SUNY Downstate Medical Center
Department of Otolaryngology
State of the Department 2017
Richard M. Rosenfeld, MD, MPH
Distinguished Professor, Chairman, and Program Director
The 2016-2017 academic year marked the 26th anniversary of the Department of Otolaryngology at the State University of New York (SUNY) Downstate Medical Center and affiliated hospitals.
Formed initially from existing services at Long Island College Hospital (LICH) and University Hospital of Brooklyn (UHB), the current academic structure for resident and medical student education includes affiliations with Kings County Hospital Center (KCHC), the Brooklyn Veterans Administration Medical Center (VAMC), Maimonides Medical Center, SUNY at Bay Ridge Ambulatory Surgery Center (SUNY Bay Ridge), New York Prebyterian – Brooklyn Methodist Hospital (NYP-BMH), Manhattan Eye, Ear, and Throat Hospital (MEETH), and Lenox Hill Hospital.
The past year was marked by continued success and excellence in research, teaching, and clinical care. Our residency program is fully ACGME accredited with commendation and no citations, and all of our graduates continue to secure a top choice in employment or fellowship training. We maintain a diverse palate of basic, clinical, and translational research supported by national, state, and institutional grants. Our clinical and audiological services are more robust and bountiful than ever and the clinicians providing them continue to grow professionally with academic awards and promotions. Please read on for a full description of other noteworthy accomplishments.
There is one word that immediately comes to mind in thinking about the past year: resilience. Defined by Merriam-Webster as "an ability to recover from or adjust easily to misfortune or change," I cannot think of a better way to describe our academic and clinical programs at SUNY Downstate.
Barely four years after creating a thriving otolaryngology service at Methodist Hospital, we faced new branding and leadership under the parent institution, NY Presbyterian, which made our future extremely uncertain. Through some anticipatory planning, and a healthy dose of resilience, effective July 1, 2017 we relocated our two residents to Lenox Hill Hospital, enhancing their exposure to otologic and head & neck surgery. This win-win relationship has also led to SUNY Downstate sponsoring a fellowship in facial plastic and reconstructive surgery, and has opened the door for continued collaboration with Hofstra Medical School, as they establish an otolaryngology residency training program. We are indebted to the leadership of Peter Costantino, and the support of Gady Har-El and Jessica Lim, for making this wonderful new relationship a reality.
Ironically, after completing the transition, the new leadership at Methodist expressed a desire to reestablish our prior relationship, including on-site resident training. We are thrilled with this new development, which sustains our clinical presence in Park Slope and creates further opportunities to enhance the residency experience. At the time of this writing details are still being discussed, but we are optimistic that an exciting and sustainable relationship will soon materialize that benefits staff, residents, and the Park Slope community.
Challenges to the stability of residency training are perhaps the most difficult to overcome, but we have also shown tremendous resilience in other initiatives. Most notably, we went live with a new electronic health record at the faculty practice sites in January, which had the potential for a disastrous impact on patient volume, staff satisfaction, and financial stability. Our practice volume and revenue, however, barely changed, suffering only a brief drop during the go-live period. We are indebted to Marina Boruk and our incredible clinical administrative staff for their proactive efforts to implement the new system efficiently and effectively.
Another setback to the Department this past year was the departure of faculty members, Joshua Silverman and Eli Gordin, both seeking to relocate closer to family. Fortunately our newest recruit, Stefan Mlot, has expertise in microvascular reconstruction and has rapidly developed a thriving clinical practice. Another recruit, Elliot Regenbogen, will join us in November 2017 as a seasoned clinician with expertise in laryngology and general otolaryngology. Despite these changes our resident training has not suffered (all graduating chiefs continue to exceed case log requirements) and our faculty practice remains strong and financially sound (a.k.a., resilient). We continue to recruit for our open positions in pediatric otolaryngology and facial plastic and reconstructive surgery.
