue to view physician-led, team-based care as the core of our current and any future healthcare delivery system. To put this particular notion in context, we need only look to pending legislation in the 113th Congress. This year, the AAO-HNS expects the introduction of three separate audiology-related bills. The bills, which represent both new and old legislative strategies, highlight how the ACA has in some ways provided a new platform by which some non-physician providers are attempting to broaden their role in terms of healthcare delivery. The AAO-HNS has been carefully monitoring the various legislative proposals, and in some cases has successfully collaborated with the audiology community to ensure patients continue to have access to the highest quality hearing healthcare. Read on for a brief overview of each audiology initiative and the accompanying AAO-HNS position. ‘Direct Access’ As in past years, the American Academy of Audiology (AAA) is continuing its pursuit of direct access to Medicare patients without a physician referral. While audiologists play a critical role in providing quality hearing healthcare, AAA’s desire for its members to independently diagnose hearing disorders transcends their level of training and expertise. Hearing and balance disorders are medical conditions and require, by necessity, a full patient history and physical examination by a physician. In its 2007 report on the audiology direct access issue, the Centers for Medicare & Medicaid Services (CMS) declared that referrals from physicians are the “key means by which the Medicare program assures that beneficiaries are receiving medically necessary services, and avoids potential payment for asymptomatic screening tests that are not covered by Medicare…” Bypassing a physician evaluation and referral can lead to misdiagnosis and inappropriate treatment that could cause lasting, and expensive, damage to patients. The AAO-HNS continues to oppose direct access and will work to ensure our position is well understood on Capitol Hill once legislation has been introduced. Amending the Definition of ‘Physician’ In November 2012, the Academy of Doctors of Audiology (ADA) announced its “18 x 18” campaign. The goal of the new campaign and pending legislative initiative is to amend Title XVIII (18) of the Social Security Act to include audiologists in the definition of “physician” by the year 2018. The 18 x 18 Campaign is the most ambitious, and troubling, audiology proposal. Although many audiologists now receive a “doctor of audiology,” or AuD degree, their training is not equal to that of an MD/DO who has also completed residency, and in some cases, additional fellowship in otolaryngology–head and neck surgery. The AAO-HNS strongly opposes the “18 x 18” campaign and is working to ensure Members of Congress and their staffs are well-informed about the expertise and/or training associated with MD/DO physicians as compared to non-physician providers with advanced “doctor” degree such as an AuD. Comprehensive Audiology Benefit (H.R. 2330) Recognizing the pitfalls associated with direct access and the “18 x 18” campaign, the American Speech-Language and Hearing Association (ASHA) has taken a much more pragmatic approach in elevating the audiology professional. By way of its new initiative, introduced as legislation (H.R. 2330) for the first time this year by U.S. Rep. Gus Bilirakis (R-FL-12), ASHA hopes to better align Medicare coverage of comprehensive audiology services with current billing and reimbursement standards of other non-physician therapeutic services covered by Medicare (PT, OT, SLP). In recognizing the importance of team-based care, H.R. 2330 specifically retains the requirement for a physician referral, ensures physician oversight of the plan of care, and preserves state scope-of-practice requirements. Prior to the introduction of H.R. 2330, representatives from ASHA solicited feedback from the AAO-HNS on its proposal, demonstrating it shares the AAO-HNS’ belief that strong, positive collaboration between audiologists and otolaryngologist-head and neck surgeons will result in the highest quality care and outcomes for individuals seeking hearing healthcare services. As a result, the leadership of the AAO-HNS has approved a “support” position on H.R. 2330. As implementation of the ACA moves forward, the AAO-HNS Government Affairs team will continue to monitor the direct and indirect impact the law may have on our members, their practices, and their patients—including any efforts to inappropriately expand scope of practice. For more information about audiology legislation in the 113th Congress and/or updates on other AAO-HNS legislative priorities, email legfederal@entnet.org or visit www.entnet.org/advocacy.
Events Surrounding the Annual Meeting
Join us for Alumni Night on Tuesday, October 1 The following schools will be represented at Alumni Night*. All receptions will take place from 6:30 pm to 8:00 pm at the Vancouver Convention Center. AAO-HNS/F International Instructors Reception Alumni Reception For: The Greater Metropolitan New York Residency Programs: Albert Einstein College of Medicine; Columbia/Cornell; Manhattan Eye, Ear and Throat Hospital; Mt. Sinai School of Medicine; New York Eye and Ear Infirmary-New York Medical College; New York University School of Medicine; SUNY Downstate Long Island College Hospital; University of Medicine and Dentistry of New Jersey Cleveland Clinic Head & Neck Institute & CWRU/University Hospitals ENT Institute Cochrane Scholars Alumni Event Georgia Regents University Alumni Reception Indiana Alumni and Friends Otolaryngology Reception Northwestern University Alumni Reception Saint Louis University School of Medicine Alumni Reception SIU School of Medicine Alumni Reception Stanford School of Medicine Alumni Reception Tufts Medical Center-Boston Medical Center Alumni Reception UCSF OHNS Alumni Reception UIC Alumni Reception University of Kansas, Missouri and Nebraska Alumni Reception University of Louisville Alumni Reception University of Maryland Alumni Event University of Michigan Alumni Reception University of Virginia Department of Otolaryngology-Head and Neck Surgery Alumni Reception University of Wisconsin Alumni Reception UT Southwestern Medical Center Alumni Function UTHSC-Otolaryngology Alumni Reception Vanderbilt Alumni Open House Washington University Department of Otolaryngology-Head & Neck Surgery Alumni Reception Wayne State University Alumni Reception Yale ENT Alumni Reception *Confirmed Alumni Receptions as of 7-15-2013. For a full list of affiliate events, visit www.entannualmeeting.org. Saturday Program ACS Ultrasound Course: Thyroid and Parathyroid Ultrasound Skills-Oriented Course* Robert A. Sofferman, MD, course director 8:00 am–4:30 pm Saturday, September 28 The objective of this course is to introduce the practicing surgeon to office-based ultrasound examination of the thyroid and parathyroid glands. The distinction of normal from malignant lymphadenopathy is emphasized with a demonstration of the comprehensive examination of lymph node basins in cervical zones I-VI. The process of ultrasound guided FNA of thyroid nodules and enlarged lymph nodes is demonstrated in didactic lecture format. Other conditions that may mimic thyroid pathology or are relevant to an understanding of cervical ultrasound will also be illustrated. In addition, skill sessions allow the surgeon to learn varied techniques of FNA of lesions in phantom models. Patient volunteers with thyroid and parathyroid pathology and lymphadenopathy will allow supervised hands-on experience with transverse and longitudinal ultrasound methods. Attendees will be instructed in the practical details and hurdles in developing office-based ultrasound. Perform office-based examination of the thyroid and parathyroid glands and related pathology; Demonstrate comprehensive examination of cervical lymph nodes in levels I-IV; Characterize differences between normal and malignant lymph nodes; Demonstrate the process of ultrasound-guided fine needle aspiration (FNA) Demonstrate through a hands-on skill session, the above skills in live and phantom models. To learn more or to register, visit http://www.entannualmeeting.org/13. *Prerequisite: “Ultrasound for Surgeons: The Basic Course,” is a prerequisite module that must be completed prior to attending this program. The Basic course is available only via CD-ROM and must be purchased separately online at http://www.acs-resource.org. The CD-ROM course will be mailed directly to your attention and takes about one hour to complete. Pricing for Ultrasound Workshop: Member: $1,350 Non-Member: $1,550 Resident Member: $675 Resident Non-Member: $775 Specialty Society Meetings during the Annual Meeting in Vancouver, BC, Canada (AAFPRS) American Academy of Facial Plastic and Reconstructive Surgery Course September 28 Essentials in Facial Plastic Surgery course —free to all residents, 1:00 pm-6:00 pm at the Pan Pacific Vancouver Hotel (AAOA) American Academy of Otolaryngic Allergy September 27-28 Hotel Fairmont Vancouver (ANS) American Neurotology Society September 28 Vancouver Convention Centre (ARS) American Rhinologic Society September 28 Hyatt Regency Vancouver (SOHN) Society of Otorhinolaryngology and Head and Neck Nurses September 27-October 1 Westin Bayshore Hotel
