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SUNY Downstate Health Sciences University

Department of Otolaryngology

State of the Department 2020

Image of the hammer boneRichard M. Rosenfeld, MD, MPH, MBA
Distinguished Professor, Chairman, and Program Director

The 2019-2020 academic year marked the 29th anniversary of the Department of Otolaryngology at the State University of New York (SUNY) Downstate Health Science University 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), Maimonides Medical Center, SUNY at Bay Ridge Ambulatory Surgery Center (SUNY Bay Ridge), New York Presbyterian – Brooklyn Methodist Hospital (NYP-BMH), Manhattan Eye, Ear, and Throat Hospital (MEETH), Lenox Hill Hospital, and Northwell ProHealth.

The past year was marked by stability, optimism, and accomplishment, allowing us to tackle the Covid-19 pandemic with resilience and fortitude. Our residency program is fully ACGME accredited, with no citations, and all graduates continue to secure a top choice in employment or fellowship. We maintain a diverse palate of basic, clinical, and translational research supported by national, state, and institutional grants.  We continue to pursue our vision of “a community where individuals can access optimal care for disorders of the ears, nose, throat, head and neck,” driven by our mission of excellence in teaching, research, patient care, and public service.

Preparedness

Every year I find one word that best reflects the state of our department and my top choice for 2020 is “preparedness,” defined as “the state of being ready for something to happen, especially for war or a disaster.”  And disaster did indeed engulf us as New York state became the epicenter of the Covid-19 pandemic, accruing more than 20% of total deaths in the United States and earning UHB a “Covid-19 only hospital” designation from Governor Andrew Cuomo. 

Perhaps the most common example of preparedness is the ubiquitous financial advice to maintain a personal emergency fund, consisting of cash for 3 to 6 months of expenses.  Yet surveys show that only 40% of Americans could access $400 of cash without going into debt, clearly a worrisome situation.  In contrast, our department is exceptionally well managed with regards to our finances and reserves, but this is not the preparedness I wish to emphasize.

The preparedness to which I refer is the reason why our residents responded to the 2019 ACGME Program Survey with 100% satisfaction, more than half expressing high satisfaction.  Despite many external challenges over the past decade, our training program shines with a full faculty complement, robust coverage of all subspecialties, synergistic affiliate sites, and the first signs of stability in many years. In other words, we were prepared for a challenge.

Our core and affiliate faculty are the lifeblood of our program, many of whom have been with us for more than a decade. Even our relatively new hires – Ann Plum, Sara Abu-Ghanem, and Ofer Azoulay – have exceeded expectations, earning rave reviews on resident evaluations for their excellence in teaching, research, and patient care. Faculty who deserve special call-out are our residency site directors, notably Matthew Hanson at KCHC, Natalya Chernichenko at NYP-BMH, Michael Weiss at Maimonides, and Jessica Lim at Lenox Hill and MEETH.  These are incredible, selfless, and dedicated individuals who advocated for our residents during Covid-19 redeployments and worked yearlong to ensure a safe, positive, and rewarding experience.

I should also highlight the emotional and social preparedness of our department. We often function more like a family with regards to interactions among residents, faculty, staff, and leadership.  Communication lines are always wide open, with clear ways to raise and address concerns without fear of retaliation.  Brooklyn’s bounty promotes personal greatness and mutual opportunity, yielding a cohesive department that is much more than the sum of our talented individuals.  We have the most congenial, respectful, and socially connected internal culture that I can recall since joining in 1992.

Even if well prepared, the impact of Covid-19 should never be downplayed. Many of our front-line residents and faculty caught the virus, in some cases requiring several weeks for recovery.  Many staff were afflicted, including Covid-19 related deaths of family and relatives.  This was an ugly, scary, heart-wrenching experience personally, and professionally, for everyone, especially healthcare workers. We will never be the same, but we survived, with resilience and lessons learned that will promote future prosperity.

