Otorhinolaryngology - Head and Neck Surgery
Description of Sites
The office of the chairman of the Department of Otorhinolaryngology-Head and Neck Surgery at Albert Einstein College of Medicine, and of the program director of the residency program, are currently located at Montefiore Medical Center. Montefiore is a large tertiary medical center that serves as the university hospital and academic medical center for Albert Einstein College of Medicine, and forms the geographic center of the program. There are currently eight full time otolaryngology faculty based at the Moses Campus representing many sub-specialties within the field of otolaryngology, including fellowship trained specialists who are leaders in the fields of rhinology, laryngology, pediatric otolaryngology, otology, and head and neck surgery.
Our otolaryngologists have been instrumental in the development of image guided sinus surgery, and residents are exposed to a large number of complex endoscopic sinus surgeries at Montefiore, many of which utilize the image guidance system. In addition, residents are also trained on an endoscopic sinus surgery simulator that was developed and refined at Montefiore .
While at Montefiore, residents are also exposed to a great deal of head and neck cancer surgery. Our surgeons are among a handful in the country that routinely perform endoscopic partial laryngectomies. The department has been instrumental in organizing a truly multidisciplinary approach to the treatment of head and neck cancer patients, leading a weekly multidisciplinary tumor board as well as playing a role in the formation of a multidisciplinary clinic where patients can see head and neck cancer surgeons, oncologists, and radiation therapists during the same visit.
In addition, there is a well-developed basic science research program that has been involved in accruing a substantial tissue bank and performing genetic analysis on a large number of head and neck tumors. This program provides significant research opportunities for residents. The Division of Speech Pathology is a strong presence at Montefiore performing videostroboscopy, as well as speech and swallow evaluation and therapy. Residents review strobes weekly with the chairman of the department.
Montefiore staffs a full service audiology division with complete audiometric testing as well as Ecog, ABR, ENG, and OAE testing. The Audiology Division supports an active research program include current research into hearing disorders and the effects of treatment for systemic disease on hearing. Two neuro-otologists perform otologic and neurotologic surgery, as well as multidisciplinary skull based surgery.
The Children's Hospital at Montefiore (CHAM), a state-of-the-art tertiary care center for all pediatric otolaryngology disorders, is a beautiful 106-bed hospital with a modern PICU and five ORs. Four pediatric otolaryngologists work in the Department of Otorhinolaryngology and perform a variety of procedures. Highlights of the program include the formation of a busy pediatric cochlear implant program, and monthly multidisciplinary airway team meetings, which often result in a variety of complex pediatric airway cases.
Residents cover the majority of otolaryngology cases in the operating room, as well as participate in inpatient consultations and emergency care. The Emergency Department at Montefiore is the fifth busiest in the United States. All inpatient consultations are reviewed and seen with the appropriate attending staff. Residents also work closely with different attendings during office hours. The assignment of a resident to an office session with an attending provides one-on-one teaching, as well as continuity of care, as the residents sees the pre-operative, intra-operative, and post-operative care for the same patient. Thus, the residents are fully integrated into the care of all patients. The residency Clinical Basic Science Course also takes place at Montefiore.
The 396 bed Jack D. Weiler Hospital, located on the Einstein Campus, is also part of this rotation. It is staffed primarily by voluntary attendings, and there is a wide variety of general otolaryngology practiced at this location. Residents on their Montefiore rotation cover both the Moses and Einstein campuses, and interact with both full-time and voluntary faculty.
Our new, state-of-the-art Montefiore Hutchinson Campus raises the bar for efficiency and innovation in healthcare. Designed with our patients in mind, the 11-floor, 280,000-square-foot facility is apatient-focused and highly-streamlined ambulatory care center that maximizes efficiency.
Patients gain immediate access to high-quality ambulatory surgery and subspecialty care in a convenient location off the Hutchinson River Parkway. The Hutchinson Campus is home to multiple specialties and services under one roof—and often on the same floor—which allows for greater physician collaboration, easier referrals, and joint consultations and shorter wait times.
The Otorhinolaryngology department will accommodate outpatient adult and pediatric patients in 14 exam rooms, 4 audiology booths, a voice lab, ENG room, a procedure room for minor procedures. Ambulatory surgical cases are provided in state of the art operating rooms.
LIJ Medical Center is an 825 bed complex on a 48 acre campus in New Hyde Park, Long Island on the borders of Nassau County and New York City. The Medical Center consists of the tertiary care LIJ Hospital, which is contiguous and connected with the 150 beds, state-of-the-art Schneider Children's Hospital, and the Hillside Psychiatric Hospital. It is a part of the North Shore - Long Island Jewish Health System, which is comprised of 11 hospitals serving Queens, Nassau, Suffolk counties, as well as Staten Island. Resident training in the LIJ Hospital and the Children's Hospital are concurrent, since the two divisions of the medical center share the same operating rooms and attending staff. The Department of Otolaryngology at LIJ also includes a large freestanding hearing and speech center, with 18 full-time audiologists and speech pathologists that provide the residents with didactic and clinical training. The Schein Voice and Laryngeal Center has become an integral portion of the residency program as both a basic and clinical research tool as well as part of teaching clinical laryngology to the residents.
