Head and Neck Oncology Fellowship

Objectives

Fellows oversee the care of all head and neck cancer patients being treated at Mass Eye and Ear/Mass General. They assist with the teaching of residents in ablative head and neck surgical procedures. They receive extensive training in free flap and pedicled reconstruction, skull base surgery, and transoral robotic surgery. They are expected to participate in tumor board, multidisciplinary clinic, resident teaching rounds, and specialty tumor board conferences.

Curriculum

Fellows play an integral role on our head and neck service. They are expected to transition to junior faculty level over the course of the year with increased autonomy and independence in managing complex head and neck cancer patients both in and out of the operating room.

Fellows typically spend four days in the operating room and one day in clinic each week. He/she will round on all patients and provide support to the resident team where and when necessary. Fellows are expected to attend multidisciplinary tumor conferences and be available to manage urgent patient care issues three weekends per month.

Appropriate supervision in and out of the operating room is provided at all times. Increased autonomy is the expectation with comfort being achieved in managing the breadth of head and neck oncologic surgery and reconstruction. Our fellows are expected to teach residents in the operating room and conduct teaching rounds on the ward. Fellows take occasional adult OHNS calls with Mass Eye and Ear faculty. An attending faculty member backs up fellows at all times.

Please note: Head and neck fellows must be eligible for a full MA state medical license. Fellows in this program are not eligible for J-1 sponsorship.  

The Head and Neck Oncology Fellowship is credentialed through the American Head and Neck Society (AHNS).  All applicants are directed to the AHNS website for details on applying.  As a member of the AHNS, we can only consider applicants from the United States and Canada. 
Fellow candidates must have completed residency in otolaryngology–head and neck surgery. Candidates should be board-certified or board-eligible and eligible for a full Massachusetts State Medical Licensure. 

All fellows are expected to participate in clinical research projects throughout the year. Past fellow research projects include:

• Extent of surgery in the management of locally advanced sinonasal malignancies. Resto VA, Chan A, Deschler DG, Lin DT. Head and Neck. 2007;30(2):222–229.
• Pectoralis major flap in composite lateral skull base defect reconstruction. Resto, VA, McKenna, MJ, Deschler, DG. Arch Otolaryngol Head Neck Surg. 2007;133:490–494. 

• National laryngopharyngectomy and reconstructive surgery survey. Richmon JD, Samji HA, Deschler DG. Laryngoscope. 2009 Aug;119(8):1472–8. 

• HPV-16 infection predicts treatment outcome in oropharyngeal squamous cell carcinoma. Nichols AC, Faquin WC, Westra WH, Mroz EA, Begum S, Clark JR, Rocco JW. Otolaryngol Head Neck Surg. 2009 Feb;140(2):228–34.
• Bcl-2 blocks cisplatin-induced apoptosis and predicts poor outcome following chemoradiation treatment in advanced oropharyngeal squamous cell carcinoma. Michaud WA, Nichols AC, Mroz EA, Faquin WC, Clark JR, Begum S, Westra WH, Wada H, Busse PM, Ellisen LW, Rocco JW. Clin Cancer Res. 2009 Mar 1;15(5):1645–54.
• Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer. Nichols AC, Finkelstein DM, Faquin WC, Westra WH, Mroz EA, Kneuertz P, Begum S, Michaud WA, Busse PM, Clark JR, Rocco JW. Clin Cancer Res. 2010 Apr 1;16(7):2138–46.
• Surgical salvage of the oropharynx after failure of organ-sparing therapy. Nichols AC, Kneuertz PJ, Deschler DG, Lin DT, Emerick KS, Clark JR, Busse PW, Rocco JW. Head Neck. 2011 Apr;33(4):516–24. 

• Primary TEP placement in patients with laryngopharyngeal free tissue reconstruction and salivary bypass tube placement. Divi V, Lin DT, Emerick KS, Rocco J, Deschler DG. Otolaryngology—Head and Neck Surgery. 2011;144(3),474–476. 

