AAO-HNSF Annual Meeting: The Intricate Work of Otolaryngologists
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- Miami played host to American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) annual meeting, with Miller School faculty and staff prominent.
- ENT is an intricate medical specialties, with most of the structures in the ear, nose and throat tiny, complex and difficult to access.
- Conference attendees discussed the variety of open, endoscopic, microscopic and robotic techniques they use to help their patients.
The annual American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) meeting was in Miami this year and prominent ENT providers and faculty presented the latest developments in ear, nose and throat care and head and neck surgery.
University of Miami Miller School of Medicine faculty sponsored a wide range of hands-on courses, including symposia on skin cancer, endoscopic sinus surgery, ear surgery, laser laryngology and several others.
“It’s certainly extra work to have a large conference in our hometown, but it’s also quite rewarding,” said Fred Telischi, M.D., the James R. Chandler Chairman of the Miller School’s Department of Otolaryngology and professor of otolaryngology, neurological surgery and biomedical engineering. “There are people here from around the world and we had the tremendous opportunity to enhance their experience in Miami and showcase our department.”
A Complex Specialty
ENT is one of the most intricate medical specialties. Most of the structures in the ear, nose and throat are tiny, complex and difficult to access. Many procedures are conducted near the brain and face, generating added concern for cognitive function and aesthetics.
“It’s challenging because we have a lot less room for error,” said Maria Suurna, M.D., professor in the Department of Otolaryngology-Head and Neck Surgery’s Division of Sleep Medicine and director of sleep surgery at the Miller School. “There are a lot of essential structures that govern daily living, quality of life, function and how we perceive the world.”
During the conference, Dr. Suurna was appointed AAO-HNSF coordinator for international affairs. She’ll promote the organization’s global educational and research programs and annual meeting, and advocate for international members.
Surgeons have adopted a variety of techniques to reach into the head and neck: microscopes to look into small areas in the ears, endoscopes to go deep into the nose, laryngoscopes to look down the throat, flexible endoscopes to see around corners and robotics to make these techniques even more precise.
“In ear, nose and throat, we diagnose and treat disorders that affect critical senses and capabilities, like hearing, smell, taste and breathing,” said Christine Dinh, M.D., associate professor of clinical otolaryngology and associate director of the T32 Otolaryngology Surgeon Scientist Program at the Miller School. “And because the anatomy of the head and the neck is intricate and composed of a variety of orifices of different shapes and sizes, we use open, endoscopic, microscopic and robotic techniques to address disease.”
The discipline encompasses many subspecialties. The conference had a diverse range of educational opportunities for plastic and reconstructive surgery, head and neck surgery, laryngology, neurotology, rhinology and many other areas. Just prior to the conference, Dr. Suurna co-chaired the International Surgical Sleep Society meeting, also held in Miami.
Cancer Surgery
Head and neck cancers can be some of the most challenging cases and the ENT community has been intent on improving outcomes. Surgeons and researchers at the conference discussed efforts to understand how these diseases progress and emerging therapies.
“There’s a lot of active research in head and neck cancer, particularly as it relates to some of the newer immunotherapies,” said Donald Weed, M.D., the W. Jarrard Goodwin Professor – Head and Neck Surgical Oncology and co-director of the Division of Head and Neck Surgery in the Department of Otolaryngology at the Miller School. “Immunotherapy has changed our ability to help a small number of patients who previously might have had incurable disease but can now have long-term responses.”
Dr. Weed cautions that immunotherapies have not been game changers in head and neck cancers. However, newer efforts are combining different immunotherapies and radiation to improve outcomes. Drs. Weed and Dinh have collaborated with experts in the field to investigate how radiation impacts inflammatory signaling in tumor microenvironments.
Resident Michelle Pei, M.D., discussed that work as a poster presentation. Early efforts are showing some promise but there’s more work to be done.
Faculty Presentations
Miller School faculty gave approximately 20 presentations at the conference and their work highlighted the diversity of the field. Bjorn Herman, M.D., an assistant professor of clinical otolaryngology at the Miller School, presented on stratifying the risk of acoustic neuromas, a type of non-cancerous inner ear tumor. Corinna Levine, M.D., an associate professor of clinical otolaryngology in the Division of Rhinology at the Miller School, led four panels, including one discussing how to best manage allergic fundal rhinosinusitis — chronic sinus infections caused by fungal allergies.
Adrien A. Eshraghi, M.D., professor of otolaryngology, neurosurgery, pediatrics and biomedical engineering, presented on intracochlear drug delivery, which targets medicines to specific parts of the inner ear. This approach is being considered to treat noise-induced hearing loss and other conditions. Francisco Civantos, M.D., professor of otolaryngology and co-chief of the Miller School’s Head and Neck Division, presented a poster on sentinel node biopsies, which help determine if cancers have spread.
ENT Outreach
In addition to research and clinical care, the conference addressed professional development and community outreach. Dr. Weed was on a panel that discussed the challenges of providing head and neck care in Haiti. In past years, he visited the island to train surgeons and support better care. Deteriorating security in Haiti has made those trips impossible now.
During the conference, Miller School clinicians helped coordinate a volunteer event, Community Outreach Opportunities for Learning Otology and Otolaryngology (COOL-OTO), with more than 50 participants setting up a STEM event at a local high school.
“This year, we went to Booker T. Washington, a historically black public high school, to set up 12 hands-on stations for around 250 students,” said Dr. Dinh. “We showed them examples of what we do in ear, nose and throat and they engaged in hands-on experience, including placing a breathing tube in an adult manikin, using endoscopes to peer into the ear canal and nasal passages, as well as screwing titanium plates to fix a face fracture. We hope to encourage them to see themselves going into a medical field or even becoming an ENT.”
Tags: Department of Otolaryngology, Dr. Adrien Eshraghi, Dr. Bjorn Herman, Dr. Christine Dinh, Dr. Corinna G. Levine, Dr. Donald Weed, Dr. Francisco Civantos, Dr. Fred Telischi, Dr. Maria Suurna, head and neck surgery, otolaryngology