Research shows that resilience is fostered by optimism, moral compass, social support, role models, physical exercise, mental exercise, flexibility, and meaningful purpose.  I remain the perennial optimist and further submit that all these factors abound in our ranks. We have proven ourselves prepared, resilient, and adaptable in exceptionally challenging circumstances, so the sky is the limit as we learn from the past and reimagine our efforts for the times ahead.

Giving Back to Our Community

We relish the opportunities offered to us in Brooklyn and give back to our community by providing quality care that spans the panoply of ENT services and facilitates patient access through diverse practice sites, comprehensive insurance participation, and opportunities for uninsured patients at UHB and KCHC.  We further serve our community with daily teaching of residents and medical students, many of whom remain in the New York metropolitan region and further contribute to the region’s health and well-being.  Here are some brief updates on our primary clinical services:

Facial plastic and reconstructive surgery (FPRS) thrive under the leadership of Sydney Butts and other full-time and voluntary faculty, including alumnus Lee Kaplowitz, who completed an FPRS fellowship, and new hire Ofer Azoulay, with expertise in facial reanimation and microvascular flaps. The division covers all aspects of FPRS, 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, Ofer Azoulay, and voluntary faculty at our multiple affiliate sites.  The Lenox Hill rotation continues to enhance our resident exposure to this subspecialty.

Otology and neurotology remain vibrant through the leadership of Matthew Hanson and Michal Preis, with contributions from others.  We offer comprehensive otologic services, ranging from ambulatory surgery to complex procedures with our neurosurgical colleagues. Our new, state-of-the art, 8-station temporal bone laboratory, is (finally) nearing completion, including a dual-head microvascular station. Abraham Shulman continues to help patients cope with tinnitus, as one of the few full-time tinnitologists worldwide.

Pediatric Otolaryngology remains strong with leadership by Nira Goldstein, Ann Plum, and Richard Rosenfeld, and contributions by Sydney Butts. We 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 covered under the leadership of Boris Bentsianov and Sara Abu-Ghanem, with contributions from our pediatric otolaryngologists, head and neck surgeons, and voluntary faculty. We provide a full range of operative and office interventions for diagnosing, managing, and rehabilitating voice, airway, and swallowing problems in children, adults, vocal professionals, stroke patients, and head and neck cancer patients.

Rhinology and skull-base surgery are robust under the leadership of Marina Boruk, Gady Har-El and others, especially at MEETH and Lenox Hill Hospital.  Services include advanced office management of rhinosinusitis and sinonasal disorders plus a full spectrum of surgical procedures, including complicated sinus surgery, image-guided procedures, neurosurgical access, and open and minimally invasive surgery for skull base lesions and tumors.

General otolaryngology and allergy are well-covered under the leadership of Marina Boruk, Victor Lagmay, and faculty at our diverse training sites.  Our new faculty recruits – Ofer Azoulay and Sara Abu-Ghanem – have greatly expanded our coverage of general otolaryngology procedures at our UHB, NYP-BMP, and KCHC.

Communicative disorders and audiology thrive under the leadership of John Weigand and Sal Saleh, whose relationships with training programs supply a steady stream of audiology trainees and interns.  Patients with cochlear implants continue to be 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

Boris Bentsianov organized the 11th Annual Frank E. Lucente Alumni and Resident Research Day program, which for the first time took place online as a Zoom conference.  Although the event was limited to resident presentations, the virtual format did attract many alumni.  Moreover, the quality and breadth of resident research presented was extraordinary. We remain grateful to Mark Stewart, Dean of the School of Graduate Studies, and Richard Kollmar, from the Department of Cell Biology for their continued engagement with our residents, faculty, and medical students, which serves as a model for research collaboration between clinicians and scientists.  Please review the full agenda and abstracts later in this report for additional details.

