Past Grand Rounds

All CME credit must be claimed by 11 PM central on the day during which the CME content was first presented.

SNOT on the Clock: Does Time to Endoscopic Sinus Surgery Affect Patient Outcomes? Christopher Bell, MD - UTHealth Houston Otorhinolaryngology Thursday, December 11, 2025 Video In this UTHealth Houston ORL Grand Rounds, Dr. Christopher Bell explores the impact of surgical timing on outcomes for patients with chronic rhinosinusitis (CRS). Drawing from both Canadian British and US data, Dr. Bell reviews the pathophysiology of CRS, the challenges of delayed access to care, and the implications of early versus late endoscopic sinus surgery. He discusses key studies, including meta-analyses and retrospective cohorts, highlighting that earlier surgery in medically recalcitrant patients is associated with improved quality of life, reduced healthcare visits, and decreased medication use, especially in those with comorbid asthma. The session features a robust discussion with faculty on healthcare system differences, overutilization risks, diagnostic challenges, and the role of education and mid-level providers. Dr. Bell emphasizes the need for balanced, evidence-based approaches to optimize patient outcomes and advocates for improved training and policy to address access and diagnostic accuracy in CRS care.

Doc, Why Can I Feel My Throat? Pathology, Diagnosis and Treatment of Irritable Larynx Syndrome Dylan Vance, MD - UTHealth Houston Otorhinolaryngology Thursday, November 13, 2025 Video In this UTHealth Houston ORL Grand Rounds, Dr. Dylan Vance presents a comprehensive overview of irritable larynx syndrome, focusing on its epidemiology, diagnosis, and treatment. The session explores the spectrum of laryngeal hypersensitivities, including chronic cough, throat clearing, vocal strain, globus sensation, laryngospasm, and pain. Dr. Vance details the underlying pathophysiology, highlighting the role of sensory receptors and neuroplasticity in symptom development. Diagnostic strategies emphasize thorough history, physical exam, and exclusion of other causes, supported by tools like laryngoscopy and validated questionnaires. Treatment approaches are multimodal, ranging from lifestyle modifications and reflux management to neuromodulators, speech therapy, superior laryngeal nerve blocks, Botox, and vocal fold augmentation. The discussion also addresses challenges in long-term management, medication side effects, and the importance of individualized care. Audience questions cover neuromodulator duration, recurrence, and behavioral therapies for refractory cases.

Improving HPV Vaccination Rates in Vulnerable Populations Through a Multi-faceted Approach Andrea Zhang, MD - UTHealth Houston Otorhinolaryngology Retrograde Cricopharyngeus Dysfunction: Standardization of Diagnosis and Treatment Abigail Watson, MD - UTHealth Houston Otorhinolaryngology Addressing Mental Health in Post-Laryngectomy Care: Gaps and Opportunities Hannah Dellacroce, MD - UTHealth Houston Otorhinolaryngology Thursday, October 23, 2025 Video This UTHealth Houston Otorhinolaryngology Grand Rounds highlighted 3 innovative research proposals. • Andrea Zhang, MD presents her research proposal on improving HPV vaccination rates in vulnerable populations, outlining barriers, current statistics, and a multifaceted intervention to increase vaccine uptake among patients aged 18–30 at UT Physicians and LBJ Hospital. She discusses study design, anticipated challenges, and the importance of provider engagement in vaccination counseling. • Abigail Watson, MD discusses retrograde cricopharyngeus dysfunction (RCPD), focusing on the standardization of diagnosis and treatment. She reviews the BURP questionnaire, current treatment paradigms, and her proposed randomized study to determine optimal botulinum toxin dosing, highlighting the need for validated outcome measures and multi-institutional collaboration. • Hannah DellaCroce, MD addresses mental health in post-laryngectomy care, emphasizing the prevalence of depression, anxiety, and PTSD. She proposes a retrospective review to identify risk factors and gaps in mental health support, with future plans for a prospective screening intervention to improve patient outcomes.

The Role of Vaccination in HPV Oropharyngeal Squamous Cell Carcinoma Andrea Zhang, MD - UTHealth Houston Otorhinolaryngology Thursday, October 9, 2025 Video In this UTHealth Houston ORL GR, Dr. Andrea Zhang presents on the role of HPV vaccination in oropharyngeal squamous cell carcinoma. The session begins with a clinical case highlighting the changing demographics of HPV-related oropharyngeal cancer, now affecting younger, healthier patients with minimal tobacco or alcohol history. Dr. Zhang explains HPV’s pathogenesis, its prevalence, and the mechanisms by which persistent infection leads to cancer, especially in the oropharynx. She reviews diagnostic approaches, including emerging liquid biopsy techniques, and discusses epidemiological trends showing a rise in HPV-positive oropharyngeal cancers, particularly among men. The presentation covers treatment modalities, the economic burden of disease, and the impact of HPV vaccination on cervical and oropharyngeal cancer rates. Dr. Zhang addresses barriers to vaccine uptake, gender disparities, and the importance of provider education. The talk concludes with strategies for otolaryngologists to promote prevention and improve vaccination rates.