• Tracheoesophageal voice after total laryngopharyngectomy reconstruction: Jejunum versus radial forearm free flap. Deschler DG, Herr MW, Kmiecik JR, Sethi R, Bunting G. Laryngoscope. 2015 Dec;125(12):2715–21.
• Treatment outcomes and prognostic factors including papillomavirus (HPV) for sinonasal undifferentiated carcinoma: A retrospective review. Gray ST, Herr MW, Sethi RKV, Diercks, G, et al. Head Neck. 2015 Mar;37(3):366–74.
• Supraclavicular artery island flap for reconstruction of complex parotidectomy, lateral skull base, and total auriculectomy defects. Emerick KS, Herr MW, Lin DT, Santos F, Deschler DG. JAMA Otolaryngol Head Neck Surg. 2014 Sep;140(9):861–6.
• Shoulder function following reconstruction with the supraclavicular artery island flap. Herr MW, Bonanno A, Montalbano LA, Deschler DG, Emerick KS. Laryngoscope. 2014 Nov;124(11):2478–83.
• Supraclavicular flap reconstruction following total laryngectomy. Emerick KS, Herr M, Deschler DG. Laryngoscope. 2014 Aug;124(8):1777–82.
• Incidence and survival patterns of cranial chordoma in the United States. Chambers KJ, Lin DT, Meier J, Remenschneider A, Herr M, Gray ST. Laryngoscope. 2014 May;124(5):1097–102. 

• The time course and microbiology of surgical site infections after head and neck surgery. Durand ML, Yarlagadda B, Rich DL, Lin DT, Emerick KS, Rocco JW, Deschler DG. Laryngoscope. 2015;125(5):1084–9.
• Transfusion in head and neck free flap patients: Practice patterns and a comparative analysis by flap type. Puram SV, Yarlagadda B, Sethi R, Muralidhar V, Chambers KJ, Emerick KS, Rocco JW, Lin DT, Deschler DG. Otolaryngol Head Neck Surg. 2015;152(3):449–57.
• Head and neck free flap surgical site infections in the era of the Surgical Care Improvement Project. Yarlagadda B, Deschler DG, Rich DL, Lin DT, Emerick KS, Rocco JW, Durand ML. Head Neck. 2015 Jan 12. Epub ahead of print.
• Risk factors for surgical site infection after supraclavicular flap reconstruction in patients undergoing major head and neck surgery. Goyal N, Emerick KS, Deschler DG, Lin DT, Yarlagadda B, Rich DL, Durand ML. Head Neck. 2016 Apr 21. Epub ahead of print.
• Long-term functional outcomes of total glossectomy with or without total laryngectomy. Lin DT, Yarlagadda B, Sethi RK, Feng AL, Shnayder Y, Ledgerwood LG, Diaz JA, Sinha P, Hanasono MM, Yu P, Skoracki RJ, Lian TS, Patel UA, Leibowitz J, Purdy N, Starmer H, Richmon JD. JAMA Otolaryngol. Head Neck Surg. 2015;141(9):797–803.
• Loco-regional control of tongue base adenoid cystic carcinoma with primary resection and radial forearm free flap reconstruction. Yarlagadda B, Meier J, Emerick K, Lin DT, Deschler DG. Ear Nose Throat J. 2017 Jan;96(1):37–40.
• Locoregional and free flap reconstruction of the lateral skull base. Richmon JD, Yarlagadda B, Wax MK, Patel U, Diaz J, Lin DT. Head Neck. 2014;37(9):1387–91.
• Heat and moisture exchange devices for patients undergoing total laryngectomy. Icuspit P, Yarlagadda B, Garg S, Johnson T, Deschler DG. ORL – Head and Neck Nursing. 2014; 32(1):20–23.
• Patient and staff perceptions of social worker consultation before surgical therapy for head and neck cancer. Yarlagadda B, Hatton E, Huettig J, Deschler DG. Health and Social Work. 2015;40(2):120–124.
• Ossifying parotid carcinoma ex pleomorphic adenoma. Mohan S, Puram SV, Yarlagadda B, Nosé V, Deschler DG. Case Rep Otolaryngol. Vol. 2015, Article ID 395358, 2015. 