James Cascio, the American author and futurist, observed "Resilience is all about being able to overcome the unexpected…The goal of resilience is to thrive." It has also been said the Brooklyn is the new battleground for health care in NY, and as an inhabitant of that war zone I can attest to both a daily dose of the unexpected and the enduring resilience of the SUNY Downstate Department of Otolaryngology. Many others may poke and prod the Brooklyn health market, but when it comes to otolaryngology SUNY Downstate is the market, providing a scope of services and relationships with referring providers that no invader can match. And it is the talent of our physicians, the quality of our residency training, and the dedication of our staff and administration that will help us thrive – and remain resilient – whatever the future brings.
Serving Brooklyn with Quality Care
Of the three pillars that support academic medical departments – research, teaching, and patient care – it is the ability of a department of serve the community with quality care that most affects the daily lives of the patients and families. With this in mind, I will briefly summarize the current state of our varied clinical programs.
Facial plastic and reconstructive surgery has shown continued excellence through the leadership of Sydney Butts, Eli Gordin, and Richard Westreich, with additional coverage by Konstantin Tarashansky. The division covers all aspects of facial plastic and reconstructive surgery, including maxillofacial trauma, cosmetic procedures, microvascular free tissue transfer, and reconstruction of complex defects of the head, neck, and related structures.
Head, neck, and skull-base surgery remains a focal point of our department under the leadership of Krishnamurthi Sundaram, Natalya Chernichenko, and Michael Weiss, with additional expertise provided by Gady Har-El, Jessica Lim, Victor Lagmay, and voluntary faculty. Stefan Mlot joined the department the past year, bringing new expertise in robotic and microvascular surgery reconstruction. Our new affiliation with Lenox Hill Hospital will further enhance the resident experience.
Otology and neurotology remain vibrant through the leadership of Matthew Hanson and Michal Preis, with contributions from other faculty. The division offers comprehensive otologic services, ranging from ambulatory surgery to complex procedures with our neurosurgical colleagues. Abraham Shulman continues to help patients worldwide cope with tinnitus, as one of the few full-time tinnitologists in clinical practice.
Pediatric Otolaryngology remains strong with leadership by Nira Goldstein, Joshua Silverman, and Richard Rosenfeld, and additional contributions by Sydney Butts, Paul Vastola, Ari Goldsmith, Mauro Ruffy, and voluntary faculty. Dr. Silverman relocated closer to family and we are actively recruiting for a replacement. We continue to offer a full spectrum of clinical services, including advanced airway reconstruction, voice restoration, endoscopic surgery, and rehabilitative services through our cleft team for children with cleft lip, cleft palate, microtia, velopharyngeal insufficiency, micrognathia, and craniofacial syndromes.
Laryngology and neurolaryngology are well covered under the leadership of Boris Bentsianov and Joshua Silverman, with contributions from our pediatric otolaryngologists, head and neck surgeons, and voluntary faculty. New expertise will come with the addition of Elliot Regenbogen, whose clinical practice has a special focus on laryngology. A full range of operative and office interventions are available to improve voice-related quality of life for children, adults, vocal professionals, and head and neck cancer patients.
General otolaryngology, allergy, and rhinology continue to expand through the leadership of Marina Boruk, Victor Lagmay, and many other faculty. Procedures include advanced endoscopic sinus surgery, complex image-guided procedures, and office balloon sinuplasty. Surgery for sleep disorders includes endoscopy, transnasal surgery, palatoplasty, stiffening procedures, and transoral robotic surgery.
Communicative disorders continues to grow through the efforts of John Weigand, Sal Saleh, and their relationships with training programs that supply a steady stream of audiology residents. Patients with cochlear implants have been well served by our collaboration with the Auditory Oral School of New York, which provides state-of-the-art mapping and support services, including participation in our monthly cochlear implant team meeting.
Research, Education, and Teaching
Natalya Chernichenko organized the annual Frank E. Lucente Alumni and Resident Research Day program, which featured keynote speaker Seth H. Daily, from the University of Wisconsin, and alumni speaker Michael Singer, from Henry Ford Health System. In addition to showcasing our resident and faculty research, our invited presentations included innovative approaches to thyroid and laryngeal surgery, and an alumni panel discussion, coordinated by Boris Bentsianov, on practice challenges and work-life balance. Please review the full agenda later in this report for additional details and abstracts.