Genetic Tumor Profiling in Head & Neck Cancer: Translating Genomics into Clinical Practice Evan de Joya, MD - UTHealth Houston Otorhinolaryngology Thursday, September 25, 2025 Video In this UTHealth Houston ORL GR, Evan De Joya, MD presents an in-depth overview of genetic tumor profiling in head and neck cancers, focusing on the integration of genomics into clinical practice. Dr. De Joya discusses the significance of HPV status, TP53 mutations, and the role of BRAF mutations in anaplastic thyroid cancer, highlighting how these genetic markers influence diagnosis, prognosis, and treatment selection. He reviews current and emerging precision medicine modalities, including small molecule inhibitors, monoclonal antibodies, antibody-drug conjugates, and radiopharmaceutical therapies. The presentation also covers actionable mutations such as NTRK and HRAS, the use of circulating tumor DNA for early detection, and the impact of immunotherapy agents like pembrolizumab and nivolumab. Dr. De Joya emphasizes the importance of identifying genetic alterations to guide targeted therapies and improve patient outcomes, while addressing the challenges and future directions of integrating genomics into routine care.

Comprehensive Facial Reanimation Liliana Ein, MD - University of Miami Thursday, September 11, 2025 Video In this UTHealth Houston ORL Grand Rounds, Liliana Ein, MD, a facial plastic and reconstructive surgeon at the University of Miami, presents a comprehensive overview of current approaches to facial reanimation. Dr. Ein discusses the spectrum of facial paralysis, highlighting differences between flaccid and non-flaccid (synkinetic) presentations and the importance of individualized assessment using validated outcome measures. She reviews surgical options including nerve transfers (masseteric-to-facial, cross-face, and hypoglossal-to-facial), muscle transfers such as gracilis, and static maneuvers for long-standing paralysis. The talk emphasizes the technical nuances, patient selection, and counseling required for each intervention, as well as the evolving role of facial retraining and Botox for synkinesis. Dr. Ein shares illustrative case examples, practical pearls, and insights into multidisciplinary care, underscoring the dynamic nature of the field and ongoing advancements in restoring facial function and expression for patients with facial nerve disorders.

Generative AI for Surgeons Martin Citardi, MD - UTHealth Houston Otorhinolaryngology Thursday, August 28, 2025 Video In this UTHealth Houston ORL Grand Rounds, Martin J. Citardi, MD, Chair of Otorhinolaryngology and Vice Dean for Clinical Technology at UT Health Houston, explores the transformative impact of generative AI in surgery and otolaryngology. Dr. Citardi provides a practical overview of how large language models like GPT are reshaping clinical workflows, from ambient documentation and chart summarization to AI-driven administrative support, translation, and clinical trial matching. He shares real-world examples, including personal experiences, and highlights innovations developed at UT Health Houston, such as automated fax processing and patient-facing chatbots. The presentation also addresses technical foundations, emerging trends like AI agents, and critical considerations around data privacy, model bias, and regulatory policy. Dr. Citardi concludes with a forward-looking discussion on the evolving role of physicians and the workforce in an era of rapidly advancing AI.

Is this the worst complication in the History of ENT? Ron Karni, MD - UTHealth Houston Otorhinolaryngology Thursday, July 10, 2025 Video In this UTHealth Houston Otorhinolaryngology Grand Rounds, Ron Karni, MD, Chief of the Division of Head and Neck Surgery, presented a detailed historical overview of laryngectomy. He began by discussing the misdiagnosis of Frederick III, which led to his untimely death and subsequently World War I. Dr. Karni emphasized the importance of understanding medical history for innovation and ethical considerations. He detailed the first total laryngectomy performed by Theodore Billroth on New Year's Eve in 1873, highlighting the technical challenges and postoperative complications. The presentation also covered the evolution of medical techniques, the significance of ethical practices in surgery, and the impact of historical events on modern medical practices. Dr. Karni concluded by discussing the potential future of laryngectomy in the era of immunotherapy and advanced medical technologies, suggesting that it may become a rare procedure.