• Minimally invasive removal of mandibular hardware after free flap reconstruction. Goyal N, Deschler DG. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 2015;153(5):888–890.
• Management of recurrent HPV-related oropharyngeal cancer. Goyal N, Lin D. Curr Otorhinolaryngol Rep. 2015;3(2):56–62.
• Use of the submental vessels for free gracilis muscle transfer for smile reanimation. Goyal N, Jowett N, Dwojak S, et al. Head Neck. June 2016.
• Risk factors for surgical site infection after supraclavicular flap reconstruction in patients undergoing major head and neck surgery. Goyal N, Emerick KS, Deschler DG, et al. Head Neck. April 2016.
• Clinical outcomes of transoral robotic-assisted surgery for the management of head and neck cancer. Goyal N, Parikh A, Lin D. Robot Surg Res Rev. September 2015:95.
• An algorithm for surgical approach to the anterior skull base. Naunheim MR, Goyal N, Dedmon MM, et al. J Neurol Surg Part B Skull Base. 2016;77(4):364–370. 

• Robotic epiglottopexy for severe epiglottic prolapse limiting decannulation. Colaianni CA, Bowe SN, Osborn HA, Lin DT, Richmon JD, Hartnick CJ. Int J Pediatr Otorhinolaryngol. 2017 Nov;102:157–159.
• Risk factors for thirty-day readmission following flap reconstruction of oncologic defects of the head and neck. Osborn HA, Rathi VK, Tjoa T, Goyal N, Yarlagadda BB, Rich DL, Emerick KS, Lin DT, Deschler DG, Durand ML. Laryngoscope. 2017 Aug 29.
• Facial nerve sacrifice during parotidectomy: A cautionary tale in pathologic diagnosis. Abt NB, Derakhshan A, Naunheim MR, Osborn HA, Deschler DG. Am J Otolaryngol. 2017 May–Jun;38(3):358–359.
• P16 and HPV discordance in oropharyngeal squamous cell carcinoma: What are the clinical implications? Osborn HA, Lin DT. Ann Hematol Oncol 2016; 3(11): 1123.
• Intraoperative cardiac arrest etiologies in head and neck surgery: A comprehensive review. Tarabanis C, Abt NB, Osborn HA. Head Neck 2018; 40:1299–1304.
• Malignancies of the paranasal sinuses and skull base. Osborn HA, Park JC, Saba NF, Blanchard P, Lin DT. Head and Neck Cancers: Evidence-based Treatment with Medical, Surgical, and Radiation Therapy. New York: Demos Medical Publishing/Springer Publishing Company, 2018. 359–370.
• Deep neck space infections. Osborn HA, Deschler DG. Infections of the Ears, Nose, Throat and Sinuses. New York: Springer Publishing Company, 2018. 329–347.

• Tip-on-tip scapular (TOTS) flap for reconstruction of combined palatectomy and rhinectomy defects. Bartholomew RA, Zenga J, Lin DT, Deschler DG, Richmon JD. Facial Plast Surg. 2018 Aug;34(4):389–393.
• Close margins and adjuvant radiotherapy in acinic cell carcinoma of the parotid gland. Zenga J, Parikh AS, Emerick KS, Lin DT, Faquin WC, Deschler DG. JAMA Otolaryngol Head Neck Surg. 2018 Nov 01;144(11):1011–1016.
• State of the art: Rehabilitation of speech and swallowing after total laryngectomy. Zenga J, Goldsmith T, Bunting G, Deschler DG. Oral Oncol. 2018 Nov;86:38–47.
• The difficult secondary tracheoesophageal puncture: A technique for safe insertion. Abdul-Aziz D, Zenga J, Deschler DG. ORL J Otorhinolaryngol Relat Spec. 2018 Nov 28;81(1):10–15.
• Sublingual gland excision for the surgical management of plunging ranula. Chen JX, Zenga J, Emerick K, Deschler D. Am J Otolaryngol. 2018 Sep–Oct;39(5):497-500.
• Endotracheal tube obstruction caused by cuff hyperinflation. Zenga J, Galaiya D, Choumanova I, Richmon JD. Anesthesiology. 2018 Sep;129(3):581.
• Microsurgical instrument-assisted facial nerve dissection for deep lobe parotid tumors. Zenga J, Lin BM, Chen J, Deschler DG. Laryngoscope. 2018 Nov;128(11):2529–2531.
• Salvage of recurrence after surgery and adjuvant therapy: A systematic review. Zenga J, Gross J, Fowler S, Chen J, Vila P, Richmon JD, Varvares MA, Pipkorn P. Am J Otolaryngol. 2018 Mar–Apr;39(2):223–227.
• Supraclavicular artery island flap in patients with ports or pacemakers. Zenga J, Chen J, Deschler DG. JAMA Facial Plast Surg. 2018 May 01;20(3):256–257.