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Otology/Neurotology
= Hands-on ($70/hour) = Mini-course ($50/hour) = Audience Response ($50/hour) = Two-hour course       Miniseminars Advances in the Objective Diagnosis of Meniere’s Disease Supported by the Equilibrium Committee Jeremy Hornibrook, MB, FRACS (Moderator); William P. R. Gibson, MD; Leonardo Manzari, MD; Tsutomu Nakashima, MD Auditory Neurology: Understanding Presbycusis Supported by the Geriatric Otolaryngology Committee Brian J. McKinnon, MD, MBA (Moderator); George A. Gates, MD; Douglas D. Backous, MD; Howard W. Francis, MD Build a Better Ear: What’s New in Chronic Ear Disease Supported by the Medical Devices and Drugs Committee and the Otology and Neurotology Education Committee Riccardo D’Eredita, MD (Moderator); Anand K. Devaiah, MD; Kenneth H. Lee, MD, PhD; John L. Dornhoffer, MD; Robert C. O’Reilly, MD Contemporary Management of Chronic Ear Disease Supported by the Otology and Neurotology Education Committee Brandon Isaacson, MD, Dennis I. Bojrab, MD (Moderators); Marc L. Bennett, MD; David Kaylie, MD; Frank Manley Warren, MD; David S. Haynes, MD; Eric E. Smouha, MD Emerging Concepts in Migraine Associated Dizziness Supported by the Equilibrium Committee Michael Hoffer, MD (Moderator); Joel A. Goebel, MD; Kim R. Gottshall, PhD; Jeffery P. Staab, MD Endoscopic Ear Surgery: Tips and Pearls Supported by the International Working Group on Endoscopic Ear Surgery Joao Flavio Nogueira, MD (Moderator); Muaaz Tarabichi, MD; Daniele Marchioni, MD; Livio Presutti, MD; David Douglas Pothier, MBCbH Neurotologic Emergencies: What the General ENT Needs to Know Supported by the American Neurotology Society (ANS) Sujana S. Chandrasekhar, MD (Moderator); George T. Hashisaki, MD; Lawrence Robert Lustig, MD; Hilary Brodie, MD, PhD; Moises A. Arriaga, MD Otogenic Pain and Aural Fullness: Mystery Diagnosis Supported by the Otology and Neurotology Education Committee Alan G. Micco, MD (Moderator); Cliff Megerian, MD; Elizabeth H. Toh, MD; Simon Ignacio Angeli, MD Practical Otologic Considerations in Head Injury Supported by the Trauma Committee Michael R. Holtel, MD (Moderator); Philip D. Littlefield, MD; Michael Hoffer, MD; Ben J. Balough, MD Temporal Bone Radiology: Beyond the Basics Ashkan Monfared, MD, Mohammad Reza Taheri, MD (Moderators); Robert K. Jackler, MD; Nikolas H. Blevins, MD; Richard K. Gurgel, MD The Martha Entenmann Tinnitus Research Center Inc.: Abraham Shulman, MD; and Barbara Goldstein, PhD; International Tinnitus Miniseminar: New Concepts in Electrophysiology and Tinnitus Supported by the Otology and Neurotology Education Committee Michael Hoffer, MD (Moderator); Carlos Olivera, MD; Leslie Prichep, MD; Tobias Kleinjung, MD; Abraham Shulman, MD New Concepts in Electrophysiology and Tinnitus Michael Hoffer, MD; Carlos Olivera, MD Leslie Prichep, MD; Tobias Kleinjung,MD; Abraham Shulman, MD Instruction Courses 3-D Projected Stereoscopic Anatomy of the Temporal Bone Michael T. Teixido, MD The Auditory Brainstem Implant and Neurofibromatosis Type 2 William H. Slattery, MD; Derald E. Brackmann, MD Auditory Neuropathy: An Evidence-Based Clinical Approach Christina Runge, MD; David R. Friedland, MD, PhD Balance Problems in the Elderly Stephen J. Wetmore, MD; David E. Eibling, MD; Kim T. Gotshall, PT Bone-Anchored Hearing Devices: New Rehabilitative Options John K. Niparko, MD; Anders M. R. Tjellstrom, MD, PhD; Mans Eeg-Olofsson, MD; Charles Limb, MD BPPV Management: Lateral, Posterior, and Conversions Judith A. White, MD The BPPV’s that Don’t Get Well Mans Magnusson, MD, PhD Chronic Ear Disease: Surgical Decisions and Techniques David S. Haynes, MD; George B. Wanna, MD The Chronic Ear Surgical Techniques and Avoiding Complications Paul R. Lambert, MD Chronic Otitis Media: Ear Surgery Derald E. Brackmann, MD; William M. Luxford, MD; Rick A. Friedman, MD, PhD Classification of Cholesteatoma: Surgical Strategy Jose N. Fayad, MD; Bernard G. Fraysse, MD Cochlear Implantation in Infants and Children Blake C. Papsin, MD, MSc, FRCS; Adrian L. James, DM, FRCS Cochlear Implantation of Obstructed and Malformed Cochleae J. Thomas Roland, MD; Daniel H. Coelho, MD Cochlear Implants and Hands-On Electrode Insertion Workshop Thomas J. Balkany, MD; Peter Sargent Roland, MD; William M. Luxford, MD; Bruce J. Gantz, MD Current Trends in the Management of Sudden Hearing Loss David S. Haynes, MD; George B. Wanna, MD Diagnosis, Treatment, and Results of Cochlear Reimplantation Susan B. Waltzman, PhD; J. Thomas Roland, MD Diagnostic Evaluation and Management of Acute Facial Palsy Elizabeth H. Toh, MD; Alan G. Micco, MD Ear Pressure and Pain William H. Slattery, MD; Eric P. Wilkinson, MD Evaluating the Tinnitus Patient and Starting a Tinnitus Center Hamid R. Djalilian, MD Glomus Tumors and Skull Base Surgery Derald E. Brackmann, MD; William H. Slattery, MD; Rick A. Friedman, MD, PhD High Resolution 3-D Cone Beam CT Imaging D. Bradley Welling, MD, PhD; Aaoaki Yanagihara, MD, PhD Hydroxyapatite and Titanium Ossicle Implants: Which to Choose Robert Battista, MD; Rex S. Haberman, MD Hydroxyapatite Cement in Temporal Bone Surgery John F. Kveton, MD Implantable Hearing Devices: Indications, Surgery, Outcomes Jose N. Fayad, MD; Jack J. Wazen, MD Intratympanic Pharmacotherapy for Inner Ear Disorders Lorne S. Parnes, MD, FRCSC; Sumit K. Agrawal, MD, FRCSC The Latest Spin on Benign Paroxysmal Positional Vertigo Lorne S. Parnes, MD, FRCS, Sumit K. Agrawal, MD, FRCS Management Congenital Aural Atresia and Acquired Canal Stenosis Paul R. Lambert, MD Management of Temporal Bone Trauma Hilary Brodie, MD, PhD; Rodney C. Diaz, MD Managing Radiation Changes to the Ear and Temporal Bone Paul W. Gidley, MD Mastoid Obliteration Techniques and Results John L. Dornhoffer, MD; Michael B. Gluth, MD Mastoidectomy for the General Otolaryngologist Rex S. Haberman, MD Medical-Legal Evaluation of Hearing Loss: Review and Update Robert A. Dobie, MD Meniere or Migraine: Similarities, Differences, Treatments Jack J. Wazen, MD; Herbert Silverstein, MD Migraine-Related Dizziness Stephen J. Wetmore, MD; David E. Eibling, MD; Kim R. Gotshall, PT Modern Mastoid Surgery: New Techniques Bruce J. Gantz, MD; Marcus D. Atlas, MD Novel Ossicular Reconstruction Techniques Michael D. Seidman, MD; Eric M. Kraus, MD Ossiculoplasty Edwin M. Monsell, MD, PhD Ossiculoplasty Techniques with Hydroxyapatite Cement Joel A. Goebel, MD Otosclerosis Surgery: Past, Present, and Future John W. House, MD; John C. Goddard, MD A Practical Approach to Assessment of Dizzy Patients Steven D. Rauch, MD Practical Management of BPPV: Diagnosis and Therapy Giacinto Asprella Libonati, MD Practical Use of Vestibular Tests in Clinical Management Moises Arriaga, MD; Micah Klump, PhD Prevention and Management of Complications in Ear Surgery Patrick J. Antonelli, MD; Rex S. Haberman, MD Pulsatile Tinnitus: Advances in Diagnosis and Management Aristides Sismanis, MD; Daniel H. Coelho, MD Regeneration Medicine for Inner Ear Diseases Jyuichi Ito, MD The Secrets of Successful Canalith Repositioning John C. Li, MD; Gerard J. Gianoli, MD Stapes Surgery: Otosclerosis, Congenital Malformations Robert Vincent, MD Sudden Sensorineural Hearing Loss: An Otologic Emergency? Sujana S. Chandrasekhar, MD; James E. Saunders, MD Surgical Decision-Making in Cholesteatoma Eric E. Smouha, MD; Dennis I. Bojrab, MD; Simon C. Parisier, MD, Barry E. Hirsch, MD Surgical Management of Eustachian Tube Disorders Dennis S. Poe, MD, PhD; Ralph B. Metson, MD Technique to Simplify Myringoplasty Masafumi Sakagami, MD, PhD; YU Yuasa, MD Techniques in Cartilage Tympanoplasty John L. Dornhoffer, MD; Konrad Schwager, MD Temporal Bone Cancer Paul W. Gidley, MD The Ten-Minute Exam of the Dizzy Patient Joel A. Goebel, MD Tinnitus Update: Treatment Strategies Michael J. Larouere, MD; John J. Zappia, MD Top Tips in Pediatric Tympanomastoid Surgery Adrian James, MD; Blake Papsin, MD Tympanoplasty: Medial Graft versus Lateral Graft Roberto A. Cueva, MD; Rick A. Friedman, MD, PhD Tympanoplasty: Medial or Medio-Lateral Graft Timothy T. K. Jung, MD
Hands
Larynogology/Broncho-Esophagology