Quality of Life Considerations in Head and Neck Cancer Survivors Amy Leming, MD - UTHealth Houston Otorhinolaryngology Thursday, June 19, 2025 Video In this UTHealth Houston ORL grand rounds, Dr. Amy Leming discusses quality-of-life considerations for head and neck cancer survivors. She emphasizes the importance of addressing the long-term and late effects of treatment, which can impact various physiological and social functions. Dr. Leming highlights the shift in patient demographics due to HPV-mediated disease and the need for a multidisciplinary approach to support these patients. She outlines the three main treatment paradigms: surgery, radiation, and chemotherapy, and their combinations, noting that none of these treatments are benign. The talk covers common sequelae such as dysphagia, xerostomia, and lymphedema, as well as the importance of early intervention and continuous follow-up. Dr. Leming also discusses the role of speech therapy, physical therapy, and other supportive measures in improving the quality of life for these patients. The session underscores the need for comprehensive survivorship care and ongoing research to better understand and mitigate treatment-related effects.

Surgical Innovation in Otolaryngology: Past Lessons, Present Tools, Future Frontiers Salman Hasan, MD - UTHealth Houston Otorhinolaryngology Thursday, June 12, 2025 Video In this UTHealth Houston Grand Rounds, Dr. Salman Hasan discusses the evolution of surgical innovation in otolaryngology, from ancient practices to modern advancements and future prospects. He highlights historical milestones, such as early nasal reconstruction techniques by ancient Indian scientist Sushruta and the development of tonsillectomy methods during the Islamic Golden Age. Dr. Hasan also covers significant contributions from pioneers like Horace Green, Chevalier Jackson, and William House, who advanced laryngology, endoscopic surgery, and cochlear implantation. Present-day tools like image-guided surgery, robotic surgery, and intraoperative neuro monitoring are examined, along with emerging technologies like augmented reality and artificial intelligence. Dr. Hasan emphasizes the importance of balancing innovation with patient safety and ethical considerations, urging the medical community to focus on improving patient care while navigating regulatory and financial challenges.

I Can’t Believe It’s Not Skin: Understanding Dermal Substitutes Gianna Rosamilia, MD - UTHealth Houston Otorhinolaryngology Thursday, May 8, 2025 Video In this UTHealth Houston Otorhinolaryngology Grand Rounds, Gianna Rosamilia, MD, presents a comprehensive overview of skin substitutes, including their history, types, and applications in head and neck surgery. Dr. Rosamilia discusses various substitutes and highlights heir composition and clinical benefits. She covers applications in scalp defects, oral cavity reconstruction, parotidectomy defects, larynx and pharynx reconstruction, nasal contouring, septal perforation repairs, tympanic membrane perforations, and skull base reconstruction. The presentation also addresses cost implications and patient-specific considerations.

Air Pollution Exposure and Chronic Rhinosinusitis: Current Links and Future Directions Naweed Chowdhury, MD - Vanderbilt University Medical Center Thursday, April 24, 2025 Video In this UTHealth Houston Otorhinolaryngology Grand Rounds, Naweed Chowdhury, MD, from Vanderbilt University, discusses the impact of air pollution, specifically PM 2.5, on chronic rhinosinusitis (CRS). Dr. Chowdhury presents epidemiologic evidence linking PM 2.5 exposure to increased incidence and severity of CRS, supported by studies from Johns Hopkins and China. He shares findings from his own research, demonstrating significant associations between PM 2.5 exposure and elevated inflammatory cytokines, tissue eosinophils, and gene expression changes in CRS patients. Experimental evidence from mouse models and air-liquid interface cultures further highlights the inflammatory responses induced by PM 2.5. Dr. Chowdhury also explores treatment outcomes, suggesting potential steroid non-responsiveness in PM 2.5-associated CRS and discusses future research directions, including the role of the NRF 2 pathway and potential therapeutic targets.

Artificial Intelligence in Facial Plastic and Reconstructive Surgery Matthew Lee, MD - Cedars Sinai Thursday, April 10, 2025 Video In this UTHealth Houston ORL Grand Rounds, Dr. Matthew Lee discusses the transformative role of artificial intelligence (AI) in facial plastic surgery. He explores AI's history, key milestones, and practical applications, such as enhancing patient education materials, automating responses to common patient questions, and using ambient AI scribes to reduce physician burnout. Dr. Lee highlights the use of computer vision models for rhinoplasty simulations and postoperative assessments, demonstrating AI's potential to improve surgical outcomes and patient care. The session underscores the importance of human-AI collaboration, leveraging AI to inform decisions while maintaining the human element in patient interactions.

Preservation Rhinoplasty Rakan Saadoun, MD - UTHealth Houston Otorhinolaryngology Thursday, March 27, 2025 Video In this UTHealth Houston ORL Grand Rounds, Dr. Rakan Saadoun discusses the technique and philosophy of preservation rhinoplasty. He explains the historical context, patient selection criteria, and the surgical techniques involved, including septal work, pyramid work, and skin soft tissue envelope dissection. Dr. Saadoun emphasizes the importance of preserving nasal ligaments and the integrity of the middle vault. He reviews the main techniques, such as the push down and let down methods, and highlights the complications and evidence supporting preservation rhinoplasty. The presentation includes detailed illustrations, cadaveric dissections, and video demonstrations to enhance understanding. Dr. Saadoun also addresses the challenges and benefits of using piezo technology for precise osteotomies. The session concludes with a discussion on the implications of preservation rhinoplasty and the need for further research to establish long-term outcomes.