Nira Goldstein continues as Director of Clinical Research and remains an incredible resource for navigating the intricacies of funding, REDcap surveys, 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 understanding the role of laryngospasm in epilepsy sudden death and pulmonary edema, with the goal of enhancing our current NIH funding with an R01 grant.

The FEL Research Grant, established by alumnus Dennis Lee, is available to residents to support research work and mission travel. This past year, the Grant allowed two PGY-5 residents – Daniel Ballard and Daniel Sukato – to participate in a surgical mission trip to the Philippines, with Michal Preis as mentor. Their group saw 1,848 patients in 4 days, including 601 ear visits with examination, cleaning, audiology, and hearing aid fitting.  Our residents performed 29 otologic surgeries, including 20 tympanoplasties and 9 tympanostomy tubes.  Of note, Dan Sukato assisted in 5 cleft lip repairs, 6 cleft palate repairs, and 3 pharyngeal flaps.

Nicole Fraser, our educational coordinator, remains an invaluable resource for students and residents, working with Richard Rosenfeld, program director, and Nira Goldstein, associate program director, to maintain a fully ACGME-accredited, citation-free, residency training program. This year was notable for having 16 residents (4 chiefs), a one-time occurrence related to prior sick leave.  Sydney Butts continues to oversee our Grand Rounds program, including our pre-rounds session focused on resident issues and education, Natalya Chernichenko has done an admirable job of enhancing our training in cultural competency and health disparities, and Ann Plum has upped our mentoring program to  a new level of structure and consistency.

Our traditional Annual Multidisciplinary Head & Neck Symposium, which would have hit a 10-year milestone, was regrettably canceled because of the Covid-19 restrictions, but we look forward to a terrific event in 2021.  The same restrictions moved all administrative and educational conferences to the Zoom platform.  Our festive resident graduation dinner, normally held at the Water Club, also became a Zoom event, with over 60 participants celebrating our chief residents. In lieu of a large party and the traditional graduation gifts, our chiefs requested support to defray the cost of their upcoming board examinations.  Through a combination of departmental funds, and generous donations from Frank Lucente and Mauro Ruffy, we were able to fully cover the cost of the examinations for our departing chiefs.

Our residency training program remains fully accredited 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 special emphasis, however, are listed below.

 

Notable Faculty Accomplishments

  • Ofer Azoulay resuscitated our microvascular free flap program, performing several successful procedures at multiple sites
  • Boris Bentsianov was the course director for the Annual Frank E. Lucente Alumni and Resident Research Day
  • Marina Boruk began a 2-year term or service on the AAO-HNS Practice Management Education Committee
  • Sydney Butts was honored with the prestigious Leadership Award by the Board of Directors of the Arthur Ashe Institute for Urban Health
  • Sydney Butts was elected as the Eastern Regional Director for the AAFPRS, is now a member of their Board of Directors, and was appointed chair of the AAFPRS Patient Safety, Quality Improvement and Accreditation Committee
  • Sydney Butts was the Full-time Faculty Honoree at the Resident Graduation event
  • Natalya Chernichenko became resident site director at NY Presbyterian – Brooklyn Methodist Hospital
  • Nira Goldstein was appointed a consultant to the AAO-HNS Pediatric Otolaryngology Education Committee
  • Matthew Hanson was recognized by Castle Connolly as a New York Top Doctor
  • Matthew Hanson did an extraordinary job in leading the otolaryngology service at KCHC during the Covid-19 crisis, earning many kudos for our faculty, residents, and division
  • Frank Lucente gave a generous donation to the graduating chief residents to help defray the cost of upcoming board examinations
  • Michal Preis mentored two of our chief residents, Daniel Ballard and Daniel Sukato, on a surgical mission trip to the Philippines
  • Richard Rosenfeld was appointed to the Health Services Administration Advisory Board for SUNY Oswego Business School
  • Richard Rosenfeld was recognized by Castle Connolly as a New York Top Doctor and as a Top Doctor in America
  • Richard Rosenfeld was appointed to the Research Committee and Expert Committee for the American College of Lifestyle Medicine
  • Mauro Ruffy gave a generous donation to the graduating chief residents to help defray the cost of upcoming board examinations
  • Jack Russo was the Voluntary Faculty Honoree at the Resident Graduation event