Department Chairman
Mark A. Varvares, MD, FACS

Surgery
Daniel G. Deschler, MD, FACS
Kevin S. Emerick, MD
Allen L. Feng, MD
Derrick T. Lin, MD, FACS
Jeremy D. Richmon, MD

Radiation Oncology
Paul M. Busse, MD
Annie Chan, MD

Medical-Oncology
John R. Clark, MD
Jung Park, MD
Lori Wirth, MD

Infectious Disease
Marlene Durand, MD
Miriam Barshak, MD

SLP-Speech
Glenn Bunting, CCC-SLP

SLP-Swallow
Tessa Goldsmith, CCC-SLP
Allison Holman, CCC-SLP
Racheal Kamer, CCC-SLP

Research
Daniel L. Faden, MD
Vinod Saladi, PhD

Neurosurgery
William T. Curry, MD
Fred Barker, MD

Radiology
Mary Beth Cunane, MD
Amy Juliano, MD
Katherine Reinshagen, MD
Laura Romo, MD

Pathology
William Faquin, MD
Peter Sadow, MD

Prosthodontics
Matthew Jackson, DMD

Past Fellows

• Vicente Resto, MD, PhD, Chair, Professor, University of Texas, Galveston 
• Jose Sanclement, MD, Assistant Professor, University of Oklahoma
• Jeremy Richmon, MD, Associate Professor, Mass. Eye and Ear 
• Anthony Nichols, MD, Associate Professor, Division Chief, University of Western Ontario
• Vasu Divi, MD, Assistant Professor, Stanford University Medical Center 
• Audrey Erman, MD, Assistant Professor, University of Arizona
• Alice Lin, MD, Kaiser Permanente, Affiliated Faculty USC, Los Angeles, CA 
• Mark Herr, MD, US Army, San Antonio, TX 
• Bharat Yarlagadda, MD, Assistant Professor, Lahey Clinic, Boston University
• Neerav Goyal, MD, MPH, Assistant Professor, Penn State Hershey 
• Tjoson Tjoa, MD, Assistant Professor, UC Irvine 
• Heather Osborn, MD, Assistant Professor, Yale University 
• Joseph Zenga, MD, Assistant Professor, Medical College of Wisconsin
• Joel Fontanarosa, MD, PhD, Assistant Professor at The University of Rochester
• Andrew Holcomb, MD, Faculty, Head and Neck Surgical Oncologist, Nebraska Methodist Hospital
• Andrew R. Larson, MD, Head and Neck Surgeon, Lahey Hospital and Medical Center, Burlington, MA
• Shanmugappiriya Ummaiyal Sivarajah, MD, MPH, FRCSC, Second Fellowship in Head and Neck Oncology and Microvascular Reconstruction with Dr. Terry Day and Head and Neck Specialists in Charleston, SC

Daniel_Deschler@meei.harvard.edu

Jeremy_Richmon@meei.harvard.edu

Vanessa_Aguilar@meei.harvard.edu