Thyroid Surgical Innovation: A Historical Perspective and Current Emerging Technologies Ugur Nur Basmaci, MD - UTHealth Houston Otorhinolaryngology Thursday, March 13, 2025 Video In this UTHealth Houston ORL Grand Rounds, Ugur Nur Basmaci, MD presents an insightful lecture on "Thyroid Surgical Innovations." Dr. Basmaci delves into the history of thyroid surgery, highlighting the remarkable advancements from the 19th century to modern-day practices. The presentation covers various innovative techniques, including remote access approaches like the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and thyroid ablation methods such as radiofrequency ablation (RFA). Dr. Basmaci also discusses the latest developments in parathyroid surgery, including parathyroid autofluorescence and intraoperative PTH monitoring. This comprehensive talk provides valuable knowledge on cutting-edge technologies and their applications in thyroid and parathyroid surgeries.

Transnasal Approach to Orbital Tumors Brian Cameron, MD - UTHealth Houston Otorhinolaryngology Thursday, February 27, 2025 Video In this UTHealth Houston ORL Grand Rounds, Brian Cameron, MD, presents an in-depth discussion on endoscopic approaches to orbital tumors. He outlines the evolution of endoscopic sinus surgery and its parallels to orbital surgery, emphasizing the importance of anatomical knowledge and surgical techniques. Dr. Cameron details the classification systems for orbital tumors, including the ORBIT system, and discusses the surgical steps, including the use of a nasal septal flap for reconstruction. He highlights the benefits and challenges of endoscopic versus external approaches, supported by case studies and outcomes.  This comprehensive talk provides valuable insights into the advancements and practical applications of endoscopic orbital surgery.

Vestibular Schwannoma Management: Past, Present, and Future Nedim Durakovic, MD - Washington University Thursday, February 13, 2025 Video In this UTHealth Houston Otorhinolaryngology Grand Rounds, Dr. Nedim Durakovic from Washington University delivers an engaging talk on the history, epidemiology, and management of vestibular schwannomas. The presentation highlights the evolution of treatment techniques and the importance of patient-centric approaches. Key takeaways include advancements in surgical techniques, the role of MRI in early detection, and the impact of patient-reported outcomes on treatment decisions. Dr. Durakovic also shares valuable insights from his ongoing research on dizziness and balance in patients with vestibular schwannomas.

When the Chance to Cut does not Cure: An Otorhinolaryngologist's Guide to Palliative Care Dylan Vance, MD - UTHealth Houston Otorhinolaryngology Thursday, January 23, 2025 Video In this UTHealth Houston ORL Grand Rounds, Dylan Vance, MD, presents an insightful talk on "When the Chance to Cut Does Not Cure: An Otolaryngologist's Guide to Palliative Care." Dr. Vance discusses the importance of palliative and supportive care in improving the quality of life for patients with serious illnesses. He highlights the roles of various team members, including doctors, social workers, and chaplains, in providing holistic care. The presentation covers the different types of Hospice care, including home Hospice, continuous care, respite care, and facility-based Hospice, and explains the challenges and benefits of each. Dr. Vance also delves into the legal aspects of palliative care in Texas, such as the Texas Advance Directives Act and the process for issuing DNR orders. The talk emphasizes the need for early integration of palliative care to enhance patient outcomes and reduce unnecessary interventions. This comprehensive guide is essential for otolaryngologists and other healthcare professionals involved in patient care.

Lymphovascular Malformations: Pathophysiology and Management for the Otolaryngologist Vivian Jin, MD - UTHealth Houston Otorhinolaryngology Thursday, January 9, 2025 Video In this UTHealth Houston ORL Grand Rounds, Dr. Vivian Jin presents on lymphovascular malformations, focusing on their pathophysiology and management for otolaryngologists. Dr. Jin discusses the historical context, including the first surgery under anesthesia for a vascular tumor in 1846. She differentiates between vascular tumors and malformations, explaining their embryologic development and clinical presentations. Treatments for hemangiomas, such as propranolol, laser therapy, and surgical options, are covered. Dr. Jin also highlights the importance of a multimodal approach for lymphatic malformations, including sclerotherapy and surgical resection. She presents a case study of a patient with an AV malformation treated with embolization and surgical resection. The presentation concludes with future directions in gene therapy and medical management advancements.