 

Notable Resident, Student, and Other Accomplishments

  • Daniel Ballard participated in a surgical mission in the Philippines, supported by a Frank E. Lucente Research Grant
  • Daniel Ballard secured his 1st choice fellowship in neurotology at University of Pittsburgh Medical Center, under the mentorship of Todd Hillman and Doug Chen
  • Sandra Ho joined a multispecialty practice at Jamaica Hospital in Queens, part of a 25-site physician network, where she will work alongside alumnus George Ferzli
  • Sean Mooney received the SUNY Downstate Award for Outstanding Medical Student Performance in Otolaryngology
  • Prayag Patel completed the resident reviewer program for Otolaryngology Head & Neck Surgery journal, being promoted, with commendation, to an independent peer reviewer
  • June Sandiford was the Staff Honoree at the Resident Graduation event
  • Sam Schild was a co-author on the AAO-HNS Tracheotomy Recommendations During the Covid-19 Pandemic, a product of the Airway and Swallowing Committee
  • Daniel Sukato participated in a surgical mission in the Philippines, supported by a Frank E. Lucente Research Grant
  • Daniel Sukato was invited back as an AAO-HNS CORE grant resident reviewer for general otolaryngology, a highly competitive position awarded to 6 of the 18 applicants
  • Daniel Sukato will enter his 1st choice fellowship in facial plastic and reconstructive surgery at UCLA, under the mentorship of Keith Blackwell
  • Alisa Timashpolsky matched at her 1st choice for pediatric otolaryngology fellowship at Children’s Hospital of Philadelphia
  • Derek Wu will enter his 1st choice academic rhinology fellowship at Northwestern, under the mentorship of David Conley and Robert Kern

 

A Bright Future

We are delighted to welcome our three new PGY-1 residents, James Alrassi, from Stony Brook University School of Medicine, Alexander Graf, from the Sydney Kimmel Medical College at Thomas Jefferson University, and Sean Mooney, from SUNY Downstate Health Sciences University. We look forward to five mutually rewarding years with these highly accomplished individuals, who will begin their PGY-1 residency training year starting in July 2020.

We are proud of our three departing chief residents and wish them health, happiness, and success. Daniel Ballard will enter his neurotology fellowship at University of Pittsburgh Medical Center, Sandra Ho will join TJH Medical Services in a multispecialty practice at Jamaica Hospital in Queens, NY, Daniel Sukato will enter his facial plastics and reconstructive fellowship at the University of California in Los Angeles, and Derek Wu will enter his academic rhinology fellowship at Northwestern University.

Reflecting again upon my word for this year – preparedness – I give endless kudos to our administrative leadership, who kept our ship afloat despite turbulent and highly unpredictable waters.  These superstars are Billy Tang at SUNY Downstate, Carole Facciponti at NYP Brooklyn Methodist Hospital, and Svetlana Lyulko and Veronica Ortiz at our Faculty Practice sites.  Their efforts, along with our other talented support staff, help fulfill our mission of research, teaching, and patient care to the benefit of our community and all stakeholders.

When I accepted a faculty position in Brooklyn in 1992 several individuals responded with concern, stating “what could you ever accomplish in Brooklyn?”  Nearly 30 years later the answer is clear: everything and more.  Brooklyn remains one of the most exciting, diverse, and opportunity-laden locations on the planet. My pledge as chairman and program director is to continue working tirelessly to embrace all opportunities and enhance an already wonderful department in an equally wonderful borough.

 

Respectfully submitted,

 Dr. Rosenfeld's Signatire
Richard M. Rosenfeld, MD, MPH, MBA
July 2020

 

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