Our department was proud to host the 12th Annual Metropolitan New York Resident Research Day Symposium, featuring resident presentations for all otolaryngology training programs in the NY metropolitan area. Jason Abramowitz and Lyuba Gitman gave terrific resident presentations on behalf of SUNY Downstate, discussing adverse events of proton pump inhibitors and the epidemiology of orofacial clefts, respectively. The program was well received and attended, including awards for best presentations based on ratings of our moderators and judges.
Nira Goldstein continues as Director of Research and remains an incredible resource for navigating the intricacies of funding, IRB approval, and statistical analysis. Nira is assisted by Richard Kollmar, who serves as Director of Basic and Translational Research, and Richard Rosenfeld, who mentors residents in biostatistics, study design, and systematic review. In addition to many observational studies and systematic reviews, translational work is active on restoring recurrent laryngeal nerve function after injury, studying perineural invasion of head and neck cancer, and understanding the role of laryngospasm in epilepsy sudden death and pulmonary edema. These, and other, projects are supported by grants from the National Institutes of Health, the State of New York, SUNY Downstate Medical Center, and the American Academy of Otolaryngology – Head and Neck Surgery Foundation.
Nicole Fraser, our educational coordinator, remains an invaluable resource working with Richard Rosenfeld, program director, and Nira Goldstein, associate program director, to maintain a citation-free department that fully implements the ACGME Next Accreditation System. Sydney Butts continues to oversee our Grand Rounds program, which has enjoyed robust attendance and continued innovation, including our pre-rounds session focused on resident issues and education.
Natalya Chernichenko directed the highly successful Seventh Annual Multidisciplinary Head & Neck Symposium, which highlighted precision medicine in head and neck cancer. Keynote speaker Luc G. T. Morris, from Memorial Sloan-Kettering Cancer Center, discussed the future of precision medicine and resources involved. The conference agenda appears later in this report and we remain grateful to Rivi and Gady Har-El for their kind support of the symposium.
Our residency training program remains fully accredited (with commendation) and continues to attract the best and brightest candidates with 100% successful attainment of desired employment or fellowship training by all graduates. We view our residency program as the centerpiece of our department, always striving to improve our responsiveness to the needs of residents and faculty.
Recognizing Our Faculty and Staff
Since our last report there have been many notable accomplishments, which are fully described in the pages that follow. Some events worthy of particular emphasis, however, are listed below.
- Boris Bentsianov was Alumni Coordinator for the SUNY Downstate class of 1977 fifteen-year reunion
- Boris Bentsianov was appointed to the AAO-HNS Airway and Swallowing Committee
- Marina Boruk became a fellow of the American Academy of Otolaryngic Allergy
- Marina Boruk coordinated the successful installation of a new electronic health record, Aprima, in the off-site faculty practice offices
- Sydney Butts was an instructor at the AOCMF North America course on pediatric craniomaxillofacial surgery and coordinated skin health screenings with the Department of Dermatology at the SUNY Downstate Skin Care Health Fair
- Sydney Butts received the Clarence and Mary Dennis Dedicated Service Award from the SUNY Downstate Alumni Association for outstanding contributions and commitment to the SUNY Downstate Medical Center and the community
- Sydney Butts participated in the Health Education and Relief Through Teaching (HEARTT) Mission in Monrovia, Liberia, with clinical and teaching responsibilities
- Natalya Chernichenko was the full-time faculty honoree at our Resident Graduation Dinner and received the Doctor's Day Award from Kings County Hospital Center
- Natalya Chernichenko was the course director for the Annual Head and Neck Symposium and the Frank E. Lucente Resident and Alumni Research Day
- John Dodaro was the voluntary faculty honoree at our Resident Graduation Dinner
- Nira Goldstein coordinated the 12th Annual Metropolitan New York Resident Research Day Symposium at SUNY Downstate Medical Center
- Matthew Hanson performed the 50th cochlear implant at UHB