= Hands-on ($70/hour) = Mini-course ($50/hour) = Audience Response ($50/hour) = Two-hour course Miniseminars Airway: Advances in Management Supported by the Voice Committee and the Airway and Swallowing Committee Paul M. Weinberger, MD (Moderator); Mark S. Courey, MD; Robert R. Lorenz, MD; Martin A. Birchall, FRCS   Dysphagia: From Science to Clinical Practice Supported by the Voice Committee Milan R. Amin, MD (Moderator); Peter C. Belafsky, MD; Timothy M. McCulloch, MD; Susan E. Langmore, PhD   Endoscopic vs. Open Treatment of Laryngotracheal Stenosis Supported by the Airway and Swallowing Committee Sid Khosla, MD (Moderator); Michael J. Rutter, MD; Alessandro de Alarcon; Guri Sandhu, FRCS; Stacey Leigh Halum, MD; Alexander T. Hillel, MD     Globus: The Perennial Complaint Melin Tan, MD, Natasha Mirza, MD (Moderators); Ramon A. Franco, MD; Philip A. Weissbrod, MD     Injection Laryngoplasty: Contemporary Indications/Techniques Sunil P. Verma, MD (Moderator); Mark S. Courey, MD; Gayle E. Woodson, MD; C. Blake Simpson, MD   Laryngeal Inflammation: Diagnosis and Treatment Challenges Supported by the American Academy of Otolaryngic Allergy (AAOA) and the American Laryngological Association (ALA) Marvin P. Fried, MD, John H. Krouse, MD, PhD (Moderators); Kenneth W. Altman, MD, PhD; John M. Delgaudio, MD; Gregory N. Postma, MD     Microlaryngoscopy: Difficult Exposures/Operative Techniques Paul C. Bryson, MD, Michael S. Benninger, MD (Moderators); Alexander T. Hillel, MD; Michael M. Johns, MD; Blake Simpson, MD   Pediatric Laryngology: Innovations and Updates Supported by the Laryngology and Brochoesophagology Education Committee Scott M. Rickert, MD (Moderator); Melissa M. Statham, MD; Alessandro de Alarcon; Karen B. Zur, MD; Christopher J. Hartnick, MD   Practical Approach to Swallowing Problems Supported by the Airway and Swallowing Committee and the Laryngology and Brochoesophagology Education Committee Catherine Rees Lintzenich, MD (Moderator); Milan R. Amin, MD; Gregory N. Postma, MD; Albert L. Merati, MD   Reflux: Pathophysiology to Management Supported by the Voice Committee and the Airway and Swallowing Committee Joel H. Blumin, MD (Moderator); Nikki Johnston, PhD; Blair A. Jobe, MD; Albert L. Merati, MD   Voice: From Cells to Song Supported by the Voice Committee and the Airway and Swallowing Committee Lucian Sulica, MD (Moderator); Clark A. Rosen, MD; Blake Simpson, MD; Susan Thibeault, PhD Instruction Courses The Actor and Singer as Patients of the Laryngologist Robert Thayer Sataloff, MD, DMA   Adding Laryngeal Reinnervation to Your Practice George S. Goding, MD; Joel H. Blumin, MD   Avoiding and Managing Complications in Laryngology Libby J. Smith, MD; VyVy Young, MD   Awake Vocal Fold Injection in the Office: When, Why, and How Lucian Sulica, MD   Building a Busy Laryngology Practice Albert L. Merati, MD; Michael M. Johns, MD   Case Based Approach to Voice Disorders: Pitfalls and Pearls C. Blake Simpson, MD; Clark A. Rosen, MD   Common Causes of Hoarseness that Are Commonly Missed Jacob Pieter Noordzij, MD; Seth M. Cohen, MD     Common Errors in Voice Diagnosis: 16 Cases in 60 Minutes Peak Woo, MD   Contemporary Management of Adult Airway Stenosis Sunil P. Verma, MD; Dinesh Chhetri, MD   Controversies in Pediatric Sialorrhea and Aspiration Mark E. Gerber, MD   Cough: Prepare for Battle Albert L. Merati, MD; Thomas Murry, PhD   Current Concepts in Vocal Fold Paralysis Lucian Sulica, MD   Dyspnea/Noisy Breathing: Organic or Non-Organic? Brent Richardson, MD   Early Vocal Fold Cancer: A Practical Guide to TLM Cordectomy Marc J. Remacle, MD; Abie Mendolsohn, MD   Endoscopic Microsurgical Techniques for Laryngeal Disease Mark S. Courey, MD; Katherine C. Yung, MD   Evaluation and Management of Swallowing Disorders Catherine Rees Lintzenich, MD   Fundamentals of Videostroboscopy Phillip Song, MD; Ramon A. Franco, MD   High Pressure Balloon Dilation of Pediatric and Adult Airway Peter J. Koltai, MD; Timothy D. Anderson, MD   High Resolution Manometry in the Management of Dysphagia Timothy M. McCulloch, MD; Michelle R. Ciucci, PhD   Laryngeal Electromyography Glendon M. Gardner, MD; Steven M. Parnes, MD   Lasers in Laryngology C. Gaelyn Garrett, MD; Robert H. Orsoff, DMD, MD   Management of Zenker’s and Hypopharyngeal Diverticula Richard L. Scher, MD; David L. Myssiorek, MD   Modern Management of Adult Laryngotracheal Stenosis Reza Nouraei, MB, BS, FRCS; Guri Sandhu, MB, BS, FRCS   New Lasers: Office and OR, Fiber Cutting and Pulsed Angiolysis James A. Burns, MD   Neurological Disease of the Larynx Andrew Blitzer, MD, DDS; Lucian Sulica, MD   Office Dysphagia Consult: Diagnosis, Management, and Coding Jonathan E. Aviv, MD   Phonosurgery: Laser/Micro Instrumentation Do’s and Don’ts Michael S. Benninger, MD; Jean Abitbol, MD   Practical Biomechanics for Laryngeal Surgery Sid Khosla, MD   Professional Singers: The Science and Art of Clinical Care Robert Thayer Sataloff, MD, DMA   Recognizing Neurological Voice Problems Phillip Song, MD   Reflux Testing in Otolaryngology: What You Need to Know Joel H. Blumin, MD; Jonathan M. Bock, MD   Spasmodic Dysphonia: Diagnosis to Management Dinesh Chhetri, MD; Joel H. Blumin, MD   Surgical Management of Dysphagia Joseph R. Spiegel, MD; Mauritis Boon, MD   Thyroid Framework Surgery Types 1-4: Factors for Success Mark S. Courey, MD; Marc J. Remacle, MD, PhD   Treatment of the Aging Voice Michael M. Johns, MD; Edie R. Hapner, PhD   Vocal Fold Injection: Fact, Fiction, and Material Selection Clark A. Rosen, MD   Vocal Fold Leukoplakia: Oncology and Voice Preservation Seth H. Dailey, MD   Vocal Nodules, Polyps and Cysts: Diagnosis and Current Treatment Clark A. Rosen, MD; Libby J. Smith, MD   Voice Play in the Diagnostic Encounter Robert W. Bastian, MD
Hands
Head and Neck Surgery
= Hands-on ($70/hour) = Mini-course ($50/hour) = Audience Response ($50/hour) = Two-hour course         Miniseminars Clinic Based Decision Making for Head and Neck Endocrine Disease Supported by the Endocrine Surgery Committee and the American Head and Neck Society (AHNS) Russell B. Smith, MD (Moderator); Salvatore M. Caruana, MD; Jason Patrick Hunt, MD; Maisie L. Shindo, MD; David L. Steward, MD; Ralph P. Tufano, MD, MBA Head and Neck Skin Cancer: When Mohs Is Not Enough Supported by the Head and Neck Surgery and Oncology Committee Christine G. Gourin, MD, MPH (Moderator); Derrick T. Lin,; Cecelia E. Schmalbach, MD; Carol R. Bradford, MD; Randal Scott Weber, MD Locally Advanced Laryngeal Cancer Supported by the Brazilian Society of Head and Neck Surgery Eugene N. Myers, MD, and Claudio R. Cernea, MD (Moderators); Fernando Walder, MD; Kerry D. Olsen, MD; Fernando Luiz Dias, MD, PhD; Roberto A. Lima, MD; Rogerio A. Dedivitis, MD, PhD Novel Techniques for Detection and Treatment of Precancer Supported by the Head and Neck Surgery & Oncology Committee and the American Head and Neck Society (AHNS) Cherie-Ann O. Nathan, MD (Moderator); Marilene B. Wang, MD; Brian Nussenbaum, MD; D. Gregory Farwell, MD; Jay O. Boyle, MD Reconstruction after Salvage Laryngectomy Supported by the Microvascular Committee Douglas B. Chepeha, MD (Moderator); Matthew M. Hanasono, MD; Urjeet Patel, MD; Eric M. Genden, MD; Andrew Rosco, MD; Eric Chanowski, MD, MPH Robotic Surgery: The Current Standard of Practice Eric M. Genden, MD (Moderator); Scott Magnuson, MD; Ronald B. Kuppersmith, MD, MBA; F. Christopher Holsinger, MD Sialendoscopy: Paradigm Shift in Salivary Gland Treatment? Supported by the European Sialendoscopy Training Center (ESTC) and the European Salivary Gland Society (ESGS) Francis Marchal, MD (Moderator); Helge Arndal, MD; Ricardo Carrau, MD; Robert A. Irvine, MD; David William Eisele, MD; Claudio R. Cernea, MD; J.M. Lopez, MD Sialendoscopy: The Beginner’s Guide to Success Supported by the Medical Devices and Drugs Committee Gordon J. Siegel, MD (Moderator); Barry M. Schaitkin, MD; Johannes Zenk, MD; David W. Eisele, MD; Michael H. Fritsch, MD Surgical Innovations for Larynx and Pharynx Cancer Supported by the American Broncho-Esophagological Association (ABEA) James A. Burns, MD (Moderator); Bruce H. Haughey; Gregory S. Weinstein, MD The “New” Cancer Patient: Young, Non-Smoker, HPV+: Evaluation Supported by the Head and Neck Surgery & Oncology Committee, Head and Neck Surgery Education Committee, and the American Head and Neck Society (AHNS) Daniel Gert Deschler, MD (Moderator); Robert L. Ferris, MD, PhD; Marilene B. Wang, MD; Samir S. Khariwala, MD; Jeremy D. Richmon, MD The New Cancer Patient: Young, Non-Smoker, HPV+: Management Supported by the Head and Neck Surgery Education Committee Richard V. Smith, MD (Moderator); Joseph X. Scharpf, MD; Eric Jason Moore, MD; Brian Nussenbaum, MD; Christine G. Gourin, MD Thyroid Surgical Care 2013: The Impact of Molecular Testing Supported by the Endocrine Surgery Committee Robert Lee Witt, MD (Moderator); Robert L. Ferris, MD; Edmund A. Pribitkin, MD; Gregory W. Randolph, MD; David L. Steward, MD Instruction Courses Advances in the Management of Papillary Thyroid Cancer Robert Lee Witt, MD Advances in Management of Recurrent Nasopharyngeal Carcinoma Jimmy Yu-Wai Chan, MBBS, MS After Thyroidectomy Jacob Pieter Noordzij, MD Aggressive Nonmelanoma Skin Cancer: Concepts and Case Studies Matthew M. Hanasono, MD; Brian A. Moore, MD   An Evidence-Based Protocol for Head and Neck Lymphedema Jan S. Lewin, PhD; Brad G. Smith Avoiding Disaster in Thyroid Surgery: Five Critical Principles David James Terris, MD; William S. Duke, MD Avoiding Management Errors of Suspected Head and Neck Tumors Kerry D. Olsen, MD; Eric J. Moore, MD Collaborative Management of Speech, Voice, and Swallowing Robert J. Stachler, MD; Francis Thomas Hall, MD, MBChB, FRACS; Jamie M. Lindholm, MS, CCC-SLP Conservation Surgery for Oropharyngeal Cancer F. Christopher Holsinger, MD; Olivier Laccourreye, MD Contemporary Management of Skull Base Malignancies Michael E. Kupferman, MD Controversies in the Management of Thyroid Nodule Ashok R. Shaha, MD Current Management of Oropharyneal Cancer Bradley Schiff, MD; Richard V. Smith, MD The Difficult Adult Airway: Captaining the Ship David M. Cognetti, MD The Difficult Neck Ashok R. Shaha, MD The Difficult Thyroid Ashok R. Shaha, MD Endoscopic and Open Approaches to the Anterior Skull Base Ehab Y. N. Hanna, MD Endoscopic-Assisted Approaches to the Orbit Stefano Sellari-Franceschini, MD; Paolo Castelnuovo, MD Endoscopic Thyroid Surgery: Basic and Advanced Techniques David James Terris, MD Evidence-Based Approach for Pharyngeal Defect Reconstruction Jimmy Yu-Wai Chan, MBBS, MS; Velda Ling Yu Chow, MD, MRCS; William I. Wei, MD Evidence-Based Approach to Treating Oral Cavity Cancer Neil D. Gross, MD; Dennis H. Kraus, MD Evidenced-Based Approach to Treating Oropharynx Cancer Neil D. Gross, MD Evidence-Based Decision Making in Cancer of the Oral Cavity Nilesh R. Vasan, MD, FRACS; Jesus E. Medina, MD Evidence-Based Decision Making in Cancer of the Oropharynx Nilesh R. Vasan, MD, FRACS; Jesus E. Medina, MD Evidenced-Based Management of Head and Neck Melanoma Michael E. Kupferman, MD Evidence-Based Management of Invasive Thyroid Cancer Joseph Scharpf, MD; Brian B. Burkey, MD Finding the Hidden Parathyroid Adenoma Eric M. Genden, MD FDG-PET for Head and Neck Cancer: Pearls and Pitfalls Russell B. Smith, MD; Richard J. Wong, MD H&N Melanoma: Achieving Clarity amongst the Controversy Cecelia E. Schmalbach, MD; Carol R. Bradford, MD How to Manage the Facial Nerve in Parotid Surgery Gregory K. Hartig, MD; Timothy M. McCulloch, MD The HPV Epidemic and Oropharyngeal Cancer James W. Rocco, MD, PhD; Derrick T. Lin, MD Hyperparathyroidism Pearls and Pitfalls Work-Up and Management David L. Steward, MD; Maisie L. Shindo, MD Improved Management of Hypocalcemia after Thyroidectomy Jacob P. Noordzji, MD; Ian L. McLeod, MD “Inside Out” Anatomy in Transoral Surgery Michael L. Hinni, MD JNA: Optimizing Surgical Care and Minimizing Recurrences Patrick J. Bradley, MBA, DCh, FRCS Laryngectomy in the Era of Chemoradiation William R. Carroll, MD; Eben L. Rosenthal, MD Lessons I Have Learned as a Parathyroid Surgeon Brendan C. Stack, Jr., MD Management of Cutaneous Melanoma of the Head and Neck Dennis H. Kraus, MD Management of Neck Metastasis from Oropharyngeal Carcinoma Steven J. Wang, MD; David William Eisele, MD Management of Salivary Gland Malignancies Michael E. Kupferman, MD Management of the Unknown Primary Head and Neck Cancer Guy J. Petruzzelli, MD, PhD Management of Vascular Malformations of the Head and Neck Milton Waner, MD; Teresa M. O, MD Managing Laryngeal Nerve Injury in Thyroid Surgery Edmund A. Pribitkin, MD; Joseph R. Spiegel, MD Medical Management of Thyroid Disease for Otolaryngologists David L. Steward, MD Minimally Invasive Surgery for Salivary Tumors and Stones Robert Lee Witt, MD; Urban W. Geisthoff, MD Neck Dissection 2013 William R. Carroll, MD; Ramon M. Esclamado, MD Neck Dissection for Thyroid Cancer Brendan C. Stack, Jr., MD Oral vs Oropharyngeal Cancer: Diverging Etiology and Treatment Terry A. Day, MD; Douglas A. Girod, MD Osteonecrosis of the Head and Neck: Contemporary Management Neal D. Futran, MD; D. Gregory Farwell, MD Paragangliomas of the Head and Neck David Myssiorek, MD; Anil K. Lalwani, MD Parathyroid Surgery: What Head and Neck Surgeons Should Know David James Terris, MD; Gregory W. Randolph, MD The Parotid Gland: Diagnosis, Medical and Surgical Approaches David William Eisele, MD; Dale H. Rice, MD Partial Laryngectomies as Salvage Treatment after RT Failure Giuseppe Spriano, MD PET Scans: The Who, When and Why & How to Get Reimbursed Cecelia E. Schmalbach, MD; Carol M. Bier-Laning, MD Post-Treatment Surveillance and Imaging in Head & Neck SCC Eben L. Rosenthal, MD; Mark K. Wax, MD Precise Surgical Localization of Cranial Nerves Mimi S. Kokoska, MD; Jeffrey Bumpous, MD Preoperative Decision Making in Thyroid Surgery Gregory W. Randolph, MD; David L. Steward, MD Putting Surgery First Again for Larynx Cancer: Why? When? How? F. Christopher Holsinger, MD; Robert L. Ferris, MD Re-Operative Parathyroid Surgery Tips for Success Ralph P. Tufano, MD, MBA; Phillip K. Pellitteri, MD Re-Operative Thyroid and Parathyroid Surgery Brendan C. Stack, Jr., MD; David L. Steward, MD RLN 2013: Continuous Vagal and SLN Monitoring Gregory W. Randolph, MD Salivary Gland Malignancies: Principles of Management Russell B. Smith, MD; Robert P. Zitsch, MD Sialendoscopy: Getting Started, Solving Problems Barry M. Schaitkin, MD; Ricardo Carrau, MD; Rohan R. Walvekar, MD Sialendoscopy: What Did We Learn during the Last 15 Years? Francis Marchal, MD; Helge Amdal, MD; Robert A. Irvine, MD Successfully Managing Challenging Patients Michael Ryan, PhD; Tamer Abdel-Halim Ghanem, MD Surgical Management of the Central Neck in Thyroid Cancer Ralph P. Tufano, MD, MBA; David L. Steward, MD Surgical Management of Oropharyngeal Cancers Alain N. Sabri, MD; Kerry D. Olsen, MD Transoral Robotic Surgery: How and Why Eric M. Genden, MD Transoral Robotic Surgery TORS for Neoplasms and Sleep Apnea Gregory S. Weinstein, MD; Bert W. O’Malley, MD; Erica Thaler, MD Treatment of Hyperthyroid Disorders and Large Goiters Maisie L. Shindo, MD; Neil D. Gross, MD The Treatment of Larynx Cancer in 2013 Richard V. Smith, MD Voice after Laryngectomy: The Basics Vocal Rehabilitation Gregory A. Grillone, MD; Michael Walsh, CCC-SLP; Itzhak Brook MD, MSc What’s New about Nonsurgical Therapies of Salivary Stones Philippe L. Katz, MD; Michael H. Fritsch, MD Workup and Management of Parapharyngeal Space Tumors James L. Netterville, MD; Alexander Langerman, MD
Companies Exhibiting at the AAO-HNSF 2013 Annual Meeting & OTO EXPOSM
(as of July 1, 2013) ABLV Academia Brasileira de Laringologia e Voz 848 Jullundur Surgical Works http://www.jullsurgindia.com 942 http://www.aborlccf.org.br Acclarent (IRT-Member) 904 Kaiser Permanente 940 http://www.acclarent.com http://www.physiciancareers.kp.org/ncal Acumed Instruments Corp. 603 Kalelker Surgicals Pvt. Ltd. 2328 http://www.e-acumed.com http://www.kalelkersurgicals.com Advanced Bionics http://www.advancedbionics.com 2033-A KARL STORZ Endoscopy-America Inc. 1524 http://www.karlstorz.com Advanced Endoscopy Devices http://www.aed.md 720 KARL STORZ  Endoscopy- Latin America 1418 http://www.karlstorz.com Aerin Medical 619 Kirwan Surgical Products Inc. 528 http://www.aerinmedical.com http://www.ksp.com ALCON (IRT Member) 1504 KLS Martin 2013 http://www.alconlabs.com http://www.klsmartin.com All Star Sales & Service 2315 Kurz Medical Inc. 2020 http://www.allstarsales.ca http://www.kurzmed.com AllMeds (AA-Partner) 1433 Leica Microsystems 1333 http://www.allmeds.com http://www.leicamicrosystems.com American Board of  Otolaryngology 2312 Lifestyle Lift (IRT Associate) 1450 http://www.ABOto.org http://www.lifestylelift.com American Hearing Aid  Associates 2220 Lisa Laser USA 1920 http://www.ahaanavigator.com http://www.lisalaserusa.com American Journal of Rhinology and Allergy 1442 LocumTenens.com 1541 http://www.AJRA.com http://www.locumtenens.com American Medical Endoscopy http://www.endoscopia.com 2309 Lumenis http://www.lumenis.com 1734 & 1734M American Tinnitus Association 1048 Maico Diagnostics 1110 http://www.ata.org http://www.maico-diagnostics.com Amplivox 815 Marina Medical 1746 http://www.amplivox.us http://www.marinamedical.com Andreas Fahl Medizintechnik 2134 McKeon Products Inc 2026 http://www.fahl.de http://www.macksearplugs.com Annals Publishing Company 718 Meda Pharmaceuticals 1340 http://www.annals.com http://www.meda.us Anthony Products/Gio Pelle 1203 MED-EL Corporation 2112 http://www.anthonyproducts.com http://www.medel.com Antigen