The Apelian Cochlear Implant opened its doors in May 2005. This addition to the existing Hearing and Speech Center is dedicated to the evaluation, treatment, and follow up of Cochlear implant patients. In addition, a dedicated conference room with state of art audio visual technology is available for teaching conferences.
Research plays an important role in the Department of Otolaryngology at LIJ, with a primary focus on laryngeal papillomatosis and an interest in head and neck cancers. Research laboratory projects for residents are available in the otolaryngology laboratory at LIJ. In addition, the North Shore - LIJ Health System includes The Feinstein Institute for Medical Research, which offers physicians who wish a career as a physician-scientist the opportunity to earn a PhD degree in molecular medicine as part of an individualized three year laboratory-based program of study. Additional information about the Graduate School can be found at http://www.feinsteininstitute.org/.
LIJ is a major Head and Neck Surgery site in the Greater Metropolitan Area. The goals of the rotation at LIJ include: management of the postoperative head and neck patient and proficiency at Otolaryngologic examination and diagnostic skills. These skills include fiberoptic laryngoscopy, medical photography, fine needle aspiration and core biopsy techniques as well as a thorough general Otolaryngologic examination. These skills are attained in the clinic, during attending rounds, emergency room consultations, and hospital consultations in the Voice Laboratory. Residents also get hands on audiologic exposure during the rotation at LIJ.
The Schneider Children's hospital is a tertiary referral center for Queens and Nassau counties affords the residents the opportunity to learn all aspects of pediatric otolaryngology including management of the pediatric airway, sinus disease, head and neck tumors and cochlear implantation. It is a level one pediatric trauma center as well.
A new ambulatory surgery center has opened across from the main campus with state of the art operating rooms and video equipment for ambulatory surgery patients.
For the new academic year, we have added a rotation to a community based Otolaryngology practice, that specializes in facial and reconstructive surgery. In addition we have arranged with the OMFS service the ability for our residents to participate in the surgical management of these patients.
There have been major changes at Beth Israel and in our department over the past 12 months. Firstly, as of July 2005 after 8 year of outstanding leadership Dr. Roy B. Sessions will be stepping down as chairman and Dr. Mark S. Persky will be taking over the position.
Beth Israel North - Singer division has closed, and the Head & Neck department has consolidated all of its in-patient and surgical care to the downtown Petrie campus. As such, we have opened a brand new head & neck surgical ward in the Dazian pavilion which includes its own 4 bed 'step down unit' dedicated to monitoring complex head & neck surgical patients. In our departmental offices, we have added an additional 8 thousand square foot clinical practice space dedicated to the management of head & neck patients.
New faculty additions include Mark Urken, MD, Daniel Buchbinder MD-DDS, Devin Okay DDS, Milton Waner, MD, and Robin Dyleski, MD. With this recent expansion in faculty we have an added increase in expertise and volume to head & neck surgical oncology, microvascular free tissue reconstruction, oral & maxillofacial surgery and prosthetics, and the management of vascular tumors of the head & neck.
Stating in July 2006 Dr. Urken will have a one year GME approved fellowship. The fellow will be dedicated towards microvascular free tissue reconstruction and will enhance our resident's education in the management of head & neck oncology.
With the departure of our pediatric otolaryngologist, Dr. John Bent, we welcome the arrival of Dr. Robin Dyleski. Because of the closing of the Beth Israel's Singer division, the pediatric ICU has been moved down to the Petrie division. This new addition of a pediatric ICU with a new pediatric otolaryngology attending will hopefully bring an increase in complexity and volume of pediatric cases to our department.
On an academic note, our department recently hosted the 15th annual multidisciplinary course in the management of head and neck cancer & thyroid and parathyroid disease. Under the direction of Dr. Urken, this one week course had an international faculty and was approved for 60 level-1 CME credits.
Rotating at Beth Israel Medical Center in the OTO-3 year, the resident is exposed to a heavy in-service patient volume with surgical cases varying from head and neck, skull base, microvascular reconstruction, otologic, laryngology, pediatric ENT, and facial plastic surgery. In the OTO 5 year, the responsibilities of the residents increase, as does their operative experience with more emphasis on surgical planning and skills. We have tailored for the AECOM OTO 5 resident, a focused otology rotation, which includes attending private office hours with senior otologists, scrubbing primarily on otologic cases, and attending the various weekly didactic otology conferences.
For more information on Beth Israel Medical Center, click here.
Jacobi Medical Center is a large city hospital with high clinical, emergency room and surgical volume. There are no private patients. In this setting, residents assume the most direct patient responsibility. It is here that they have the experience of long-term care of their own patients. Residents are expected to evaluate new problems, to schedule the appropriate tests and/or surgery, and to provide follow-up for that patient. They are involved in both medical and surgical management of diseases and disorders. Jacobi Medical Center is also the site of a Level 1 Trauma Center, one of New York City's busiest emergency departments. This affords the residents a broad experience in maxillofacial trauma, blunt and penetrating neck trauma, and extensive experience in soft tissue repair in the emergency room. The residents will get the majority of their trauma training at JMC. Laboratory instruction of the maxillofacial plating systems is available. Our faculty includes fellowship-trained head and neck surgeon, facial plastic and reconstructive surgeon, and neuro-otologist. Reconstructive rhinoplasty for post-traumatic defects is a large portion of the caseload as well as an increasing number of otologic cases.
For more information on Jacobi Medical Center, click here.