- Frank Lucente received the SUNY Gold Medical for Excellence in Medical Leadership
- Frank Lucente was recognized by the International Journal of Head and Neck Surgery for his inspirational contributions to the field of ENT surgery
- Stefan Mlot joined the department as Chief of Robotic and Microvascular Surgery
- Elliot Regenbogen was recruited as a full-time general otolaryngologist with a subspecialty interest in laryngology
- Richard Rosenfeld received the Najoua Milka-Cabanne Innovation Award from the Guidelines International Network, with sponsorship by AAO-HNS
- Richard Rosenfeld was inducted into the SUNY Distinguished Academy and became a member of the Transitional Executive Committee
- Richard Rosenfeld began an online healthcare MBA program at SUNY Oswego
- Sal Saleh supervised and trained two audiology residents in their final year
- Krishnamurthi Sundaram was appointed Otolaryngology Division Chief at NYP-BMH and was selected for the 2017 Methodist Healers Hall Hall of Fame
- Krishnamurthi Sundaram was appointed to the Audit Committee of the American Rhinologic Society and the History Committee of the North American Skull Base Society
- John Weigand completed more than 2,000 free hearing screenings, representing SUNY Downstate at about two community health fairs every month
- John Weigand supervised and trained five audiology residents in their final year, and was the preceptor for several other second and third year students
- Michael Weiss joined the AAO-HNS BOG Socieoeconomic and Grassroots Committee
- Michael Weiss was appointed to the program committee for the 2018 Triological Society Combined Sections Meeting
Notable Resident, Student, and Other Accomplishments
- Jason Abramowitz presented at the Metropolitan NY Resident Research Day
- Hamid Arjomandi received the Doctor's Day Award at Kings County Medical Center and was the resident honoree at the Downstate Graduating Residents and Fellows Event
- Daniel Ballard and Alysa Timashpolsky represented our department at the AAO-HNS annual leadership and advocacy conference
- Elizabeth Floyd and Richard Rosenfeld ran the Brooklyn 15K in Prospect Park
- Lyuba Gitman presented at the Metropolitan NY Resident Research Day
- Nikita Kohli matched her first-choice laryngology fellowship with Andrew Blitzer at Mount Sinai St. Luke's and Mount Sinai West
- Lee Kaplowitz matched his first-choice facial plastic and reconstructive surgery fellowship with William Lawson at the Mount Sinai Hospital
- Arman Sobhani was recognized for Outstanding Medical Student Performance in Otolaryngology
- Daniel Sukato became the Downstate program representative for the AAO-HNS Section for Residents and Fellows
- Derek Wu was appointed to the AAO-HNS Pediatric Otolaryngology and the AAO-HNS Airway and Swallowing committees
- SUNY Downstate Department of Otolaryngology became the parent program sponsor for the fellowship in Facial Plastic and Reconstructive Surgery at Lenox Hill Hospital
A Bright Future
We are delighted to welcome our three new PGY-1 residents, Ankit Kansal from Yale University, Sam Schild, from Robert Wood Johnson, and Ryan Tabtabai from the University of Connecticut.
We are proud of our three departing chief residents and wish them health, happiness, and success. Hamid Arjomandi joins a 14-otolaryngologist group with Kaiser Permanente in Southern California, where his wife, Atousa, will practice pediatric dentistry. Elizabeth Floyd begins a fellowship in facial plastic and reconstructive surgery with Steve Perkins in Indianapolis, Indiana. Lyuba Gitman begins a fellowship in pediatric otolaryngology with George Zalzal at Children's National Medical Center in Washington, DC.
Some of our staff have already been acknowledged, but let me close by thanking our administrative miracle workers, Billy Tang at SUNY Downstate, Carole Facciponti at NY Methodist, and Svetlana Lyulko and Veronica Ortiz at our Brooklyn Heights Faculty Practice. Their efforts, along with all of our other talented support staff, help fulfill our mission of research, teaching, and patient care to the benefit of our community and all stakeholders.
I remain the perennial optimist regarding our department's future because of the wonderful patients, faculty, staff, residents, and students we are blessed to interact with daily. Moreover, Brooklyn remains one of the most exciting, diverse, and opportunity-laden locations on the planet. My pledge as chairman is to continue working tirelessly to embrace all opportunities and enhance an already wonderful department in an equally wonderful borough.
Richard M. Rosenfeld, MD, MPH