Laboratories Inc 535 Medical Digital Developers LLC 839 http://www.antigenlab.com http://www.dscopesystems.com Apdyne Medical Company 734 MediCapture Inc. 1240 http://www.apdyne.com http://www.medicapture.com Arches Natural Products Inc 1525 Medifix Inc. 2045 http://www.tinnitusformula.com http://www.medifixinc.com ArthroCare 2003 MedInvent LLC 716 http://www.arthrocare.com http://www.nasoneb.com ATMOS Inc 2304 Mediplast AB 624 http://www.atmosmed.de http://www.mediplast.com Atos Medical Inc. 1041 MedNet Technologies 625 http://www.atosmedical.us http://www.mednet-tech.com AudGenDB 2221 Medtronic Surgical Technologies 1204 http://www.AudGenDB.chop.edu http://www.medtronicENT.com Audigy Medical 1544 Mega Medical Company Ltd 512 http://www.audigymedical.com http://www.megamedical.co.kr Audiology Management  Group Inc. 2334 Merz Aesthetics Inc. 2126 http://www.audiologymanagementgroup.com http://www.merzaesthetics.com Bausch + Lomb 1611 Microline Surgical Inc. 2305 http://www.bausch.com http://www.microlinesurgical.com Baxter Healthcare 1151 Micromedical Technologies Inc. 1020 http://www.baxter.com http://www.micromedical.com Beaver-Visitec International 827 Microsurgery Instruments Inc. 822 http://www.beaver-visitec.com http://www.microsurgeryusa.com Beutlich LLC 818 Miltex, an Integra Company 1543 http://www.beutlich.com http://www.integralife.com BFW Inc. 1940 Modernizing Medicine Inc. 616 http://www.bfwinc.com http://www.modmed.com Bien-Air Surgery 1424 MTI 1724 http://www.bienair.com http://www.mti.net Biomet Microfixation 744 Natus Medical Incorporated 825 http://www.biometmicrofixation.com http://www.natus.com Blue Tree Publishing Inc. 934 NeilMed Pharmaceuticals Inc. 1404 http://www.bluetreepublishing.com http://www.neilmed.com Boston Medical Products 715 Neurosign 620 http://www.bosmed.com http://www.neurosignsurgical.com Brainlab http://www.brainlab.com 1818 Neurovision Medical Products Inc. 628 http://www.neurovisionmedical.com Brazilian Association of ENT 947 New York Head and Neck Institute 740 http://www.aborlccf.org.br http://www.nyhni.org Carestream 634 NexTech 1033 http://www.carestream.com/ent-allergy http://www.nextech.com Carl Zeiss Meditec 1133 NP Screen Canada Inc. 948 http://www.meditec.zeiss.com http://www.npscreen.ca/site/ Cenefom Corp 820 Officite (AA-Partner) 2303 http://www.cenefom.com http://www.officite.com Ceredas http://www.ceredas.com 607 Olympus America Inc. (IRT Associate) 1604 http://www.olympusamerica.com ChartLogic Inc 1512 OmniGuide Surgical 2140 http://www.chartlogic.com http://www.omniguidesurgical.com CHEER Practice-Based  Research Network 2321 Optim LLC 623 http://www.cheerresearch.org http://www.optim-llc.com Cincinnati Children’s  Hospital Medical Center 2145 Oticon Medical LLC 2104 http://www.cincinnatichildrens.org/moleculargenetics http://www.oticonmedicalusa.com Claron Technology Inc 1350 OTOMED Inc. 941 http://www.clarontech.com http://www.otomed.com ClientTell 728 OtoMetrix Medical Technologies 1446 http://www.clienttell.net http://www.otometrix.com Clinicon Corporation 1843 OTOTRONIX 1834 http://www.clinicon.com http://www.ototronix.com Cobalt Medical Supply Inc. 2042 Otoxchange 2216 http://www.cobaltmed.com http://www.otoxchange.com Cochlear Americas 1903 Pan American Congress of Otolaryngology, HNS 843 http://www.cochlear.com http://www.panamorl.com ConeScan 1439 Parnell Pharmaceuticals Inc. 722 http://www.conescan.com http://www.parnellpharm.com Cook Medical 925 Passy-Muir Inc. 952 http://www.cookmedical.com http://www.passy-muir.com Covidien 1047 PENTAX Medical 1023 http://www.covidien.com/rms http://www.pentaxmedical.com Cytophil Inc 2313 PeriOptix Inc. 2234 http://www.cytophil.com http://www.perioptix.com DePuy Synthes 804 Phonak 2033-B http://www.synthes.com http://www.advancedbionics.com Designs for Vision Inc http://www.designsforvision.com 2122 Physician Assistants in Otolaryngology-HNS 1344 http://www.entpa.org Doc’s Proplugs Inc 434 Piezosurgery Inc. 1040 http://www.proplugs.com http://www.piezosurgery.us Doctus Equipamentos Médicos 1143 Plural Publishing Inc. 920 http://www.doctus.med.br http://www.pluralpublishing.com DocumENT 1650 PracticeLink.com 736 http://www.DocumENT-EMR.com http://www.practicelink.com Ear Nose & Throat Journal 536 Prescott’s Inc. 1941 http://www.vendomegrp.com http://www.surgicalmicroscopes.com Ecleris 1034 Quest Medical Inc. 2125 http://www.ecleris.com http://www.questmedical.com Elsevier 812 Reliance Medical Products 1225 http://www.grason-stadler.com http://www.reliance-medical.com ENT & Audiology News 617 RGP Inc. 1039 http://www.entandaudiologynews.com http://www.rgpdental.com Entellus Medical (IRT Member) 1516 Richard Wolf Medical Instruments Corp 533 http://www.entellusmedical.com http://www.richardwolfusa.com ENTrigue Surgical Inc. http://www.entriguesurgical.com 1116 Rose Micro Solutions http://www.rosemicrosolutions.com 534 & 2127 Envoy Medical 710 SAGE 835 http://www.envoymedical.com http://www.sagepub.com EPIC Hearing Healthcare 2039 Sandhill Scientific Inc. 2043 http://www.epichearing.com http://www.sandhillsci.com Essentia Health 618 SANOSTEC Corp 1939 http://www.EssentiaHealth.org http://www.maxairnosecones.com Ethicon Endo-Surgery 1104 Scopis GmbH 527 http://www.ethicon.com http://www.scopis.com Euroclinic Division of  DRE Medical 1644 Seiler Precision Microscopes 1509 http://www.dremed.com http://www.seilermicro.com Eyemaginations (AA-Partner) 610 Shen Yun Show Vancouver Organizing Committee 626 http://www.eyemaginations.com http://www.shenyunperformingarts.org Feather Safety Razor Co. Ltd. http://www.feather.co.jp 726 Shippert Medical Technologies Inc. 1044 http://www.shippertmedical.com Fiegert Endotech Inc 2235 Siemens Hearing Instruments 817 http://www.fiegertendotech.net http://www.siemens-hearing.com Firefly Global 723 SinuScience Network 1319 http://www.fireflyglobal.com http://www.sinuscience.com GE Healthcare 1523 SinuSys Corp 605 http://www.ge.com http://www.sinusys.com General Surgical Company  (India) PVT LTD 1339 SMR 1912 http://www.gescoindia.com http://www.globalsurgical.com/ENTHome.aspx Genzyme 1142 Somna Therapeutics 2214 http://www.genzyme.com http://www.somnatherapeutics.com Global Surgical Corp 1911 Sonitus Medical Inc 2226 http://www.globalsurgical.com http://www.sonitusmedical.com GN Otometrics 1447 Sontec Instruments Inc 2204 http://www.otometrics.com http://www.sontecinstruments.com Grace Medical 1926 Sophono 2141 http://www.gracemedical.com http://www.sophono.com Grason-Stadler 1410 SOPRO-COMEG 725 http://www.grason-stadler.com http://www.us.acteongroup.com Greenway Medical Technologies 1014 Soredex http://www.soredex.com 1840 http://www.greenwaymedical.com Health eCareers/ENT Careers Live! (AA-Premier) 448 SoundCure Inc 2222 http://www.healthecareers.com http://www.soundcure.com Healthworld International Inc. 2318 Springer 821 http://www.healthworldintl.com http://www.springer.com Hemostatix Medical Technologies 1742 Starkey http://www.starkey.com 1824 http://www.hemostatix.com Hood Laboratories Inc http://www.hoodlabs.com 1844 Stryker http://www.stryker.com 1534 & 1534M InHealth Technologies 704 Summit Medical Inc. 1139 http://www.inhealth.com http://www.summitmedicalusa.com Inspire Medical Systems Inc 1841 SURGIMENTS 847 http://www.inspiresleep.com http://www.surgiments.com Insta-Mold Products 828 SurgiTel/General Scientific Corp 2319 http://www.instamold.com http://www.surgitel.com Instrumentarium 2019 TeleVox Software 833 http://www.instrumentarium-online.com http://www.televox.com Intelligent Hearing Systems 2233 Teva Respiratory 640 http://www.ihsys.com http://www.tevarespiratory.com Interacoustics 914 The Doctors Company (AA-Premier) 1348 http://www.interacoustics-us.com http://www.thedoctors.com Interamerican Association  of Pediatric ORL 842 The JAMA Network 1942 http://www.iapo.org.br http://www.jamanetwork.com Intersect ENT Inc 604 Thieme Medical Publishers 917 http://www.intersectent.com http://www.thieme.com Intersocietal Accreditation  Commission 1444 United Endoscopy 508 http://www.intersocietal.org http://www.endoscope.com Intuitive Surgical http://www.intuitivesurgical.com 1717 University Medical Center Hamburg-Eppendorf 2333 http://www.voxel-man.de Invictus Medical Innovations  LLC (IMI) 2314 Valam 1750 http://www.invictusmed.com http://www.valam.com Invotec International Inc. 1147 Vision Sciences 834 http://www.invotec.net http://www.visionsciences.com J. Morita Manufacturing Corp 504 Wiley 611 http://www.morita.com/global/en http://www.wiley.com Jaypee Brothers Medical  Publishers (P) Ltd 936 Xoran Technologies Inc. 1233 http://www.jaypeebrothers.com http://www.xorantech.com JEDMED http://www.jedmed.com 1320 & 1428 Zumax Medical Company Ltd. http://www.zumaxmedical.com 643
OTO EXPOSM-Vancouver Bound!
