UT ORL Update, our first on-line departmental newsletter, summarizes current topics in otorhinolaryngology. The newsletter’s target audience includes physicians and other healthcare providers, although subscriptions are not limited to members of these groups.
Martin J. Citardi, MD Professor & Chair Otorhinolaryngologists, like other physicians, consider innovation to be a core driver in improving the health of patients, since innovation offers the promise of new therapeutic alternatives. In the ideal world, innovation improves...
Read More Coding for Innovation
Sancak Yuksel, MD Associate Professor In contrast to adults, the diagnosis of a thyroid nodule in children is rare. In these cases, the workup and treatment generally follows the guidelines set forth by the American Thyroid Association (ATA) and...
Read More Management of Thyroid Nodules in Children
Ronda Alexander, MD Assistant Professor Often in medicine, our ability to treat disease outpaces our reconstructive capacity. This was long the case in Otolaryngology which for years provided curative surgery but had little to offer patients who suffered cosmetic...
Read More What is Laryngoplasty?
Soham Roy, MD,FACS,FAAP Professor, Director A tremendous amount of media attention has been paid recently to tonsillectomy surgery in children, partially due to President Obama’s comments on tonsillectomy during the pivotal September 2009 speech to the nation on healthcare...
Read More New Clinical Practice Guideline for Tonsillectomy
Martin J. Citardi, MD Professor & Chair The 2011 edition of Current Procedure Terminology introduces several new codes that will likely have a major impact on the reimbursement for procedures of the paranasal sinuses. The changes reflect the culmination...
Read More 2011 CPT Introduces New Codes for Balloon Dilatation of Paranasal Sinus Ostia and Surgical Navigation
Ron J. Karni, MD Associate Professor & Chief Over the past decade, a rise in the incidence of oropharynx cancer has been associated with HPV positivity. This shift in the demographics of head and neck cancer may be related...
Read More Should HPV status guide treatment in oropharyngeal carcinoma?
Ronda Alexander, MD Assistant Professor It’s not unusual for a treatment that clinicians anecdotally ‘know’ works to remain unpaid by insurers who classify it as experimental. This is due, in part, to the wait for research that proves the...
Read More A New Dawn for Migraine…Botox
Sancak Yuksel, MD Associate Professor Two years ago a group of French physicians, Leaute-Labreze et al. reported their spectacular results in treating infantile hemangiomas with oral propranolol, an antihypertensive drug. This very recent and serendipitous discovery seems to change...
Read More No More Surgery for Airway Hemangioma?
Ron J. Karni, MD Associate Professor & Chief In patients who are referred for surgical management of primary hyperparathyroidism, a successful outcome may be defined as identification and removal of the adenoma with a commensurate drop in post-operative PTH...
Read More A Role for Surgeon-Performed Ultrasound in the Management of Primary Hyperparathyroidism
Amber Luong, MD, PhD Associate Professor This past spring represented one of the worst allergy seasons in Houston. The unusually long cold season delayed some trees from blooming and consequently led to an usually high peak in the number...
Read More Allergy Update
Samar Fakhri, MD Professor One of the most exciting aspects of attending scientific meetings is to explore new products and technologies presented during the program sessions or showcased by the exhibitors. At the recent Combined Otolaryngology Society Meetings (COSM)...
Read More Is 3-D Endoscopic Sinonasal Surgery Coming to an OR Theater near You?
Soham Roy, MD,FACS,FAAP Professor, Director As we move toward a world where medical treatments are judged not by pizzazz but by efficacy and cost-effectiveness, evidence-based medicine (EBM) has become the new thrust of medical education and practice. Along with...
Read More Hoarseness: Can Evidence-based Medicine and Practical Experience Get Along?
Yitzhak Etan Weinstock, MD Assistant Professor The term “goiter” simply refers to an abnormal enlargement of the thyroid gland. There are multiple causes of goiters and their presence does not necessarily indicate that the thyroid gland is malfunctioning on...
Read More Large Benign Goiters: Special Considerations for Management
Sancak Yuksel, MD Associate Professor As we all know, normal hearing is binaural. Binaural hearing provides some major benefits: better and targeted hearing in a noisy environment, better localization of sounds, and more natural and balanced hearing quality. If...
Read More Bilateral Cochlear Implantation: Achieving a Stereo Effect
Amber Luong, MD, PhD Associate Professor Johnson & Johnson recently announced its acquisition of Acclarent for over $800 million. This acquisition and the recent survey for new CPT codes for the balloon sinus ostial dilation beg the question as...
Read More Balloon Dilatation of the Sinuses for Chronic rhinosinusitis: Should we slow down and look at the data?
Ron J. Karni, MD Associate Professor & Chief Patients with Papillary Thyroid Carcinoma (PTC) exhibit excellent rates of disease control and survival with total thyroidectomy and post-operative radioactive iodine (RAI) therapy. In the United States, overall survival is greater...
