Department of Otolaryngology - Service Chief Reports

Richard Westreich, MD, Director at LICH

Sydney C. Butts, MD, Director at UHB/KCHC

The Division of Facial Plastic and Reconstructive Surgery, under the direction of Dr. Richard Westreich, performed over 200 plastic and reconstructive surgeries during the past academic year.  There was an even distribution of facial plastic surgery cases including trauma surgery, post-ablative reconstruction, congenital deformity repair, functional nasal correction and cosmetic facial procedures.  Active facial plastic surgery services and on-call coverage were maintained at all of the affiliate hospitals and several satellite office sites. 

During the past academic year, attending and resident papers were published on assessments of facial asymmetry and nasal deviation.   Resident research projects in the facial analysis and nasal surgery are currently underway.  Chapters and other research projects are also currently being worked upon.

The otolaryngology service has become actively involved in the management of congenital craniofacial anomalies over the past year, including several cleft lip and palate cases generated from our coverage of the busy neonatal intensive care units at SUNY Downstate, Kings County Hospital and Long Island College Hospital. Through collaboration with the NICU, general pediatrics and the pediatric subspecialties, as well as local speech/language pathologists, comprehensive and multidisciplinary care is brought to these patients. 

During the Downstate/Kings County rotation, the otolaryngology service provides coverage of facial trauma in a rotation schedule with the oral surgery and ophthalmology services. Over the last 12 months, over 70 facial fractures were repaired. Residents participate in formalized didactic activities relating to maxillofacial trauma during this rotation. This includes a hands-on fracture plating workshop at the start of the Downstate/Kings County rotation lead by Dr. Butts. Senior residents are sent to participate in maxillofacial trauma courses sponsored by the AO. Dr. Butts has been involved with maxillofacial trauma education on a national level as a faculty member of the AO and will be a co-instructor of an instruction course at the 2010 annual AAO-HNS meeting on pediatric facial trauma.

Current research and clinical projects include investigations of practice trends relating to the treatment of infantile hemangiomas and a review of the presentation and management of sinonasal lesions in the pediatric population. Dr. Butts is serving as the section editor of both the otolaryngology and maxillofacial trauma sections of the Atlas of Pediatric Emergency Medicine for which several of the faculty and residents are contributing co-authors.

Drs. Westreich, Butts, and Parhiscar have worked together to develop a comprehensive facial plastic surgery resident curriculum, which is scheduled on a two year cycle. Resident lectures, attending lectures, and case presentations are incorporated into the didactics. A compendium of articles which complements these lectures is distributed to each resident and updated periodically. Guest lectures from individuals with areas of specific expertise are also included.

In summary, the Division of facial plastic surgery continues to provide residents and medical students with significant exposure to cosmetic and reconstructive procedures of the face. Our recent staff additions have provided continuity and helped to preserve the volume of cases critical to resident training. We expect further growth over the next few years in all aspects of the subspecialty.