The AAO-HNSF Annual Meeting & OTO EXPOSM is the vanguard for the otolaryngology community. Each year, thousands of attendees come for the education sessions, but don’t realize how much education is offered on the OTO EXPOSM show floor where hundreds of companies showcase the products and services used by ENT physicians and personnel worldwide. Only at the OTO EXPOSM can you See an extensive array of products and services from leading manufacturers and companies that cover all aspects of otolaryngology. Connect with your peers and learn about the tools necessary to provide the best patient care to Resolve challenges you are facing when it comes to delivering solutions to your patients. See This year we are headed to beautiful Vancouver, BC, Canada, and the excitement continues to build each day. Items on display in the OTO EXPOSM cover a wide range of categories including surgical instruments, medical devices, imaging equipment, robotic surgery apparatus, and even services that provide efficiency and cohesion to medical records. Exhibitor Product Showcase Your Academy strives to provide every attendee with an unforgettable experience at the 2013 Annual Meeting & OTO EXPOSM. To achieve this, we have expanded the opportunities to couple your learning experience with medical device and product demonstrations on the OTO EXPOSM floor with a Product Showcase. Several of our corporate partners will be presenting their ENT products in 20-minute intervals during the lunch hour in a theater-style venue. This is a great opportunity for medical students, residents, and Academy members at every level of their careers to participate in live discussions about the best practices of new and existing products in otolaryngology. Staying on the cutting edge of technology and medical products positions you to achieve excellence in patient care and distinguishes you in the job market. Connect Being able to touch and interact with the products and services that are provided by our exhibiting companies allows you the opportunity to learn how they can advance your practice to the next level. Not only will there be tools that you already use, but there will be new and exciting items on display. Our exhibitors are looking forward to demonstrating their equipment. Networking alone is a valuable feature of the OTO EXPOSM. Your peers will be there identifying new concepts and this venue allows you the chance to discuss ideas and collaborate on methods and ideologies in our specialty. This is where you can look to build strategic alliances in the ENT community and use each other for future references. It’s an incredible experience! Resolve Looking for ways to be more efficient with your medical records? Are you thinking of investing in robotic surgery? Want to know which surgical instruments can help you to improve the care you already provide? Our exhibiting companies can answer these and many more questions at the OTO EXPOSM. AAO-HNS/F provides you with the venue for hands-on education where you can find ways to become knowledgeable and innovative in the field of otolaryngology, which will result in your patients getting the best care possible. The OTO EXPOSM is an invaluable resource where you can see the best in our specialty, connect with your fellow peers, and resolve business challenges facing otolaryngology today. We look forward to welcoming you to Vancouver this fall. Be sure that your passport is current and please visit our website for additional information: http://www.entannualmeeting.org/13/.
David R. Nielsen, MDAAO-HNS/F EVP/CEO
Saluting Harry W. McCurdy, MD, and Deployed Physicians
Summer is often the time when our patriotism flourishes. The combination of the celebration of our nation’s birth and independence, family reunions and vacations, travel around the country, graduations, weddings, and for some, a bit of respite from the grueling and unrelenting stress and tension of the workplace can give us a chance to reflect on our heritage. And so I will take the opportunity now to stray from what’s wrong and what needs to be fixed—the discussion of the politics of health care reform itself and those surrounding it—and focus briefly on “what’s right with America.” Living near Washington, DC, I have a far greater appreciation for our country and those who preserve it full time in our military and public service. For more than a decade now, I have lived surrounded by men and women in our armed forces; personal neighbors and friends whose concerns I am intimately aware of, not distant unrecognizable nameless statistics. Not long ago I attended a patriotic service where tribute was paid to our military veterans and those currently serving. When those in the audience with military service were asked to stand, more than half the audience arose. Witnessing firsthand the sacrifices made by the families, spouses, and children of our deployed service men and women is a far more compelling experience than simply being told about it from afar. This summer my sense of patriotism was augmented by the experience of attending the services for our departed colleague, leader, and friend, Harry W. McCurdy, MD, past executive vice president of the Academy. As I shared with you some months ago, Dr. McCurdy died at the age of 94. It was fitting and timely that we, his friends and the beneficiaries of his lifetime of service, raised the funds necessary to create the Harry W. McCurdy Endowment and honored him in person last year at our annual meeting here in Washington, DC. His family has shared with us how much it meant to him to be so recognized and honored. He served during a crucial period in the formation of the modern-day Academy as the old American Council of Otolaryngology and the American Academy of Otolaryngology combined to form our current structure, The American Academy of Otolaryngology—Head and Neck Surgery. Dr. McCurdy had lengthy and distinguished military service and recognition, and qualified for interment and services in Arlington National Cemetery with the many thousands of heroes and soldiers to whom we owe our freedoms. As is always the case for those so qualified, there was a waiting period before the formal military honors and burial could take place. On July 29, Dr. McCurdy was laid to rest with full military honors in Arlington National Cemetery. Since moving to the Washington, DC, area, it has been my privilege on several occasions to be present at such a ceremony. It is impossible to attend and witness the solemn honor bestowed on those men and women who have so qualified and their families without a very humbling sense of gratitude for the freedom, the liberty, and prosperity, and the peace in which we are so privileged to live. The procession of the caisson, the 21-gun salute, the playing of taps, the folding of the flag and its presentation to the family all evoke the most deeply felt emotion imaginable. It is a powerful reminder of the sacrifices of “lives, fortunes, and sacred honor” referenced in our Declaration of Independence that have been (and still continue to be) laid down by those who promote, defend, and when necessary, fight for our freedom. In the classic movie, “Born Yesterday,” in which Billie, the protagonist, goes from being ignorant of her heritage and the political freedom, which she enjoys to learning firsthand about how government works and her personal obligation to know about and participate in democracy, she is reminded by her teacher, “The whole damned history of the world is a story of the struggle between the selfish and the unselfish!” We are obligated to reflect on and honor those unselfish souls who have sacrificed so much to maintain our political freedoms. And so, we honor those of our membership who not only chose to be physicians, but to serve in military and public health service capacities. To our veterans, to our current military service men and women, and especially to those who are deployed away from family and loved ones: We honor you; we salute you; and we thank you for the gift of freedom and liberty you give to us.