Read More Papillary Thyroid Carcinoma: Management of the Neck
Tang Ho, MD Associate Professor Nasal obstruction secondary to anatomic nasal deformities is a fairly routine problem seen by the otolaryngologists in the office, usually in the setting of someone who has failed medical management. While routine septoplasty and inferior...
Read More Functional Septorhinoplasty for Nasal Obstruction
Tang Ho, MD Associate Professor The reconstruction of a subtotal to total lower lip defect, whether it be due to trauma or cancer resection, presents a significant challenge for the plastic and reconstructive surgeon. In addition to the clear immediate...
Read More Lip Reconstruction
Ron J. Karni, MD Associate Professor & Chief Lip cancer is the most common malignant lesion of the oral cavity, constituting 25-30% of all oral cavity cancer cases. It is the second most common malignancy of the head and neck...
Read More Lip Cancer
Martin J. Citardi, MD Professor & Chair Every day, physicians rely upon Current Procedural Terminology (CPT) to report their services for payment by the Centers for Medicare & Medicaid Services (CMS) and other third-party payers. Increasingly, CPT coding captures quality...
Read More Current Procedural Technology: History, Structure, Process & Controversies
Ronda Alexander, MD Assistant Professor The Wall Street Journal reported recently that approximately 650 surgical fires are reported in U.S. hospitals each year, and another three to four times as many are “near misses” or unreported events.1 The risk...
Read More Surgical Fires in Otorhinolaryngology
Amber Luong, MD, PhD Associate Professor As both clinicians and patients will attest, chronic rhinosinusitis with nasal polyposis (CRSwNP) represents a challenging disease to manage. Functional endoscopic sinus surgery is often required and successful for the initial management, but...
Read More Role of Anti-leukotriene Agents in the Management of Chronic Rhinosinusitis with Nasal Polyps
Ronda Alexander, MD Assistant Professor This March, I had the great opportunity to travel with a mission group to La Habana, Cuba. It was a result of some conversations I shared with my co-fellow over the course of our...
Read More Mission Trip to La Habana, Cuba
Amber Luong, MD, PhD, Associate Professor Asthma is characterized by episodic lower respiratory symptoms (mostly commonly shortness of breath due to wheezing) that result from reversible pulmonary airflow obstruction. Many patients with asthma also suffer from allergic rhinitis and...
Read More The Diagnosis of Asthma in Otorhinolaryngology Patients
Amber Luong, MD, PhD Associate Professor Over 50 million of people suffer from allergies a year in the United States. Many control their symptoms with over-the-counter medications and avoidance measures. A subset of allergy sufferers, approximately 3 million, has...
Read More Understanding the Mechanism of Allergen Immunotherapy
Samar Fakhri, MD Professor In the traditional classification of cerebrospinal fluid (CSF) leaks, spontaneous (or idiopathic) rhinorrhea is included under the “normal-pressure” category. As such, the absence of a recognizable etiology is axiomatic to the diagnosis of a spontaneous...
Read More Significance of Empty Sella in the Management of Spontaneous CSF Leaks
Ronda Alexander, MD Assistant Professor When considering vocal fold augmentation, the lynchpin of success is finding the perfect material for your patient’s indication. For those patients who are either unwilling or unsuitable for operative thyroplasty, injection medialization is an...
Read More Radiesse®: A New Material for Vocal Fold Injection Augmentation
Martin J. Citardi, MD Professor & Chair Over the past 12-15 years, rhinologists and general otolaryngologists have increasingly embraced the use of intraoperative surgical navigation in more complex endoscopic procedures of the paranasal sinuses. The lack of real-time imaging...
Read More The Emerging Role for Intraoperative Imaging in Surgical Rhinology
Martin J. Citardi, MD Professor & Chair Since its introduction more than 3 years ago, balloon catheter dilatation of sinus ostia has engendered considerable controversy. In 2008, a variety of publications have provided additional information about the technology and...
Read More New Ethmoid Spacer For Drug Delivery
Ronda Alexander, MD Assistant Professor The past decade has seen vocal fold paresis gain a foothold in the diagnostic algorithm of otorhinolaryngologists. It is now accepted that neurologic impairments of vocal fold motion exist along a continuum and can...
Read More Vocal Fold Paresis: New Recognition for a Subtle, but Disabling Disorder
Samar Fakhri, MD Professor Over the last 3 decades, we have witnessed a tremendous expansion of the applications of the rigid endoscope as a surgical tool. Improved understanding of endoscopic sinonasal anatomy, technological advances in instrumentation and imaging protocols,...
Read More Minimally Invasive Endoscopic Surgery for Malignant Tumors of the Skull Base
Amber Luong, MD, PhD Associate Professor Chronic rhinosinusitis represents a syndrome characterized by nasal symptoms including discolored nasal drainage, nasal obstruction or congestion, and pain or tenderness over the sinuses; this syndrome resulting results from a number of possible...
Read More New Horizons for Allergic Fungal Rhinosinusitis