James L. Netterville, MD, AAO-HNS/F President
OTO EXPOSM Challenges with Information, Innovation
The deadline to save on advanced meeting registration—August 23, 2013—is upon us, and I want to talk about this outstanding meeting and the array of opportunities it offers. Most importantly,I want to invite you personally to join me in Vancouver, BC, Canada. I am looking forward to seeing you there. Exceptional Education Offerings The 117th AAO-HNSF Annual Meeting & OTO EXPOSM is most exciting for me both because it culminates in this fantastic honor of representing you, our members, this year, and because of the robust education experience of this upcoming meeting. Did you know that you can earn up to 27.5 hours of continuing education credit by attending instruction courses, mini seminars, and scientific oral presentations at this meeting? After several planning trips to Vancouver, I can tell you this is an inspiring location. Our meeting will build on the city’s diversity and majesty, transmitting Vancouver’s energy to attendees. And I have more great news. It is my pleasure to announce that the John Conley, MD Lecture on Medical Ethics presenter is none other than one of our own and NBC’s incomparable chief medical editor and news personality, Nancy L. Snyderman, MD. With her appearance at the Opening Ceremony, the meeting will receive the best kind of kickoff, one that focuses on being the best practitioners of otolaryngic care. Immediately following the ceremony, the meeting excitement carries to the grand opening of the OTO EXPOSM, where the spirit of innovation charges the atmosphere and medicine’s practice becomes tangible. Medicine Extends Beyond the Exam Room Since this issue of the Bulletin gives you a first glimpse of the myriad exhibitors at this year’s meeting, I wanted particularly to highlight the value that the OTO EXPOSM presents to attendees. The very concept of an exposition (an outgrowth of the French market place) connotes a festive display of progress and invention. There is a showcase of cultures as well, and in the case of our specialty the diversity is global and extraordinary, but universal in its emphasis on scientific and technological innovations. Our meeting is considered the World’s best gathering of otolaryngologists. This year’s EXPO is in the city of one of the most famous expositions and world’s fairs—Expo 86, the 1986 World Exposition on Transportation and Communication. Expo 86 was the last World’s Fair in North America. Whether we are introverts who seek ideas or extroverts who learn best from others, as physicians we all are interested in tools and technologies that improve patient care. The OTO EXPO is the best chance we have each year to look for those innovations. It is in the hall that you can really target your search for those practical applications of the latest findings in care. Many of us have had this experience before but are still awed by the number of vendors and possibilities for exploration that the EXPO presents. Over time, I have heard of strategies developed by members to successfully discover innovative solutions appropriate to their time and budget. Following are those recommendations: Seven Show Strategies Use this issue of Bulletin to research exhibitors pre-show by visiting their microsites anonymously, or set up appointments for those solutions that top your needs. Plan for a time to visit the floor just to check for innovations in tools and technology. When energy ebbs, seek out areas with small tables or conversation niches near the exhibitors you want to engage to jump-start the exchange of ideas with them and others. Eat lunch in the OTO EXPOSM hall and talk to colleagues—exhibitors too are happy to have you lunch in their area. And it’s free. Use vendors as a concierge service to help you find other colleagues that they know to solve problems or discuss similar issues. Leave your information and questions with avendor to follow up. “Revisit” any booth after the show at www.entnet.org/annual_meeting and look for your post-show Meeting Daily 365. For all the details about themeeting, go to www.entnet.org/annual_meeting. I look forward to seeing you there. – See more at: http://aaobulletin.365.staging2.ascendmedia.com/Highlight.aspx?p=472&id=6238#sthash.aYkusoZy.dpuf
Stacey L. Ishman, MD, MPHBOG Member-at-Large
Guidelines, Evidence, and Development
Evidence-Based Medicine and Guidelines You can’t open a journal these days without hearing about guidelines and evidence-based medicine. Many of the benefits of these are obvious: the ability to improve patient safety and quality, cost savings from standardization, and clear goals of care. While their application is dependent on the specific clinical situation faced by the individual patient and provider, hospital system adoption is critical to implementation. In addition, the use of guidelines provides practitioners with a clear opportunity to avoid the use of historical diagnostics and treatments that do not have proven effectiveness, thus reducing the need to practice defensive medicine. While the benefits of the guidelines are substantial, not everything has been rosy. The insurance industry has misinterpreted some of these guidelines and intervention from our Academy has been critical in getting indicated procedures covered by insurance. In addition, the local implementation of these guidelines is not always straightforward. A recent article in the journal Otolaryngology–Head & Neck Surgery by Lisa E. Ishii, MD, highlights the components of effective guideline implementation.1 She suggests that once there is buy-in to institution compliance with national guidelines, an ideal strategy should include leadership commitment with a stated expectation that all members of the organization should participate. Next, an education plan should be developed with dissemination via multiple educational methods and a systems plan should be developed with measurement tools to gauge success over time. Lastly, provider incentives should be put into place to align guideline utilization metrics with academic and financial reward systems.  Goal-focused Practice Inherent in this last recommendation is the assumption that each of us has set time aside to create a personal set of goals that may or may not be in substantial alignment with institutional metrics. Like many other physicians, I spend much of my day bogged down in minutiae—focused on a consent form, a prescription, or a single patient phone call, and rarely take the opportunity to focus on the big picture. The sage advice of one of my colleagues, Christine G. Gourin, MD, was that I focus my planning on multiple goal windows: six weeks, six months, and six years. This would allow me to work on the to-do list, but still focus on long-term goals and set up interim targets to help me accomplish them.Just as we plan for synergy between individual and organizational goals, the Academy’s Board of Governors (BOG) is working to align our resources and energy toward those goals most important to its members. In order to accomplish this, the BOG wants to hear from you.   Contact the Board of Governors Let us know what issues are important to you and might be appropriate for dissemination and feedback through our regional system. Let us know what topics you think should be next in guidelines development. Let us know if you are having legislative or socioeconomic issues in your states and hospital systems. Just like guideline implementation, the services of the Board can only be as good as the buy-in from its members and feedback to let us know how we can best focus our collective efforts.In addition, the BOG will be having its committee meetings/sessions in Vancouver, BC, Canada, beginning on Saturday, September 28, and will have our General Assembly meeting Monday afternoon, September 30. We invite broad participation and do not require participants to be appointed members or sit formally on a committee in order to attend and contribute. Please plan to contact your state society’s BOG governor, legislative representative, or public relations representative, or email us directly with suggestions at bog@entnet.org. We look forward to seeing you in Vancouver.­   Reference Ishii LE. Closing the Clinical Gap: Translating Best Practice Knowledge to Performance with Guidelines Implementation. Otolaryngol Head Neck Surg. 2013;148(6):898-901.
Member Engagement: Residents’ Perspective
From the AAO-HNS Section for Residents  and Fellows-in-Training 2012-2013 Governing Council This spring, residents and fellows-in-training had the opportunity to attend the Board of Governors (BOG) Spring Meeting & OTO Advocacy Summit. Thanks to the generosity of the Academy, the BOG, and others who helped support Resident Leadership Grants (RLG), became engaged with the legislative process and the inner workings of the BOG. We were continually recognized as valued voices and featured as the future of otolaryngology. The enthusiasm and mentorship directed toward our group was truly inspiring. The BOG Spring Meeting provides an intimate setting in a collegial atmosphere. You sit next to leaders in the field and can interact with some of the most active members of our specialty. These policymakers and leaders show tremendous interest in residents and fellows-in-training by intentionally introducing themselves throughout the meeting and including you at all events. At a professional level, there are unmatched networking and mentorship opportunities whether you are pursuing a fellowship or a career in academia or private practice. You will hear life experiences and practice management advice from academicians, private- (single or multispecialty) and hospital-based practitioners, and everything in between. On a resident-to-resident level the meeting is a great place to do some of the most important networking of the meeting—with other residents. Residents from programs across the country interact in an advocacy-based environment that helps make lasting connections. It affords residents the opportunity to find positions within the Academy, in the Section for Residents and Fellows-in-Training (SRF), and other committee opportunities that meet their interests within the AAO-HNS. Perhaps the most important aspect of the meeting is that you are up close with the issues we face as a specialty. The meeting concludes with a visit to “the Hill” and a face-to-face visit with your state’s Members of Congress and their aides. It’s a unique opportunity to sit down and discuss the challenges otolaryngology faces at national and local levels. If you are a resident or fellow-in-training reading this, we highly recommend going to the meeting next year. You won’t be disappointed. It’s different, it’s vital, and it’s worth it for the potential mentorship alone. For the young physician, the meeting is an avenue to finding leadership roles and having your voice heard among those who guide our field. Also, be sure to take advantage of BOG and SRF events during the AAO-HNSF 2013 Annual Meeting & OTO EXPOSM in Vancouver, BC, Canada. BOG committee meetings begin on Saturday morning, September 28, and are open to all members. Become more involved with your SRF, attend the SRF General Assembly 2:30 pm-4:30 pm Monday, September 30, and volunteer to serve.
Jay S. Youngerman, MDPlainview, NYCandidate, BOG Chair-elect
2013 BOG Candidates
Joseph E. Hart, MD Waterloo, Iowa Candidate, BOG Secretary What are your qualifications and what is your experience? I have been in private practice in Iowa since completing my residency in 1994. I am in a large multi-specialty group and have served on its board. I have served in hospital leadership at both of the hospitals in our area. I have been chief of surgery, president of the medical staff, and chair of credentials. I have served on the Iowa Medical Society Board. For our specialty, I served in leadership as our state president. I also have served on the AAO-HNS Ethics, Patient Safety and Quality Improvement (PSQI), Physician Resources, and Medical Informatics committees. I have attended Board of Governors meetings since 1999 and have served as vice chair of the Legislative Representatives committee, member of the SEGR committee, as well as chair of Rules and Regulations. I am a member of the ENT-PAC and Millennium Society. My motivation comes from serving my community and my colleagues to make a positive difference for the future of healthcare. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. As Secretary of the Board of Governors, I would support the vision, mission, and journey as we serve our colleagues and thus their patients and their communities in advocacy, quality,education, membership strength, and sustainability. Each of these is intertwined in this increasingly challenging environment in which we find ourselves. Change and uncertainty is at the forefront of all conversations. We must rely on each other to make the choices and decisions that can best serve our patients and their families. Then the pieces can be addressed as they interlock with each other, as we do. The answers to the current problems and ones on the horizon come from communication, first and foremost. In this role I would need to be a conduit bringing forward information, concerns, and possible solutions from the local and regional level to the national level, and back.This must be accomplished with a respectful, clear and concise, but determined manner. Sanjay R. Parikh, MD Seattle, WA Candidate, BOG Secretary What are your qualifications and what is your experience? I have been a long-term, dedicated supporter and leader in our Academy’s mission. I am currently vice-chair of the BOG Socioeconomic & Grassroots Committee and a member of the Executive Committee. I have previously served as a member of the Board of Directors and chair of the Young Physicians’ Committee. I have been a participant in BOG Legislative, Big on Goals, and Public Relations committees. I have been a presenter, instructor, journal reviewer, Millennium Society member, and Honor Award recipient for the Academy. On behalf of all surgeons, I have lobbied for healthcare and liability reform on Capitol Hill on several occasions. I have also had executive or leadership positions in the American College of Surgeons, AMA, Northwest Academy of Otolaryngology, American Rhinologic Society, and American Society of Pediatric Otolaryngology. Through this experience in society leadership, I believe I am well positioned to serve as secretary of the BOG. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. My goal on the Board of Governors is to ensure that the Academy recognizes the challenges that private practice and academic otolaryngologists face every day. We are at a crossroads with reimbursement, liability threats, and uncertain healthcare reform. Fortunately,our Academy’s strategic plan is to pro-actively create programs to address these challenges. As secretary of your Board of Governors, my priority would be to promote advocacy, practice management, and education. I will foster member engagement for advocacy, liability reform, and securing of our scope of practice. I will ensure that our Academy understands the current practice climate by developing programs in EMR, safety, adopting mid-level providers, and optimizing reimbursement. The Board of Governors was established to provide a voice for its members in private practice and academics. As your BOG secretary, Iwill do my best to make sure your Academy hears that voice. Wendy B. Stern, MD North Dartmouth, MA Candidate, BOG Chair-elect What are your qualifications and what is your experience? The BOG is a grassroots member network established to act as a conduit for information between individual otolaryngologists as represented by their societies and the Academy. I believe organizational success requires active participation. I served as president ofthe Massachusetts Society of Otolaryngology (MSO) and still am a board member.I first became involved with the BOG as the MSO public relations representative, serving on that BOG committee and eventually becoming itsco-chair. I now serve as chair of the Academy’s Media and PR Committee. I participate in all BOG committees and related activities. I am concluding mytwo-year term as Secretary of the BOG. I am a tenacious worker with innovative ideas, an unbeatable work ethic, and a proven record of dedication demonstrated in establishing and growing a private practice in the last 21 years and my 15 years of involvement with the MSO and BOG. I believe that these experiences place me in a strong position to serve you and otolaryngology as chair of the BOG. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. Otolaryngology is a small specialty with a loud voice. Changes in medicine are occurring nationally, locally, and within our specialty. Key issues such as quality, access to care, scope of practice, training, subspecialization, ACOs, EMR, pay for performance, pay for call, and to sell or not to sell, highlight many of our members’ concerns. Our Academy leaders have been present and participating in the dialogue impacting our healthcare system. The BOG brings your voices on these issues to the Academy. The BOG leadership is working to enhance this dialogue by creating regional networks with our member societies that will report to our Legislative Affairs Committee and our Socioeconomic and Grassroots Committee. I am dedicated to seeing this through. I want to encourage otolaryngologists representing the broad diversity of our membership to take part in shaping our specialty by becoming active in their local and specialty societies and by participating directly with the BOG. Our Academy is improving its website and social media. I envision the BOG utilizing these tools to improve communication and accomplish its goals. As chair of the BOG I will continue my commitment to these endeavors. Jay S. Youngerman, MD Plainview, NY Candidate, BOG Chair-elect What are your qualifications and what is your experience? Elected secretary/treasurer, vice president, and president Long Island Society of Otolaryngology (LISO) Elected legislative representative/governor LISO, 17 years. Legislative representative committee, eight years Carrier relations committee, three years First member-at-large BOG establishing position and determining its role BOG Executive Committee, eight years Chair Big on Goals Subcommittee/Committee, three years Chair BOG Development/Fund Raising Task Force,three years — reestablished Millennium Society, Millennium Society Lounge,Membership Benefits, Partners For Progress (founding member), Hal Foster(founding member) raising millions of future Academy dollars Academy Development Committee (founding member) BOG Chair Award, Academy Honor Award ENT PAC JSAC President Melville Surgical Center Chief Division of Otolaryngology North Shore Plainview Founded Long Island ENT Associates PC—1983, Managing Partner NYSSO-HNS, MSSNY Castle Connolly Best Doctors 1994-2013 I have actively advocated for our specialty locally,statewide, and federally. As chair, I would encourage and empower all of our members to do the same. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors? The BOG is the grassroots organization connecting members to the Academy. We must encourage greater participation by our membership through local societies, not only advancing AAO-HNS academic goals, but in these changing times the socioeconomic hurdles we are, and will be, facing. BOG members (private practice,academic, military, resident/fellows) will direct and assist the Academy creating guidelines/quality measures while supporting the Academy financially. Having prior leadership roles(Academy, hospital chair, ambulatory or president, past health insurance company advisor) I am familiar with scope of practice, non-physician false advertising, ICD-9/ICD-10, coding, insurance company antics, and ACOs. Through strength, expertise, and education, I will help our members and state and local societies advance our Academy’s mission, defending their right to practice in a stable environment,benefiting otolaryngologists and patients. I would dedicate myself to helping our local societies obtain the tools and resources they need, encouraging more active involvement in the socioeconomic, academic, and political future of otolaryngology.
BOG Awards Spotlight New York Members
New York State Receives BOG Model Society Award The New York State Society of Otolaryngology-Head and Neck Surgery (NYSSO) is the recipient of the 2013 Board of Governors (BOG) Model Society Award. Steven M. Parnes, MD, governor and public relations representative, and Gavin Setzen, MD, legislative representative, represent the society on the BOG. NYSSO members promoted ENT awareness observances through their practice websites including Kids E.N.T. month (February), National Sleep Awareness Month (March), Oral Head and Neck Cancer Awareness Month (April), World Voice Day (April), and National Audiology Awareness Month (October). Additionally, many members offered free head and neck cancer screening services in their offices. Siobhan Kuhar, MD, PhD, made a media presentation to the New York State Department of Motor Vehicles, promoting the New York State Partnership Against Drowsy Driving. NYSSO is a founding member of the New York Coalition of Specialty Care Physicians. Legislatively, NYSSO leadership and staff participated in monthly coalition conference calls to plan activities for the 2012 state legislative session, including sponsorship of a fundraiser to honor four key legislative committee chairs, and a joint lobby day. Otolaryngology was represented at Lobby Day by NYSSO members from different districts in the state and two residents from the Albany Medical Center training program. Enactment of the hearing aid access bill was a cornerstone of the society’s legislative program and a focus of the coalition’s lobby day, several meetings with individual legislators, and roundtable discussions. Additionally, NYSSO created a database matching ENTs with members of key senate and assembly committees for targeted grassroots messaging about the New York hearing aid access bill. Understanding that any allied health practice expansion creates a domino effect and enhances the likelihood that other non-physician groups will enjoy similar success, NYSSO took a strong stand in opposition to a number of expansion bills including ones that would: Authorize certain dentists to perform any procedure in the oral and maxillofacial area regardless of its relation to the oral cavity; Expand podiatric practice to include treatment of, or surgery on, the ankle and all soft tissue structures of the leg below the knee; and Permit optometrists to prescribe a wide range of oral medications, including controlled substances. Additionally, NYSSO lobbied on proactive bills of importance to medicine including legislation: To allow collective negotiations between healthcare providers and certain health insurance plans under close state monitoring; To provide greater transparency and standardized disclosure of health insurance companies’ out-of-network payment policies; and To require truth in advertising for all health professionals. NYSSO does not have a political action ommittee (PAC) of its own, but established an advocacy fund and solicited contributions to help offset some of the organization’s costs related to coalition participation, support of legislative fundraisers, and advocacy efforts aimed at policy makers and insurers. BOG Practitioner Excellence Award The 2013 BOG Practitioner Excellence Award will be presented to Michael Setzen, MD, of Great Neck, NY. Dr. Setzen was nominated by his peers as having been at the forefront of otolaryngology as a private practitioner with a significant academic involvement manifested by the numerous papers, presentations at scientific meetings both in the U.S. and worldwide, and the organization of many major scientific meetings both locally and nationally. Dr. Setzen is nationally renowned in rhinology and has become a go-to person with respect to socioeconomic issues in otolaryngology. Throughout his professional career, Dr. Setzen has devoted a significant amount of his time as a civic leader and served in numerous leadership positions with national, state, and local medical organizations. Dr. Setzen is the immediate past president of the American Rhinologic Society (ARS). At the AAO-HNS, he is a past BOG chair and currently serves as the co-chair of Physician Payment Policy Workgroup (3P), that acts on behalf of the Academy responsible for all issues related to socioeconomic affairs and practice management and is a key component of health policy for the Academy. He is also a member of the AAO-HNS Board of Directors and has been a member on the board on and off for the past 20 years in different capacities, as board representative for private practice and most recently as chair of practice management. His dedication in service to AAO-HNS is evidenced by the two awards he has received from the Academy, namely, the Honor Award and the Distinguished Service Award. He is a member of the Millennium Society, Partners for Progress, and the ENT PAC. Dr. Setzen has been the president of the Long Island Society of Otolaryngology, Nassau Surgical Society, and the New York Head and Neck Society. Dr. Setzen is the chief of the rhinology section at North Shore University Hospital in Manhasset, NY, a clinical associate professor of otolaryngology at NYU School of Medicine, and adjunct clinical assistant professor of otolaryngology at Weill Cornell University College of Medicine.Please join the Board of Governors to honor NYSSO and Dr. Setzen during the BOG General Assembly meeting, Monday afternoon, September 30, in Vancouver, BC, Canada.